近视青少年在阅读状态下调节反应和像差的研究  

Accommodative responses and aberrations with natural pupils in Myopic Juvenile under reading status

作　　者：保金华[1] 任凤英[1] 乐融融[1] 吕帆[1] 

机构地区：[1]温州医学院眼视光学院,325027

出　　处：《中华实验眼科杂志》2011年第5期450-455,共6页Chinese Journal Of Experimental Ophthalmology

基　　金：国家“十一五”科技支撑计划项目（2007BA118809）

摘　　要：背景近距离工作时，视网膜的成像质量受调节、瞳孔和像差的共同影响；而近距离工作时视网膜成像的清晰度又被认为是青少年近视发生发展的可能诱因。因此，研究近视及正视青少年在阅读状态下的眼动参数和像差的差异性显得尤为重要。目的研究有初发性近视和进展性近视的青少年在阅读状态下的调节反应、瞳孔直径和像差的差异，从视网膜离焦诱导近视和像差诱导近视这两个假说探讨调节反应和像差与近视发生发展的相关机制。方法57例年龄12～16岁青少年受试者分为正视组16眼、初发性近视组20眼和进展性近视组21眼。嘱受试者阅读左眼前25effl处电脑显示屏上由快速序列视觉呈现方式软件所呈现的一篇中文短文，用SEIKO—WV500型自动验光仪测量调节反应，实时录像记录瞳孔直径，并用WASCA波前像差仪测量像差，对3组间的结果进行比较。结果各组受试者的调节反应和像差的个体差异均较大，在4D的调节刺激下，初发性近视组和进展性近视组的调节滞后值为（1．72±0．53）D，（1．74±0．44）D，高于正视组的（0．96±0．55）D，差异有统计学意义（t=4．25、t=4．47，P〈0．01）。初发性近视组和进展性近视组的调节滞后差异无统计学意义（t=0．18，P〉0．05）。调节刺激在0～4D时，所有受试者的瞳孔直径、全眼像差、高阶像差、球差和彗差均随着调节力的增加而显著减小（P〈0．01），但在同一调节刺激下，不同屈光组之间受试者的瞳孔直径、全眼像差、高阶像差、球差和彗差的差异均无统计学意义（P〉0．05）。结论初发性近视和近视进展过程中在近距离阅读状态下存在较高的调节滞后，近距离阅读状态下对离焦的低模糊敏感性、较高的调节滞后及远视性离焦可能是近视发生、发展的促进因素。Background Image clarity during near work is influenced by several factors, such as accommodative lag, pupil size and monochromatic aberrations. Since image clarity during extended reading at near distance has been cited as a possible inducement of myopia in childhood and a possible difference between myopic and emmetropic people throughout life,it is important to examine these factors in myopic and emmetropic myopic juvenile during reading at near distance. Objective The aim of this study was to investigate the relationships among wavefront aberrations,accommodative response and pupil size in early onset and progressive myopes eyes under the different reading status and explore the possible mechanism of the development of myopia as well. Methods Fifty-seven subjects aged from 12 to 16 years were enrolled and grouped as emmetropes, the onset of myopes and progressive myopes. Reading material were Chinese novels presented by rapid serial visual presentation at a distance of 25 cm. Accommodative response and pupil size were recorded by a Grand Seiko WV-500 autorefractor. The Image J software was used to calculate the pupil diameter. Wavefront aberrations were then measured with a WASCA wavefront analyzer. Results Aberrations and accommodative response showed large inter-subject variability. With accommodative stimulus of 4 diopter, the accommodative lag in the early-onset of myopes group and progressive myopes group were （ 1.72±0.53 ） D and （ 1.74±0.44 ） D, showing larger value in comparison with （0.96±0. 55 ） D of emmetropes group （ t = 4.25, t = 4.47, P〈0.001 ）. However, there were no significant differences in accommodative lag between the early-onset of myopes group and progressive myopes group（ t = 0. 18,P〉0.05 ）. The mean value of pupil diameter, total RMS value, high-order RMS value, spherical aberration and coma were all significantly reduced with the stimulus varied from 0 D to 4 D（P〈0.01 ）. However,none of the pupil sizs,total RMS value, high-order RMS value, spherical abe

关 键 词：近视 波前像差 调节反应 瞳孔直径 

分 类 号：R778.11[医药卫生—眼科]