Response to correction of refractive errors and hypoaccommodation in children with congenital Zika syndrome
Response to correction of refractive errors and hypoaccommodation in children with congenital Zika syndrome
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DOI：
10.1016/j.jaapos.2017.07.206
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发表时间：
2017-12-01
期刊：
影响因子：
1.6
通讯作者：
Hyvaerinen, Lea
中科院分区：
文献类型：
--
作者：
Ventura, Liana O.;Lawrence, Linda;Hyvaerinen, Lea
目的描述先天性寨卡综合征（CZS）患儿矫正屈光不正和调节减退的即时反应。方法本研究纳入了2015年5月至12月出生的确诊为CZS并参加多学科早期干预计划的儿童。所有儿童接受全面的眼科检查，包括动态视网膜检影和睫状肌麻痹验光。如果儿童符合屈光不正的标准，则规定其完全矫正，并且额外加3.00的斜视，屈光不正功能障碍和/或低视力的过度矫正。单眼和双眼的视觉反应莱亚光栅测试在30厘米，有和没有眼镜，在第1天的眼镜wear.RESULTS共60名儿童进行了评估（平均年龄在评价，11.5 +/- 1.1个月，范围，9.0-16.0个月）。在眼镜矫正之前，所有儿童的莱亚光栅测试反应均异常。21名儿童中有17名（81%）存在调节不足。对所有儿童都规定了过度矫正。即使戴眼镜，视觉反应也低于正常;然而，在37名儿童（62%）和119只眼睛中的74只（62.2%）中发现双眼视觉立即改善。单眼视力改善方面，115只眼中有27只眼（23.5%）结构异常，44只眼（38.3%）结构正常。8月与11月的屈光状态比较，正视（P = 0.001）、远视（P = 0.000）、近视（P = 0.007）、散光（P = 0.004）差异有统计学意义。随着时间的推移，他们的屈光状态发生了重大变化，需要定期更新。
PURPOSE To describe the immediate response to correction of refractive errors and hypoaccommodation in children with congenital Zika syndrome (CZS).METHODS Children born between May and December 2015 with a confirmed diagnosis of CZS and enrolled in a multidisciplinary early intervention program were included in this study. All children received a comprehensive ophthalmic examination, including dynamic retinoscopy and cycloplegic refraction. Children were prescribed their full correction if they met the criteria for refractive error, and additional plus 3.00 overcorrection for strabismus, accommodative dysfunction, and/or low vision. Monocular and binocular visual responses to Lea Grating Test at 30 cm, with and without eyeglasses, were measured on day 1 of glasses wear.RESULTS A total of 60 children were evaluated (mean age at evaluation, 11.5 +/- 1.1 months; range, 9.0-16.0 months). Lea Grating Test responses were abnormal in all children prior to spectacle correction. Hypoaccommodation was present in 17 of 21 children (81%). Overcorrection was prescribed for all children. Visual responses were subnormal even with glasses use; however, immediate improvement in binocular vision was found in 37 children (62%) and in 74 of 119 eyes (62.2%). For the monocular visual improvement, 27 of 115 eyes (23.5%) had structural abnormalities, and 44 of 115 eyes (38.3%) were structurally normal. There was a statistical difference between the cycloplegic refraction of the children in August and in November, including emmetropia (P = 0.001), hyperopia (P = 0.000), myopia (P = 0.007), and astigmatism (P = 0.004).CONCLUSIONS Eyeglasses can improve visual acuity in children with CZS. Significant changes in their refractive status over time requires periodic updates.