本文選題：弱視 + 瞳孔對光反射��； 參考：《昆明醫(yī)科大學(xué)》2012年碩士論文

【摘要】：目的： 探討6-10歲正常及弱視兒童瞳孔對光反射的特征,為視覺敏感期兒童弱視的早期篩查及診斷治療,以及弱視治療療效分析提供相關(guān)參考依據(jù)。 方法： 應(yīng)用中國科學(xué)院昆明動物研究所所研制的瞳孔測試儀檢測6-10歲60例非弱視兒童,60例屈光參差性弱視兒童和60例屈光不正性弱視兒童的瞳孔對光反射參數(shù)。通過對5個參數(shù)(暗適應(yīng)后期既給光刺激時瞳孔像素值A(chǔ)SC,給光后瞳孔面積收縮至最小時的像素值A(chǔ)N；從開始給光到瞳孔收縮面積最小時的像素值的時間TC,瞳孔最大收縮率S；瞳孔收縮平均速度CV)的測量,在非弱視兒童與屈光不正性弱視兒童之間,屈光參差性兒童的弱視眼與非弱視眼之間,屈光參差性弱視以及屈光不正性弱視兒童輕中重度之間,以及部分屈光不正性弱視兒童在經(jīng)過治療訓(xùn)練后視力提高前后,屈光參差性弱視兒童非弱視眼與正常非弱視兒童雙眼之間,屈光參差性兒童弱視眼與屈光不正性弱視兒童雙眼之間,以及在總體180只非弱視眼和180只弱視眼之間的兩組數(shù)據(jù)進(jìn)行統(tǒng)計學(xué)分析。 結(jié)果： 1.屈光不正性弱視兒童與正常(非弱視)兒童相比較,弱視兒童的瞳孔面積較非弱視兒童大,無論是在暗適應(yīng)末期還是光刺激后瞳孔縮小到最小值；瞳孔從暗適應(yīng)末期到收縮到最小值時的平均收縮速度和瞳孔最大收縮率較小,收縮時間延長,差異均具有統(tǒng)計學(xué)意義(P0.05)。 2.屈光參差性弱視兒童弱視眼與非弱視眼相比較,弱視眼的瞳孔面積較非弱視兒童大,無論是在暗適應(yīng)末期還是光刺激后瞳孔縮小到最小值；瞳孔從暗適應(yīng)末期到收縮到最小值時的平均收縮速度和瞳孔最大收縮率較小,收縮時間延長,差異均具有統(tǒng)計學(xué)意義(P0.05)。 3.屈光不正性弱視兒童輕中重度3組的對比,隨著弱視程度的加深,瞳孔面積變大,無論是在暗適應(yīng)末期還是光刺激后瞳孔縮小到最小值；瞳孔從暗適應(yīng)末期到收縮到最小值時的平均收縮速度和瞳孔最大收縮率變小,收縮時間延長,差異均具有統(tǒng)計學(xué)意義(P0.05)。 4.屈光參差性弱視兒童輕中重度3組的對比,隨著弱視程度的加深,瞳孔面積變大,無論是在暗適應(yīng)末期還是光刺激后瞳孔縮小到最小值；瞳孔從暗適應(yīng)末期到收縮到最小值時的平均收縮速度和瞳孔最大收縮率變小,收縮時間延長,差異均具有統(tǒng)計學(xué)意義(P0.05)。 5.屈光不正性弱視兒童治療訓(xùn)練前后的對比,治療后矯正視力提高,瞳孔面積變小,無論是在暗適應(yīng)末期還是光刺激后瞳孔縮小到最小值；瞳孔從暗適應(yīng)末期到收縮到最小值時的平均收縮速度和瞳孔最大收縮率變大,收縮時間縮短,差異均具有統(tǒng)計學(xué)意義(P0.05)。 6.屈光參差性弱視兒童非弱視眼與正常非弱視兒童雙眼的對比,瞳孔面積偏大,無論是在暗適應(yīng)末期還是光刺激后瞳孔縮小到最小值；瞳孔從暗適應(yīng)末期到收縮到最小值時的平均收縮速度和瞳孔最大收縮率偏小,收縮時間延長,差異均具有統(tǒng)計學(xué)意義(P0.05)。 7.屈光參差性弱視兒童弱視眼與屈光不正性弱視兒童雙眼的對比,瞳孔面積偏小,無論是在暗適應(yīng)末期還是光刺激后瞳孔縮小到最小值；瞳孔從暗適應(yīng)末期到收縮到最小值時的平均收縮速度和瞳孔最大收縮率偏大,收縮時間縮短,差異均具有統(tǒng)計學(xué)意義(P0.05)。 8.180只弱視眼與180只非弱視眼的對比,前者瞳孔面積較大,無論是在暗適應(yīng)末期還是光刺激后瞳孔縮小到最小值；瞳孔從暗適應(yīng)末期到收縮到最小值時的平均收縮速度和瞳孔最大收縮率較小,收縮時間延長,差異均具有統(tǒng)計學(xué)意義(P0.05)。 結(jié)論： 1、弱視兒童(眼)與正常非弱視兒童(眼)相比,瞳孔面積較大,瞳孔對光反射的靈敏度及收縮幅度較小,且與弱視程度直接相關(guān),說明了瞳孔測試儀在弱視的臨床診斷具有一定的應(yīng)用價值。 2、弱視兒童(眼)經(jīng)過訓(xùn)練治療,矯正視力提高后,瞳孔面積變小,瞳孔對光反射的靈敏度及收縮幅度增加。因此,瞳孔測試儀也可以作為弱視療效評估的檢測手段。
[Abstract]:Purpose :

Objective To investigate the characteristics of pupil ' s reflex in children aged 6 - 10 years and children with amblyopia , and provide relevant reference for the early screening and diagnosis of amblyopia in children with visual acuity and the analysis of amblyopia treatment efficacy .

