多区正向光学离焦镜片对双眼视功能和视觉质量影响的随机双盲对照研究  

A randomized double-blind controlled study on the effects of wearing defocus incorporated multiple segments lenses on binocular visual function and visual quality

作　　者：李晓莹 马薇[1] 宋雨桐[1] 刘陇黔[1] Li Xiaoying;Ma Wei;Song Yutong;Liu Longqian(Department of Ophthalmology,West China Hospital,Sichuan University,Laboratory of Optometry and Vision Sciences,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院眼科,四川大学华西医院眼视光学与视觉科学研究室,成都610041

出　　处：《中华实验眼科杂志》2025年第2期130-137,共8页Chinese Journal Of Experimental Ophthalmology

基　　金：四川省自然科学基金(2024NSFSC1722)。

摘　　要：目的评估配戴多区正向光学离焦(DIMS)镜片对近视儿童双眼视功能和视觉质量的影响。方法采用随机双盲对照研究方法,于2021年1月至2022年3月在四川大学华西医院招募6~15岁近视儿童176例352眼。采用随机数字表法将其分为DIMS组85例170眼和单光组91例182眼,分别配戴DIMS和单光镜片,最终完成随访并纳入分析者共151例302眼,其中DIMS组72例144眼,单光组79例158眼。在戴镜前和戴镜后6、12个月分别测量受试者的调节幅度、调节灵敏度、远/近水平眼位、调节性集合与调节比值(AC/A),分析2个组受试者戴镜1年的视功能变化。每次随访均测量受试者主观对比敏感度(CS),客观评估镜片对视觉质量的影响。结果2个组戴镜前后不同时间点单眼调节幅度、双眼调节灵敏度总体比较差异均有统计学意义(Waldχ^(2)_(时间)=84.435、48.201,均P<0.001),其中2个组戴镜后6和12个月单眼调节幅度均较戴镜前下降,双眼调节灵敏度均较戴镜前增加,差异均有统计学意义(均P<0.001)。戴镜后12个月,DIMS组和单光组单眼调节幅度分别较戴镜前下降2.68 D(95%CI:1.60~3.75 D)和2.82 D(95%CI:1.81~3.84 D)。2个组戴镜前后不同时间点远水平眼位和近水平眼位总体比较差异均有统计学意义(Waldχ^(2)_(时间)=10.398、23.947,均P<0.01),其中,戴镜后12个月DIMS组远水平眼位较戴镜前向外漂移0.68^(△)(95%CI:0.06~1.25^(△)),差异有统计学意义(P<0.05);DIMS组和单光组近水平眼位分别较戴镜前向外漂移1.67^(△)(95%CI:0.15~3.20^(△))和1.73^(△)(95%CI:0.49~2.96^(△)),差异均有统计学意义(均P<0.05)。2个组戴镜前后不同时间点梯度性AC/A值和计算性AC/A值总体比较差异均有统计学意义(Waldχ^(2)_(时间)=22.001、13.411,均P<0.01),其中2个组戴镜后12个月梯度性AC/A值均较戴镜前降低,单光组戴镜后12个月计算性AC/A值较戴镜前降低,差异均有统计学意义(均P<0.05)。2个组间调节幅度、�Objective To evaluate the effects of wearing defocus incorporated multiple segments(DIMS)spectacle lenses on binocular visual function and visual quality in myopic children.Methods A randomized double-blind controlled study was conducted.A total of 176 children(352 eyes)with myopia aged 6 to 15 years were enrolled in the West China Hospital of Sichuan University from January 2021 to March 2022.They were randomly divided into DIMS group of 85 cases(170 eyes)and single-vision group of 91 cases(182 eyes)wearing DIMS and single-vision lenses,respectively,using the random number table method.A total of 151 cases(302 eyes)who completed follow-up visits were included in the analysis,including 72 cases(144 eyes)in the DIMS group and 79 cases(158 eyes)in the single-vision group.Before and after 6 and 12 months of lens wear,accommodation amplitude,binocular accommodative sensitivity,distance/near horizontal eye position,and accommodative convergence/accommodation(AC/A)of subjects were measured.Changes in visual function over the year were compared between the two groups.In addition,subjective contrast sensitivity(CS)was assessed at each follow-up visit to evaluate the effect of the lenses on visual quality.The study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of West China Hospital of Sichuan University(No.2020-06).Parents or legal guardians signed written informed consent before the child's participation.Results There were significant differences in monocular accommodation amplitude and binocular accommodation sensitivity at different time points between before and after lens wear in both groups(Waldχ^(2)_(time)=84.435,48.201;both P<0.001).In both groups,monocular accommodation amplitude was decreased and the biocular accommodation sensitivity was increased at 6 and 12 months after wearing glasses compared with baseline(all P<0.001).After 12 months of lens wear,the monocular accommodation amplitude decreased by 2.68 D(95%CI:1.60-3.75 D)in DIMS group and 2.82 D(95%CI:1.81

关 键 词：近视 眼调节 对比敏感度 眼位 离焦 视功能 视觉质量 

分 类 号：R77[医药卫生—眼科]