中华实验眼科杂志
中華實驗眼科雜誌
중화실험안과잡지
CHINESE JOURNAL OF EXPERIMENTAL OPHTHALMOLOGY
2015年
6期
513-517
,共5页
王凯%李岩%石晓庆%吴夕%赵明威%黎晓新
王凱%李巖%石曉慶%吳夕%趙明威%黎曉新
왕개%리암%석효경%오석%조명위%려효신
眼调节/生理%近视/预防和控制%眼屈光/生理%眼镜/三棱镜%人%正视眼
眼調節/生理%近視/預防和控製%眼屈光/生理%眼鏡/三稜鏡%人%正視眼
안조절/생리%근시/예방화공제%안굴광/생리%안경/삼릉경%인%정시안
Accommodation,ocular/physiology%Myopia/prevention & control%Refraction,ocular/physiology%Eyeglasses/prism%Humans%Emmetropia
背景 有效控制青少年近视的进展是视光学研究领域的热点之一,有学者采用附加底朝内(BI)三棱镜的方法控制近视的进展,然而由于改变眼的集合会影响调节反应,因此这种方法的效果值得讨论. 目的 观察正视眼附加不同性质的三棱镜后调节反应和调节微波动的变化. 方法 采用前瞻性研究方法,纳入2014年7月在北京大学人民医院参加体检的正常受试者22人,年龄21~27岁,受试眼均无屈光不正.受试者分别自愿接受未附加三棱镜、附加3△BI和3△底朝外(BO)三棱镜的干预,各种干预过程间隔3 min,测量间隔期间嘱患者眺望远处.采用开放视野红外自动验光仪分别在不同干预情况下记录瞳孔直径和调节反应曲线,采集的屈光度数据减去-3.0D即为调节反应,以调节反应的均方根(RMS)作为调节微波动幅度.采用一维离散傅里叶变换分析调节反应曲线的频谱特征.采用重复测量单因素方差分析对3种干预下调节反应值、调节微波动幅度和瞳孔直径的差异进行比较. 结果 未附加三棱镜、附加3△BI三棱镜和附加3△BO三棱镜后受试眼的调节反应值分别为(+0.31±0.78)、(+0.51±0.75)和(+0.18±0.72)D,总体比较差异有统计学意义(F=28.078,P=0.000),其中与未附加三棱镜比较,附加3△BI三棱镜后受试眼调节滞后量增加,而附加3△BO三棱镜后受试眼调节滞后量下降,差异均有统计学意义(P=0.000、0.012).未附加三棱镜、附加3△BI三棱镜和附加3△ BO三棱镜后受试眼调节微波动幅度的差异比较无统计学意义(F=0.062,P=0.879).未附加三棱镜、附加3△BI三棱镜和附加3△BO三棱镜受试眼调节反应频谱低频信号功率(0～0.5 Hz)分别占总功率(0～2.5 Hz)的97.5％、98.3％和91.4％.附加3△ BI的三棱镜后受试者的平均瞳孔直径为(5.37±0.69)mm,大于未附加三棱镜受试者的(5.07±0.66)mm和附加3△BO三棱镜后的(5.01±0.69) mm,差异均有统计学意义(均P=0.000). 结论 与附加BI三棱镜相比,附加BO三棱镜能够改善调节滞后,缩小瞳孔,同时减少调节反应中的低频信号成分.
揹景 有效控製青少年近視的進展是視光學研究領域的熱點之一,有學者採用附加底朝內(BI)三稜鏡的方法控製近視的進展,然而由于改變眼的集閤會影響調節反應,因此這種方法的效果值得討論. 目的 觀察正視眼附加不同性質的三稜鏡後調節反應和調節微波動的變化. 方法 採用前瞻性研究方法,納入2014年7月在北京大學人民醫院參加體檢的正常受試者22人,年齡21~27歲,受試眼均無屈光不正.受試者分彆自願接受未附加三稜鏡、附加3△BI和3△底朝外(BO)三稜鏡的榦預,各種榦預過程間隔3 min,測量間隔期間囑患者眺望遠處.採用開放視野紅外自動驗光儀分彆在不同榦預情況下記錄瞳孔直徑和調節反應麯線,採集的屈光度數據減去-3.0D即為調節反應,以調節反應的均方根(RMS)作為調節微波動幅度.採用一維離散傅裏葉變換分析調節反應麯線的頻譜特徵.採用重複測量單因素方差分析對3種榦預下調節反應值、調節微波動幅度和瞳孔直徑的差異進行比較. 結果 未附加三稜鏡、附加3△BI三稜鏡和附加3△BO三稜鏡後受試眼的調節反應值分彆為(+0.31±0.78)、(+0.51±0.75)和(+0.18±0.72)D,總體比較差異有統計學意義(F=28.078,P=0.000),其中與未附加三稜鏡比較,附加3△BI三稜鏡後受試眼調節滯後量增加,而附加3△BO三稜鏡後受試眼調節滯後量下降,差異均有統計學意義(P=0.000、0.012).未附加三稜鏡、附加3△BI三稜鏡和附加3△ BO三稜鏡後受試眼調節微波動幅度的差異比較無統計學意義(F=0.062,P=0.879).未附加三稜鏡、附加3△BI三稜鏡和附加3△BO三稜鏡受試眼調節反應頻譜低頻信號功率(0～0.5 Hz)分彆佔總功率(0～2.5 Hz)的97.5％、98.3％和91.4％.附加3△ BI的三稜鏡後受試者的平均瞳孔直徑為(5.37±0.69)mm,大于未附加三稜鏡受試者的(5.07±0.66)mm和附加3△BO三稜鏡後的(5.01±0.69) mm,差異均有統計學意義(均P=0.000). 結論 與附加BI三稜鏡相比,附加BO三稜鏡能夠改善調節滯後,縮小瞳孔,同時減少調節反應中的低頻信號成分.
