斜位和融像聚散能力於測量順序先後的變化

Variability of phoria and fusion vergence in the measure priorities

陳儀瑾(Yi-Chin Chen)

指導教授 ： 陳賢堂

共同指導教授 ： 葉上民(Shang-Min Yeh)

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/csmu202200062

摘要

目的：
融像聚散度為維持良好的視覺至關重要的因素以及診斷雙眼視功能的指標之一，在臨床測試上常見的測試順序為負融像聚散度(Divergence, BI)、正融像聚散度(Convergence, BO)、下轉(Infravergence, BU)、上轉(Supravergence, BD)，且有研究指出測試順序與斜位的類型皆會影響融像聚散度之數值，因此本研究目的為探討在測量融像聚散時，是否會因為測試順序的先後與垂直融像介入以及斜位類型而影響融像聚散度的結果。

方法：
本研究研究方法採單盲的方式進行，受測者先進行基本的視覺檢測，包含測量驗度儀、瞳孔間距測量、遠距離與近距離視力檢測、遮蓋測試、眼外肌運動測試、立體視覺、近距離水平和垂直斜位量。接續測量不同測試順序的融像聚散能力。將60名受測者隨機均分為四組並且每組的受測者分別完成四種不同順序的融像聚散測試。

結果：
納入60名受測者於本研究中，年齡範圍介於20至29歲（平均年齡22.62 ± 2.05歲）。結果顯示對於垂直融像聚散，先測有顯著高於後測的聚散數值(BU : p = 0.006 ; BD : p = 0.020)；在顯著內斜位受測者中，BI(p = 0.038)與BU(p = 0.046)測試先後有顯著的差異；垂直融像介入與測試先後對於水平融像和顯著外斜位受測者皆無統計學上顯著的影響。

結論：
斜位和融像聚散沒有相關性，而測試的先後和垂直融像介入對於水平融像力在本研究中沒有受到影響，測試的先後對於垂直融像影響最為明顯，未來在測量融像聚散值之前應特別注意，尤其是在垂直融像測量時常會忽略其影響。

關鍵字

斜位 ； 融像聚散 ； 測試順序

並列摘要

Purpose
Fusional vergence is one of the most important factors and diagnostic indicators for maintain binocular single vision. The common order of testing in clinical tests are divergence(BI), convergence(BO), infravergence(BU), supravergence(BD), and some researches have pointed out that the order of testing and the type of phoria will affect the value of the fusion vergence, so the purpose of this research was to investigate whether the results of fusional vergence were affected by the order of tests, the intervention of vertical vergence, and the type of phoria when measuring fusional vergence.

Methods
The research was a randomized, single-blind experimental. Participants will first perform basic visual examination, including refraction, interpupillary distance, distance and near visual acuity, cover test, extraocular motilities, stereopsis, near lateral and vertical phoria. The participants are then randomly divided into four groups and each participant are required to complete four different order of fusional vergence tests before the research are completed.

Results
The study included 60 participants aged 20 to 29 years (mean age 22.62 ± 2.05 years). The results show that pre-test (BU－BD / BD－BU; BD－BU / BO－BD)was significantly higher in vertical fusional vergence measurement (BU: p = 0.006; BD: p = 0.020). In participants with esophoria, BI (p = 0.038) and BU (p = 0.046) were significantly different in pre- (BI－BO / BU－BD)and post-tests(BI－BU / BD－BU), however, vertical vergence intervention or order of testing had no significant effect on either horizontal fusional vergence and exophoria participants.

Conclusion
There is no correlation between phoria and fusional vergence. The pre-test and post-test and vertical vergence intervention were not affected in this study for horizontal fusion vergence, while the pre-test and post-test in vertical vergence effect is the most apparently. Therefore, special attention should be paid before measuring vergence in the future, especially in vertical vergence measurements.

並列關鍵字

Fusional vergence ； Order of testing ； Phoria

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