CAJ | 학술논문

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.
목적 연구수평은사대취산괄응이급쌍안조절반응적영향,탐토은사화근시발전속도지간적상관관계.방법 림상병례대조연구.대2013년9～11월재천진의과대학본과혹연구생자원삼여116명근시수시자,근거근거은사량(near phorias,NP)분위삼조:정위조(N조)48례(-6△≤NP≤0),외은사조(EXO조)42례(NP＜-6△),내은사조(ESO조)26례(NP＞0△).지속주시40cm처시빈현시종단(VDT)열독20 min,열독전후분별행주각험광,원거(5 m)여근거(40 cm)수평은사측량,AC/A치급단안(MA)여쌍안(BA)조절반응(응용Shin-Nippon WR-5100K홍외선개방시야전자동전뇌험광의).결과 열독전삼조MA여BA차이비교균구유통계학의의,기중EXO조:BA＞MA(t=9.264,P＜0.01);N조:BA＞MA(t=4.840,P＜0.01); ESO조:MA＞BA(t =-6.064,P＜0.01).열독전후삼조적취산괄응차이비교유통계학의의(x2=44.026,P＜0.01).EXO조표현위집합성취산괄응(외은사량감소);ESO조여N조균표현위개산성취산괄응(ESO조내은사량감소;N조외은사량증대).결론 은사통과집합성조절대쌍안조절반응산생영향,불동은사재융상성취산수구방향적작용하표현위불동방향적취산괄응.내은사쌍안조절체후량교고,가능여근시적발전속도유관.
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.