不同阅读距离的调节反应在近视发生发展中的表达  

Expression of accommodative response in development of myopia

作　　者：徐丹[1] 吕帆[1] 瞿佳[1] 

机构地区：[1]温州医学院眼视光学院温州医学院眼视光学院近视研究所,325003

出　　处：《眼科研究》2006年第3期313-316,共4页Chinese Ophthalmic Research

基　　金：浙江省自然科学基金(602168);浙江省自然科学基金青年人才基金(RC9606);温州市科技局基金(S2002A034);温州市科技局重大课题(S2002A002)资助

摘　　要：目的检测近视眼在不同距离调节刺激下的调节反应等参数。研究其在正视眼、稳定性近视眼和进展性近视眼中的表达。方法38名志愿者,根据屈光状态分组,测量在不同调节刺激下的调节反应(AR)和调节性辐辏(AC/A),并分析结果。结果进展性近视组的AR/AS斜率显著低于正视组(P<0.05),进展性近视组的AC/A高于正视组和稳定性近视组(P<0.01)。进展性近视组在高调节刺激水平(2 D,3 D)下所表现的调节反应显著低于正视组(P<0.05)。结论进展性近视组在高调节需求下有较低的调节反应,较高的调节滞后导致视网膜模糊像,长期的视网膜模糊像可能是引发眼轴近视化发展的主要因素。Objective To evaluate the accommodative response under different accommodative stimuli among myopes, Methods Thirty-eight volunteers including 16 emmetropes（EMM） ,13 stable myopes（SM） and 9 progressive myopes（PM） were enrolled for this study. SEIKO-500 auto-refractor was used to measure the accommodative response and accommodative convergence in three accommodative stimulus conditions（ 1 D. 2 D. 3 D）, or the slope of accommodative response / accommodative stimulus （AR/AS） , slope of accommodative convergence / accommodative stimulus （AC/AS） and slope of accommodative convergence / accommodative response（AC/A）, AR/AS and AC/AS curves were plotted and the slopes were used to calculate the responsive AC/A. These data were compared among groups. Results The slope of AR/AS in progressive myopia was lower than that in emmetropia（0. 592 7 ± 0. 144 4 vs 0. 772 6 ± 0. 180 8 ） （P 〈 0.05 ）. The slope of AC/AS in progressive myopia was higher than that in stable myopia（3. 776 7 ± 0. 835 2 vs 2. 619 5 ± 1. 147 8 ） （ P 〈 0.01 ）. The AC/A in progressive myopia was higher than that in emmetropia and stable myopia （ 6. 674 2 ± 1.954 0 vs 4.301 4 ± 1.649 7,4. 091 3 ± 2. 446 2 ） （ P 〈 0.01 ）. However, progressive myopia showed significant lower accommodative response （0. 859 1 D, 1. 552 9 D ） than emmtropia （ 1.111 3 D,1. 552 9 D） in high accommodative demand （ 2 D, 3 D ） （ P 〈 0.05 ）. Conclusion Progressive myopia shows lower accommodative response at high accommodative demand. High accommodative lag induces retinal image blur and the associated high levels of defocus blur at near may lead to myopia shift or development.

关 键 词：调节反应 调节滞后 AR/AS坡度 AC/A 

分 类 号：R778.11[医药卫生—眼科]