CAJ | 학술논문

背景近年来青少年近视的发生率逐渐增加,近视儿童近距离用眼后表现出调节反应减少,调节滞后增加和调节微波动,与近视的形成和发生密切相关,但存在一定的争议. 目的对比正视和近视学龄儿童近距离阅读状态下调节微波动的差异,探讨其与近视发生发展的可能联系. 方法采用病例对照研究设计,纳入8 ～12周岁学龄儿童89例,其中正视者47例,近视者42例.应用综合验光仪对所有入选者进行小瞳孔下规范主觉验光,并检查双眼视功能和立体视觉,用Grand Seiko WAM5500型红外验光仪测量阅读距离为25 cm及40 cm时两组受试者调节反应及调节微波动,采用独立样本t检验对两组的检测结果进行比较,而组内不同阅读距离时调节微波动的变化采用配对t检验进行分析. 结果当阅读距离为25 cm时,正视组受试者的调节反应为(2.67±0.31)D,大于近视组受试者的(2.31±0.33)D,差异有统计学意义(t=5.330,P=0.000)；阅读距离为40 cm时,正视组受试者的调节反应为(1.70±0.23)D,也大于近视组的(1.49±0.24)D,差异有统计学意义(t=4.140,P=0.000).阅读距离为25 cm时,近视组的调节微波动明显大于正视组的(0.26±0.08)D,差异有统计学意义(t=3.180,P=0.002)；阅读距离为40 cm时,近视组的调节微波动为(0.27±0.10)D,大于正视组的(0.24±0.09)D,但差异无统计学意义(P=0.220).阅读距离为25 cm时近视组受试者的调节微波动明显高于40 cm的调节微波动,差异有统计学意义(t=3.850,P=0.000),而正视组在这2个距离的调节微波动差异无统计学意义(P=0.145).结论随着调节反应的增大,近视儿童较正视儿童的调节滞后量增加,调节微波动增大.
배경 근년래청소년근시적발생솔축점증가,근시인동근거리용안후표현출조절반응감소,조절체후증가화조절미파동,여근시적형성화발생밀절상관,단존재일정적쟁의. 목적 대비정시화근시학령인동근거리열독상태하조절미파동적차이,탐토기여근시발생발전적가능련계. 방법 채용병례대조연구설계,납입8 ～12주세학령인동89례,기중정시자47례,근시자42례.응용종합험광의대소유입선자진행소동공하규범주각험광,병검사쌍안시공능화입체시각,용Grand Seiko WAM5500형홍외험광의측량열독거리위25 cm급40 cm시량조수시자조절반응급조절미파동,채용독립양본t검험대량조적검측결과진행비교,이조내불동열독거리시조절미파동적변화채용배대t검험진행분석. 결과 당열독거리위25 cm시,정시조수시자적조절반응위(2.67±0.31)D,대우근시조수시자적(2.31±0.33)D,차이유통계학의의(t=5.330,P=0.000)；열독거리위40 cm시,정시조수시자적조절반응위(1.70±0.23)D,야대우근시조적(1.49±0.24)D,차이유통계학의의(t=4.140,P=0.000).열독거리위25 cm시,근시조적조절미파동명현대우정시조적(0.26±0.08)D,차이유통계학의의(t=3.180,P=0.002)；열독거리위40 cm시,근시조적조절미파동위(0.27±0.10)D,대우정시조적(0.24±0.09)D,단차이무통계학의의(P=0.220).열독거리위25 cm시근시조수시자적조절미파동명현고우40 cm적조절미파동,차이유통계학의의(t=3.850,P=0.000),이정시조재저2개거리적조절미파동차이무통계학의의(P=0.145).결론 수착조절반응적증대,근시인동교정시인동적조절체후량증가,조절미파동증대.
Background The incidence of myopia is increase.Some researches documented that formation of myopia is closely related with weakness of the accommodative response,enhancement of accommodative lag and accommodative microfluctuations in short-distance use of eyes.However,there still is controversy.Objective This study sought to compare the accommodative microfluctuations among emmetropic and myopic school-aged children at reading,and to discuss its potential relationship with the onset and development of myopia.Methods A casecontrolled study was designed.Eighty-nine children aged 8-12 years old were recruited in this study,including 47emmetropic children and 42 myopic children.Refractive error were checked by subjective refraction in phoropters and binocular vision and stereopsis were examined in all the subjects.A Grand Seiko WAM5500 auto-refractor was used to measure the accommodative responses and accommodative microfluctuations with different stimulus in 40 cm and 25 cm.The differences in accommodative response and accommodative microfluctuations at 25 cm and 40 cm reading distance were compared between the emmetropic children and myopic children using independent sample t test,and change of accommodative microfluctuations in myopic children at 25 cm and 40 cm reading distance was evaluated by paired t test.Results When the reading distance was 25 cm and 40 cm,the accommodative responses of emmetropes were (2.67 ±0.31) D and (1.70 ±0.23) D,and they were higher than (2.31 ± 0.33) D and (1.49 ±0.24) D of myopes,showing significant differences (t =5.330,P =0.000; t =4.140,P =0.000).Accommodative microfluctuation of myopes was(0.35 ±0.16)D in 25 cm reading distance and that of emmtropes was(0.26±0.08)D,with significant difference between them (t =3.180,P =0.002).However,there was not significant difference in accommodative microfluctuation at 40 cm reading distance between the myopic children and emmtropie children [(0.27±0.10) D vs.(0.24±0.09) D] (P=0.220).In myopic children,the accommodative microfluctuation at 25 cm reading distance was(0.35±0.16) D,showing a much increase than(0.27±0.10) D at 40 cm reading distance(t=3.850,P =0.000),but an insignificant difference in the accommodative mierofluctuations was seen between the 25 cm and 40 cm reading distance in the emmetropic children (P =0.145).Conclusions With the increased accommodative stimulus,myopic children present lower accommodative responses and larger accommodative microfluctuations.