目的：观察并分析弱视患儿应用精细训练联合虚拟现实视觉训练的治疗效果。

方法：病例对照研究。选取2015-12/2017-12首次就诊于我院眼科的弱视患儿232例416眼，随机分为两组，A组采用精细训练治疗，B组采用精细训练联合虚拟现实视觉训练治疗，治疗时间为6mo。治疗结束后随访6mo，观察不同年龄段和不同程度弱视患儿的临床疗效。

结果：B组患儿基本治愈率(51.4% vs 35.6%)和总有效率(91.3% vs 80.8%)均高于A组(P<0.01)。4～6、>6～8、>8～10岁患儿中，A组基本治愈率分别为55.9%、34.9%、11.1%，B组基本治愈率分别为70.6%、54.6%、22.2%； A组总有效率分别为100.0%、81.4%、55.6%，B组总有效率分别为100.0%、93.0%、77.8%，两组基本治愈率(A组：r_s=-0.76，P<0.01； B组：r_s=-0.78，P<0.01)和总有效率(A组：r_s=-0.67，P<0.01； B组：r_s=-0.64，P<0.01)均随年龄增长呈下降趋势。轻、中、重度弱视患儿中，A组基本治愈率分别为63.3%、25.0%、4.9%，B组基本治愈率分别为81.0%、44.3%、9.8%； A组总有效率分别为83.5%、79.5%、78.0%，B组总有效率分别为91.1%、89.8%、95.1%，两组基本治愈率与弱视程度均呈负相关(A组：r_s=-0.93，P<0.01； B组：r_s=-0.89，P_B组<0.01)，但总有效率与弱视程度无明显相关性(A组：r_s=0.00，P=12.316； B组：r_s=0.00，P=15.603)。

结论：精细训练联合虚拟现实视觉训练治疗弱视安全有效，临床疗效与患者的年龄和弱视程度具有一定的相关性。

METHODS: Case control study. 232 cases(416 eyes)of amblyopia were diagnosed in Baoding children's Hospital for the first time. They were randomly divided into two groups. Group A was treated with fine training, while group B was treated with fine training combined with visual training. Duration of treatment was 6mo. The patients were followed up for 6mo. Objective to observe the clinical efficacy of amblyopia in children of different ages and degrees.

RESULTS: The total basic cure rate was 35.6%(74/208)in group A and 51.4%(107/208)in group B, which was higher than that in group A(P<0.01). The total effective rate was 80.8%(168/208)in group A, 91.3%(190/208)in group B, which was higher than that in group A(P=0.006). Therapeutic effect of each age group: the basic cure rates of group A were 55.9%(38/68), 34.9%(30/86), 11.1%(6/54)(r_s=-0.76, P<0.01), respectively. The basic cure rates of group B were 70.6%(48/68), 54.6%(47/86), 22.2%(12/54)(r_s=-0.78, P<0.01), respectively. The basic cure rate of group A and group B decreased with age. The effective rates of group A were 100%(68/68), 81.4%(70/86), 55.6%(30/54)(r_s=-0.67, P<0.01), respectively. The effective rates of group B were 100%(68/68), 93.0%(80/86), 77.8%(42/54)(r_s=-0.64, P<0.01), respectively. The efficiencies of A and B groups decreased with age. Therapeutic effect of amblyopia degree groups: the basic cure rates of group A were 63.3%(50/79), 25.0%(22/88)and 4.9%(2/41)(r_s=-0.93, P<0.01), respectively. The basic cure rates of group B were 81.0%(64/79), 44.3%(39/88)and 9.8%(4/41),respectively(r_s=-0.89, P<0.01). The basic cure rate of groups A and B was negatively correlated with the degree of amblyopia. The effective rates of group A were 83.5%(66/79), 79.5%(70/88), 78.0%(32/41)(r_s=0.00, P=12.316), respectively. The effective rates of group B were 91.1%(72/79), 89.8%(79/88), 95.1%(39/41)(r_s=0.00, P=15.603), respectively. There was no significant correlation between amblyopia severity and efficiency in groups A and B.

CONCLUSION: Fine training combined with virtual reality brain vision training is a safe and effective way to treat amblyopia. There is a certain correlation between the clinical efficacy and the age and the degree of amblyopia.