不同中间视觉环境下近视人群瞳孔直径的分布及其影响因素  

Pupil size of myopes under different mesopic conditions and its influencing factors

作　　者：李梦迪 王雁[1] 宋一 张琳[1] 赵新恒 张妍 Li Mengdi;Wang Yan;Song Yi;Zhang Lin;Zhao Xinheng;Zhang Yan(Tianjin Eye Hospital,Nankai University Eye Institute,Clinical College of Ophthalmology,Tianjin Medical University,Tianjin Eye Institute,Tianjin Key Laboratory of Ophthalmology and Visual Science,Optometric Center of Tianjin Eye Hospital,Tianjin 300020,China)

机构地区：[1]天津市眼科医院、南开大学附属眼科医院、天津医科大学眼科临床学院、天津市眼科研究所、天津市眼科学与视觉科学重点实验室、天津市眼科医院视光中心,天津300020

出　　处：《中华实验眼科杂志》2023年第4期338-343,共6页Chinese Journal Of Experimental Ophthalmology

基　　金：国家自然科学基金项目(81670884、81873684)。

摘　　要：目的探讨不同中间视觉环境下中国近视人群瞳孔直径的分布,并分析其可能的影响因素。方法采用横断面研究,收集2018年12月至2019年4月于天津市眼科医院拟行屈光手术的近视患者214例428眼,年龄17~45岁,平均(22.62±4.88)岁。根据散光值将受试者分为散光值<-1.5 D组372眼和散光值≥-1.5 D组56眼。采用Colvard瞳孔仪测量0.2 lx的低中间视觉下瞳孔直径(LMPS),采用Pentacam眼前节分析仪测量6~12 lx的高中间视觉下瞳孔直径(HMPS);比较不同眼别、性别和散光值组瞳孔直径;分析瞳孔直径与可能影响因素,如年龄、性别、等效球镜度、球镜度、柱镜度、柱镜轴向、平均角膜曲率(Km)及中央角膜厚度之间的关系。结果Colvard瞳孔仪及Pentacam测量的中间视觉瞳孔直径分别为(6.806±0.776)mm和(3.312±0.540)mm。Colvard测量的男性受试者的瞳孔直径为(6.692±0.754)mm,大于女性的(6.668±0.792)mm,差异有统计学意义(t=2.935,P=0.004)。在高中间视觉下,散光值≥-1.5 D组瞳孔直径小于散光值<-1.5 D组,差异有统计学意义(t=2.611,P=0.009)。在低中间视觉下,瞳孔直径与年龄、Km均呈弱的负相关(r=-0.213、-0.210,均P<0.001)。在高中间视觉下,瞳孔直径与柱镜度呈弱的正相关(r=0.124,P=0.010),与Km呈弱的负相关(r=-0.142,P=0.003)。多重线性回归分析结果显示,LMPS=0.659×HMPS-0.019×年龄-0.084×Km+8.662;Pentacam测量结果可预测约28%的LMPS,当结果在3.6 mm以下时,可较好地预测≤7 mm的LMPS。结论年龄和角膜曲率是中间视觉瞳孔直径的影响因素,年龄较大、角膜曲率较陡峭的近视患者瞳孔直径相对小。在高中间视觉下,散光对瞳孔直径有影响。Pentacam测量瞳孔结果可一定程度上预测LMPS,但不能代替标准环境下暗瞳仪测量结果。Objective To explore the pupil size distribution of the Chinese myopic population under different mesopic conditions,and to analyze the possible influencing factors.Methods A cross-sectional study was conducted.Two hundred and fourteen myopic patients(428 eyes)who underwent refractive surgery in Tianjin Eye Hospital from December 2018 to April 2019 were randomly selected.The patients were 17 to 45 years old,with an average age of(22.62±4.88)years old.The patients were divided into astigmatism<-1.5 D group(372 eyes)and astigmatism≥-1.5 D group(56 eyes)according to their astigmatism measurements.The low mesopic pupil size(LMPS)(0.2 lx)was measured with the infrared Colvard pupillometer,and the high mesopic pupil size(HMPS)(6-12 lx)was obtained through the anterior Pentacam segment analyzer.The pupil size was compared between both eyes,different sexes and different astigmatism measurements.The relationship between pupil size and possible influencing factors,such as age,sex,spherical equivalent,spherical diopter,cylinder diopter,axis,mean keratometry(Km),and central cornea thickness was analyzed.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Tianjin Eye Hospital(No.201912).Written informed consent was obtained from each subject or their guardians.Results The pupil sizes measured by the Colvard pupillometer and Pentacam were(6.806±0.776)mm and(3.312±0.540)mm,respectively.The pupil size of male subjects was(6.692±0.754)mm,which was larger than(6.668±0.792)mm of females,showing a statistically significant difference(t=2.935,P=0.004).Under the high mesopic condition,the pupil size of astigmatism≥-1.5 D group was lower than that of astigmatism<-1.5 D group,with a statistically significant difference(t=2.611,P=0.009).Under the low mesopic condition,pupil size was negatively correlated with age and Km(r=-0.213,-0.210;both at P<0.001).Under the high mesopic condition,pupil size was weakly positively correlated with cylinder power(r=0.124,P=0.010)and was w

关 键 词：瞳孔 中间视觉 近视 影响因素 

分 类 号：R778.11[医药卫生—眼科]