Fixation control and eye alignment in children treated for dense congenital or developmental cataracts.
Fixation control and eye alignment in children treated for dense congenital or developmental cataracts.
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DOI：
10.1016/j.jaapos.2011.11.007
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发表时间：
2012-04
期刊：
影响因子：
1.6
通讯作者：
Hertle, Richard W.
中科院分区：
文献类型：
--
作者：
Birch, Eileen E.;Wang, Jingyun;Felius, Joost;Stager, David R., Jr.;Hertle, Richard W.
许多接受白内障治疗的儿童出现斜视和眼球震颤；然而，关于发病年龄和持续时间方面的不良眼球运动结果的临界期，人们知之甚少。5岁以前接受过致密性白内障摘除手术的儿童被纳入术后研究。在整个随访期间定期评估眼球对齐情况。根据≥5岁时的眼球运动记录，确定注视稳定性和相关的眼球摆动。用多因素Logistic回归分析单侧(单侧与双侧)、发病年龄和/或视觉剥夺持续时间是否与不良的眼球运动结果相关，并确定多变量优势比(OR)。共有41名儿童被包括在内。其中，27例(66%)发展为斜视；29例(71%)发展为眼球震颤。先天发病与斜视的显著风险相关(OR，5.3；95%CI，1.1-34.1)；婴儿发病与眼球震颤的显著风险相关(OR，13.6；95%CI，1.6-302)。持续6周与斜视(OR，9.1；95%CI，1.9-54.2)和眼球震颤(OR，46.2；95%CI，6.0-1005)相关。先天性发病与眼球震颤严重程度的眼间不对称相关(OR，25.0；95%CI，2.6~649)，单眼白内障(OR，58.9；95%CI，5.1~2318)。偏侧性(单侧与双侧)和发病年龄是不良眼球运动结局的重要不可改变的危险因素。剥夺时间是不良眼球运动结果的一个重要的可改变的危险因素。目前的研究表明，减少眼球震颤和斜视的风险与剥夺≤6周有关。
Many children treated for cataracts develop strabismus and nystagmus; however, little is known about the critical period for adverse ocular motor outcomes with respect to age of onset and duration. Children who had undergone extraction of dense cataracts by the age of 5 years were enrolled postoperatively. Ocular alignment was assessed regularly throughout follow-up. Fixation stability and associated ocular oscillations were determined from eye movement recordings at ≥5 years old. Multivariate logistic regression was used to evaluate whether laterality (unilateral vs bilateral), age at onset, and/or duration of visual deprivation were associated with adverse ocular motor outcomes and to determine multivariate odds ratios (ORs). A total of 41 children were included. Of these, 27 (66%) developed strabismus; 29 (71%) developed nystagmus. Congenital onset was associated with significant risk for strabismus (OR, 5.3; 95% CI, 1.1–34.1); infantile onset was associated with significant risk for nystagmus (OR, 13.6; 95% CI, 1.6–302). Duration >6 weeks was associated with significant risk for both strabismus (OR, 9.1; 95% CI, 1.9–54.2) and nystagmus (OR, 46.2; 95% CI, 6.0–1005). Congenital onset was associated with significant risk for interocular asymmetry in severity of nystagmus (OR, 25.0; 95% CI, 2.6–649), as was unilateral cataract (OR, 58.9; 95% CI, 5.1–2318). Laterality (unilateral vs bilateral) and age at onset were significant nonmodifiable risk factors for adverse ocular motor outcomes. Duration of deprivation was a significant modifiable risk factor for adverse ocular motor outcomes. The current study demonstrated that reduced risk for nystagmus and strabismus was associated with deprivation ≤6 weeks.
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