Stereopsis and long-term stability of alignment in esotropia
Stereopsis and long-term stability of alignment in esotropia
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DOI：
10.1016/j.jaapos.2003.10.003
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发表时间：
2004-04-01
期刊：
影响因子：
1.6
通讯作者：
Leffler, J
中科院分区：
文献类型：
--
作者：
Birch, EE;Stager, DR;Leffler, J
目的：最近的研究，婴儿和矫正性内斜视（ET）的重点是立体视作为一个最终的结果衡量判断治疗的成功或失败。本研究的目的是通过评估手术对准或光学矫正后立即出现的立体视是否在维持长期对准中起作用来扩展这种方法。方法.随机点立体视锐度评估在3个月内的初始手术对70名儿童与婴儿ET和在3个月内的初始光学矫正66名儿童与屈光性ET。在大于或等于5岁时，评估不良结局，包括对齐丢失、弱视和无立体视觉。使用风险因素分析来评估早期零立体视是否会增加随后不良结果的风险。结果如下：在婴儿ET队列中，早期无立体视与复发性ET或连续性外斜视的手术风险增加3.6倍（95%置信区间[CI] 2.4至4.1），大于或等于5岁时无立体视的风险增加4.2倍（95% CI 3.3至4.4）。在治疗性ET队列中，早期无立体视与ET手术风险增加17.4倍（95%CI 3.3至32.2）相关，大于或等于5岁时无立体视风险增加32.2倍（95%CI 15.8至35.6）。结论：治疗方案旨在优化立体视结果，促进长期稳定性的路线。
Purpose: Recent studies of infantile and accommodative esotropia (ET) have focused on stereoacuity as a final outcome measurement for judging the success or failure of treatment. The purpose of the present study was to extend this approach by evaluating whether the presence of stereopsis developing immediately after surgical alignment or optical correction plays a role in maintenance of long-term alignment. Methods. Random-dot stereoacuity was assessed within 3 months of initial surgical alignment in 70 children with infantile ET and within 3 months of initial optical correction in 66 children with accommodative ET. At greater than or equal to 5 years of age, adverse outcomes were assessed including loss of alignment, amblyopia, and nil stereopsis. Risk-factor analysis was used to evaluate whether early nil stereopsis increased the risk for subsequent adverse outcomes. Results: In the infantile ET cohort, early nil stereopsis was associated with a 3.6 times (95% confidence interval [CI] 2.4 to 4.1) greater risk of surgery for recurrent ET or consecutive exotropia and a 4.2 times (95% CI 3.3 to 4.4) greater risk for nil stereopsis at greater than or equal to 5 years of age. In the accommodative ET cohort, early nil stereopsis was associated with a 17.4 times (95% CI 3.3 to 32.2) greater risk of surgery for ET and a 32.2 times (95% CI 15.8 to 35.6) greater risk for nil stereopsis at greater than or equal to 5 years of age. Conclusion: Treatment protocols designed to optimize stereoacuity outcomes promote long-term stability of alignment.