Refining Clinical Quantification of Depth of Suppression in Amblyopia through Synoptophore Measurement.
Refining Clinical Quantification of Depth of Suppression in Amblyopia through Synoptophore Measurement.
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DOI：
10.3390/life13091900
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发表时间：
2023-09-12
期刊：
影响因子：
--
通讯作者：
Ooi TL
中科院分区：
文献类型：
--
作者：
Plaumann MD;Roberts KL;Wei W;Han C;Ooi TL
背景：弱视与双眼抑制不平衡有关。现有的临床抑制措施，如价值4点测试，提供了有关抑制的定性信息，但不能精确地量化它。同视机，一个成熟的仪器在双眼视觉诊所，历史上已被用来衡量抑制定性以及，但有能力量化抑制。我们扩展了同视机的能力，通过开发一个系统的照明操作协议，以量化弱视的抑制。研究方法：26个先前治疗的成人弱视进行我们的协议上的同视机，以测量获得融合反应所需的照明平衡。单独地，这些相同的弱视者使用Worth 4 Dot进行测试，因为它在美国是经典的，利用不同的测试距离和房间照明来限定抑制反应。结果如下：对于同视机和Worth 4 Dot检验，更小、更中心的靶显示更大的抑制程度（同视机：χ 25，26 = 25.538，p < 0.001; Worth 4 Dot：χ 23，26 = 39.020，p < 0.001）。抑制深度测量的两种测试之间存在显著相关性（rT> 0.345，p < 0.036），其中同视机测量的灵敏度更高，因为抑制可以在定量尺度上分级。斜视性弱视的抑制作用大于非斜视性弱视（z > 2.410，p < 0.016）。此外，抑制深度与视敏度（rT = 0.604，p < 0.001）和立体视敏度（rT = 0.488，p = 0.001）的眼间差异相关。结论：我们通过测量同视机的照度输出并开发抑制测试方案来扩展同视机的实用性，该抑制测试方案与Worth 4 Dot（临床标准）相比毫不逊色，同时通过更灵敏的抑制量化来改进后者。
Background: Amblyopia is associated with unbalanced suppression between the two eyes. Existing clinical measures of suppression, such as the Worth 4 Dot test, provide qualitative information about suppression but cannot precisely quantify it. The Synoptophore, a well-established instrument in binocular vision clinics, has historically been used to gauge suppression qualitatively as well but has the capability to quantify suppression. We extended the capability of the Synoptophore through the development of a systematic protocol of illumination manipulation to quantify suppression in amblyopia. Methods: Twenty-six previously treated adult amblyopes underwent our protocol on the Synoptophore to measure the illumination balance needed to obtain fusion responses. Separately, these same amblyopes were tested with Worth 4 Dot as it is classically performed in the United States, utilizing different test distances and room illuminations to qualify the suppression response. Results: Smaller, more central targets revealed larger magnitudes of suppression for both the Synoptophore and Worth 4 Dot tests (Synoptophore: χ25,26 = 25.538, p < 0.001; Worth 4 Dot: χ23,26 = 39.020, p < 0.001). There was a significant correlation between the two tests for depth of suppression measurements (rΤ > 0.345, p < 0.036), with more sensitivity measured by the Synoptophore, as suppression could be graded on a quantitative scale. Strabismic amblyopes demonstrated more suppression than non-strabismic amblyopes (z > 2.410, p < 0.016). Additionally, depth of suppression was correlated with interocular difference in both visual acuity (rΤ = 0.604, p < 0.001) and stereoacuity (rΤ = 0.488, p = 0.001). Conclusions: We extended the utility of the Synoptophore by measuring its illuminance outputs and developing a suppression testing protocol that compared favorably with Worth 4 Dot (clinic standard) while improving upon the latter through more sensitive quantification of suppression.
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