【作者】 石彦杰；

【导师】 燕振国；

【作者基本信息】 兰州大学 ， 眼科学， 2012， 硕士

【摘要】 目的应用血氧水平依赖的功能磁共振(Blood oxygen level dependent-function magnetic resonance imaging, BOLD-fMRI)技术,研究屈光性弱视患儿立体视皮层功能特点,对比比较屈光不正性弱视与屈光参差性弱视之间脑皮层的激活差异及特点。方法初诊弱视患儿11例,其中屈光不正性患儿5例(2男3女,平均8±1.5岁),屈光参差性患儿6例(4男2女,平均9±2岁)。所有被试均为远视性弱视,中心凹注视；均为右利手；所有被试无局部及全身特殊病史。试验前充分矫正屈光不正；规范化弱视训练后1周及4周时复查fMRI。通过E-Prime2.0软件编写视觉刺激任务程序,刺激模式为对比度接近80%的红蓝立体图像,以SIEMENS MAGNETOM Verio3.0T磁共振扫描系统,分别采集弱视儿童BOLD-fMRI数据。采用SPM8软件包对图像进行处理及分析。比较1.不同时期弱视儿童脑皮层激活差异；2.不同时期屈光不正性弱视组与屈光参差性弱视组间视皮层激活强度及范围的差异变化特点。结果1.当设定P值为0.001,激活范围阈值为10个体素时,屈光性弱视患儿双眼的兴奋区域为以枕叶为中心的视觉皮层,其中以BA18/19/17区皮层激活程度最显著；随训练时间延长,弱视组立体视皮层功能活动范围及活动强度均有所增强。2.当设定P值为0.05,激活范围阈值为10个体素时进行组间比较时,屈光不正性弱视相关视皮层神经元活动水平及激活范围均较屈光参差性弱视有所增加,主要集中在额叶(BA6/BA9/BA10区)、顶叶后部(BA40/BA7区)。结论1、立体视觉的形成涉及多个脑区,主要位于枕叶,尤以BA17区、BA18区、BA19区为著；2、随弱视时间的延长,弱视患者立体视皮层活动强度及范围增强；3、屈光参差性弱视与屈光不正性弱视立体视较易受到损害。更多还原

【Abstract】 Purpose To evaluate the stereoscopic visual cortex functional changes in amblyopia children, and compare the visual cortex functional-differences between ametropic and anisometropic amblyopia with the aid of blood oxygenation level dependent-functional MRI.Methods11amblyopia children were enrolled in this study,include5ametropic(2M3F, average age:8±1.5year) and6anisometropic(4M2F, average age:9±2year). They were all hyperopic amblyopia, central vision type and right handedness. They didn’t have any local and systemic disease except for amblyopia. Must be correct ametropia, and review fMRI inspection after regular amblyopia treatment one week and four week.The visual stimulation program was designed by E-Prime2.0software, the red-blue stereoscopic image with the contrast closed to80%as stimulus modality. A3.0-T SIEMENS MAGNETOM Verio scanner was employed to scan the activative visual cortex. and the image process was analyzed by SPM8package, to To evaluate the stereoscopic visual cortex functional changes in amblyopia children, and to compare the cortical activations differences between two groups. The analysis consisted:1.The spatial extent and intensity of the visual cortex activation difference different in the amblyopes groups along with the time.2. The differences of spatial extent and intensity of the visual cortex activation between the ametropic amblyopes groups and the anisometropic amblyopes groups along with the time.Results (1) The primary excited region of the visual cortex in refractive amblyopic children located at the occipital lobe, especially the BA18/19/17areas, along with the training time, the spatial extent and intensity of the visual cortex activation extend stranger and stranger, when set to P value was0.001and activated threshold for ten voxels.(2)The changes of spatial extent and intensity of the visual cortex activation in ametropic amblyopia groups are stranger than that in anisometropic amblyopes groups. mainly in frontal lobe (BA6/BA9/BA10areas), posterior parietal(BA40/BA7areas), when set to P value was0.05and activated threshold for ten voxels.Conclusions1) The function of Stereopsis visual consists of several encephalic region, mainly in occipital lobe, spaciously in BA17/18/19areas;2) Along with the training time, the spatial extent and intensity of the visual cortex activation become stranger;3) the anisometropic amblyopias’stere visual was incline to fragile than that of ametropic amblyopias.更多还原