【作者】 汪晓倩；

【导师】 瞿小妹； 周行涛； 戴锦晖；

【作者基本信息】 复旦大学 ， 眼科学， 2010， 硕士

【摘要】 目的：定量研究中心注视性弱视患者的红绿色觉功能,探讨L/M锥细胞相对敏感性在屈光发育中的作用。方法：门诊收集82名中心注视的既往弱视／屈光不正患者,依次对双眼进行下列检查：眼位检查、眼部裂隙灯检查、直接检眼镜检查、注视性质、主导眼、暗室下色盲镜(HMC Anomaloskop Typ 47700)进行Rayleigh颜色匹配、标准照明条件下标准对数视力测量裸眼视力(UCVA)、主觉验光、最佳矫正视力(BCVA)、根据既定入组标准,分为弱视组(43例86眼,弱视59眼)、既往弱视组(24例48眼,既往弱视40眼)、非弱视组(15例30眼)。使用SPSS 13.0统计软件分析不同组间、组内Rayleigh匹配结果的差别及其与等效球镜、BCVA、主导眼等因素的关系。结果：中心注视性弱视眼的色觉异常率为0.017%。弱视组(59眼)的红绿匹配点值较非弱视组(30眼)大,差异存在统计学意义(p<0.05),与等效球镜、最佳矫正视力无显著相关,红绿匹配范围无统计学差异。弱视组内,单眼弱视(23眼)与双眼弱视(16眼)的Rayleigh匹配结果无统计学差异。单眼弱视者的弱视眼与健眼比较,红绿匹配范围较大,差异有统计学意义(p<0.05),红绿匹配点无显著差异。非弱视组内,非主导眼的红绿匹配范围比主导眼大(p<0.05),既往弱视组也显示出同样的差异,但无统计学意义。结论：中心注视性弱视眼的红绿色觉无明显异常,红绿色觉与形觉在P通路上相独立。中心注视性弱视眼M锥相对L锥敏感,但目前并未发现其与屈光发育显著相关。非优势眼对中长波长色光的分辨力较优势眼差,提示中枢对非优势眼的色觉感知存在抑制。更多还原

【Abstract】 Objective:To investigate the red-green color vision function of amblyopia with central fixation quantitatively, and the possible effect of L/M-cone sensitivity in ocular refractive development.Methods:Totally 82 patients were enrolled, they were divided into 3 groups: amblyopia group (43 cases,86 eyes,59 amblyopic eyes), amblyopia history group (24 cases,48 eyes,40 eyes recovered form amblyopia), non-amblyopia group (15 cases, 30 eyes), following examination were done binocularly:cover test, slit lamp examination, direct ophthalmoscope examination, eye fixation, dominant eye determination, Rayleigh matching with the anomaloscope (HMC Anomaloskop Typ 47700) in a dark room, uncorrected visual acuity (UCVA) test, subject refraction and best corrected visual acuity (BCVA) test. All data were analyzed by SPSS 13.0 statistical software among groups to dig out the relation among red-green color vision, refratctive error, BCVA, dominant eye and other factors.Results:Prevalence of color vision deficiency in amblyopia with central fixation was 0.017%. The mean value of R-G match points of amblyopia group was statistically larger than that of non-amblyopia group (p<0.05), but the difference was unrelated to spherical equivalent and the best corrected visual acuity. No difference was found in R-G match range among the groups. In amblyopia group, there was no difference in Raiyleigh match data of unilateral amblyopia compared with those of bilateral amblyopia. For unilateral amblyopia, R-G match range of the amblyopic eyes was markedly wider than that of the healthy ones (p<0.05), without significant difference in R-G match point. There was a smaller but significant increase of R-G match range in the non-dominant eyes of non-amblyopia group compared with dominant eyes (p<0.05). Although the difference for amblyopia history group was similar in R-G match range to that for non-amblyopia group, it did not reach significance at the 0.05 Conclusions:Red-green color vision appears to be normal in amblyopia with central fixation and is transmitted independently of form vision in the P pathway. M cones of amblyopic eyes with central fixation are relatively more sensitive than L cones, which is not related to refractive development obviously. Non-dominant eye has a worse discrimination of mid- and long-wavelength light than the dominant eye, suggesting that visual cortex could suppress the color perception of the non-dominant eye.更多还原