间歇性外斜视合并近视患者调节功能的评价

doi:10.3760/cma.j.cn115909-20200527-00226

Abstract
Figure/Table
References (32)
Related Citation (10)

Download: PDF (812 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS) Supporting Info

Guide

Abstract Objective: To compare the clinical characteristics relevant to the ability to accommodate in patients with intermittent exotropia (IXT) concomitant with myopia or non-myopia. Methods: This was a retrospective clinical study. Forty IXT patients between 6 and 15 years old were recruited from Beijing Tongren Hospital between December 2019 and January 2020. Of these, 20 patients were diagnosed with both IXT and myopia, while the other 20 patients were diagnosed with IXT and non-myopia. The evaluation parameters were refractive errors, dominant eyes, strabismus angle, AC/A, accommodative response (normal, accommodative lag, and accommodative lead), accommodative amplitude, and negative/positive relative accommodation. The revised Newcastle Control Score (RNCS) method was used to evaluate the ability to control exotropia. A paired t-test for dependent samples was used for comparison between the two eyes in each group and a two-sample t-test and nonparametric test were used to compare data between the two groups. Categorical data were compared using Fisher's exact test or a χ2 test. Results: The AC/A (2.78±1.09) of the myopia group was significantly lower than that of the non-myopia group (3.93±1.99) (t=-2.263, P=0.029). The accommodative amplitudes for the dominant eye (6.77±2.42) and non-dominant eye (6.52±2.16) in the myopia group were both lower than those for the dominant eye (9.14±2.89) and non-dominant eye (8.07±2.60) in the non-myopia group (t=-2.80, P=0.008; t=-2.05, P=0.047). The accommodative amplitude of the dominant eyes was significantly higher than the non-dominant eyes in the non-myopia group (t=2.572, P=0.019). The differences in accommodative amplitudes between the two eyes in the myopia group were not statistically significant. No significant differences were found in the positive relative accommodation, negative relative accommodation or accommodative response. The RNCS in the IXT combined with myopia group (7.20±1.96) was significantly higher than that in the non-myopia group (5.50±2.83)(t=2.203, P=0.034). Conclusions: Changes in accommodative characteristics are important indicators for the onset and progression of myopia, including a decline in AC/A and a decrease in accommodative amplitudes in the dominant and non-dominant eyes and a trend to balance between the two eyes.

Key words： intermittent exotropia accommodative ability myopia

Received: 27 May 2020

PACS:

Fund: High-level Health Technical Talent Training Program of Beijing Health System (2015-3-023); Capital Clinical Characteristic Application Research Project, Beijing Municipal Science & Technology Commission (Z171100001017066); Capital Health Development Research Project (Key Research Project), Beijing Municipal Health Commission (SF2018-1-2051); Capital Research Project of Clinical Diagnosis and Treatment Technology and Translational Application, Beijing Municipal Science & Technology Commission (Z201100005520044)

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

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors

Cite this article:

URL:

https://www.cjoovs.com/EN/10.3760/cma.j.cn115909-20200527-00226 OR https://www.cjoovs.com/EN/Y2021/V23/I1/6

