摘要
目的分析视觉训练对成年人视功能异常所致视疲劳症状的改善作用。方法采用系列病例观察研究方法,收集2018年10月至2019年10月在天津市眼科医院视光中心视觉训练室进行视觉训练的成年人视功能异常所致的视疲劳患者93例186眼,其中男48例,女45例;平均年龄(30.43±6.39)岁。所有患者双眼视功能初次检查包括综合验光仪检查屈光度、Worth 4 Dots检查双眼视、立体视、Von-Graefe法测量远近距水平眼位、旋转棱镜法测量融像范围、融合交叉圆柱镜法测量调节反应、负镜片法测量调节幅度、翻转拍测量调节灵活度以及聚散灵活度。训练师根据检查结果和患者具体情况制定个性化训练方案,每训练5次后复查1次。将初查、第1次复查及第2次复查结果进行比较。结果初次检查时近隐斜视度为-8.0(-15.3,-3.0)^(△),第1次复查时减少至-5.0(-9.0,0.0)^(△),差异有统计学意义(Z=-3.586,P<0.01);左右眼初次检查时调节幅度分别为4.00(3.25,5.25)D和4.00(3.00,5.00)D,第1次复查时分别提高至5.50(4.25,7.00)D和5.00(3.75,7.00)D,差异均有统计学意义(Z=-4.284、-3.995,均P<0.01);初次检查时远距离正融像破裂点为7.5(5.0,15.8)^(△),恢复点为0.0(0.0,4.0)^(△),第1次复查时分别增加至11.0(6.0,22.0)^(△)和4.0(0.0,7.0)^(△),差异均有统计学意义(Z=-3.192、-3.748,均P<0.01);初次检查时近距离正融像破裂点为18.0(8.0,28.0)^(△),恢复点为6.0(0.0,12.0)^(△),第1次复查时分别增加至26.0(21.5,35.0)^(△)和11.5(6.0,16.0)^(△),差异均有统计学意义(Z=-4.695、-3.377,均P<0.01);单眼及双眼的调节灵敏度从初查时2~3个周期/min增加至第1次复查时的10~12个周期/min,差异均有统计学意义(均P<0.01)。Logistic回归分析结果显示,年龄、远隐斜和近隐斜不是右眼和左眼调节幅度改善程度差异的影响因素。初查时,22例患者的CISS评分为(25.13±9.64)分,第1次复查时降至(19.18±7.22)分,差异有�
Objective To analyze the improving effect of visual therapy on the symptoms of asthenopia caused by abnormal visual function in adults.Methods A serial case study was conducted.Ninety-three adult patients(186 eyes)with visual dysfunction caused by abnormal visual function who underwent training in the visual training room of the Optometry Center of Tianjin Eye Hospital from October 2018 to October 2019 were enrolled,among which there were 48 males and 45 females.The average age of patients was(30.43±6.39)years old.Binocular visual function examination included vision examination by phoropter,simultaneous vision and stereopsis by Worth 4 Dots test,distance and near heterophoria by Von-Graefe method test,fusion range by rotating prism method,the accommodation reaction by fusion cross cylindrical lens(FCC),the accommodation amplitude by minus technique,the accommodation flexibility and the vergence flexibility by flipper,and a personalized training program was formed on the basis of the above examination results.The training process was divided into initial examination,first review and second review,and each stage containing 5 times of training was followed by a review.The results of the initial examination,first review and second review were compared.The study protocol was approved by an Ethics Committee of Tianjin Eye Hospital(No.KY201906).Written informed consent was obtained from each patient prior to any examination.Results The average near heterophoria was-8.0(-15.3,-3.0)^(△)at the initial examination,and it was reduced to-5.0(-9.0,0.0)^(△)at the first review,showing significant difference(Z=-3.586,P<0.01).The mean accommodation amplitude of left and right eyes were 4.00(3.25,5.25)D and 4.00(3.00,5.00)D respectively before visual training,which were increased to 5.50(4.25,7.00)D and 5.00(3.75,7.00)D at the first review,showing significant differences(Z=-4.284,-3.995;both at P<0.01).The broken point and the recovery point of the long-distance positive fusion at the initial inspection were 7.5(5.0,15.8)^(�
作者
王静
江洋琳
芦文丽
张琰
Wang Jing;Jiang Yanglin;Lu Wenli;Zhang Yan(Tianjin Key Laboratory of Retinal Functions and Diseases,Tianjin Branch of National Clinical Research Center for Ocular Disease,Eye Institute and School of Optometry,Tianjin Medical University Eye Hospital,Tianjin 300384,China;Tianjin Eye Hospital,Tianjin 300022,China;Office of Health Statistics,Department of Epidemiology and Health Statistics,School of Public Health,Tianjin Medical University,Tianjin 300070,China)
出处
《中华实验眼科杂志》
CAS
CSCD
北大核心
2021年第6期543-549,共7页
Chinese Journal Of Experimental Ophthalmology
基金
天津市科技计划项目(17ZXHLXY00050)
天津市眼科医院科技基金项目(YKYB1907)。
关键词
视功能
视疲劳
视觉训练
视觉可塑性
成年人
Visual function
Asthenopia
Vision therapy
Vision plasticity
Adults
