眼科 ›› 2023, Vol. 32 ›› Issue (4): 310-315.doi: 10.13281/j.cnki.issn.1004-4469.2023.04.008

• 论著 • 上一篇    下一篇

儿童间歇性外斜视的注视稳定性研究

黄威栋1,2   杨旭波3   

  1. 1四川大学华西临床医学院眼视光学系,成都610041; 2空军军医大学第一附属医院眼科,西安 710000; 3四川大学华西医院眼科,成都 610041
  • 收稿日期:2022-12-13 出版日期:2023-07-25 发布日期:2023-07-25
  • 通讯作者: 杨旭波, Email: cocayang@163.com
  • 基金资助:
    四川省卫健委资助项目(20PJ032)

Study on fixation stability of intermittent exotropia in children

Huang Weidong1, 2, Yang Xubo3   

  1. 1 Optometry and Visual Science Department, West China School of Medicine, Sichuan University, Chengdu 610041, China; 2 Department of Ophthalmology, The First Affiliated Hospital of Air Force Medical University, Xi’an 710000, China; 3 Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu 610041, China
  • Received:2022-12-13 Online:2023-07-25 Published:2023-07-25
  • Contact: Yang Xubo, Email: cocayang@163.com
  • Supported by:
    Sichuan Provincial Health Commission Fund Projects (20PJ032) 

摘要: 目的 研究间歇性外斜视儿童与正常儿童的注视性眼球运动和扫视性眼球运动的差异。设计 病例对照研究。研究对象 华西医院眼科斜弱视门诊就诊的儿童,其中间歇性外斜视31例,正常儿童22例。方法 所有受试者距离电脑显示屏80 cm观看屏幕,采用视觉生物信息刺激技术-增视能眼动仪软件,利用其增强现实技术对双眼注视性、扫视性眼球运动进行数据采集和分析,Tobii Eye Tracker 5 4C眼球追踪仪器捕捉眼球运动方位和轨迹,屈光不正者在矫正状态下进行。主要指标 矫正视力、屈光度、三棱镜斜视度、注视点水平方向偏移量、注视点垂直方向偏移量。结果 在注视性眼球运动方面,间歇性外斜视组在右上、正右、左下方向注视时,其小范围注视稳定性与正常儿童组有显著差别,其中正右(Z=-2.764,P=0.006)注视点的偏移体现在水平方向,左下(Z=-2.112,P=0.035)注视点的偏移体现在垂直方向,右上注视点在水平(Z=-2.266,P=0.023)、垂直(Z=-2.113, P=0.035)方向皆有显著偏移。在扫视性眼球运动方面,间歇性外斜视患儿扫视第一行行首(Z=-2.140,P=0.032)、行尾(Z=-2.573,P=0.010),第二行行首(Z=-2.907,P=0.004)、行尾(Z=-2.365,P=0.018),第三行行尾(Z=-3.268,P=0.001),第四行行首(Z=-2.022,P=0.043)时在水平方向上有明显的偏移;在扫视第一行行首(Z=-2.527,P=0.011)、行尾(Z=-2.031,P=0.042),第三行行尾(Z=-2.257,P=0.024),第四行行首(Z=-2.826,P=0.005)时,在垂直方向上有明显的偏移;在扫视第三行时,行首和行尾注视位置相比,在垂直方向的偏移量有明显差异(Z=-2.858,P=0.004)。结论 与正常儿童相比,间歇性外斜视患儿的注视性眼球运动和扫视性眼球运动均表现出不同程度的受损。(眼科,2023,32: 310-315)

关键词:  , 间歇性外斜视, 注视性眼球运动, 扫视性眼球运动

Abstract:  Objective To compare the differences in fixative eye movements and saccadic eye movements between children with intermittent exotropia and normal children. Design Case-control study. Participants Children attending the strabismus and amblyopia outpatient clinic at West China Hospital, including 31 cases of intermittent exotropia and 22 normal children. Methods All subjects watched the screen at a distance of 80 cm from the computer display screen, and used the visual biological information stimulation technology-enhanced vision eye tracker software, and used its augmented reality technology to collect and analyze binocular fixation and saccadic eye movements. Tobii Eye Tracker 5 4C eye tracking device captures the orientation and trajectory of eyeball movement, and it was performed under corrected state for those with ametropia. Main Outcome Measures Corrected visual acuity, refractive error, prism diopters of strabismus, horizontal deviation of fixation point, vertical deviation of fixation point. Results In terms fixation eye movement, significant differences were observed between the intermittent exotropia group and the normal group in the directions of upper-right, straight-right, and lower-left gaze. The deviations of fixation points were significant in the horizontal direction for straight-right (Z=-2.764, P=0.006) and in the vertical direction for lower-left (Z=-2.112, P=0.035), while both horizontal (Z=-2.266, P=0.023) and vertical deviations (Z=-2.113, P=0.035) were significant for upper-right gaze points. In terms of saccadic eye movement, the intermittent exotropia group glanced at the beginning of the first line (Z=-2.140, P=0.032) and the end of the line (Z=-2.573, P=0.010), the beginning of the second line (Z=- 2.907, P=0.004) and the end of the line (Z=-2.365, P=0.018), the end of the third line (Z=-3.268, P=0.001), the beginning of the fourth line (Z=-2.022, P=0.043), there was an obvious offset in the horizontal direction; when scanning the first line (Z=-2.527, P=0.011) and the end of the line (Z=-2.031, P=0.042), the third line end (Z=-2.257, P=0.024), and the fourth row head (Z=-2.826, P=0.005), the intermittent exotropia group had a significant shift in the vertical direction. In the third row, there were significant differences in the vertical deviation of fixation positions at the beginning and end of the row (Z=-2.858, P=0.004). Conclusion Children with intermittent exotropia have different degrees of impairment in both fixation eye movement and saccadic eye movement compared to normal children. (Ophthalmol CHN, 2023, 32: 310-315)

Key words:  , intermittent exotropia, fixation eye movement, saccadic eye movement