摘要
目的比较弱视儿童的弱视眼与对侧健眼的瞳孔直径在不同光照条件下的变化差异，分析其视觉通路功能与对侧健眼的差异。方法随机选择30例单眼弱视儿童，包括屈光参差性弱视17例、屈光不正性弱视8例以及斜视性弱视5例，其中中度弱视13例，轻度弱视17例。所有患者弱视眼矫正视力0．2～0．8，所有患者对侧健眼矫正视力0．9～1．2。应用照相机拍摄法在普通光照条件、直接对光条件、间接对光条件及夜间环境条件下，让受试者分别注视远距和近距E视标，来测量弱视眼与对侧健眼的瞳孔直径，比较其差异。结果在四种不同光照条件下，受试者在注视远距及近距E视标时，其弱视眼组的瞳孔直径均大于对侧健眼组（P〈0．05），弱视眼在看远看近两种状态下，直接对光反射时的瞳孔直径均大于间接对光反射时的瞳孔直径；弱视眼在间接对光反射时的瞳孔直径均大于健眼直接对光反射时的瞳孔直径；弱视眼直接对光反射时的瞳孔直径均大于健眼间接对光反射时的瞳孔直径，差异均有统计学意义（P〈0．05）。结论弱视眼视网膜功能较对侧健眼要降低，弱视眼的近反射中枢（枕叶视皮质）功能可能较对侧健眼下降，并且E—W核功能下降是弱视眼瞳孔直径异于对侧健眼的主要原因，从而推断弱视在发生发展的过程中，弱视眼的视网膜、视觉传导通路及视皮层均存在损害。
Objective Under different four illumination conditions, comparing the variance of pupil size between the amblyopia eyes and the contralateral normal eyes in monocular amblyopia children to analyze the variance in fimction of visual pathway of the amblyopia eyes. Methods 30 monocular amblyopia children were selected in random which is including 17 anisometropic amblyopia children, 8 ametropia amblyopia children and 5 strabismic amblyopia children, in which of them, there＇re 13 Moderate amblyopia and 17 mild amblyopia.The corrected vision of the amblyopia eyes in all of the subjects is 0.2-0.8 ,while their contralateral normal eyes is 0.9-1.2,Pupil size measured by digital camera means under different four illumination conditions -daylight, direct light refiexion, indirect light reflexion and dark illumination.Every subjects were required to focus on far E optotype and near E optotype respectively, then we compared the pupil size of amblyopia eyes with those of contralateral eyes.Results Under different four illumination conditions,when subjects focus on far and near E optotype ,the pupil size of amblyopia eyes was larger than contralateral eyes （paired-samples t test, P〈0.05 ）.The pupil size of amblyopia eyes on direct light reflexion condition was larger than amblyopia eyes on indirect light reflexion condition, whatever they focus on at far or near;the pupil size of amblyopia eyes on indirect light reflexion condition was also larger than contralateral eyes on direct light reflexion condition, the pupil size of amblyopia eyes on direct light reflexion condition was also larger than contralateral eyes on indirect light reflexion condition（paired-samples t test, P〈0.05 ）.Conclusion The results revealed characteristic suggesting a malfunction of the retina, the visual cortex in amblyopic eyes, besides, the malfunction of E-W nucleus is probably the main reason for the abnormal pupil size in amblyopic eyes.This clinical finding infers that impairment exits in rentia, visual pathway and also visual cortex during the development of the amblyopia.
出处
《中国实用眼科杂志》
CSCD
北大核心
2009年第7期739-744,共6页
Chinese Journal of Practical Ophthalmology
关键词
弱视
瞳孔直径
瞳孔对光反射
Amblyopia
Pupil size
Pupillary light reflex
