成人雙眼視覺功能、視知覺與動暈症之相關暨藍色濾鏡片介入對視知覺的影響

Correlation Between Binocular Visual Functions, Visual Perception and Motion Sickness: Blue Filter Lenses Intervention on Visual Perception on Patients with Motion Sickness

陳至莛(Jhih-Ting Chen)

指導教授 ： 蘇國禎

共同指導教授 ： 鄭靜瑩(Ching-Ying Cheng)

中山醫學大學/醫學科技學院/視光學系/碩士(2022年)

https://doi.org/10.6834/csmu202200044

摘要

目的
動暈症是常見的中樞神經系統症狀。動暈症發的歷程又稱作感覺衝突，其中視覺為一個重要的因素，但鮮少將雙眼視覺功能、視知覺與動暈症一起討論。此外，光治療用於調節中樞神經系統、內分泌系統，並且也能調節視丘、下視丘中的生理反應，過去就有研究使用濾鏡片進行神經相關修復的訓練或治療。因此本研究目的為探討成人雙眼視覺功能、視知覺與動暈症之相關暨濾鏡片介入對視知覺的影響。
方法
本研究收納20至25歲的成年人，研究對象填寫基本資料與動暈易感性問卷後進行分組，總計納入21名為易暈組；33名為正常組共計54人。研究對象在量測慣用處方度數與遠近視力值後，將接受雙眼視覺功能檢測包含遠近眼位檢測、遠近注視偏差、遠近融像聚散能力、正負相對調節力、單雙眼調節靈敏度、聚散靈敏度、立體視、對比敏感度、聚合近點與調節近點；隨後進行視知覺檢測，包含視知覺（MVPT）、周邊意識、平衡力板檢測。研究將所有研究對象的檢測結果、基本資料與問卷以IBM SPSS Statistic v.22統計軟體分析。
結果
研究結果顯示，易暈組的雙眼視覺功能表現中，比起正常組有較好的遠距離負融像聚散、遠距離垂直融像聚散、近距離正融像聚散能力；比起正常組有較差的調節幅度與立體視表現。在視知覺項目中，易暈組與正常組沒有顯著差異。相關性中，周邊意識與近距離雙眼視覺功能相關、MVPT與遠距離雙眼視覺功能較有相關、平均擺動速率與遠距離雙眼視覺功能較有相關。最後在濾鏡片介入後，易暈組與正常組的視知覺功能如周邊意識、MVPT皆有提升表現。平衡表現中Ellipse of COP與平均擺動速率在兩組配濾片後皆趨向更穩定的狀態。
結論
在特定的雙眼視覺功能項目中具有預測動暈易感性的能力，易暈者有較差的調節與立體視空間定位能力，因此需要更好的融像聚散來代償其調節與立體視的不足；藍色濾片透過調節副交感神經作用，刺激乙醯膽鹼影響視知覺訊號表現，使得受試者的平衡狀態趨向穩定，這個影響不論易暈與否皆有效果。

關鍵字

雙眼視覺功能 ； 視知覺 ； 動暈症 ； 動暈易感性 ； 藍色濾鏡片 ； 光治療

並列摘要

Purpose
Motion sickness is a common symptom of autonomic dysfunction. The process of motion sickness can be traced back to sensory conflict, and visual sensory is a critical component. Rarely did researchers discuss binocular functions with visual perception and motion sickness. In addition, light phototherapy is used to regulate several systems, such as central nervous system, in thalamus and hypothalamus. The use of fitler lenses for neurological rehabilitation training has been studied in the past. Therefore, the purpose of the study was to explore the correlation between binocular visual functions, visual perception and motion sickness in adults and the impact of filter lenses intervention on visual perception.
Method
Adults within 20 to 25 year-old were enrolled in the study. After completing the basic information and the motion sickness susceptibility questionnaire, subjects were devided into two groups, sick tendency (ST) group with 21 subjects and normal group with 33 subjects. Subjects were first examined distance habitual prescription and VA, then phoria, fixation disparity (FD), positive/negative fusional vergence (PFV/NFV), vertical fusional vergence (VFV), positive/negative relative accommodation (PRA/NRA), accommodative facility (AF), vergence facility (VF), stereopsis, contrast sensitivity (CS), near point of convergence (NPC) and near point of accommodation (NPA). Also, MVPT, peripheral awareness (PA), balance force plate were examined. All examination datas, basic information and questionnaire were analyzed with IBM SPSS Statistic v.22.
Result
The result showed ST group had better distance NFV, distance VFV and Near PFV in binocular functions. However, NPA and stereopsis were worse than normal group. No significant differecnes in visual perception were found within two groups. In addition, PA was correlated with near binocular functions, MVPT and mean velocity of body sway were correlated with distance binocular function. Finally, after filter lenses intervention, visual perception such as PA and MVPT were improved in both groups. In balance performance, Ellipse of COP and mean velocity of body sway tended to be more stable after wearing filter lenses.
Conclusion
Motion sickness susceptibility can be vaticinated by specific binocular funcitons. Subjects with susceptible motion sickness have poor spatial positioning due to poor stereopsis and NPA. Therefore, they need better fusional vergence to compensate for the poor stereopsis and NPA. Likewise, blue filter lenses can stimulate acetylcholine to enhance visual signals due to activating the prarsympathetic nerve, which stabilizes subjects’ state of balance. Last but not the least, intervention with blue filter is effective in both groups.

並列關鍵字

Binocular Function ； Visual Perception ； Motion Sickness ； Motion Sickness Susceptibility ； Blue Filter lenses ； Light Therapy

參考文獻

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