가림치료 중 우세안의 시력이 약시안보다 낮아진 환자들의 임상양상
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목적: 가림치료 중 우세안의 시력이 약시안보다 낮아진 환자들의 임상양상을 알아보고자 하였다. 대상과 방법: 단안약시 진단하에 가림치료를 시행받은 500명 중 우세안의 시력이 약시안보다 낮아져 우세안이 뒤바뀐 환자 28명의 임상양상을 후향적으로 분석하였다. 결과: 사시약시 21명(내사시 18명), 굴절부등약시 5명, 혼합약시 2명이었다. 우세안이 뒤바뀐 시기는 가림치료 시작 후 66.75 ± 83.63 주였다. 17명은 약시치료 중, 11명은 유지요법 중 발생하였고, 뒤바뀐 시력은 모든 환자에서 회복되었다. 뒤바뀐 시력의 지속기간은 평균 15.00 ± 24.43주, 외래방문 횟수는 평균 4.68 ± 8.65회였다. 이 중 5명에서는 뒤바뀐 시력의 지속기간(평균 59.80 ± 30.14주, p=0.016)과 외래방문 횟수(평균 18.40 ± 14.48회, p＜0.001)가 나머지 23명의 기간(평균 5.78 ± 4.04주)과 횟수(평균 1.70 ± 1.22회)에 비해 유의하게 길었으며, 이들은 모두 순응도가 나빴고 사시약시였다. 결론: 가림치료 중 우세안의 시력이 약시안보다 낮아진 모든 환자에서 시력은 회복되었으며, 순응도가 나빴던 몇명을 제외하고 빠른 시간 내에 회복되었다.
Abstract
Purpose: To investigate the clinical features of patients with decreased visual acuity (VA) of the dominant eye as compared to that of the amblyopic eye during occlusion therapy. Methods: The authors analyzed clinical features of 28 patients with VA reversed between the two eyes during occlusion therapy among 500 patients treated with occlusion therapy under the diagnosis of monocular amblyopia, Results: Twenty-one patients with strabismic amblyopia (SA), five patients with anisometropic amblyopia (AA) and two patients with combined amblyopia (CA) were enrolled in the present study. Decreased VA of the dominant eye as compared to that of the amblyopic eye occurred 66.75 ± 83.63 weeks after the onset of occlusion therapy. Reversion of VA between both eyes occurred during amblyopia treatment in 17 patients and during maintenance therapy in 11 patients. The reversed VA was recovered in all patients. The mean duration (MD) of reversed VA was 15.00 ± 24.43 weeks, and the number of clinic visits (CV) was 4.68 ± 8.65. In five patients, the MD of reversed VA (59.80 ± 30.14 weeks, p = 0.016) and the number of CVs (18.40 ± 14.48, p < 0.001) were significantly longer than those of the other 23 patients (MD of reversed VA: 5.78 ± 4.04 weeks, number of CV: 1.70 ± 1.22); those five patients had low compliances and SAs. Conclusions: Visual acuity was recovered in all patients with decreased VA of the dominant eye as compared to that of the amblyopic eye during occlusion therapy, rapid recovery was observed in most patients except in several patients with low compliance.
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