摘要背景 人类具备不同阶度的空间感知觉,但目前临床所用的立体视检查多采用图像移位的零阶刺激模式,临床上应根据不同阶度空间感知的神经地形图建立新的空间感知觉筛查系统. 目的 检查弱视和斜视患儿零阶、一阶、二阶多维空间感知觉的缺损状态,以研究弱视和斜视患儿在多维空间感知觉立体视功能方面的缺损情况,并探讨零阶、一阶、二阶空间感知觉缺损的内在关联.方法 对北京儿童医院眼科门诊就诊的4～14岁儿童79例进行空间感知觉检查,受检者根据临床症状的不同分为正常组19名、屈光不正性弱视组19例、屈光参差性弱视组12例、斜视组18例、斜视合并弱视组11例.依次用一套新的多维空间感知觉筛查系统检查各组患儿零阶、一阶、二阶随机点及线条空间感知觉,并进行差异比较. 结果 在所有研究对象中,存在零阶、一阶、二阶随机点感知通道缺失者分别为24例(占30.4％)、1 8例(占22.8％)、24例(占30.4％),平均为27.9％；零阶、一阶、二阶线条空间感知通道缺失分别为37例(占46.8％)、37例(占46.8％)、32例(占40.5％),平均为44.7％.零阶空间感知有缺失的患儿中,仍残留有一阶、二阶空间感知的随机点占41.6％,线条占43.2％；零阶随机点或线条空间感知觉均无缺损的患儿中,存在一阶或/和二阶空间感知觉缺损的患儿占37.5％.患有弱视或斜视的患儿与正常组相比各阶空间感知的差异均有统计学意义(P＜0.05). 结论 弱视或斜视患儿空间感知通道存在缺失,零阶空间感知觉存在缺失的患儿仍部分残留有一阶或二阶空间感知觉,而零阶空间感知觉正常的患儿可能一阶或二阶空间感知觉有缺损.视觉信息加工的多维空间感知觉模型能够指导弱视或斜视等视觉信息加工障碍患儿的检查,并能开展一系列的感知觉学习治疗.

abstractsBackground There is multi-dimensional order of spatial stereopsis perception in human,however,current stereopsis examination is zero-order of position disparity.A multi-dimensional space perception model is very important for the detection of stereoacuity.Objective This study was to screen the deficit of zero-order,first-order,second-order multi-dimensional spatial stereopsis perception in amblyopia and strabismus children and to explore the association of zero-order,first-order,second-order spatial perception deficit.Methods Multidimensional spacial perception was examined in 79 children aged 4-14 years in Beijing Children' s Hospital.Nineteen normal children,19 children with ametropia amblyopia,12 children with anisometropic amblyopia,18 children with strabismus and 11 children with strabismus combined amblyopia were included this study.The random-dot and line spatial stereopsis perception in zero-order,first-order and second-order were examined with a new system of multidimensional space perception screening.Written informed consent was obtained from each subject or custodian before any ocular examination associated with this study.Results Absence of zero-order,first-order,second-order random-dot channel was found in 24 children (24/79,30.4％),18 children (18/79,22.8％) and 24 children (24/79,30.4％) respectively,with an average percentage of 27.9％.Absence of zero-order,first-order,second-order line channel was examined in 37 children (37/79,46.8％),37 children (37/79,46.8％),32 children (32/79,40.5％),with an average percentage of 44.7％.In the children with a deficiency of the zero-order spatial perception,the children who still remained the first-order or/and second-order spatial perception of random-dot accounted for 41.6％ and that of lines accounted for 43.2％.In children without deficiency of zero-order random-dot or lines spatial space perception,deficiency of first-order and/or second-order spatial perception was in 37.5％ children.Various order spatial perception deficiency was seen in children suffering from amblyopia or strabismus compared with normal group(P ＜ 0.05).Conclusions There exists spatial perception deficiency in children with amblyopia or strabismus.The patients with zero-order spatial perception absence partially remain a first-order or/and second-order spatial perception;while the patients with normal zero-order spatial perception might have first-order or second-order spatial perception deficiency.The multi-dimensional space perception model has a directive role for the training of visual information process and the treatment of spatial perceptual learning in children with amblyopia or strabismus.