青岛市崂山区4~6岁正常儿童三棱镜度数的调查分析
The Investigation of the Prism Degree among the Normal Children Aged 4 - 6 Years Old in Laoshan District of Qingdao

作者: 刘 冰 , 谢丽娟 , 韩秀敏 , 单若冰 :青岛市妇女儿童医院,山东 青岛;

关键词: 三棱镜隐斜视儿童调查Prism Phoria Children Investigation

摘要:
目的:调查青岛市崂山区4~6岁正常儿童看远、看近的三棱镜度数,分析这一年龄段正常儿童三棱镜的分布规律,为该年龄段斜视患儿进行手术设计提供三棱镜度数方面的参考依据。方法:以整群抽样的方式随机抽取崂山区2所幼儿园,对4~6岁324名儿童应用角膜映光点法及遮盖去遮盖法确定正位、隐性斜视、内斜视、共同性外斜视等;采用国际标准视力表进行视力检测;使用手持电脑验光仪(莫廷影像)测量屈光度数;应用三棱镜进行看近、看远三棱镜度数的测量。分析视力及眼位正常的儿童看远、看近的三棱镜度数并分析不同年龄组儿童的三棱镜度数。数据采用描述统计、成组配对t检验及单因素方差进行分析。结果:受检儿童共324人,正常组275人,其中,看近正位15人(4.63%),看近隐斜视260人(80.25%),1人内隐斜视,259人外隐斜视;看远正位255人(78.7%),隐斜视20人(6.17%),均为外隐斜视。看近三棱镜度数为(−9.21 ± 5.31) PD,看远三棱镜度数为(−0.31 ± 1.41) PD。看近–看远三棱镜度数的差异在统计学上有显著性(P = 0.000)。不同年龄组看近、看远的三棱镜度数在统计学上没有显著性差异。结论:4~6岁正常儿童看近有−9 PD的外隐斜视,看远基本正位。对临床上看远斜视度数小于看近斜视度数但是差别程度达不到集合功能不足型外斜视的患儿,以看远正位进行手术设计。

Abstract: Objective: To investigate the prism value among the normal children aged 4 - 6 years old in Laoshan district of Qingdao and try to provide the normal distributions which may help to plan the strabismus surgery. Methods: 324 children of 2 kindergartens from Laoshan district were randomly sampled to determine if they were orthoptics, phoria, esotropia, concomitant extropia using light reflex test and cover-uncover test. The visual acuity and the ametropia of children were tested by the international standard visual acuity chart and the hand-held auto-refractomer separately. To compare the prism value among the different age teams, the data were analyzed by the paired-test, and the one-way ANOVA test. Results: There were 275 children in the normal team. Among the normal children, 15 children were orthoptic; 260 children (80.25%) were at near viewing phoria; 1 child was esophoria; the others were exophoria. However, only 20 children (6.17%) were distance phoria and they were all exophoria. The difference of prism value between the near viewing and distance viewing was significant in the normal team (P = 0.000). The prism value at near viewing was (−9.21 ± 5.31) PD; however, the value was (−0.31 ± 1.41) PD in distance. There was no difference among the different age teams. Conclusions: Among the normal 4 - 6 years old children, the prism value at near viewing was about −9 PD and the distance prism value was about 0 PD. Therefore, maybe 0 PD in the distance was the target of the strabismus surgery, especially to those who had more divergent degree at near viewing that did not reach the diagnosis of the insufficient divergent strabismus. Besides the binocular function, it was suggested to plan the surgery operation according to the prism value among the normal children aged 4 - 6 years old.

文章引用: 刘 冰 , 谢丽娟 , 韩秀敏 , 单若冰 (2015) 青岛市崂山区4~6岁正常儿童三棱镜度数的调查分析。 眼科学, 4, 78-82. doi: 10.12677/HJO.2015.44014

参考文献

[1] 李冰, 何媛媛, 关楠, 等. 沈阳市和平区7946名学龄前儿童斜视弱视调查[J]. 中国斜视与小儿眼科杂志, 2010, 18(2): 93-93.

[2] 刘明华. 清远市区5011名学龄前儿童斜视弱视调查[J]. 中国妇幼保健, 2013, 28(21): 3478-3479.

[3] 陈吉, 白静, 郁佳佳, 等. 学龄前儿童弱视与斜视1092例调查分析[J]. 中国儿童保健杂志, 2012(6): 530-532.

[4] 林世斌, 黄育强, 马迪, 等. 汕头地区城乡中小学生斜视现况(2009~2010年)横断面研究[J]. 中国斜视与小儿眼科杂志, 2013(3): 8-10.

[5] 金涵, 易敬林, 谢晖, 等. 学龄前儿童视觉发育状况调查研究[J]. 中华眼科杂志, 2011, 47(12): 1102-1106.

[6] Lança, C., Serra, H. and Prista, J. (2014) Strabismus, Visual Acuity, and Uncorrected Refractive Error in Portuguese Children Aged 6 to 11 Years. Strabismus, 22, 115-119.
http://dx.doi.org/10.3109/09273972.2014.932395

[7] Babinsky, E., Sreenivasan, V. and Candy, T.R. (2015) Near Heterophoria in Early Childhood. Investigative Ophthalmology & Visual Science, 56, 1406-1415.
http://dx.doi.org/10.1167/iovs.14-14649

[8] Radaković, M., Ivetić, V., Naumović, N., et al. (2012) Heterophoria and Fusional Convergence and Divergence in Preschool Children. Medicinski Glasnik (Zenica), 9, 293-298.

[9] Leone, J.F., Cornell, E., Morgan, I.G., et al. (2010) Prevalence of Heterophoria and Associations with Refractive Error, Heterotropia and Ethnicity in Australian School Children. British Journal of Ophthalmology, 94, 542-546.
http://dx.doi.org/10.1136/bjo.2009.163709

分享
Top