视感知觉检查系统对共同性外斜视术后立体视功能重建的相关预测因素

doi:10.3760/cma.j.cn115909-20200408-00141

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Abstract Objective: To evaluate the accuracy, sensitivity and specificity of the plasticity score in examinations of visual perception and training systems in the clinical application for predicting the recovery of stereopsis in patients with concomitant exotropia. Methods: This was a prospective clinical study. A total of 136 patients with concomitant exotropia were continuously recruited and underwent surgery in Beijing Tongren Hospital from January 2017 to September 2017. Of these, there were 109(80.2%) cases of intermittent exotropia and 27(19.9%) cases of constant exotropia. One week after the surgery, all patients underwent visual perception plasticity testing. Spearman correlation was used to analyze the correlation between the type of exotropia, age at surgery, duration of strabismus, deviation angle of preoperative strabismus, deviation angle of strabismus one week after surgery, and plasticity score. All patients underwent visual perception training one week after surgery for 6 months. The far stereopsis and near stereopsis acuity tests were performed 1 month, 3 months, and 6 months after surgery, and the ROC curve was plotted to evaluate the accuracy, sensitivity and specificity of the plasticity score in predicting stereopsis after concomitant exotropia surgery. The Delong test was used to compare the predictive efficacy of the plasticity score and traditional clinical indicators on the recovery of stereopsis function 6 months after surgery. Results: The plasticity score was correlated with age preoperative deviation angle, the course of strabismus, strabismus type and deviation angle one week after surgery (r was -0.3, -0.2, -0.3, 0.4, -0.3, P<0.05, respectively). The plasticity score can predict far and near stereopsis at different time points during the 6 month interval after surgery. There was a moderate predictive significance for both far and near stereopsis six months after surgery (AUC>0.7, P<0.001). For the traditional clinical indicators, preoperative near stereopsis had a low degree of predictive significance for near stereopsis 6 months after surgery (AUC=0.63<0.7, P=0.009), but there was no significant difference when compared with the plasticity score (Z=1.2, P=0.06). The preoperative far deviation angle had a low predictive significance for the complete recovery of both near and far stereopsis 6 months after surgery (AUC=0.66<0.7, P=0.02), but there was no significant difference of degree of predictive significance between the deviation angle and plasticity score (Z=1.4, P=0.15). Conclusions: The plasticity score can effectively predict the recovery of far and near stereopsis in patients with concomitant exotropia after surgery, and provide the basis for further diagnosis and treatment strategies for patients after surgery.

Key words： concomitant exotropia stereopsis visual perceptual checking and training system plasticity score

Received: 08 April 2020

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Fund: Beijing Municipal Science & Technology Commission (Z171100001017066); The Priming Scientific Research Foundation for the Senior Researcher in Beijing Tongren Hospital, Capital Medical University (TRYY-KYJJ-2016-012); High Level Health Technical Talent Training Program of Beijing Municipal Health Bureau (2015-3-023); Beijing Municipal Hospital Research and Development Program (PX2017045)

Corresponding Authors: Jing Fu, Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Capital Medical University, Beijing 100730, China (Email: fu_jing@126.com)

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https://www.cjoovs.com/EN/10.3760/cma.j.cn115909-20200408-00141 OR https://www.cjoovs.com/EN/Y2020/V22/I12/895

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