不同光照环境下弱视儿童眼间抑制深度比较

doi:10.3760/cma.j.cn115909-20210113-00014

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摘要目的：比较弱视患儿和正常儿童对光照环境下的适应情况。方法：系列病例研究。收集2020 年 1─11月在温州医科大学附属眼视光医院门诊就诊的屈光参差性弱视儿童作为弱视组，并选择同期门诊就诊的视力正常儿童作为对照组。利用偏振片+中灰密度镜（ND）定量测量不同光照环境下（分别为15、220、2 000 lx）的眼间抑制情况，分析弱视儿童的抑制深度与环境亮度的相关性，并比较弱视儿童和正常儿童对光照环境的适应情况。数据分析采用重复测量方差分析、独立样本t检验及 Spearman相关性分析。结果：共纳入弱视组27例，对照组10例。与15 lx相比，2 000 lx下弱视组（近距离q=5.76，P<0.001；远距离q=4.85，P=0.0027）和对照组（近距离q=6.93，P<0.001；远距离q=8.31， P<0.001）的眼间抑制更明显，差异均有统计学意义。3种光照环境下弱视组与正常组的眼间抑制差别不同，在2 000 lx光照时差别较明显（近距离P=0.0114、P=0.0014、P=0.0018；远距离均P<0.001）。弱视患儿在15 lx时的抑制深度与在220 lx（近距离r=0.9318，P<0.001；远距离r=0.9172，P<0.001）和 2 000 lx时（近距离r=0.8699，P<0.001；远距离r=0.7445，P<0.001）的抑制深度均有相关性。结论：眼间抑制受不同光照环境影响，环境越亮的情况下眼间抑制越深。与正常儿童相比，弱视儿童存在对亮环境代偿更差的现象，且受环境亮度的影响较大。

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关键词 ：弱视, 眼间抑制, 环境亮度, 定量检测

Abstract： Objective: To study inter-ocular suppression in children with amblyopia under different environmental luminance, and to compare the adaptive mechanisms of amblyopic and normal children to environmental luminances. Methods: In this prospective cohort study from January 2020 to November 2020 in the Eye Hospital, Wenzhou Medical University, inter-ocular suppression was measured quantitatively with polarized and neutral density filter lenses under different environmental luminances in amblyopic children with anisometropia as the amblyopia group and normal group. The relationship between inter-ocular suppression and environmental luminance (15 lx, 220 lx, 2 000 lx) was analyzed in children with amblyopia and the adaptive mechanisms to environmental luminance were compared between the two groups. A total of 27 amblyopic patients and 10 normal controls were included in the study. The data were analyzed by repeated measurements ANOVA, independent samples t-test and Spearman rank correlation analysis. Results: When comparing 15 lx with 2 000 lx, inter-ocular suppression was more obvious in the amblyopia group at 2 000 lx (near, q=5.76, P<0.001; far, q=4.85, P=0.0027), compared to the control group (near, q=6.93, P<0.001; far, q=8.31, P<0.001) and the differences were statistically significant. The mean differences in inter-ocular suppression between the amblyopia group and normal group were compared under different environmental luminance, and the differences were even greater at 2 000 lx (near, P=0.0114, 0.0014, 0.0018; far, all P<0.001). Inter-ocular suppression at 15 lx was significantly correlated with that at 220 lx (near, r=0.9318, P<0.001; far, r=0.9172, P<0.001) and 2 000 lx (near, r=0.8699, P<0.001; far, r=0.7445, P<0.001). Conclusions: The influence of different environmental luminances on inter-ocular suppression is regulated by environmental luminance; the brighter the environmental luminance is, the deeper the suppression. Compared with normal children, amblyopic children have worse compensation for a bright environment, and amblyopic children are more affected by environmental luminance.

Key words： amblyopia inter-ocular suppression environment luminance quantitative detection

收稿日期: 2021-01-13

PACS:

基金资助: 国家自然科学基金（82070995）；温州市科技局项目（Y20180726）

通讯作者: 余新平（ORCID：0000-0001-5599-4151），Email：yu-xinping@163.com

引用本文:

陈惠赵天源许金玲周锦景余新平. 不同光照环境下弱视儿童眼间抑制深度比较[J]. 中华眼视光学与视觉科学杂志, 2021, 23(5): 321-328. Hui Chen, Tianyuan Zhao, Jinling Xu, Jinjing Zhou, Xinping Yu. Quantitative Comparison of Inter-Ocular Suppression under Different Environmental Luminance in Children with Amblyopia. Chinese Journal of Optometry Ophthalmology and Visual science, 2021, 23(5): 321-328. DOI: 10.3760/cma.j.cn115909-20210113-00014

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https://www.cjoovs.com/CN/10.3760/cma.j.cn115909-20210113-00014 或 https://www.cjoovs.com/CN/Y2021/V23/I5/321

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