【作者】 雷迅文；

【导师】 李晓林；

【作者基本信息】 兰州大学 ， 眼科学， 2008， 硕士

【摘要】 目的:对增视能视觉训练系统和传统综合训练方法治疗儿童弱视的疗效进行对比观察,分析其视力、P-VEP、mf-ERG的变化,并对外斜视的患儿行手术治疗,观察双眼视功能的恢复情况,摸索儿童弱视快速、有效的治疗方法。方法:应用增视能多维视觉训练系统和传统综合训练对244例400(各200)眼儿童弱视进行治疗;增视能训练组给予视觉刺激、视觉精细、同时知觉、融合功能、立体视觉等不同的视觉训练方案:传统综合训练组采取遮盖、精细目力训练、CAM视觉刺激、红光闪烁、后像、光刷等治疗。对比观察两种方法在弱视治疗后1月、3月、9月、12月的视力、p-VEP、mf-ERG的变化;对外斜视性弱视增视能训练和综合训练分别治愈的30例患者行斜视手术治疗,术后增视能组行多维三级功能训练,综合训练组行家用同视机三级功能训练,观察术前、术后1月、2月、3月、6月不同时间的双眼视功能变化情况。结果:弱视患儿中远视眼比近视眼和散光眼多见。轻、中度屈光不正多见。屈光不正性和斜视性弱视,轻度、中度弱视,中心注视性弱视增视能训练的有效率高于综合疗法组,而且同一疗程内增视能训练系统的弱视治愈率明显高于综合疗法组,两者差异有统计学意义(P＜0.05);近视、散光性弱视,屈光参差性弱视,重度弱视,旁中心注视性弱视两种治疗方法差异无统计学意义(P＞0.05);两种治疗方法随着疗程的延长,增视能训练组轻、中度弱视同一时间P-VEPP100峰潜时缩短、P100振幅提高较综合疗法组明显,差异有统计学意义(P＜0.05);而mf-ERG第一环P1波振幅密度的变化随着疗程的延长增视能训练组提高明显(P＜0.05);增视能训练系统在外斜视术后双眼视功能恢复中明显高于综合疗法组(P＜0.05)。术后6个月,增视能组20例查有近立体视觉,与综合疗法组相比差异有统计学意义(P＜0.05)。结论:增视能多维视觉训练系统对儿童弱视的疗效优于传统综合疗法,缩短了视觉功能障碍治疗的周期,具有针对性强,方法简单明了、易操作、多样化、儿童乐意接受等优点,是治疗儿童弱视较为理想有效的方法,值得临床推广。更多还原

【Abstract】 Objective:To compared observation in intelligent Vision training system and traditional training methods in treatment of amblyopia in children,analysis changing of vision,P-VEP,mf-ERG,and strabismus children do surgery,observation of the recovery of binocular vision function after operation regularly,finding children amblyopia fast and effective methods of treatment.Methods:Application by intelligent Vision training system and traditional training methods on 244 cases of 400(200 each)for the treatment of amblyopia in children. Intelligent vision training group by giving visual stimulation,fine visual,simultaneous perception,integration features,such as stereoscopic vision different visual training programmes;Traditional training group to take cover,fine visual training,CAM visual stimulation,lights flashing,ocular spectrum,light brush and other treatment. Comparison of the vision,p-VEP,mf-ERG changes after the treatment of amblyopia 1m,3m,9m,12m in two methods;Strabismic amblyopia by intelligent Vision training system and traditional training methods of the 30 cases were cured patients with strabismus surgery,postoperative by intelligent Vision training system group will be three functional training,traditional training group will be three functional training synophtophore home,Observation of preoperative and postoperative 1m,2m,3m,6m different times of the binocular vision changes.Results:Amblyopia in children with hyperopia more than myopia and astigmatism, light to moderate refractive error is more.Refractive error,strabismic amblyopia,light to moderate amblyopia,centre watching amblyopia,by intelligent vision training is more efficient than the traditional training group,the cure rate of intelligent vision training is significantly higher than traditional training in the same treatment,the difference is statistically significant(p<0.05);myopia,astigmatism, anisometropia amblyopia,severe,eccentric fixation amblyopia,two treatment was no significant difference(p>0.05).with the extended of two treatments,as to the intelligent vision training group by light to moderate amblyopia the same time P-VEP P100 latency-shortened,raise P 100 amplitude was significantly more traditional training group,there was significant difference-(p<0.05);With the course of the extension,the first central mf-ERG P1 amplitude density change by intelligent vision training group significantly increased,there was significant difference(p<0.05);The recover of the binocular function was significantly higher in intelligent vision training system by exotropia after operation than that in the traditional training group(P<0.05).20 cases being near stereovision by intelligent vision training group after 6m,compared with the traditional training group has a significant difference(p<0.05).Conclusion:By intelligent vision training system for the treatment of amblyopia in children is superior to the traditional,shorten the visual dysfunction treatment cycle. targeted strong,clear and simple methods,easy to operate,diversification,children prepared to accept,it is the better effective way in the treatment of amblyopia,it’s worthy using in clinic.更多还原