굴절조절내사시에서 굴절부등에 따른 임상양상 비교
Comparison of Clinical Features in Refractive Accommodative Esotropia According to the Presence of Anisometropia
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목적: 굴절조절내사시에서 굴절부등 유무에 따른 임상양상의 차이를 알아보고자 하였다. 대상과 방법: 굴절조절내사시 환자 45명을 대상으로 양안의 구면렌즈대응치가 1D 이상 차이가 나는 굴절부등시군과, 차이가 없는 굴절동등시군으로 구분하여 발생연령, 안경교정연령, 초진 및 최종내원시 안경교정 전후 사시각과 안경교정 후 정위 도달기간, 약시빈도,입체시와 융합력, 대상부전 빈도 및 조절눈모음비를 비교하였다. 결과: 초진시와 최종내원시 약시 빈도, 대상부전 및 조절눈모음비는 두 군 사이에 유의한 차이를 보이지 않았다. 굴절교정 한달 후사시각이 굴절부등시군은 근거리 8.80 ± 5.63 프리즘디옵터(Prism Dipoters, PD), 원거리 8.67 ± 5.42PD, 굴절동등시군은 근거리4.54 ± 6.59PD, 원거리 5.19 ± 6.7PD로 유의한 차이를 보였다(p=0.042). 굴절교정 후 정위 도달기간은 굴절부등시군에서 2.20 ±1.01개월, 굴절동등시군에서 1.47 ± 0.86개월로 굴절부등시군이 통계학적으로 유의하게 길었다(p=0.017). 결론: 굴절조절내사시에서 굴절부등시군이 굴절동등시군에 비해 정위에 도달하는 시간이 길었지만, 임상양상의 차이는 보이지 않았다.
Abstract
Purpose: To compare the clinical features according to the presence of anisometropia in refractive accommodative esotropia patients. Methods: Forty-five refractive accommodative esotropia patients were divided into 2 groups : patients who had anisometropia of more than 1.00D (anisometropia group), and patients who had anisometropia of less than 1.00D (isometropia group). Age at onset, age when glasses were first worn, the initial and final angle of esotropia with or without hyperopic correction,the recovery time to orthophoria after hyperopic correction, the degree of stereoacuity and the frequency of amblyopia,the prevalence of deterioration, and the ratio of accommodative-convergence to accommodation were retrospectively reviewed. Results: There were no statistical differences between the 2 groups in the frequency of amblyopia, the prevalence of deterioration,and the ratio of accommodative-convergence to accommodation at the initial and final visit. The angles of deviation with hyperopic correction at the 1-month follow-up visit in the anisometropia group and the isometropia group were 8.80 ± 5.63 PD for near, 8.67 ± 5.42 PD for distance, and 4.54 ± 6.59 PD for near 5.19 ± 6.7 PD for distance, respectively;the difference was statistically significant (p = 0.042). The recovery time to orthophoria after hyperopic correction in patients associated with anisometropia was 2.20 ± 1.01 months, significantly longer than 1.47 ± 0.86 months in patients associated with isometropia (p = 0.017). Conclusions: In refractive accommodative esotropia patients associated with anisometropia, the recovery time to orthophoria after hyperopic correction was significantly prolonged but there were no statistical differences in other clinical manifestations.
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