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目的研究弱视眼波前像差特点,分析像差在弱视形成中的作用机制,为弱视治疗提供依据。设计病例系列研究。研究对象弱视患者112例,正视眼30例。方法利用主观波前像差仪比较弱视眼与正视眼的像差,对可能参与弱视形成的球镜、柱镜和年龄等因素进行协方差分析,明确主要影响因素。主要指标整体像差、高阶波前像差、各阶及各项波前像差。结果弱视组整体像差(0.90±0.72)大于正视眼组(0.35±0.17),在像差第5项(45°和135°斜散光),正视眼组、弱视组、弱视治愈组、难治性弱视组间表现出特征性差异,其中弱视组(0.32±0.64)明显高于正视眼组(0.06±0.21);难治性弱视组最佳矫正视力虽已达到0.7～0.8,但第5项像差(0.33±0.36)仍明显高于正视眼组;而弱视治愈组(0.11±0.25)与正视眼组无显著差异,弱视治愈组斜散光趋于正常。结论视网膜成像质量下降与弱视形成有关。人眼正视化过程中难以矫正的斜散光使视觉信息质量下降,最终导致弱视。斜散光不仅是导致弱视的重要原因之一,也是治疗弱视的关键。
Objective To study the characteristics of wavefront aberrations in amblyopic eyes and analyze the mechanism of aberrations in the formation of amblyopia, so as to provide basis for treatment of amblyopia. Design case series research. 112 cases of amblyopia patients, 30 cases of face eye. Methods The subjective wavefront aberrometer was used to compare the aberrations of amblyopia and emmetropia, and the covariance analysis of the spherical, lenticular and age factors that may be involved in the formation of amblyopia was performed. The main influencing factors were identified. The main indicators of the overall aberration, high-order wavefront aberration, various orders and various wavefront aberrations. Results The total aberration (0.90 ± 0.72) in the amblyopic group was larger than that in the eyepithelial group (0.35 ± 0.17). In the fifth group (45 ° and 135 ° oblique astigmatism), the group of eyesight, the group of amblyopia, Amblyopic group showed characteristic differences, of which amblyopia group (0.32 ± 0.64) was significantly higher than the eyelid eye group (0.06 ± 0.21); refractory amblyopia group best corrected visual acuity has reached 0.7 ~ 0.8, but the first 5 The aberration (0.33 ± 0.36) was still significantly higher than that of the eyedrops group; while in the amblyopia-treated group (0.11 ± 0.25), it was not significantly different from that of the eyedrops group (P <0.05). Conclusion The decrease of retinal image quality is related to the formation of amblyopia. The oblique astigmatism, which is difficult to correct in the process of visualization of the human eye, degrades the quality of visual information and eventually leads to amblyopia. Skew astigmatism is not only one of the important causes of amblyopia, but also the key to the treatment of amblyopia.