阿托品联合部分遮盖法治疗大龄儿童屈光参差性弱视

[摘要] 目的 探讨阿托品联合部分遮盖法对大龄儿童屈光参差性弱视的治疗效果。 方法 39例10～16岁屈光参差性弱视儿童，男23例，女16例，在适宜的屈光矫正基础上，健眼涂阿托品眼膏并部分时间完全遮盖，配合弱视眼精细目力训练。每月随访，记录最佳矫正视力（best corrected visual acuity，BCVA）对应的LogMAR对数变换值，弱视眼视力连续3个月不再提高后，停用阿托品眼膏，缩短完全遮盖时间。 结果 全部39例患儿视力均明显提高，治疗前弱视眼BCVA平均0.21±0.19（LogMAR），治疗后平均0.62±0.32（LogMAR），差异具有统计学意义（P < 0.01）。遮盖时间平均（9.1±4.4）个月，在治疗开始后的前6个月内视力提高最快。10～12岁组视力提高程度与15～16岁组，差异具有统计学意义（P < 0.05）， 与13～14岁组差异无统计学意义（P > 0.05）。中度弱视眼视力提高程度高于重度弱视眼，差异具有统计学意义（P < 0.05）。 结论 大龄儿童屈光参差性弱视仍有可能治愈，阿托品联合部分遮盖法提高了治疗的依从性，效果好。

[关键词] 阿托品；部分遮盖；屈光参差性弱视；大龄儿童

[中图分类号] R777.4+4 [文献标识码] A [文章编号] 1674—4721（2012）09（c）—0005—03

Effectiveness of atropine combined partial occlusion therapy in anisometropic amblyopia of older children

ZHANG Dan

Department of Ophthlmology， Chuanying Second Hospital of Jilin City in Jilin Province， Jilin 132011， China

[Abstract] Objective To explore the therapeutic effect of joint part of atropine covering method for older children with anisometropic amblyopia. Methods Thirty—nine cases of 10—16 years anisometropic amblyopia in children， including 23 male cases and 16 female cases. In a suitable refractive correction， apply atropine on the basis of the healthy eye and cover completely part of the time combined with with the amblyopic eye fine eyesight training. Monthly follow up visual changes. Stop applying atropine after the amblyopic vision stops increasing for 3 consecutive months. Shorten the time to completely cover. Results All 39 cases of visual acuity weie improved significantly. Before treatment， the average amblyopia eyesight was 0.21±0.19， after treatment 0.62±0.32， so the difference was statistically significant （P < 0.01）. the average covering time was （9.1±4.4） months. 6 months after the start of treatment， the visual acuity was improved most quickly. The difference was statistically significant between the age groups of 10—12 years old and 15—16 years old （P < 0.05）， while not statistically significant between 10—12 years old and 13—14 years old （P > 0.05）. The degree of moderate amblyopia vision improvement was higher than that of the severe amblyopia vision. Hence the difference between them was statistically significant （P < 0.05）. Conclusion Older children with anisometropic amblyopia are still potentially curable. Atropine combined with partial covering method improved treatment compliance， and therefore， the effect is good.

[Key words] Atropine； Part—time occlusion； Anisometropic amblyopia； Older children