隐斜对成年人近视眼双眼调节反应与聚散适应的影响  

Effect of heterophoria on binocular accommodation response and vergence adaptation of adult with myopia

作　　者：肖婷婷[1] 高祥璐[1] 张艳龙[1] 王琦[1] 邢秀丽[1] 吕安琪[1] 

机构地区：[1]天津医科大学眼科医院, 300384

出　　处：《中国实用眼科杂志》2014年第7期832-835,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的 研究水平隐斜对聚散适应以及双眼调节反应的影响,探讨隐斜和近视发展速度之间的相关关系.方法 临床病例对照研究.对2013年9-11月在天津医科大学本科或研究生自愿参与116名近视受试者,根据近距隐斜量（near phorias,NP）分为三组：正位组（N组）48例（-6△≤NP≤0）,外隐斜组（EXO组）42例（NP＜-6△）,内隐斜组（ESO组）26例（NP＞0△）.持续注视40cm处视频显示终端（VDT）阅读20 min,阅读前后分别行主觉验光,远距（5 m）与近距（40 cm）水平隐斜测量,AC/A值及单眼（MA）与双眼（BA）调节反应（应用Shin-Nippon WR-5100K红外线开放视野全自动电脑验光仪）.结果 阅读前三组MA与BA差异比较均具有统计学意义,其中EXO组：BA＞MA（t=9.264,P＜0.01）;N组：BA＞MA（t=4.840,P＜0.01）; ESO组：MA＞BA（t =-6.064,P＜0.01）.阅读前后三组的聚散适应差异比较有统计学意义（x2=44.026,P＜0.01）.EXO组表现为集合性聚散适应（外隐斜量减小）;ESO组与N组均表现为开散性聚散适应（ESO组内隐斜量减小;N组外隐斜量增大）.结论 隐斜通过集合性调节对双眼调节反应产生影响,不同隐斜在融像性聚散需求方向的作用下表现为不同方向的聚散适应.内隐斜双眼调节滞后量较高,可能与近视的发展速度有关.Objective To study the effects of heterophoria type on binocular accommodation response and vergence adaptation of adult with myopia and to explore the related fact between heterophoria and the development of myopia.Methods Clinical case control study.There were 116 voluntary undergraduate or postgraduate with myopia from Tianjin Medical University investigated during September to November 2013.Participants were assigned to three groups according to near phorias （NP）,including exophoria group （EXO） 42 participants （NP〈-6△）,esophoria group （ESO） 26 participants （NP〉0△）,normal phoria group （N） 48 participants （-6△≤NP≤0△）.They were continuous to read vedio display terminal （VDT） at 40cm for 20 minutes.Operations including subjective refraction,distance （5m） and near （40cm） horizontal heterophoria,AC/A value,monocular （MA） and binocular （BA） accommodation response using Shin-Nippon WR-5100K open vision automatic infrared refractometer were performed before and after reading.Results The results demonstrated that the difference of MA and BA of the three groups had statistically significant difference.EXO group：BA〉MA （t 9.264,P 〈0.001）; N group：BA〉MA （t =840,P 〈0.001）; ESO group：MA〉BA （t-6.064,P 〈0.001）.The vergence adaptation of three groups had statistically significant difference （x2=4.026,P 〈0.001）.EXO group showed convergence adaptation （less exophoria）; ESO group and N group showed divergence adaptation （less esophoria in ESO group and more exophoria in N group）.Conclusions The heterophoria type has effects on binocular accommodation response by vergence accommodation.The different types of heterophoria show vergence adaption with different direction in the effect of varying fusional vergence demands.There is a relationship between the esophoria with higher lag of binocular accommodation and the development of myopia.

关 键 词：隐斜 调节反应 聚散适应 

分 类 号：R770.425[医药卫生—眼科]