正视和近视青少年对比度视力与像差的关系  

Association of visual performance and wavefront aberration in emmetropic and myopic teenagers

作　　者：乐融融[1] 保金华[1] 任凤英[1] 吕帆[1] 

机构地区：[1]温州医学院附属眼视光医院,浙江温州325027

出　　处：《中华眼视光学与视觉科学杂志》2011年第5期346-349,共4页Chinese Journal Of Optometry Ophthalmology And Visual Science

基　　金：国家＂十一五＂科技支撑计划资助项目（2007BA118B09）;浙江省大学生科技创新资助项目（浙教高教[2009]30号文件）

摘　　要：目的 比较初发性近视、进展性近视以及正视青少年明、暗环境下对比度视力（CVA）的差异,及其与像差和瞳孔的相关性.方法 横断面群组研究.58名年龄为12～16岁的青少年根据屈光状态及近视发生时间分为3组：正视组18人,等效球镜度（0.00±0.20）D;初发性近视21人,等效球镜度（-1.03±0.33）D;进展性近视19人,等效球镜度（-2.67±0.77）D.记录受试者左眼CVA、瞳孔直径和全眼波前像差.采用配对t检验、重复测量方差分析、单因素方差分析和Pearson相关分析对获得的数据进行处理.结果 初发性近视组的CVA低于进展性近视组和正视组（F=199.17、234.54,P＜0.01）,在低对比度（25％、10％）和暗环境下更为明显.3组青少年受试者明环境下全眼总像差（除去一阶和二阶离焦）、高阶像差、四阶球差以及彗差的均方根值[分别为（0.205±0.108）μm、（0.101±0.057）μm、（0.028±0.039）μm 以及（0.066±0.056）μm],低于暗环境下的各像差值[分别为（0.599±0.257）μm、（0.355±0.141）μm、（0.148±0.122）μm 以及（0.195±0.034）μm],差异具有统计意义（t=14.94、16.71、7.89、6.28,P＜0.05）.在同一亮度环境下,近视组像差与正视组之间差异无统计学意义.除明环境100％对比度下,CVA与总高阶像差存在负相关关系（r=-0.275,P＜0.05）外,其余情况下,CVA与高阶像差、瞳孔之间不存在相关性.结论 初发性近视者CVA低于进展性近视和正视者,差异在低对比度和暗环境下更明显.初发性近视CVA的下降与视网膜成像质量下降无直接关系,可能为皮层因素起主导作用.Objective To investigate the differences in contrast visual acuity （CVA） under both bright and dark conditions in recent-onset myopic,progressive myopic and emmetropic teenagers; to investigate the correlation between CVA and wavefront aberration,together with pupil size; to study the possible mechanisms involved.Methods A cross-sectional trial design was used in this study.CVA was measured in 58 left eyes from 58 teenagers aged from 12 to 16 yeats.They were divided into 3 groups：emmetropes,18 subjects,with an average spherical equivalent refractive error （SER）of （0.00±0.20）D; recent onset myopes,21 subjects,with an average SER of （-1.03±0.33）D; and progressive myopes,19 subjects,with an average SER of （-2.67±0.77）D.All subjects underwent CVA testing with full spectacle correction under both bright and dark conditions with a Multi-Functional Visual Acuity Analyzer （MFVA-100）.Pupil size and monochromatic wavefront aberration were measured with a real-time image recording system and a Hartmann-Shack wavefront aberrometer.Data were analyzed using paired samples t test,repeated measure variance analysis,one-way ANOVA and Pearson correlation.Results Myopes had a lower CVA than emmetropes.And recent-onset myopes had a lower CVA than progressive myopes and emmetropes （F=199.17,234.54,P〈0.01）,especially under low contrasts （25%,10%） and dark conditions.Root mean square （RMS） values of total aberrations （C2-C7 without C20） and total higher-order aberrations （HOA）,spherical aberration and coma increased significantly with a pupil in dark light [（0.205±0.108）μm,（0.101±0.057）pm,（0.028±0.039）μm and （0.066±0.056）μm] than with a pupil in bright light [（0.599±0.257）μm,（0.355±0.141）μm,（0.148±0.122）μm and （0.195±0.034）μm） （t=14.94,16.71,7.89,6.28,P〈0.05）.There was no significant difference in the RMS values of HOA between emmetropes and myopes.Except for under bright and 100% contrast conditions,CVA had significant negative co

关 键 词：对比度 视力 像差 瞳孔 光刺激 

分 类 号：R778[医药卫生—眼科]