双眼协动参数在近视眼的差异研究

A study on difference of ocular motor parameters in myopia

目的 探讨调节和辐辏的关系在近视发生、发展中的作用。方法 本研究对象包括 31例成人正视者与 4 6例成人近视者 ,近视者又分为高度近视者 (>- 6 0 0D)、中度近视者 (- 6 0 0～ -3 2 5D)和轻度近视者 (- 3 0 0～ - 0 5 0D)。双眼协动参数测量包括远距隐斜、近距隐斜及正、负相对调节 ,对不同屈光度数组的计算性调节 (AC/A)进行分析和比较。结果 近视组的计算性AC/A高于正视组 ,且计算性AC/A有随近视程度加深而增加的趋势。近视组和正视组的远隐斜及负相对调节差异无显著意义 (P >0 0 5 ) ,但近视组的正相对调节其绝对值显著低于正视组 (P <0 0 5 ) ,且近视组的近隐斜较正视组的近隐斜有内隐斜倾向 (P <0 0 5 )。结论 调节、辐辏及其相互作用协动参数在近视者中有明显的差异 ,AC/A为该差异的关键参数 ,并因近视度数增高而呈上升趋势 ,AC/A增高表明近视者在近距离工作时存在视网膜离焦趋势。

Objective This study sought to assess the difference of these ocular motor parameters in myopia onset and development were explored. Methods 31 emmetropia and 46 myopia adult subjects were included in this study. The myopia subjects were divided into three groups as mild myopia, moderate myopia and high myopia. Phoria at distance and near, positive and negative relative accommodation (NRA/PRA) were measured. Accommodative convergence and accommodation stimulus ratio (AC/A) was determined through phoria values′ calculation.Results Calculated AC/A of myopia was higher than that of emmetropia, and there were trends of elevated AC/A with myopia power increasing. There was significant difference in phoria in near between the myopia group and emmetropia group, but none in that of distance. There was no significant difference in NRA. However, PRA of myopia was lower than that of the emmetropia(P<0.05). Conclusions Ocular motor parameters are different in myopia eyes. AC/A is one of key parameters among them, and AC/A is increased in myopia, which indicates out of focus of retinal image in the developing myopia.