Microperimetry MP-3 assessment reveals reduced macular fixation stability in children with concomitant exotropia: a case-control study

Li Fang; Deng Siyuan; Wu Tingfei; He Hong

doi:10.16016/j.2097-0927.202606052

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Microperimetry MP-3 assessment reveals reduced macular fixation stability in children with concomitant exotropia: a case-control study

Clinical Medicine | 更新时间：2026-10-30

- Microperimetry MP-3 assessment reveals reduced macular fixation stability in children with concomitant exotropia: a case-control study
- Journal of Army Medical University Vol. 48, Issue 20, Pages: 2949-2956(2026)
- 作者机构：
  
  中山大学中山眼科中心海南眼科医院（海南省眼科医院）斜弱视专科，海南省眼科学重点实验室，海南海口
- 作者简介：
  
  He Hong，E-mail：irisheh@foxmail.com
- 基金信息：
  
  the Joint Project on Health Science and Technology Innovation of Hainan Province(WSJK2026QN029)
- DOI：10.16016/j.2097-0927.202606052
  CLC： R770.422;R729;R777.41
- Received：11 June 2026，
  
  Revised：2026-09-10，
  
  Accepted：12 September 2026，
  
  Published：30 October 2026
- 稿件说明：
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李芳，邓斯元，吴挺飞，等.微视野计MP-3评估显示共同性外斜视儿童黄斑固视稳定性下降：一项病例-对照研究［J］.陆军军医大学学报，2026，48（20）：2949-2956.DOI：10.16016/j.2097-0927.202606052.

Li F，Deng S Y，Wu T F，et al.Microperimetry MP-3 assessment reveals reduced macular fixation stability in children with concomitant exotropia： a case-control study［J］.J Army Med Univ，2026，48（20）：2949-2956.DOI：10.16016/j.2097-0927.202606052.
李芳，邓斯元，吴挺飞，等.微视野计MP-3评估显示共同性外斜视儿童黄斑固视稳定性下降：一项病例-对照研究［J］.陆军军医大学学报，2026，48（20）：2949-2956.DOI：10.16016/j.2097-0927.202606052. DOI：

Li F，Deng S Y，Wu T F，et al.Microperimetry MP-3 assessment reveals reduced macular fixation stability in children with concomitant exotropia： a case-control study［J］.J Army Med Univ，2026，48（20）：2949-2956.DOI：10.16016/j.2097-0927.202606052. DOI：

摘要

目的

共同性外斜视是儿童青少年最常见的斜视类型，常伴双眼视功能异常，可能破坏视觉与眼球运动系统之间的协调，进而影响黄斑固视稳定性。本研究应用微视野计MP-3评估共同性外斜视儿童的黄斑固视稳定性，探讨其与非斜视儿童的差异及潜在影响因素。

方法

采用病例-对照研究设计方案，纳入2024年2月至2025年10月在海南省眼科医院斜弱视专科确诊的共同性外斜视儿童40例（外斜视组）及年龄匹配的非斜视儿童30例（正常对照组）。在单眼条件下应用微视野计MP-3评估黄斑固视功能，记录固视点落在直径2°（P1）和4°（P2）范围内的百分比，并计算包含68.2%、95.4%及99.6%固视点的双变量轮廓椭圆面积（bivariate contour ellipse area， BCEA）。比较外科视组主导眼、主斜眼及正常对照组组间各固视参数（P1、P2、68.2%BCEA、95.4%BCEA、99.6%BCEA）的差异，并分析外斜视组内上述参数与斜视持续时间、斜视度、立体视功能、屈光状态及斜视亚型的相关性。

结果

外斜视组年龄8~13岁，其中男24例，女16例；正常对照组年龄7~12岁，其中男16例，女14例。外斜视组主导眼、主斜眼和正常对照组P1比较差异有统计学意义（

=10.673，

=0.005）；外斜视组主导眼（

=-3.005，

=0.003）和主斜眼（

=-2.620，

=0.009）的P1值均显著低于正常对照组，但主导眼与主斜眼之间无显著差异。外斜视组主导眼、主斜眼和正常对照组P2、68.2%BCEA、95.4%BCEA及99.6%BCEA差异无统计学意义。外斜视组主导眼和主斜眼各固视参数与斜视持续时间、斜视度、等效球镜度、近用立体视均无相关性。主斜眼散光度数与P1（

