主观与客观测量人眼调节性集合与调节比率的研究  

Comparison study on subjective and objective measurements of the accommodative convergence to accommodation ratio

作　　者：徐菁菁[1] 徐丹[1] 黄涛[1] 姜俭[1] 吕帆[1] 

机构地区：[1]温州医学院附属眼视光医院,325027

出　　处：《中华眼科杂志》2012年第5期398-402,共5页Chinese Journal of Ophthalmology

基　　金：浙江省省卫生厅基金（20098111）;浙江省教育厅基金（Y200804007）;温州市科技局基金（Y20090056）;浙江省自然科学基金（Y2100921）;国家“十一五”科技支撑项目（2007BA118B09）

摘　　要：目的探讨客观和主观方法测量调节性集合与调节（AC／A）比率，分析其差异及原因。方法40名年轻人志愿参加本试验。客观AC／A比率测量：用眼动追踪仪分别记录在100、50、33和25cm时的调节性集合量，分别除以调节刺激值，得出客观刺激性AC／A比率；结合红外自动验光仪测量的各距离的调节反应，得到客观反应性AC／A比率。主观AC／A比率测量：使用VonGrade方法得到的计算性AC／A比率和梯度性AC／A比率。两组数据通过独立样本t检验，进行比较分析。结果眼动追踪仪客观记录所得刺激性AC／A比率为（4．77±1．84）A／D，与VonGraefe法计算性AC／A比率的（3．67-4-1．09）△／D比较，差异有统计学意义（t=2．995，P=0．004）且无相关性（r=0．172，P=0．332）；与VonGraefe法梯度性AC／A比率的（3．35±1．36）A／D比较，差异有统计学意义（≠=3．603，P=0．001）且无相关性（r=0．134，P=0．448）。眼动追踪仪法测量受试者所得刺激性AC／A比率和反应性AC／A比率有显著相关性（r=0．871，P=0．000）和明显差异（P=0．000），在高AC／A比率人群这一差异更加明显。结论由于受近感知因素的影响更大，眼动追踪仪法测量的客观AC／A比率往往比临床测量的主观性AC／A比率结果更高。客观方法测得的反应性AC／A比率能更加真实地体现调节与辐辏之间的相互作用，用其作为监测近视发生发展的重要指标之一更加可信。Objective To detect the accommodative convergence to accommodation （AC/A） ratios measured respectively by objective and subjective methods. The differences and its relative factors were explored. Methods Forty young volunteers were measured by eye tracker to get the amount of convergence when fixating at the target at 100 cm, 50 cm, 33 cm and 25 cm and were measured by infrared auto-refractor to get corresponding accommodative responses. AC/A ratio based on these two measurements were compared with the calculated and the gradient AC/A ratio from Von Graefe tests. Results Mean value of stimulated AC/A ratio measured by eye tracker was higher than the calculated and gradient AC/A ratio by Von Graefe method （P =0. 003, 0. 001 ）. There are statistic correlation （ r = 0. 871 ,P = 0. 000） and difference （ P = 0. 000） between stimulated AC/A ratio and response AC/A ratios both measured by eye tracker, and the difference trends to be greater with the higher AC/A ratio. Conclusion The objective AC/A ratio is usually higher than the clinical subjective measurement because of more proximal effect. The response AC/A ratio measured objectively may reveal realistically the mutual effect and relationship between accommodation and convergence and it seems to be more credible to be the monitor parameter on progression of myopia in clinics.

关 键 词：眼球运动检测 斜视 调节 眼 会聚 眼 

分 类 号：R77[医药卫生—眼科]