Abstract:

Objective　To explore the correlations between macular sensitivity, fixation stability, and best corrected visual acuity (BCVA) in children with anisometropic amblyopia. Methods　A total of 184 children with anisometropic amblyopia who were treated in Huangdao District Traditional Chinese Medicine Hospital from January 2022 to February 2023 were selected, including 184 amblyopic eyes and 184 contralateral eyes, as the research subjects. Among them, there were 94 boys and 90 girls, aged 4-12 (8.10±1.72) years. The BCVA, macular sensitivity, and fixation stability parameters, as well as differences in the thickness of the nerve fiber layer around the optic disc and the thickness of the macular area were measured for the amblyopic and contralateral eyes. The light sensitivity and fixation stability parameters in the macular area of the amblyopia and contralateral eyes were compared by rank sum test, as well as the BCVA, the average light sensitivity within 10° of the macular area, and the percentage of fixation point within 2° diameter before and after treatment. The thickness of the nerve fiber layer around the optic disc and the thickness of the macular area in the amblyopic and contralateral eyes were compared by t test. The correlation was analyzed using Spearman rank correlation analysis. Results　The BCVA of the amblyopic eyes was higher than that of the contralateral eyes [0.5 (0.4, 0.6) LogMAR vs. 0.1 (0, 0.2) LogMAR], with a statistically significant difference (Z=-4.454, P<0.05). The average light sensitivity within 10° of the macular area and the percentage of fixation point within 2° diameter of the amblyopic eyes were 25.40 (23.10, 28.00) dB and 49.98 (42.30, 61.10)%, respectively, which were lower than that of the contralateral eyes [28.40 (26.10, 29.60) dB and 70.40 (58.29, 77.50)%], with statistically significant differences (Z=-4.463 and -3.182, both P<0.05). The parameters of light sensitivity and fixation stability in the macular area of amblyopia, the thickness of the nerve fiber layer around the optic disc, and the thickness of the macular area were not correlated with BCVA (all P>0.05). The thickness of the lower macular area was positively correlated with the thickness of the nerve fiber layer around the lower optic disc (r=0.443, P<0.05), and the thickness of the nasal macular area was positively correlated with the thickness of the nerve fiber layer around the nasal optic disc (r=0.401, P<0.05). After treatment, the BCVA, the average light sensitivity within 10° of the macular area, and the percentage of fixation point within 2° diameter of the amblyopic eyes were 0.3 (0.1, 0.5) LogMAR, 27.65 (25.51, 28.93) dB, and 62.50 (51.54, 70.02)%, respectively, which were better than those before treatment [0.5 (0.4, 0.6) LogMAR, 25.40 (23.10, 28.00) dB, and 49.98 (42.30, 61.10)%], with statistically significant differences (Z=-2.932, -3.332, and -2.993, all P<0.05). Conclusion　Children with anisometropic amblyopia have a decrease in macular sensitivity and fixation stability within the 2° range, there is a correlation between the thickness of the macular area and the thickness of the nerve fiber layer around the optic disc, which deserves further research.

Key words:

Anisometropic amblyopia, Macula lutea, Retinal light sensitivity, Fixation stability, Best corrected visual acuity, Children

摘要：

目的　探讨屈光参差性弱视儿童黄斑光敏感度及固视稳定性与最佳矫正视力（BCVA）的相关性。方法　选取2022年1月至2023年2月在青岛市黄岛区中医医院治疗的屈光参差性弱视儿童184例，其中弱视眼184只、对侧眼184只。其中男94例，女90例；年龄4～12（8.10±1.72）岁。测量弱视眼和对侧眼BCVA、黄斑光敏感度及固视稳定性参数，以及视盘周围神经纤维层厚度、黄斑区厚度差异，采用秩和检验比较弱视眼和对侧眼黄斑区光敏感度和固视稳定性参数，以及治疗前后BCVA、黄斑10°范围内平均光敏感度和固视点落在直径2°内的百分比；t检验分析弱视眼和对侧眼视盘周围神经纤维层厚度、黄斑区厚度；相关性采用Spearman秩相关分析。结果　弱视眼BCVA高于对侧眼［0.5（0.4，0.6）LogMAR比0.1（0，0.2）LogMAR］，差异有统计学意义（Z=-4.454，P<0.05）；弱视眼黄斑10°范围内平均光敏感度、固视点落在直径2°内的百分比分别为25.40（23.10，28.00）dB、49.98（42.30，61.10）%，低于对侧眼［28.40（26.10，29.60）dB、70.40（58.29，77.50）%］，差异均有统计学意义（Z=-4.463、-3.182，均P<0.05）；弱视眼黄斑区光敏感度和固视稳定性参数、视盘周围神经纤维层厚度、黄斑区厚度均与BCVA无相关性（均P>0.05）；下方黄斑区厚度与下方视盘周围神经纤维层厚度呈正相关（r=0.443，P<0.05），鼻侧黄斑区厚度与鼻侧视盘周围神经纤维层厚度呈正相关（r=0.401，P<0.05）。弱视眼治疗后BCVA、黄斑10°范围内平均光敏感度、固视点落在直径2°内的百分比分别为0.3（0.1，0.5）LogMAR、27.65（25.51，28.93）dB和62.50（51.54，70.02）%，均优于治疗前［0.5（0.4，0.6）LogMAR、25.40（23.10，28.00）dB、49.98（42.30，61.10）%］，差异均有统计学意义（Z=-2.932、-3.332、-2.993，均P<0.05）。结论　屈光参差性弱视儿童黄斑光敏感度及2°范围内的固视稳定性有所降低，黄斑区厚度与视盘周围神经纤维层厚度存在相关性，值得进一步研究。

关键词:

屈光参差性弱视, 黄斑, 光敏感度, 固视稳定性, 最佳矫正视力, 儿童