本文選題：屈光參差 + 雙眼視　； 參考：《天津醫(yī)科大學(xué)》2010年碩士論文

【摘要】： 研究目的：通過測(cè)量近視性屈光參差患者日常戴鏡狀態(tài)下的各項(xiàng)雙眼協(xié)動(dòng)參數(shù),了解其視功能狀況,探討屈光參差對(duì)雙眼視覺的影響。 研究對(duì)象： 1、近視性屈光參差組：隨機(jī)選取自2008年8月至2009年6月間于天津市眼科醫(yī)院就診的近視性屈光參差患者以及天津醫(yī)科大學(xué)在校學(xué)生共49人。納入標(biāo)準(zhǔn)：(1)屈光參差為雙眼球鏡差值≥1.50D和/或柱鏡差值≥1.00D且柱鏡少于1/2球鏡度數(shù)。(2)均為近視性屈光參差者。(3)日常所戴眼鏡單眼矯正視力≥0.8,且戴鏡時(shí)間超過半年。(4)無眼部器質(zhì)性病變。(5)經(jīng)遮蓋法檢查無顯斜視。(6)無老視等生理性調(diào)節(jié)功能減退。 2、對(duì)照組：選取同期就診的非屈光參差者44人作為對(duì)照組。納入標(biāo)準(zhǔn)：(1)正視、近視及近視散光患者(雙眼球鏡差值1.50D和/或柱鏡差值1.00D,且柱鏡少于1/2球鏡度數(shù))。(2)無斜視、弱視及其他眼部器質(zhì)性病變。(3)無老視等生理性調(diào)節(jié)功能減退。 研究方法： 分別對(duì)兩組研究對(duì)象進(jìn)行視網(wǎng)膜檢影(他覺驗(yàn)光),使用綜合驗(yàn)光儀進(jìn)行主覺驗(yàn)光,測(cè)量其矯正視力。使用頂焦度計(jì)測(cè)量所戴眼鏡后頂點(diǎn)焦度,檢查鏡片光學(xué)中心水平距離,確認(rèn)患者戴鏡的矯正視力。以所戴眼鏡度數(shù)和光學(xué)中心水平距離為基礎(chǔ),測(cè)量患者遠(yuǎn)(5m)、近距離(40cm)的分離性水平隱斜視,計(jì)算AC/A比率；測(cè)量遠(yuǎn)、近距離水平聚散力,集合近點(diǎn),測(cè)量調(diào)節(jié)功能,包括調(diào)節(jié)幅度、調(diào)節(jié)滯后、相對(duì)調(diào)節(jié)及調(diào)節(jié)靈敏度。根據(jù)所得數(shù)據(jù)繪制雙眼視分析圖表,并利用Sheard準(zhǔn)則分析雙眼視狀況。 結(jié)果： 1、屈光參差組與對(duì)照組分離性水平隱斜視的比較兩組研究對(duì)象遠(yuǎn)、近距離分離性水平隱斜視均以外隱斜居多,屈光參差組的分離性水平隱斜程度大于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。 2、屈光參差組與對(duì)照組的AC/A比率比較兩組AC/A比率均接近正常值,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。 3、屈光參差組與對(duì)照組水平聚散力的比較(1)遠(yuǎn)距離水平聚散力的比較 屈光參差組遠(yuǎn)距離水平聚散力的BI破裂點(diǎn)、恢復(fù)點(diǎn)值和BO模糊點(diǎn)、破裂點(diǎn)、恢復(fù)點(diǎn)值均小于對(duì)照組,差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。 (2)近距離水平聚散力的比較 屈光參差組近距離水平聚散力的BI和BO模糊點(diǎn)、破裂點(diǎn)、恢復(fù)點(diǎn)值均小于對(duì)照組,除BO恢復(fù)點(diǎn)值(P0.05)以外,其他差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。 4、屈光參差組與對(duì)照組調(diào)節(jié)功能的比較 (1)屈光參差組雙眼調(diào)節(jié)幅度差大于對(duì)照組雙眼調(diào)節(jié)幅度差,調(diào)節(jié)靈敏度小于對(duì)照組,兩組相比差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。 (2)屈光參差組與對(duì)照組相對(duì)調(diào)節(jié)值、調(diào)節(jié)滯后量接近,差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。 5、屈光參差組集合近點(diǎn)與對(duì)照組的比較 屈光參差組集合近點(diǎn)較遠(yuǎn),兩組相比差異無統(tǒng)計(jì)學(xué)意義(P0.05)。 結(jié)論： 1、屈光參差影響水平眼位,特別是近距離分離性水平眼位呈現(xiàn)較大程度的外隱斜。 2、屈光參差者遠(yuǎn)、近距離水平聚散力均減小,融合儲(chǔ)備的下降對(duì)維持正常雙眼視造成影響。患者遠(yuǎn)距離可以擁有正常雙眼單視功能,但注視近距離時(shí),部分患者可能存在單眼視狀態(tài)。 3、屈光參差者雙眼的調(diào)節(jié)幅度差別大,可能是由于矯正過程中高度屈光不正眼的低矯正,以及矯正視力差別造成。 4、屈光參差者雙眼的調(diào)節(jié)靈敏度小,直接提示融合功能受到影響。 5、屈光參差者長(zhǎng)期堅(jiān)持戴鏡,可以使AC/A比率、集合近點(diǎn)和調(diào)節(jié)滯后恢復(fù)到正常范圍,提示正確、及時(shí)地矯正對(duì)于維持正常雙眼單視功能的必要性。 6、Sheard準(zhǔn)則對(duì)于評(píng)價(jià)雙眼視功能有重要作用,屈光參差者的準(zhǔn)則符合率低。
[Abstract]:Objective : To investigate the effect of anisometropic anisometropic anisometropic anisometropic anisometropic anisometropic anisometropic amblyopia on binocular vision in patients with myopia .



