Abstract:【Objective】To observe the application effect of brain visual function training and occlusion therapy in the clinical treatment of children refractive amblyopia.【Methods】A total of 96 cases of children with refractive amblyopia admitted to our hospital were divided into two groups according to the random envelope method. In the control group,47 patients were treated with occlusion therapy combined with refine training,while 49 patients in the observation group were treated with occlusion therapy combined with brain visual function training. The total treatment effective rate,stereoscopic visual acuity (SA≤60"),corrected visual acuity,refraction,diopter,adjustment amplitude,adjustment flexibility,adjustment lag and the occurrence of adverse reactions were compared between the two groups. 【Results】The total effective rate in the observation group was 90.74% (49/54),which was higher than that in the control group (69.64%,39/56) (P<0.05). Comparison of the incidence of SA≤60" in the two groups before treatment,the difference was not statistically significant (P>0.05). The incidence of stereoacuity SA≤60" in the posttreatment observation group 75.51% (37/49)was higher than that in the control group 38.30% (18/49) (P<0.05). The comparison of corrected visual acuity and refraction diopter in the two groups before treatment did not show statistical difference (P>0.05); However,the corrected visual acuities in two groups were higher after 6 months and 12 months treatment; And it was even higher in the observation group than in the control group (P<0.05). After 6 months and 12 months treatment,the refraction diopters in both groups decreased,and the reduction in the observation group was greater than that in the control group (P<0.05). In terms of the adjustment amplitude,adjustment flexibility and adjustment lag,there were no statistically significant differences between two groups before treatment (P>0.05).The amplitude and flexibility of children in the two groups increased after treatment. And children in the observation group showed better results compared to the control group (P<0.05). Meanwhile,the adjustment lag of the two groups decreased compared to before treatment; And the adjustment lag of the observation group was even lower than that of the control group (P<0.05). The overall incidence of adverse reactions in two group was no difference (P>0.05). 【Conclusion】The occlusion therapy combined with brain visual function training refractive amblyopia treatment can significantly improve the vision of children,effectively improve the regulation function of the affected eye. It is very safe and is worth popularizing in clinical use.
桑可欣, 郅瑛, 杜蕊, 蔡敏. 脑视觉功能训练联合遮盖方案治疗儿童屈光不正性弱视的临床效果[J]. 医学临床研究, 2023, 40(8): 1124-1127.
SANG Ke-xin, ZHI Ying, DU Rui, et al. Observation of Brain Visual Function Training and Occlusion Therapy in Clinical Treatment of Children Refractive Amblyopia. JOURNAL OF CLINICAL RESEARCH, 2023, 40(8): 1124-1127.
[1] KULIKOVA I L,PASHTAEV N P,BATKOV Y N,et al. Femtosecond laser-assisted lasik in children with hyperopia and anisometropic amblyopia: 7 years of follow-up[J].J Refract Surg,2020,36(6):366-373. [2] 倪莉.“3D视觉训练”新科技应用前景[J].现代雷达,2021,43(7):94-95. [3] 孟晓莹. 不同眼部遮盖治疗对屈光不正性弱视儿童视力及立体视锐度的改善作用[J].临床与病理杂志,2021,41(1):60-66. [4] 中华医学会眼科学分会斜视与小儿眼科学组. 弱视诊断专家共识(2011年)[J].中华眼科杂志,2011,47(8):768. [5] 黄琴,李艳萍,吴俊姬,等.儿童屈光不正性弱视和斜视性弱视视网膜厚度的对比[J].实用临床医学,2015,9(8):77-79. [6] KADHUM A,SIMONSZ-TóTH B,van ROSMALEN J,et al.Long-term follow-up of an amblyopia treatment study: change in visual acuity 15 years after occlusion therapy[J].Acta Ophthalmol,2021,99(1):e36-e42. [7] MUSCH D C,BAKER J D. Patching and atropine for severe amblyopia: are both better than patching alone?[J].JAMA Ophthalmol,2021,139(9):996-997. [8] 刘旭辉,边靖芳,崔浩然,等. 虚拟现实/增强现实设备在眼科的应用及其对眼健康影响的研究进展[J].中华医学杂志,2022,102(2):158-162. [9] BIRCH E E,CASTAÑEDDA Y S,CHENG-PATEL C S,et al. Self-perception in preschool children with deprivation amblyopia and its association with deficits in vision and fine motor skills[J].JAMA Ophthalmol,2020,138(12):1307-1310. [10] 梁彩红,欧春蓓,邱悦,等. 虚拟现实技术对弱视儿童视功能的影响[J].护理实践与研究,2021,18(1):35-38. [11] 张威,余爱华,蔡小军. 视觉虚拟现实训练与传统训练方法治疗儿童弱视的比较[J].中华眼视光学与视觉科学杂志,2020,22(11):842-846. [12] 何海龙,郭雅楠,付晶. 屈光性弱视患儿视力和双眼视觉屈光矫正效果的临床研究[J].中华眼科医学杂志(电子版),2021,11(4):198-204. [13] 缪亚香,肖爱萍,田弘亚,等. 不同程度远视性屈光参差性弱视儿童视力康复后调节功能恢复情况的研究[J].中国中医眼科杂志,2023,33(1):25-29.