간헐외사시 환자의 조절눈모음비

Abstract

Purpose: To measure the ratio of accommodative-convergence to accommodation (AC/A ratio) in patients with pseudodivergence excess type and convergence insufficiency type of intermittent exotropia [X(T)], and to compare with a normal group. Methods: A total of 55 subjects were divided into 3 groups: pseudodivergence excess type, convergence insufficiency type, and normal group. Age, gender, and refractive error of patients were examined. The deviation angle was measured at near and distance by using a prism cover test, followed by an interpupillary distance measurement. The AC/A ratio was calculated using a heterophoria and a gradient method. Results: There was no statistically significant difference in age, gender, and the refractive errors among the 3 groups. The mean value of AC/A ratio using the heterophoria method was 9.50 in pseudodivergence excess type patients, 2.59 in convergence insufficiency type patients, and 5.47 in the normal group. Using the gradient method, the mean value of AC/A ratio was 1.47, 0.03, and 2.08 in each group, respectively. There was no statistically significant difference in mean values between patients with pseudodivergence excess type and the normal group, except when obtained using the gradient method (p = 0.43). Conclusions: A distinct difference in AC/A ratio existed when computed by the heterophoria method between patients with pseudodivergence excess type or convergence insufficiency type and the normal group. In the gradient method, however, the ratios of convergence insufficiency type patients were lower compared to the normal group, indicating the gradient method is more accurate than the heterophoria method.

목적: 거짓눈벌림과다형과 눈모음부족형 간헐외사시 환자에서 조절눈모음비를 측정하여 정상인과 비교하고자 하였다. 대상과 방법: 대상자는 55명으로 거짓눈벌림과다형군, 눈모음부족형군, 정상인군으로 나누었다. 나이, 성별, 굴절이상을 조사하였으며, 프리즘가림검사로 근거리, 원거리 사시각, 동공간 거리를 측정하였다. 조절눈모음비는 근, 원거리편위이용법과 계단적검사법으로 구하였다. 결과: 나이, 성별비, 굴절이상은 세 군에서 통계학적으로 유의한 차이가 없었다. 조절눈모음비는 근, 원거리편위이용법에 의해 거짓눈 벌림과다형 환자군의 경우 평균 9.50, 눈모음부족형 환자군은 2.59, 정상인군은 5.47이었으며, 계단적검사법에 의해 각각 1.47, 0.03, 2.08이었고, 거짓눈벌림과다형 환자군에서 계단적검사법 의해 구한 값만이 정상인군과 비교하였을 때, 통계학적으로 유의한 차이가 없었다(p=0.43). 결론: 근, 원거리편위이용법으로 측정한 조절눈모음비는 거짓눈벌림과다형과 눈모음부족형 환자군에서 정상군과 뚜렷한 차이를 보였으나, 계단적검사법은 눈모음부족형군에서만 정상군에 비해 낮음을 알 수 있어, 계단적 검사법이 더 정확한 측정법으로 생각한다.