Method :

The pupil of 60 non - amblyopia children aged 6 - 10 , 60 cases of anisometropic amblyopia and 60 cases of ametropic amblyopia were measured by pupil tester developed by Kunming Institute of Animal Research , Chinese Academy of Sciences .
the maximum pupil shrinkage rate S from the time TC of the pixel value that starts to give the light to the pupil contraction area ;
The measurement of pupil contraction mean velocity ( CV ) was statistically analyzed between the non - amblyopia children and the ametropic amblyopia children , the anisometropic amblyopia and the anisometropic amblyopia children , the anisometropic amblyopia children and the normal non - amblyopia children ' s eyes , the anisometropic amblyopia children ' s amblyopia and the anisotropism amblyopia children ' s eyes , and the two groups of data between the total 180 non - amblyopia and 180 amblyopia eyes .

Results :

1 . Compared with normal ( non - amblyopia ) children in children with ametropic amblyopia , the pupil area of amblyopia children is larger than that of non - amblyopia children , whether at the end of dark adaptation or after light stimulation , the pupil is reduced to the minimum value ;
The average systolic velocity and the maximum pupil contraction rate of the pupil from the end of darkness to the minimum were smaller , the contraction time was prolonged , and the difference was statistically significant ( P0.05 ) .

2 . Compared with the non - amblyopia children , the pupil area of the amblyopia eyes was larger than that of the non - amblyopia children , whether at the end of the dark adaptation or after the light stimulation , the pupil was reduced to the minimum ;
The average systolic velocity and the maximum pupil contraction rate of the pupil from the end of darkness to the minimum were smaller , the contraction time was prolonged , and the difference was statistically significant ( P0.05 ) .

3 . Compared with the mild - moderate - severe group , the pupil area became larger as the degree of amblyopia deepened , whether the pupil was reduced to the minimum at the end of dark adaptation or after light stimulation ;
The average systolic velocity and the maximum pupil contraction rate of the pupil from the end of darkness to the minimum were smaller , the contraction time was prolonged , and the difference was statistically significant ( P0.05 ) .

4 . Compared with the mild moderate and severe group , the pupil area became larger as the degree of amblyopia deepened , whether at the end of dark adaptation or after light stimulation , the pupil was reduced to the minimum ;
The average systolic velocity and the maximum pupil contraction rate of the pupil from the end of darkness to the minimum were smaller , the contraction time was prolonged , and the difference was statistically significant ( P0.05 ) .

5 . Before and after the treatment of ametropic amblyopia children , the corrected visual acuity improved and the pupil area became smaller , whether at the end of dark adaptation or after light stimulation , the pupil was reduced to the minimum ;
The average systolic velocity and the maximum pupil contraction rate of the pupil from the end of darkness to the minimum were significant , and the contraction time was shortened and the difference was statistically significant ( P0.05 ) .

6 . Compared with the normal non - amblyopia children ' s eyes , the pupil area of anisometropic amblyopia children was larger than that of normal non - amblyopia children .
The average systolic velocity and the maximum pupil contraction rate of the pupil from the end of darkness to the minimum were small , the contraction time was prolonged , and the difference was statistically significant ( P0.05 ) .

7 . Compared with the children with amblyopia of anisometropic amblyopia and ametropic amblyopia , the pupil area is small , whether at the end of dark adaptation or after light stimulation , the pupil is reduced to the minimum value ;
The average systolic velocity and the maximum pupil contraction rate of the pupil from the end of darkness to the minimum were significant , the contraction time was shortened , and the difference was statistically significant ( P0.05 ) .

8.180 eyes were compared with 180 non - amblyopia eyes , the pupil area of the former was larger , whether at the end of dark adaptation or after light stimulation , the pupil was reduced to the minimum ;
The average systolic velocity and the maximum pupil contraction rate of the pupil from the end of darkness to the minimum were smaller , the contraction time was prolonged , and the difference was statistically significant ( P0.05 ) .

Conclusion :

1 . Compared with the normal non - amblyopia children ( eyes ) , the pupil area is larger , the sensitivity of the pupil to light reflection and the contraction amplitude are small , and it is directly related to the degree of amblyopia , which shows that the pupil tester has certain application value in the clinical diagnosis of amblyopia .

2 . The pupil area becomes smaller and the pupil ' s sensitivity and contraction amplitude of the pupil are increased . Therefore , the pupil tester can also be used as the detection means for the evaluation of amblyopia curative effect .
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R777.44

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