Associations Of Anisometropia With Strabismus、Amblyopia And Stereoacuity In Children

Objective: Preliminary explore the correlation of anisometropia of different type and different degree and strabismus,amblyopia,stereopsis.Methods: Collect 126 children cases who came to Wuhan Tong Ji Hospital and were diagnosised by anisometropia during 2016-05 to 2017-01,age range from 3 to 15 years old,and normal control group 30 cases whose age range from 5 to14 years old.Each group of subjects accept slit lamp and fundus examination to exclude other diseases.Examination indexes include visual acuity,diopter,strabismus,far stereopsis,Titmus and random point static 0 stereopsis.According to the degree,anisometropia can divide into mild group(refractive difference≥1.00D)、moderate group(refractive difference≥2.00D)and severe group(refractive difference≥3.00D).According to the type,anisometropia can divide into hypermetropic anisometropia,myopic anisometropia,astigmatic anisometropia and mixed anisometropia.Results:Ⅰ Strabismus and anisometropia(1)The relationship between different type of anisometropia and strabismus.(a)the comparison between the control group and the anisometropia group: There was no statistics difference between control group and astigmatism group(P > 0.05),but there was significant statistics difference between the control group and the other groups(P<0.05),compared with the normal control group,the incidence of strabismus was higher in hyperopia,myopia and mixed groups;(b)Comparison in anisometropia groups,there was significant statistics difference in all of the groups except the mixed group and the hyperopia group(P > 0.05),the hyperopia group and the astigmatism group(P < 0.05).The myopia group is easier to cause strabismus than other groups.(2)The relationship between different degree of anisometropia and strabismus.There was statistical difference in all of the groups except the mild group and the moderate group,the moderate group and the severe group(P>0.05),there was significant statistics difference between other two groups(P < 0.05).When the anisometropia difference≥1.00 D,the incidence of strabismus is higher than the control group.Ⅱ Amblyopia and anisometropia(1)The relationship between different type of anisometropia and amblyopia.(a)There was a significant difference between the normal control group and the other groups(P < 0.05),the anisometropia group is easier to cause amblyopia compared with the normal control group;(b)Comparison in anisometropia groups,there was no significant difference between the hyperopia group with the mixed group and the astigmatism group with the myopic group(P>0.05),but in other groups,there are no statistical differences.Hyperopia anisometropia and mixed anisometropia are more likely to cause amblyopia compare with astigmatism anisometropia and myopic group.(2)The relationship between different degree of anisometropia and amblyopia.Except that there are no significant difference between the control group and the mild group(P < 0.05),the other groups exist significant differences(P < 0.05).When the anisometropia difference≥2.00 D,the proportion of amblyopia is significantly increased,the greater of the anisometropia difference,the larger of the amblyopia proportion.Ⅲ Stereo vision and anisometropia(1)Far stereo vision.(a)There is statistically difference between the anisometropia group and the normal control group(P<0.05).(b)Comparison of anisometropia groups,there are statistically differences between hyperopia group and astigmatism group,astigmatism group and mixed group,myopic group and mixed group(P<0.05),far stereopsis of astigmatism group is better than hyperopia group and mixed group,in other groups,there is no statistically differences.(c)The more serious of anisometropia,the worse of the far stereo vision,the difference has statistical significant(P < 0.05).(2)Titmus stereopsis.(a)Hyperopia anisometropia and mixed anisometropia are worse than normal control group and myopic anisometropia and astigmatism anisometropia.(b)When the anisometropia difference≥2.00 D,the near stereo vision is worse than the control group,the greater of the anisometropia difference,the worse of stereo vision.(3)Random point static 0 stereopsis.(a)The anisometropia group is worse than the normal control group,the difference has statistically significant(P < 0.05).(b)The stereopsis of the astigmatism and myopia group was better than that of the hyperopia group and the mixed group.(c)When the anisometropia≥1.00 D,the fine stereopsis are damaged,the larger of anisometropia,the serious of the damage.When the anisometropia≥3.00 D,the stereopsis of all was innormal.(4)There is no significant difference between the patients with anisometropia and strabismus with those don’t have strabismus in Titmus and Random point static 0 stereopsis(P>0.05);There is significant difference between the patients who have amblyopia and those don’t have amblyopia in fur stereo vision,Titmus and Random point static 0 stereopsis(P<0.05).Conclusion(1)The patients with anisometropia are easier have strabismus,during which myopic anisometropia patient are worse;when the anisometropia difference≥1.00 D,the incidence of strabismus is higher than the control group.(2)Hyperopia anisometropia and mixed anisometropia are more likely to cause amblyopia than astigmatism anisometropia and myopic anisometropia,when the binocular refractive difference≥2.00 D,the proportion of amblyopia was significantly increased,and the more serious,the greater of the proportion.(3)When the binocular refractive difference≥1.00 D,the more severe of anisometropia,the worse of far stereopsis.(4)When the binocular refractive difference≥2.00 D,there is significant decrease in the near stereopsis compared with the normal control group,and the more severe anisometropia,the greater of the decrease.the near stereopsis of myopic anisometropia and astigmatism anisometropia are better than hypermetropic anisometropia and mixed anisometropia.(5)When the binocular refractive difference≥1.00 D,random point static 0 stereopsis is damaged,and the more severe of anisometropia,the more damage of stereopsis.the fine stereopsis of hypoopia anisometropia and astigmatism anisometropia are better than hyperopia anisometropia and mixed anisometropia.When the anisometropia≥3.00 D,the stereopsis of all was innormal.(6)There is no obvious Titmus and random point static 0 stereopsis decrease in anisometropia combined with strabismus,but stereopsis decreased significantly in patients with anisometropia combined with amblyopia.