Study Object :



1 . myopic anisometropic group : randomly selected from August 2008 to June 2009 in Tianjin Eye Hospital and 49 people in Tianjin Medical University .



2 . The control group : 44 non - anisometropic patients who visited the same period as the control group were selected as the control group . The criteria were as follows : ( 1 ) emmetropic , myopia and myopic astigmatism patients ( the difference of binocular spherical mirror is 1.50D and / or the difference of the column mirror is 1.00D , and the column lens is less than 1 / 2 sphere degrees ) . ( 2 ) There is no visual , amblyopia and other ocular organic lesions . ( 3 ) There is no aging and other physiological regulation functions .



Study method :



retinoscopy was performed on two groups of subjects , and the corrected visual acuity was measured by using a comprehensive optometry instrument . The focal length of the lens was measured by using the top power meter , the horizontal distance of the optical center of the lens was examined , and the corrected visual acuity of the lens was confirmed .
Measure the distance , near - distance horizontal gathering force , set near - point , measure and adjust function , including adjusting amplitude , adjusting lag , relative regulation and adjusting sensitivity . Draw binocular vision analysis chart according to the obtained data , and analyze binocular vision condition by using Smyth criterion .



Results :



1 . Compared with the control group , the difference was statistically significant ( P0.05 ) .



2 . The AC / A ratio of the anisodine group and the control group was close to the normal value , and the difference was not statistically significant ( P0.05 ) .



3 . Comparison of astigmatism between anisometropic group and control group ( 1 ) Compared with the control group ( 1 ) , the comparison between the two groups



The BI rupture point , the recovery point value and the BO fuzzy point , the fracture point and the recovery point value of the long - distance horizontal dispersion force of the anisometropic group were smaller than those of the control group , and the difference was not statistically significant ( P0.05 ) .



( 2 ) Comparison of near - distance horizontal forces



There was no statistical difference between the BI and BO fuzzy points , the rupture points and the recovery point values of the near - level scatter force of the anisometropic group , except for the BO recovery point value ( P0.05 ) .



4 . Comparison of adjustment function between anisometropic group and control group



( 1 ) The difference of binocular accommodation amplitude in anisometropic group was larger than that of control group , and the sensitivity was lower than that of control group , and the difference was statistically significant ( P0.05 ) .



( 2 ) There was no statistical significance ( P0.05 ) .



5 . Comparison of near - point and control group in anisometropic group



There was no significant difference between the two groups ( P0.05 ) .



Conclusion :



1 . anisometropic anisotroscopy affects the horizontal eye level , especially the near - close separation horizontal eye position presents a large degree of external oblique .



2 . The level of astigmatism decreased and the decrease of fusion reserve had an effect on maintaining normal binocular vision . The patient had normal binocular single - view function , but at close distance , some patients might have single - eye vision .



3 . The difference of the adjustment range between the refractive index and the refractive error is large , which may be caused by the low correction of the high refractive error in the correction process and the difference of corrected visual acuity .



4 . The adjustment sensitivity of the binocular is small , which directly suggests that the fusion function is affected .



5 . Long - term persistent wearing of the lens by refractive index can restore the AC / A ratio , the set near - point and the regulation lag to the normal range , and prompt the correct and timely correction of the necessity of maintaining the single - view function of the normal binocular .



6 . The criterion of Smyth is important for evaluating binocular visual function , and the criterion of refractive index is low .

【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2010
【分類號(hào)】：R777.44

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