摘要
目的探讨A-V型斜视的临床特征。设计回顾性病例系列。研究对象A-v型斜视患者324例。方法对2009年1月至2010年1月于北京同仁医院眼科门诊就诊诊断为A-V型斜视的患者324例，其中A型斜视114例，v型斜视210例。方法对所有患者的临床资料进行分析，观察其发病特点、斜视度、斜视类型、眼球运动特点和双眼视觉等临床特征。主要指标发病年龄、就诊年龄、斜视度分布、伴随发生的斜视类型、眼球运动异常和双眼视觉。结果A型斜视患者和v型斜视患者中，1岁内发病者分别为70例（61．40％）和109例（51．90％）（体O．07），在3－9岁间就诊者分别为18例（15．78％）和127例（60．48％）（P〈O．01）。A型斜视患者中有25例（21．93％）是知觉性斜视，而v型斜视中知觉性斜视仅有3例（1．43％）；在v型斜视中，先天性斜视有43例（20．48％），而A型斜视中仅有6例（5．26％）。A型斜视中48例（42．11％）患者单侧上斜肌亢进，64例（56．14％）患者双侧上斜肌亢进，1例（0．88％）患者不伴斜肌运动异常；v型斜视中，103例（49．05％）患者单侧下斜肌亢进，93例（44．29％）患者双侧下斜肌亢进，9例（4．29％）患者不伴斜肌运动异常。A型斜视患者中仅11例（9．65％）有同视机一级功能，所有患者均无远、近立体视。v型外斜视中有26例（12．38％）有近立体视，24例（11．43％）有不同程度的同视机立体视。结论A．V型斜视患者发病年龄早，伴知觉性斜视多见，而v型斜视多伴发先天性斜视；多数A．V型斜视伴有斜肌运动异常；A型斜视较V型斜视更易损伤双眼视觉。（腰科。2011。20：203-207）
Objective To investigate the clinical features of strabismus with A or V pattern. Design Retrospective case series. Participants 324 cases with A or V pattern strabismus. Methods Clinical data from Jan. 2009 to Jan. 2010 were retrospectively analyzed. Main Outcome Measures Age of onset, age at the first diagnosed, distribution of deviation angle, accompanied strabismus type, ocular movement and binocular vision. Results Seventy cases （61.40%） of A-pattern strabismus and 109 cases （51.90%） of V-pattern had an onset within 1 year of age （P=0.07）. The ages at the first diagnosed were younger in patients with V-pattern strabismus than those with A-pattern （P〈0.01）. Twenty-five eases （21.93%） of sensory strabismus were diagnosed in A-pattern strabismus while only 3 （1.43%） in V-pattern. Congenital strabismus were found in 43 cases （20.48%） of V-pattern while in 6 cases （5.26%） of A-pattern. There were 48 cases （42.11%） with monocular superior oblique overaetion, 64 （56.14%） cases with binocular superior oblique overaction, only 1 case （0.88%） without oblique abnormality in A-pattern strabismus. There were 103 cases （49.05%） with monocular inferior oblique overaction, 93 cases （44.29%） with binocular inferior oblique overaction, 9 cases （4.29%） without oblique abnormality in V-pattern strabismus. Only 11 patients （9.650/o） with A-pattern had simultaneous perception and none had distance or near stereoscopic vision, while 26 （12.38%） cases of V-pattern had near stereoscopic vision and 24 cases （11.43%） had different levels of distance binocular vision. Conclusions A-V pattern strabismus is manifested early onset in life, accompanied by more sensory strabismus in A-pattern while more congenital strabismus in V-pattern. Most of A-V pattern strabismus has abnormality of oblique muscle. Binocular vision tends to be damaged more seriously in A-pattern than in V-pattern. （Ophthalmol CHN, 2011, 20： 203-207）
出处
《眼科》
CAS
2011年第3期203-207,共5页
Ophthalmology in China
基金
国家自然科学基金(30600688)
北京市优秀人才培养资助(2010D003034000007)
关键词
A-V型斜视
临床特征
strabismus/A-V pattern
clinical features
