굴절조절내사시의 성공적인 최종 입체시에 영향을 미치는 최초인자
The Initial Factors Influencing Successful Final Stereoacuity in Refractive Accommodative Esotropia
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목적: 굴절조절내사시의 성공적인 최종입체시에 영향을 주는 초진관련 인자가 무엇인지 알아보고자 하였다. 대상과 방법: 티트무스검사가 가능한 2세 이상의 굴절조절내사시 환아 48명을 대상으로 초진 시 조절마비굴절검사의 원시값, 안경착용최초연령, 굴절교정 후 입체시, 약시 정도에 따라 분류하여 최종입체시에 영향을 미치는 인자를 찾아보았다. 결과: 대상환아의 추적관찰기간은 43.51 ± 30.02개월이었다. 초진 시 조절마비굴절검사상 원시값은 평균 4.67 ± 2.18D, 안경착용최초연령은 평균 48.09 ± 20.22개월이었으며, 굴절이상 교정 후 측정한 평균 입체시는 1243.75 ± 1378.24초각이었다. 성공적인 최종입체시 획득은 초진 시 약시가 없는 경우 83.3%, 가벼운(mild) 약시를 보였던 경우 75.0%, 중간(moderate)약시를 보였던 경우42.9%로 통계학적으로 유의한 차이를 보였다(p=0.039). 원시값에 따라 +1.0D~3.0D 미만, +3.0D~5.0D 미만, +5.0D 이상을 보였던경우 각각 83.3%, 66.7%, 61.9% (p=0.362)에서, 안경착용 최초연령에 따라 2세-4세 미만, 4세-6세 미만, 6세 이상을 보였던 경우각각 71.4%, 75.0%, 54.5% (p=0.334)에서 성공적인 최종입체시를 보였으나 유의한 차이는 없었다. 결론: 굴절조절내사시의 최종 입체시는 초진 시 약시 정도와 유의한 관계를 보였다.
Abstract
Purpose: To evaluate the initial factors influencing successful final stereoacuity in patients with refractive accommodative esotropia. Methods: The charts of 48 refractive accommodative esotropia patients 2 years of age or older andassessed using the Titmusstereoacuity test were retrospectively reviewed. Hyperopic refractive error on post-cycloplegic refraction, age at first glasses,stereoacuity after refractive correction and amblyopia were categorized and evaluated as the factors influencing finalstereoacuity. Results: The mean follow-up period was 43.51 ± 30.02 months. The mean hypermetropia at the initial examination was 4.67 ±2.18 diopters (D), the mean age at first glasses was 48.09 ± 20.22 months and the mean stereoacuity after refractive correctionwas 1243.75 ± 1378.24 seconds of arc. The rates of successful stereoacuity at the final visit were 83.3% without amblyopia,75.0% with mild amblyopia and 42.9% with moderate amblyopia which were statistically significant (p = 0.039). Hyperopic refractiveerror and age at first glasses were categorized as +1.0 to <3.0 D, +3.0 to <5.0 D, ≥+5.0 D and 2 to <4 years, 4 to <6 yearsand ≥6 years, respectively, and the rates of successful stereoacuity at the final visit were 83.3%, 66.7%, 61.9% (p = 0.362) and71.4%, 75.0% and 54.5% (p = 0.334), respectively. Conclusions: The amblyopia at the initial examination was significantly associated with the outcome of stereoacuity at the finalvisit in patients with refractive accommodative esotropia.
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