=0.407，

=0.009）、P2（

=0.460，

=0.003）呈弱正相关，与68.2%BCEA（

=-0.404，

=0.010）、95.4%BCEA（

=-0.404，

=0.010）及99.6%BCEA（

=-0.391，

=0.013）呈弱负相关，而主导眼散光度数与各固视参数均无显著相关性。按双眼视功能（近/远立体视、融合功能、同时视）及斜视亚型（间歇性/恒定性）分层，各亚组间固视参数差异均无统计学意义。

结论

共同性外斜视儿童存在一定程度的视网膜固视稳定性下降，主要表现为黄斑区固视点集中度降低；该下降与斜视持续时间、斜视度、屈光状态、双眼视功能及斜视亚型等潜在影响因素均无明显关联。微视野计MP-3可有效评估儿童固视功能，为斜视视觉功能评估提供客观指标。

Abstract

Objective

Concomitant exotropia

the most common type of strabismus in children and adolescents

is often accompanied by binocular visual dysfunction

which may disrupt the coordination between the visual and oculomotor systems

thereby affecting macular fixation stability. To assess macular fixation stability in children with concomitant exotropia

this study used the MP-3 microperimeter to explore the differences in fixation stability between these patients and age-matched non-strabismic children

and investigate potential influencing factors for fixation abnormalities.

Methods

A case-control study was conducted on 40 children diagnosed with concomitant exotropia (exotropia group) admitted to our department and 30 age-matched non-strabismic children (normal control group) between February 2024 and October 2025. Macular fixation function was evaluated under monocular conditions using the MP-3 microperimeter. The percentages of fixation points within the 2° (P1) and 4° (P2) diameter circles

as well as the bivariate contour ellipse area (BCEA) encompassing 68.2%

95.4%

and 99.6% of fixation points

were recorded. Fixation stability parameters (P1

68.2%BCEA

95.4%BCEA

and 99.6%BCEA) were compared between groups

and the correlations of these parameters with clinical characteristics

including strabismus duration

deviation angle

stereopsis

refractive status

and exotropia subtype

were analyzed within the exotropia group.

Results

There were 40 children in the exotropia group (24 boys and 16 girls

aged 8 to 13 years) and 30 children in the normal control group (16 boys and 14 girls

aged 7 to 12 years). There was a statistically significant difference in P1 values among the dominant eyes of the exotropia group

the deviating eyes of the exotropia group

and the normal control eyes (

=10.673

=0.005). Pairwise comparisons showed that the P1 values o

f the dominant eyes (

=-3.005

=0.003) and the deviating eyes (

=-2.620

=0.009) were significantly lower in the exotropia group than the normal control group

with no significant difference between the dominant and deviating eyes. No significant differences were observed in terms of P2

68.2%BCEA

95.4%BCEA

or 99.6%BCEA among the dominant eye and the deviated eye in the exotropia group

and the normal control group. In the exotropia group

no significant correlations were found between any fixation parameters (for either dominant or deviating eyes) and exotropia duration

deviation angle

spherical equivalent

or near stereopsis. However

in the deviating eyes

the degree of astigmatism showed weak positive correlations with P1 (

=0.407

=0.009) and P2 (

=0.460

=0.003)

and weak negative correlations with 68.2%BCEA (

=-0.404

=0.010)

95.4%BCEA (

=-0.404

=0.010) and 99.6%BCEA (

=-0.391

=0.013)

whereas the astigmatism degree of the dominant eye showed no significant correlation with any fixation parameter. Stratified analyses according to binocular visual function (near/far stereopsis

fusion

and simultaneous perception) and strabismus subtype (intermittent/constant) revealed no significant differences in fixation parameters between any subgroups.

Conclusion

Children with concomitant exotropia exhibit mild impairment of retinal fixation stability

mainly manifested as reduced concentration of fixation points within the central macular region. This decrease is not significantly associated with potential influencing factors such as exotropia duration

deviation angle

refractive status

binocular visual function

or exotropia subtype. The MP-3 microperimeter enables effective and objective assessment of pediatric fixation function

providing reliable quantitative parameters for visual function in strabismus.

关键词

Keywords

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