| Amblyopia is a clinical frequent ophthalmopathy of children. In classical theory, optesthesia development is critical to amblyopiagenesia。There is still uncontent therapy effect in some patient。To comprehend the influencing factor of therapeutic efficacy in amblyopia, we collect the information of amblyopia invalid,who subject treatment in the ophthal- mology department of our hospital from Aprial in 2002 to March in 2007 year。According to starting year of accepting treatment; time of therapy; amblyopia type; curing method; severity and nature of fixation,divid groups and observ its curative effect,respectively。Applying statistics analysis,retrospectively study the correlation between the multifactor and therapeutic effect。1.method and subjectThere are 136 case(210 eye) whose final diagnosis is amblyopia and received therapy at the (out-patient clinic) OPD of ophthalmology in our hospital from Aprial of 2002 year to March of 2007 year. Among them, the man is 75 and the woman is 61,the year beginning treatment is 3- 21,average year is 9.58±2.31. Of the all, strabismus amblyopia has 55 case, ametropic amblyopia is 98, form deprivation amblyopia has 8 individual, and antimetropia amblyopia is 49, 163 eyes with central fixation account to 77.2%。With one criterion and standardization operating and recording during examination。For young children, several method was used and repeated exam simultaneously to obtain objective and actual information。Examination include: 1)routine distant and near acuity of vision,slit-lamp and direct ophthalmoscopy examination;2)mydriasis and optometry matching glasses;3)examination of anorthopia;4)examination of triple visual function.Training approach including: traditional combined training andmulti-medial training,ie MEICHEN visual stimulus instruction system, once daily。Triple visual function below the mark and binocular visual acuity exceed 0.1,adopted synoptophore derepression therapy at the same time. Treatment Course is 6 months to 2 years. When acuity of vision arrive 1.0 in less six month, decrement treatment one month and completing be executed.According to Chinese ophthalmology academy children amblyopia and anorthopia prevention and curing groupˊs definition and classify of amblyopia, evaluation criterion of therapeutic effect in 1996. Statistics method:utilizeing statistical analysis software SPLM3.0 to deal with data;chi-square test compare interclass difference,P<0.05 is statistical signi- ficance。2. ResultIn low-age group,becoming effective case are 110 and 85 in tradition therapeutics and multi-media therapeutics, effective power is 88.5% and 94.04 %,compare between two groups,P <0. 05,difference is significance; the data in eld group is 41 and 39, effective power is 56.1% and 56.4 %, P > 0. 05, without; significant difference. The becoming effective case in low-aged group is 195 and the effective power is 88.2%, but in elder group the information are 45 and 56.2%, interclass comparig, P <0. 05,difference is statistical significance。The data in light amblyopia,middle amblyopia and heavy amblyopia is 118,89 and 39, furthermore effective power is 87.4%, 80.1% and 70.9%, compare among three group P <0. 05,difference is significant. Ametropia amblyopia,anisometropia amblyopia,strabismus amblyopia and form deprivation amblyopiaˊeffective power are 88.9%, 79.2%, 76.1% and 47.4%, to compare interclass, P <0. 05,discrepancy notable。3. DisscussionAmblyopia is a kind of frequent ophthalmocace in children, and has a higher incidence than other disease. Psychophysics investigation demonstrate that amblyopia is induced by abnormal vision experience during sensitive optesthesia developmental period,and is a syndrome charactered imparing the ability of space-vision involved in central vision,space allocation and contrast sensitivity. Amblyopia is a integration of a series of contradictory process which include learning and memorying of vision function,the neuron and synapticˊ growth,conjunction and plasticable change; and involved in the molecule mechanism of neurotrophy,the mechanism of bioactivity factor and related receptor,neurophysiobiochemistry mechanism of binocular competition and the mechanism of autoregulation。Recency , utilizeing modern multi-media technology and combining the orthodox amblyopia therapy theory, developed many kind of new amblyopia therapeutic pattern, curing software gathered sound,light,flash,graph is a power tool, altered the monotonous and boring condition of tradition therapy, raise the childrenˊsubjective motility, elevate curative effect , shorten the course of treatment. Software make use of flash,audio,video dynamic multi-media technology, in the progress of visual training , builduping coordinate fitting of hand,eye and brain, prior to , raiseing childrenˊinterest ,blending therapy in games, catering childrenˊpsychology , thus , alert the amblyopia therapy from passive to positive. This investigation result shows multi-media therapeuticsˊeffective power in low-aged group higher than traditional therapy, however the effective power in elder has no difference, possible reason lies in itˊs interest, raise the children compliance,and thus elevate the effect. But in elder children,self-possession is better and dependence inclined to traditional training, hence there is no evident raise in visial. Moreover, missing the critical optesthesia developmental period of elder maybe another reason failure to therapy success. Oncemore, we can conclude another verdict is severity of amblyopia is negative correlated with effect, and the prognosis of different kind amblyopia are diversity, maybe hint different mechanism existence .4.Conclusion1 In amblyopia therapy, especial in low-aged children, multi-media treatment has better therapy effect than elder. But need to deep research to explore the prostecdtive efficacy .2. The therapeutic efficacy of ametropic amblyopia,anisometropic amblyopia,strabismic amblyopia,form deprivation amblyopia is decrement by turn, hint exist different pathomechanism.3. Therapeutic efficacy in low-aged children surpass elder group, hint the effect of early treatment is excellent, thus vocate early diagnosis ,early treatment.4 Amblyopia severity directly impact curative effect; the heavier exent ,the poorer prognosis。... |
PDF Full Text Request