배경 유효공제청소년근시적진전시시광학연구영역적열점지일,유학자채용부가저조내(BI)삼릉경적방법공제근시적진전,연이유우개변안적집합회영향조절반응,인차저충방법적효과치득토론. 목적 관찰정시안부가불동성질적삼릉경후조절반응화조절미파동적변화. 방법 채용전첨성연구방법,납입2014년7월재북경대학인민의원삼가체검적정상수시자22인,년령21~27세,수시안균무굴광불정.수시자분별자원접수미부가삼릉경、부가3△BI화3△저조외(BO)삼릉경적간예,각충간예과정간격3 min,측량간격기간촉환자조망원처.채용개방시야홍외자동험광의분별재불동간예정황하기록동공직경화조절반응곡선,채집적굴광도수거감거-3.0D즉위조절반응,이조절반응적균방근(RMS)작위조절미파동폭도.채용일유리산부리협변환분석조절반응곡선적빈보특정.채용중복측량단인소방차분석대3충간예하조절반응치、조절미파동폭도화동공직경적차이진행비교. 결과 미부가삼릉경、부가3△BI삼릉경화부가3△BO삼릉경후수시안적조절반응치분별위(+0.31±0.78)、(+0.51±0.75)화(+0.18±0.72)D,총체비교차이유통계학의의(F=28.078,P=0.000),기중여미부가삼릉경비교,부가3△BI삼릉경후수시안조절체후량증가,이부가3△BO삼릉경후수시안조절체후량하강,차이균유통계학의의(P=0.000、0.012).미부가삼릉경、부가3△BI삼릉경화부가3△ BO삼릉경후수시안조절미파동폭도적차이비교무통계학의의(F=0.062,P=0.879).미부가삼릉경、부가3△BI삼릉경화부가3△BO삼릉경수시안조절반응빈보저빈신호공솔(0～0.5 Hz)분별점총공솔(0～2.5 Hz)적97.5％、98.3％화91.4％.부가3△ BI적삼릉경후수시자적평균동공직경위(5.37±0.69)mm,대우미부가삼릉경수시자적(5.07±0.66)mm화부가3△BO삼릉경후적(5.01±0.69) mm,차이균유통계학의의(균P=0.000). 결론 여부가BI삼릉경상비,부가BO삼릉경능구개선조절체후,축소동공,동시감소조절반응중적저빈신호성분.
Background How to control progression of myopia is a central issue in clinical optometry.Some clinical trials showed that wearing base-in (BI) prism can slow down progression of myopia to certain degree.However,whether BI prism or base-out (BO) prism should be used is worth discussing.Objective This study was to investigate the influences of different prisms on accommodative response and microfluctuation in emmetropias.Methods This clinical trail was approved by Ethic Committee of Peking University People's Hospital.During July in 2014,twenty-two emmetropias of 22 normal volunteers aged 21-27 years were recruited from Peking University People's Hospital under the written informed consent.An open-field infrared refractometer was used to monitor and record pupil diameter and accommodative response under three conditions including non-prism,3△ BI prism,and 3△ BO prism.The accommodative response value was calculated as the difference between reading value and-3.0 D,and root mean square (RMS) of accommodative response value served as amplitude of accommodative microfluctuation.Spectrum of accommodative response was analyzed by one dimension discrete Fourier transformation.The differences of accommodative response value,amplitude of accommodative microfluctuation and pupil diameter among three conditions were compared using repeated one-way ANOVA.Results The accommodative response values were (+0.31±0.78),(+0.51±0.75) and (+0.18±0.72) D under the non-prism,3△BI prism and 3△BO prismconditions,respectively,with a significant difference among them (F =28.078,P =0.000),and compared with the non-prism condition,the accommodative lag of 3△BI prism condition was increased and that of 3△BO prism condition was reduced (P =0.000,0.012).No significant difference was found in the amplitude of accommodative microfluctuation among the three conditions (F=0.062,P =0.879).The percentages of low frequency signal power (0-0.5 Hz)/total power (0-2.5 Hz) was 97.5％,98.3％ and 91.4％ under the non-prism,3△BI prism and 3△BO prism condition,respectively.The pupil diameter was (5.37-±0.69) mm under the 3 △ BI prism condition,which was larger than (5.07±0.66) mm under the non-prism condition and (5.01 ±0.69) mm under the 3△ BO prism condition (both at P =0.000).Conclusions Compared with wearing 3△ BI prism,wearing 3△ BO prism lessens the accommodative lag,decreases the pupil diameter and reduces the power of low frequency component in accommodative response.
