비굴절조절내사시 환자의 조절눈모음비

Abstract

Purpose: To measure the ratio of accommodative-convergence to accommodation (AC/A ratio) in patients with nonrefractive accommodative esotropia in comparison to refractive accommodative esotropia and normal groups. Methods: A total of 43 subjects were divided into 3 groups: the nonrefractive accommodative esotropia group (group 1), the refractive accommodative esotropia group (group 2) and the normal group (group 3). Age, sex, age of onset, and refractive errors were recorded. The deviation angle was measured near and at distance by using a prism cover test. The AC/A ratio was calculated using a gradient method. Results: Refractive errors were 2.3 ± 1.7 D (OD) and 2.4 ± 2.1 D (OS) in group 1, 4.8 ± 0.9 D (OD) and 4.6 ± 1.1 D (OS) in group 2, and -0.3 ± 1.5 D (OD) and -0.5 ± 1.5 D (OS) in group 3. Group 2 had higher mean refractive errors than groups 1 and 3, while the difference in refractive error between group 1 and group 3 was not statistically significant. The AC/A ratio was 5.5 in group 1, 2.1 in group 2 and 2.2 in group 3; there was no significant difference between groups 2 and 3, while group 1 had a significantly higher AC/A ratio than both of these groups. Conclusions: AC/A ratio in patients with nonrefractive accommodative esotropia is higher than that of refractive accommodative esotropia or normal children. It could be used for bifocal lens as non-surgical treatment.

목적: 비굴절조절내사시 환자의 조절눈모음비를 알아보고 굴절조절내사시 환자군, 정상아군과 비교하고자 한다. 대상과 방법: 비굴절조절내사시 환자군 10명(1군), 굴절조절내사시 환자군 17명(2군), 정상아군 16명(3군)을 대상으로 나이, 성별, 발생시기, 초진연령, 굴절이상을 조사하고, 근거리와 원거리 사시각을 측정하였다. 조절눈모음비는 계단적 검사법으로 구하였다. 결과: 굴절이상은 평균 구면렌즈대응치로 1군에서 우안 2.3 ± 1.7 D, 좌안 2.4 ± 2.1 D, 2군에서 우안 4.8 ± 0.9 D, 좌안 4.6 ±1.1 D, 3군에서 우안 -0.3 ± 1.5 D, 좌안 -0.5 ± 1.5 D로 1군과 2군, 2군과 3군 사이에는 통계학적으로 유의한 차이(p=0.00)를 보였고, 1군과 3군은 유의한 차이는 없었다(p=0.31). 조절눈모음비는 계단적 검사법에 의해 1군 5.5, 2군 2.1, 3군 2.2로 2군과 3군은 유의한 차이가 없었고, 1군과 2군, 1군과 3군 사이에는 유의한 차이를 보였다(p=0.00). 결론: 비굴절조절내사시의 조절눈모음비는 굴절조절내사시와 정상아보다 높았으며 이는 비수술적인 치료로써 이중초점렌즈를 사용 시 참고치로 이용할 수 있겠다.