[1]	Li SM, Liu LR, Li SY, et al. Design, methodology and baseline data of a school-based cohort study in Central China: The Anyang Childhood Eye Study. Ophthalmic Epidemiol, 2013, 20(6): 348-359. DOI: 10.3109/09286586.2013.842596.
[2]	Nusz KJ, Mohney BG, Diehl NN. The course of intermittent exotropia in a population-based cohort. Ophthalmology, 2006, 113(7): 1154-1158. DOI: 10.1016/j.ophtha.2006.01.033.
[3]	Ekdawi NS, Nusz KJ, Diehl NN, et al. The development of myopia among children with intermittent exotropia. Am J Ophthalmol, 2010, 149(3): 503-507. DOI: 10.1016/ j.ajo.2009.10.009.
[4]	Shin KH, Hyun SH, Kim IN, et al. The impact of intermittent exotropia and surgery for intermittent exotropia on myopic progression among early school-aged children with myopia. Br J Ophthalmol, 2014, 98(9): 1250-1254. DOI: 10.1136/ bjophthalmol-2013-304777.
[5]	Rosenfield M, Logan NS. Optometry: science, techniques and clinical management. Optometry, 2010, 81(12): 628-629. DOI: 10.1016/j.optm.2010.10.002.
[6]	李凤鸣, 谢立信. 中华眼科学. 3版. 北京: 人民卫生出版社, 2014.
[7]	Somer D, Demirci S, Cinar FG, et al. Accommodative ability in exotropia: Predictive value of surgical success. J AAPOS, 2007, 11(5): 460-464. DOI: 10.1016/j.jaapos.2007.01.123.
[8]	Quick MW, Newbern JD, Boothe RG. Natural strabismus in monkeys: Accommodative errors assessed by photorefraction and their relationship to convergence errors. Invest Ophthalmol Vis Sci, 1994, 35(12): 4069-4079. DOI: 10.1007/BF00171387.
[9]	Gwiazda J, Thorn F, Held R. Accommodation, accommodative convergence, and response AC/A ratios before and at the onset of myopia in children. Optom Vis Sci, 2005, 82(4): 273-278. DOI: 10.1097/01.opx.0000159363.07082.7d.
[10]	杜东成, 周雄武, 杜超, 等. 共同性斜视的AC/A比率. 中国斜视与小儿眼科杂志, 2006, 14(4): 187-189. DOI: 10.3969/ j.issn.1005-328X.2006.04.011.
[11]	谢芳, 张伟, 郭新, 等. 间歇性外斜视合并屈光不正患者集合与调节比率分析. 中华眼科杂志, 2014, 50(7): 489-493. DOI: 10.3760/cma.j.issn.0412-4081.2014.07.003.
[12]	李丽华, 南莉, 江洋琳, 等. 对症视觉训练对双眼视功能参数的影响. 中华眼视光学与视觉科学杂志, 2013, 15(3): 178-180. DOI: 10.3760/cma.j.issn.1674-845X.2013.03.012.
[13]	Singh NK, Mani R, Hussaindeen JR. Changes in stimulus and response AC/A ratio with vision therapy in convergence insufficiency. J Optom, 2017, 10(3): 169-175. DOI: 10.1016/ j.optom.2016.10.001.
[14]	Lin SY, White GE. Mandibular position and head posture as a function of eye dominance. J Clin Pediatr Dent, 1996, 20(2): 133-140.
[15]	Samarawickrama C, Wang JJ, Huynh SC, et al. Macular thickness, retinal thickness, and optic disk parameters in dominant compared with nondominant eyes. J AAPOS, 2009, 13(2): 142-147. DOI: 10.1016/j.jaapos.2008.11.004.
[16]	Cheng CY, Yen MY, Lin HY, et al. Association of ocular dominance and anisometropic myopia. Invest Ophthalmol Vis Sci, 2004, 45(8): 2856-2860. DOI: 10.1167/iovs.03-0878.
[17]	Wang Q, Wu Y, Liu W, et al. Dominant eye and visual evokedpotential of patients with myopic anisometropia. Biomed Res Int, 2016, 2016: 5064892. DOI: 10.1155/2016/5064892.
[18]	Ito M, Shimizu K, Kawamorita T, et al. Association between ocular dominance and refractive asymmetry. J Refract Surg, 2013, 29(10): 716-720. DOI: 10.3928/1081597X-20130813-02.
[19]	Zhou D, Ni N, Ni A, et al. Association of visual acuity with ocular dominance in 2045 myopic patients. Curr Eye Res, 2017, 42(8): 1155-1159. DOI: 10.1080/02713683.2017.1297464.
[20]	Momeni-Moghaddam H, McAlinden C, Azimi A, et al. Comparing accommodative function between the dominant and non-dominant eye. Graefes Arch Clin Exp Ophthalmol, 2014, 252(3): 509-514. DOI: 10.1007/s00417-013-2480-7.
[21]	王婷. 间歇性外斜视患者调节功能与集合功能的评价. 天津: 天津医科大学, 2012.
[22]	Kushner BJ. Accommodative ability in exotropia: predictive value of surgical success. J AAPOS, 2008, 12(2): 216-217; author reply 217-218. DOI: 10.1016/j.jaapos.2007.11.011.
[23]	Cacho P, García A, Lara F, et al. Diagnostic signs of accommodative insufficiency. Optom Vis Sci, 2002, 79(9): 614-620. DOI: 10.1097/ 00006324-200209000-00013.
[24]	Joosse MV, Esme DL, Schimsheimer RJ, et al. Visual evoked potentials during suppression in exotropic and esotropic strabismics: strabismic suppression objectified. Graefes Arch Clin Exp Ophthalmol, 2005, 243(2): 142-150. DOI: 10.1007/ s00417-004-0994-8.
[25]	Yang HK, Hwang JM. Decreased accommodative response in the nondominant eye of patients with intermittent exotropia. Am J Ophthalmol, 2011, 151(1): 71-76. DOI: 10.1016/ j.ajo.2010.06.047.
[26]	Maxwell J, Tong J, Schor CM. The first and second order dynamics of accommodative convergence and disparity convergence. Vision Res, 2010, 50(17): 1728-1739. DOI: 10.1016/j.visres.2010.05.029.
[27]	马可, 刘陇黔. 青年人近视眼与各调节因素的关系. 眼视光学杂志, 2006, 8(2): 85-87. DOI: 10.3760/cma.j.issn.1674- 845X.2006.02.005.
[28]	Labhishetty V, Bobier WR. Are high lags of accommodation in myopic children due to motor deficits? Vision Res, 2017, 130: 9-21. DOI: 10.1016/j.visres.2016.11.001.
[29]	徐艳春, 范春雷, 马小力, 等. 青少年近视眼正相对调节力下降的临床分析. 中华眼视光学与视觉科学杂志, 2013, 15(1): 34-37. DOI: 10.3760/cma.j.issn.1674-845X.2013.01.009.
[30]	李育, 王唯为, 张海峰. 间歇性外斜视患者双眼调节功能的变化. 首都食品与医药, 2016, 23(16): 36-37.
[31]	林惠玲, 胡玉艳, 徐昕頔, 等. 间歇性外斜视的调节灵活度和调节反应. 中华眼视光学与视觉科学杂志, 2018, 20(5): 265- 268. DOI: 10.3760/cma.j.issn.1674-845X.2018.05.003.
[32]	Koh LH, Charman WN. Accommodative responses to anisoaccommodative targets. Ophthalmic Physiol Opt, 2008, 18(3): 254-262. DOI: 10.1111/j.1475-1313.1998.00329.x.