複視に対するプリズム適応の検討 Indications of prism prescription for diplopia

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【<b>複視に対するプリズム適応の検討</b>】<br>〈<b>目的</b>〉処方されたプリズムに満足した症例としなかった症例を比較することによって、不満足であった原因を検討する。<br>〈<b>対象と方法</b>〉平成15年1月~平成17年5月に複視を主訴に浜松医科大学眼科を受診した20歳以上の患者、総数144名のうち眼位の記載が不十分のもの、追跡ができなかったものを除く86名を対象とした。<br>プリズム眼鏡を処方され満足した適応群と処方を受けなかったか、受けても不満足であった不適応群に分け性別、年齢、診断、視力、眼位、について検討した。<br>〈<b>結果</b>〉86名のうち、自然治癒は12名、適応群は33名、不適応群はプリズム処方で不満足17名および手術24名をあわせた41名であった。水平、回旋斜視角で適応群、不適応群の二群間に有意差はなかったが、上下斜視角では有意差を認めた。また、上斜筋麻痺では、年齢および上下斜視角で有意差を認めたが、上斜筋麻痺以外で有意差は認められなかった。<br>〈<b>結論</b>〉プリズムを勧めて満足できたものは対象者の半数以下であった。また、プリズムに適応できるかどうかは上下斜視角の程度に強く影響された。疾患別では、若年齢の上斜筋麻痺患者は斜視角が大きく、プリズムに満足しないことが多かったが、上斜筋麻痺以外では二群間に統計的に明らかな要因は認められず、症例ごとにトライアルをする必要があると思われた。

<b>Purpose</b><br>To clarify the reasons of dissatisfaction for prisms by means of comparing the cases who were successfully treated with prisms and the cases who were not.<br><b>Subjects and Methods</b><br>This is a retrospective chart review.<br>The patients older than 20 years, who visited Hamamatsu university school of medicine, department of Ophthalmology with a chief complaint of diplopia between January 2003 and May 2005 were studied. Within 144 patients, the patients with insufficient records of eye positions and the patients who were not followed were excluded. The remaining 86 cases were studied.<br>The patients were divided into two groups: 1) adaptation: who were satisfied with prisms, and 2) non-adaptation: who were not satisfied with prisms. Gender, age, diagnosis, vision, and ocular deviations were compared between the two groups.<br><b>Results</b><br>Twelve patients did not require prisms because of little trouble and they were excluded from the study. Thirty-three patients were adapted to the prisms. Seventeen patients did not satisfy prisms regardless they were prescribed prisms, and 24 patients underwent strabismus surgery. A total of 41 patients were classified to the non-adapted group.<br>There were no significant differences between the two groups in age, gender, the amount of horizontal deviation and the amount of torsional deviation. Only the vertical deviation was significantly larger in non-adapted group than in the adapted group (near: p<0.001, far: p<0.0001). Among the patients with superior oblique palsy, the amount of vertical deviation was larger and the patients were younger in the non-adapted group. These findings were not observed in the patients without superior oblique palsy, <br><b>Conclusions</b><br>Less than a half of patients satisfied with prisms. The patients' satisfaction was strongly influenced by the amount of vertical deviation. Young patients with superior oblique palsy were unlikely to satisfy with the prisms. It is difficult to speculate the patients who may satisfy with prisms or not. Therefore we need to try prisms on each patient.

収録刊行物

  • Japanese orthoptic journal  

    Japanese orthoptic journal 35, 93-97, 2006-08-31 

    JAPANESE ASSOCIATION OF CERTIFIED ORTHOPTISTS

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各種コード

  • NII論文ID(NAID)
    10018262827
  • NII書誌ID(NCID)
    AN10084015
  • 本文言語コード
    JPN
  • 資料種別
    ART
  • ISSN
    03875172
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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