ارتباط سن شروع استفاده از عينك و تغييرات عيوب انكساري در كودكان مبتلا به ايزوتروپياي تطابقي

The relationship between the age when spectacles wear initiated and refractive error changes in children with accommodative esotropia

مقدمه و اهداف ايزوتروپياي تطابقي شايعترين نوع استرابيسم در بين كودكان است و درمان اوليه آن اصلاح كامل عيوب انكساري مي باشد. با توجه به اينكه امتروپيزيشن توسط وضعيت انكساري چشم و حدت بينايي كنترل مي شود، اصلاح هايپروپي در سنين كودكي ممكن است سبب تداخل در امتروپيزيشن شود. هدف از اين مطالعه بررسي ارتباط سن شروع استفاده از عينك و تغييرات عيوب انكساري در كودكان مبتلا به ايزوتروپياي تطابقي است. مواد و روش ها در اين مطالعه مقطعي ­پرونده هاي پزشكي بيماران مبتلا به ايزوتروپياي تطابقي انكساري (ايزوتروپيايي كه ميزان آن پس از اصلاح كامل رفركشن سيكلوپلژيك به كمتر از ۱۰ پريزم ديوپتر كاهش يابد) مرور شدند و داده هاي انكساري براي سه گروه كودكان بر اساس سن شروع استفاده از عينك تحليل شد. يافته ها ۶۲ بيمار وارد مطالعه شدند. سن ميانگين شروع استفاده از عينك 2.5 سال و متوسط طول دوره پيگيري، 1.9 سال بود. ارتباط بين سن شروع استفاده از عينك با اسفريكال اكيوالان و هايپروپي از نظر آماري معني دار بود (0.05 >p) ولي با آستيگماتيسم معني دار نبود (0.05

Background and Aim: Accommodative esotropia is the most common strabismus among children and its initial treatment is optical correction of the full refractive error. Considering the fact that emmetropization is controlled by refractive status of the eye and visual acuity, early correction of hyperopia in childhood may impede emmetropization. The purpose of the present study was to assess the relationship between age when spectacles wear initiated and refractive error changes in children with accommodative esotropia. Materials and Method: In the present crosssectional study, medical records of 1 to 8yearold patients diagnosed with refractive accommodative esotropia (esotropia decreased to within 10∆ with full hyperopic correction) were reviewed and the refractive data was analyzed for 3 groups of children based on their age when spectacles wear initiated. Results: A total of 62 patients were included in the study. The mean age when spectacles wear initiated was 2.5 years and the mean of followup period was 1.9 years. The relationship between age when spectacles wear initiated with changes in spherical equivalent and hyperopia was statistically significant (plt 0.05), but with astigmatism it was not revealed to be significant (pgt 0.05). There is a negative relationship between spherical equivalent and hyperopia with the age when spectacles wear initiated. Conclusion: The age when spectacles wear initiated is significantly correlated to the changes in spherical equivalent and hyperopia in children with accommodative esotropia. The lower the age when spectacles wear initiated, the higher the spherical equivalent and hyperopia. The possibility that full correction of hyperopia impedes emmetropization must be considered.