刺激小脑顶核对青少年眼调节功能的影响(英文)

Effects of fastigial nucleus stimulation on adolescent eye accommodation☆

背景:文献报道电刺激小脑顶核可明显增加脑组织的血液供应,由于眼部组织血供和脑组织血供关系密切,电刺激小脑顶核是否也能增加脉络膜、睫状体的血液供应呢?目的:评估刺激小脑顶核对改善青少年近视和眼调节功能的作用。设计:前后对照研究。单位:一所大学眼耳鼻喉科医院的眼科门诊。对象:1999-12/2000-12收集复旦大学附属眼耳鼻喉科医院眼科门诊8名轻度近视儿童,男6例,女2例;年龄9～12岁。干预:用刺激小脑顶核的方法对受试者实施电刺激。检测颈动脉及眼视盘血流参数,用综合验光仪检测刺激前后的单双眼相对性调节、调节幅度、调节灵敏度。主要观察指标:①脑循环动力学检测刺激前后颈动脉血流速度。②共焦扫描激光多普勒检测刺激前后视乳头血流。③眼调节功能指标的变化。结果:8名受试儿童刺激前双眼调节幅度、调节灵敏度、负相对性调节、-1正相对性调节分别为(4.83±1.42)D,(12.21±4.24)min,(2.62±0.56)D,4.19±0.90)D,刺激后1个月分别为5.72±0.34)D,(((21.20±4.30)min,(2.84±0.61)D,(4.28±0.92)D。刺激后1个月-1的调节功能各项指标均有显著性改善。结论:通过体外刺激小脑顶核可明显改善青少年近视的调节功能,但对于调节功能的改善与眼屈光发展的关系,以及是否能延缓近视形成,有待进一步研究。

BACKGROUND:Certain literature reports that stimulating fastigial nucleus can g reatly increase the blood supply of brain.If stimulating fastigial nucleus can i ncrease the blood supply of choroid and ciliary body due to the close relationsh ip between ocular blood supply and brain blood supply? OBJECTIVE:To assess the effects of fastigial nucleus stimulation on improvemen t of adolescent myopia and eye accommodation. DESIGN:Before after study. SETTING:Outpatient Clinic,Ophthalmic Department of Ophthalmology and Otolaryng ology Hospital of a University. PARTICIPANTS:Totally 8 children visited Ophthalmic Department of Affiliated Op hthalmology and Otolaryngology Hospital of Fudan University due to slight myopia between December 1999 and December 2000 were involved.There were 6 boys and 2 g irls aged from 9 to 12 years old. INTERVENTION:Electricity stimulation was conducted to testees with fastigial n ucleus stimulation method.To detect the blood flow parameters of carotid artery and optic disc and test the relative accommodation of single eye and double eyes ,accommodation scope and sensitivity before and after stimulation with eye exami nation machine. MAIN OUTCOME MEASURES:①Flow velocity before and after stimulation is detected with cerebral hemodynamic test.②Blood flow of optic papilla before and after s timulation is detected with confocal scanning laser Doppler.③Changes of indicat ors of eye accommodation. RESULTS:The both eyes accommodation scope, accommodation sensitivity,negative relative accommodation, positive relative accommodation of the 8 children before stimulation was(4.83±1.42)D,(12.21±4.24)minute-1,(2.62±0.56)D,(4.1 9±0.90)D respectively while the value of above indicators turned to (5.72±0. 34)D,(21.20±4.30)minute-1,(2.84±0.61)D,(4.28±0.92)D one month afte r stimulation.The indicators of accommodation were significantly improved after stimulation. CONCLUSION:The accommodation of adolescent myopia can be greatly improved by i n vitro fastigial nucleus stimulation.However,it needs further study on the rela tionship between it and accommodation improvement,development of eye refraction as well as if it can postpone the myopia.