목적: 본 연구는 약시치료에 의한 감각개선이 굴절이상, 조절 및 원근 사위의 안기능에 영향을 미치는지를 알아보고자 하였다. 방법: 본 연구는 약시가 치료된 10명(17안, 평균나이 $10.7{\pm}2.9$년)을 대상으로 약시 치료 전과 치료 후의 굴절이상도, 조절오차 및 원근 사위를 비교하였다. 굴절이상도는 개방형 자동굴절검사기(N-Vision-5001, Shin Nippon, Japan)로 측정하였며 조절오차는 40 cm 거리에서 단안평가법(MEM)을 이용하여 측정하였다. 사위는 원거리는 3 m 근거리는 40 cm에서 Howell 사위카드, 차폐 또는 Maddox rod에 의한 방법으로 측정하여 비교 분석하였다. 결과: 평균 교정시력은 약시치료 전에 $0.46{\pm}0.11$(소수시력)에서 약시치료 후에 $1.03{\pm}0.13$으로 유의하게 증가되었다(p < 0.001). 구면굴절이상도는 치료 전에 원시도가 $+2.29{\pm}0.86D$에서 치료 후에 $+1.1{\pm}2.38D$로 감소하였지만(p < 0.05), 난시변화는 치료 전에 $-1.80{\pm}1.41D$에서 치료 후에 $-1.65{\pm}1.30D$로 유의적 변화가 없었다. 조절오차는 치료 전에는 조절지체 $+1.1{\pm}0.75D$에서 치료 후에는 $+0.5{\pm}0.59D$로 유의적 수준에서 감소하였다(p<0.05). 원거리사위는 치료 전에는 eso $2.9{\pm}6.17PD$(prism diopters)에서 치료 후에 eso $0.2{\pm}3.49PD$로 유의 수준에서 감소하였고, 근거리 사위 또한 치료 전에는 eso $0.4{\pm}2.32PD$에서 치료 후에는 exo $2{\pm}4.9PD$로 유의 수준에서 변화하였다(p<0.05). 시력 향상과 조절력 감소는 높은 상관관계(r = 0.88, p < 0.001)가 있었다. 결론: 약시치료 후 교정시력과 시감각의 개선과 함께 원시성 굴절이상도는 감소하였으며 약시치료에 의한 시감각의 개선은 조절오차를 개선시키고 조절에 영향을 받는 사위를 변화시키는 것으로 나타났다.
목적: 본 연구는 약시치료에 의한 감각개선이 굴절이상, 조절 및 원근 사위의 안기능에 영향을 미치는지를 알아보고자 하였다. 방법: 본 연구는 약시가 치료된 10명(17안, 평균나이 $10.7{\pm}2.9$년)을 대상으로 약시 치료 전과 치료 후의 굴절이상도, 조절오차 및 원근 사위를 비교하였다. 굴절이상도는 개방형 자동굴절검사기(N-Vision-5001, Shin Nippon, Japan)로 측정하였며 조절오차는 40 cm 거리에서 단안평가법(MEM)을 이용하여 측정하였다. 사위는 원거리는 3 m 근거리는 40 cm에서 Howell 사위카드, 차폐 또는 Maddox rod에 의한 방법으로 측정하여 비교 분석하였다. 결과: 평균 교정시력은 약시치료 전에 $0.46{\pm}0.11$(소수시력)에서 약시치료 후에 $1.03{\pm}0.13$으로 유의하게 증가되었다(p < 0.001). 구면굴절이상도는 치료 전에 원시도가 $+2.29{\pm}0.86D$에서 치료 후에 $+1.1{\pm}2.38D$로 감소하였지만(p < 0.05), 난시변화는 치료 전에 $-1.80{\pm}1.41D$에서 치료 후에 $-1.65{\pm}1.30D$로 유의적 변화가 없었다. 조절오차는 치료 전에는 조절지체 $+1.1{\pm}0.75D$에서 치료 후에는 $+0.5{\pm}0.59D$로 유의적 수준에서 감소하였다(p<0.05). 원거리사위는 치료 전에는 eso $2.9{\pm}6.17PD$(prism diopters)에서 치료 후에 eso $0.2{\pm}3.49PD$로 유의 수준에서 감소하였고, 근거리 사위 또한 치료 전에는 eso $0.4{\pm}2.32PD$에서 치료 후에는 exo $2{\pm}4.9PD$로 유의 수준에서 변화하였다(p<0.05). 시력 향상과 조절력 감소는 높은 상관관계(r = 0.88, p < 0.001)가 있었다. 결론: 약시치료 후 교정시력과 시감각의 개선과 함께 원시성 굴절이상도는 감소하였으며 약시치료에 의한 시감각의 개선은 조절오차를 개선시키고 조절에 영향을 받는 사위를 변화시키는 것으로 나타났다.
Purpose: This study is to investigate if the improvement of visual sensory (VS) by amblyopia treatment affects the ocular functions in refractive errors, accommodative errors and phoria at distance and near. Methods: 10 subjects (17 eyes, mean age of $10.7{\pm}2.9$ years) who treated ambl...
