左旋多巴联合综合疗法治疗屈光不正性弱视儿童及青少年的临床观察

摘要

目的：探讨左旋多巴联合综合疗法治疗屈光不正性弱视儿童及青少年的临床疗效，以及对患儿图形视觉诱发电位（P-VEP）和视功能的影响。方法：70例（78眼）屈光不正性弱视儿童及青少年采用随机数字表法分为观察组（35例，40眼）和对照组（35例，38眼）。对照组将接受佩戴矫正眼镜、遮盖疗法、视觉刺激训练等综合疗法；观察组患儿在对照组治疗基础上加用左旋多巴，每次0.125（d1～3）～0.25 g，bid，两组疗程均为6个月。比较两组患儿的治疗效果、P-VEP、视觉敏感度和视功能，以及不良反应发生情况。结果：治疗后，观察组患儿的有效率（92.50％）明显高于对照组（76.32％），差异有统计学意义（P＜0.05）；观察组患儿的P-VEP P100波的波幅明显大于对照组，潜伏期明显短于对照组，差异均有统计学意义（P＜0.05）；观察组患儿各个空间频率下的对比度均明显高于对照组，矫正辐辏范围、矫正分开范围均明显大于对照组，矫正近立体视锐度明显小于对照组，差异均有统计学意义（P＜0.05）。两组患儿不良反应发生率比较，差异无统计学意义（P＞0.05）。结论：左旋多巴联合综合疗法有助于改善屈光不正性弱视儿童及青少年的视觉中枢神经元功能，提高其视觉敏感度和双眼立体视觉功能，进而提高治疗效果。%OBJECTIVE:To investigate the clinical efficacy of levodopa combined with comprehensive therapy for ametropic amblyopia children and teenagers and its effeets on pattern visual evoked potential(P-VEP)and visual function. METHODS:70 pa-tients(80 eyes)with ametropic amblyopia were randomly divided into observation group(35 cases,40 eyes)and control group(35 cases,38 eyes). Control group received comprehensive therapy as wearing correctional glasses,occlusion therapy and visual stimu-lation training;observation group additionally received levodopa 0.125(d1-3)-0.25 g/time,bid,on the basis of control group for 6 months. Therapeutic efficacy,P-VEP,Visual sensitivity and visual function were compared between two groups,and the occur-rence of ADR was recorded. RESULTS:The effective rate of observation group(92.50%)was significantly higher than that of con-trol group(76.32%),with statistical significance(P<0.05);the wave amplitude of P-VEP P100 in observation group were signifi-cantly greater than in control group,and the incubation period was significantly shorter than control group,with statistical signifi-cance(P<0.05);visual acuity under different spatial frequency contrast were significantly higher than control group,and correc-tion convergence range and correction separation range of observation group were significantly greater than those of control group, while corrected near stereo vision was significantly less than control group,with statistical significance (P<0.05). There was no statistical significance in ADR incidence between 2 groups (P>0.05). CONCLUSIONS:Levodopa combined with comprehensive therapy can improve the function of visual central neurons,and improve visual acuity and binocular stereo vision functions so as to improve therapy efficacy.