徳島大学における屈折異常弱視と不同視弱視の検討

Review of ametropic and anisometropic amblyopia at Tokushima University

目的：2003年4月までの17年10か月間に当科で治療を開始した屈折異常弱視と不同視弱視169例の報告。症例：症例の内訳は，3歳児健診に視力検査が導入された1991年4月よりも前に75例（前期群），それ以後に94例（後期群）である。前期群と後期群での屈折異常弱視はそれぞれ31例と44例であり，不同視弱視はそれぞれ37例と57例である。結果：治療開始の平均年齢は，屈折異常弱視では前期群6.1歳と後期群4.9歳であり，不同視弱視ではそれぞれ6.5歳と5.3歳であった。治療開始年齢は，後期群が前期群よりも有意に早かった。治療期間は両群間に有意差がなかった。後期群では，就学前に治療が終了できる例が多かった。4歳未満で治療を開始した例では，中途脱落と視力の再低下が少なかった。結論：3歳児健診に視力検査が導入された1991年以後では，弱視の治療開始が早くなり，視力転帰が向上した。

Purpose：To review 169 cases treated by us for amblyopia during 17 years 10 months through April 2003. Cases：The series consisted of two groups. A former group of 75 cases started treatment before April 1991 when health-check program was introduced for 3-year-old children. The latter group of 94 cases started treatment after April 1991. There were 75 cases of ametropic amblyopia,comprising 31 cases in the early group and 44 cases in the latter. There were 94 cases of anisometropic amblyopia,comprising 37 cases in the former group and 57 cases in the latter. Findings：Treatment for ametropic amblyopia started at an average of 6.1 years in the former group and 4.9 years in the latter. The difference was significant. Treatment for anisometropic amblyopia started at an average of 6.5 years in the former group and 5.5 years in the latter. The difference was significant. There was no difference between two groups regarding duration of treatment. Conclusion：Treatment for amblyopia started at an earlier age with better outcome after introduction of health-check program for 3-year-old children.