Purpose: This study is to investigate if the improvement of visual sensory (VS) by amblyopia treatment affects the ocular functions in refractive errors, accommodative errors and phoria at distance and near. Methods: 10 subjects (17 eyes, mean age of $10.7{\pm}2.9$ years) who treated amblyopia completely, were participated for this study. Refractive errors, accommodative errors, and distance and near phoria were compared between before and after treatments of amblyopia. Refractive errors and accommodative errors at 40 cm were measured using openfield auto-refractor (NVision-5001, Shin Nippon, Japan) and using monocular estimated method (MEM) respectively. Phoria was determined at 3 m for distance and at 40 cm for near using Howell phoria card, cover test or Maddox rod. Results: Mean corrected visual acuity (CVA) significantly increased from $0.46{\pm}0.11$ (decimal notation) for before amblyopia treatment to a level of $1.03{\pm}0.13$ for after amblyopia treatment (p < 0.001). For spherical refractive error, hyperopia significantly decreased from $+2.29{\pm}0.86D$ to a level of $+1.1{\pm}2.38D$ (p < 0.05) but astigmatism did not significantly change; $-1.80{\pm}1.41D$ for before treatment and $-1.65{\pm}1.30D$D for after treatment (p > 0.05). Accommodative error significantly decreased from accommodative lag of $+1.1{\pm}0.75D$ to a level of $+0.5{\pm}0.59D$ (accommodative lag) (p < 0.05). Distance phoria significantly changed from eso $2.9{\pm}6.17PD$ (prism diopters) to a level of eso $0.2{\pm}3.49PD$ (p < 0.05), and near phoria also significantly changed from eso $0.4{\pm}2.32PD$ to level of exo $2{\pm}4.9PD$ (p < 0.05). There was a high correlation (r = 0.88, p < 0.001) between improvement of visual acuity and decrease of accommodative lag. Conclusions: Hyperopic refractive error decreased with improvement of CVA or VS by amblyopia treatment. And the improvement of VS by amblyopia treatment also improved accommodative error, and changed phoria coupled with accommodation.
Purpose: This study is to investigate if the improvement of visual sensory (VS) by amblyopia treatment affects the ocular functions in refractive errors, accommodative errors and phoria at distance and near. Methods: 10 subjects (17 eyes, mean age of $10.7{\pm}2.9$ years) who treated amblyopia completely, were participated for this study. Refractive errors, accommodative errors, and distance and near phoria were compared between before and after treatments of amblyopia. Refractive errors and accommodative errors at 40 cm were measured using openfield auto-refractor (NVision-5001, Shin Nippon, Japan) and using monocular estimated method (MEM) respectively. Phoria was determined at 3 m for distance and at 40 cm for near using Howell phoria card, cover test or Maddox rod. Results: Mean corrected visual acuity (CVA) significantly increased from $0.46{\pm}0.11$ (decimal notation) for before amblyopia treatment to a level of $1.03{\pm}0.13$ for after amblyopia treatment (p < 0.001). For spherical refractive error, hyperopia significantly decreased from $+2.29{\pm}0.86D$ to a level of $+1.1{\pm}2.38D$ (p < 0.05) but astigmatism did not significantly change; $-1.80{\pm}1.41D$ for before treatment and $-1.65{\pm}1.30D$D for after treatment (p > 0.05). Accommodative error significantly decreased from accommodative lag of $+1.1{\pm}0.75D$ to a level of $+0.5{\pm}0.59D$ (accommodative lag) (p < 0.05). Distance phoria significantly changed from eso $2.9{\pm}6.17PD$ (prism diopters) to a level of eso $0.2{\pm}3.49PD$ (p < 0.05), and near phoria also significantly changed from eso $0.4{\pm}2.32PD$ to level of exo $2{\pm}4.9PD$ (p < 0.05). There was a high correlation (r = 0.88, p < 0.001) between improvement of visual acuity and decrease of accommodative lag. Conclusions: Hyperopic refractive error decreased with improvement of CVA or VS by amblyopia treatment. And the improvement of VS by amblyopia treatment also improved accommodative error, and changed phoria coupled with accommodation.
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문제 정의
However, it still remains a question whether there are correlations between sensory and motor in ocular functions of accommodation and phoria. So this study is to investigate using a novel method whether improvement of visual sensory by amblyopia treatment affects ocular functions or not.
This study showed that improvement of visual sensory by amblyopia treatment improved accommodative responseor reduced accommodative lag. In this study, vision training by physical technic was not used for accommodative improvement, but used only added lenses for improving visual sensory.
가설 설정
Banks[3] also suggested that visual accommodation is commonly viewed as a control system with two primary components; a sensory component which evaluates the clarity or sharpness of the retinal image in order to determine whether an accommodative change is required, and a motor component which implements the changes in lens shape needed to maximize images sharpness. Among two primary components, he hypothesized that sensory is programming of accurate accommodative responses being dependent on the detection of the consequences of inaccurate accommodation. Thus the sensory hypothesis holds that accommodative development results from development in the ability to detect the image blurring resulting from focusing error, and this study confirmed Banks’ hypothesis.
제안 방법
This study showed that improvement of visual sensory by amblyopia treatment improved accommodative responseor reduced accommodative lag. In this study, vision training by physical technic was not used for accommodative improvement, but used only added lenses for improving visual sensory. As results of this study, improvement of sensory may have a decisive effect on accommodative improvement.
대상 데이터
10 subjects (17eyes) (mean age of 10.7± 2.9 years) who have treated amblyopia completely, were participated for this study.
성능/효과
For sphericalrefractive error, hyperopia significantly decreased by+2.29± 0.86D to a level of +1.1± 2.38D (paired t-test: p < 0.05) but astigmatism did not significantly changed;−1.80± 1.41D for before treatment and −1.65 ± 1.30D for after treatment (paired t-test: p > 0.05).
1 D during the amblyopia treatment period of 50±20 months (about 4 years). This study showed that refractive error in the amblyopic hyperopia was not much changed than in myopia and hyperopia. In a study of refractive error for Korean myopia children, Kim and Kim[15] reported that myopia increased –0.
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