目的:比较弱视儿童主动视力治疗(AVT)和常规补片治疗对视力(VA)和立体视敏度的改善。
方法:这项研究包括65名5至16岁的儿童(平均年龄±SD,11.00±3.29年)伴有单侧弱视。其中,31名儿童接受了积极视力治疗(AVT组),34例患儿接受了常规修补治疗(修补组)。AVT组经历了AVT的三个连续阶段:单眼阶段(追踪,扫视,固定,视觉运动,眼手协调,和中央外围活动),双眼期(复视意识,反抑制,双目视野中的单目固定,住宿活动,双边一体化,和精细运动活动)和双眼相(融合和立体视)。修补小组根据儿科眼病调查组的指南修补了他们的眼睛。两组在基线和治疗三个月后测量最佳校正单眼VA和立体视敏度。
结果:两种AVT的弱视眼(AE)的平均视力均有显着改善(0.32±0.11logMAR,p<0.001)和修补组(0.27±0.19logMAR,p=0.001)。然而,AVT组和修补组之间AE的平均视力增加没有显着差异(p=0.059)。在AVT(0.81±0.34,p<0.001)和修补组(0.32±0.34,p<0.001)中,立体视力的平均增益(弧秒)均具有统计学意义。与修补组相比,AVT组的立体视力增加明显更高(p<0.001)。
结论:主动视力疗法治疗弱视儿童时,在立体视力改善方面比常规补片疗法有更好的影响,但在VA方面没有影响。
OBJECTIVE: To compare improvements in visual acuity (VA) and stereoacuity between active vision therapy (AVT) and conventional patching therapy in children with amblyopia.
METHODS: This study included 65 children aged 5 to 16 years (mean age±SD, 11.00±3.29 years) with unilateral amblyopia. Among them, 31 children underwent active vision therapy (AVT group), and 34 children underwent conventional patching therapy (patching group). AVT group underwent three sequential phases of AVT: Monocular phase (pursuit, saccades, fixation, visuomotor, eye-hand coordination, and central peripheral activities), biocular phase (diplopia awareness, antisuppression, monocular fixation in a binocular field, accommodative activities, bilateral integration, and fine motor activities) and binocular phase (fusion and stereopsis). Patching group patched their fellow eyes as per guidelines by Pediatric Eye Disease Investigator Group. Best-corrected monocular VA and stereoacuity were measured at baseline and after three months of therapy in both groups.
RESULTS: There were significant improvements in the mean acuities in amblyopic eye (AE) in both AVT (0.32±0.11 logMAR, p <0.001) and patching groups (0.27±0.19 logMAR, p ˂ 0.001). However, there was no significant difference in mean acuity gains in AE between AVT and patching groups (p = 0.059). Mean gains in stereoacuities (log seconds of arc) were statistically significant in both AVT (0.81±0.34, p < 0.001) and patching groups (0.32±0.34, p < 0.001). The stereoacuity gain in the AVT group was significantly higher compared to patching group (p < 0.001).
CONCLUSIONS: Active vision therapy had a better impact than conventional patching therapy in terms of improvement of stereoacuity but not in terms of VA when used for treating children with amblyopia.