远视儿童高阶像差的研究

Wavefront analysis of the ocular higher-order aberrations in hyperopic children

目的探讨远视儿童的高阶像差分布、影响因素及对视功能的影响。设计临床病例系列。研究对象44例(81眼)3￣13岁等效球镜+0.50￣+6.63D远视儿童。方法使用Allegretto波阵面像差仪对上述远视儿童进行波阵面像差测量分析。主要指标高阶像差及其分布,高阶主导像差、高阶像差与瞳孔大小、性别和屈光状态的关系,高阶像差与戴镜矫正视力的关系。结果在6.5mm和4.0mm瞳孔直径时,总高阶像差、3阶和4阶像差均方根值(RMSh、RMS3、RMS4)分别为(0.20±0.05)、(0.15±0.06)、(0.10±0.02)μm和(0.09±0.03)、(0.07±0.03)、(0.05±0.02)μm,差异均有统计学意义(P<0.05),RMSh值呈正态分布;高阶像差均以3阶像差所占比例最高,均占80.2%,主导像差以C7为最高。瞳孔从4.0mm增大到6.5mm,RMSh、RMS3、RMS4分别增加1.36、1.42、1.45倍。不同类型的高阶主导像差对戴镜矫正视力无影响(P>0.05)。RMSh值与戴镜矫正视力无相关性(P>0.05)。性别、球镜、柱镜对RMSh无显著影响(P>0.05)。结论远视儿童高阶像差分布范围宽,部分患儿RMSh值较高;高阶像差各阶及RMSh值随瞳孔增大而增加;远视患儿中高阶主导像差以垂直彗差居多;瞳孔增大时球差、彗差比率增加。(眼科,2006,15:187-190)

Objective To evaluate objectively the profile and variable factors of the ocular higher-order aberrations（HOA ）among hyperopic children. Design Case series. Participants 44 hyperopic children （81 eyes） with spherical equivalence from ＋0.50D to ＋6.63D and age from 3 to 13 years old. Methods The root-mean-square （RMS） value of the HOA （RMSh） was measured with Allegretto wave analyzer. Main Outcome Measures The RMSh at 4.0mm and 6.5mm pupil diameter were calculated, and the variable factors were analyzed, such as pupil diameter, gender, refractive power, spectacle-corrected visual acuity （SCVA）. Results RMSh, RMS3 and RMS4 were （0.20±0.05）μm, （0.15±0.06）μm and （0.10±0.02）μm at 6.5mm pupil diameter; （0.09±0.03）μm, （0.07±0.03） μm and （0.05±0.02）μm at 4.0mm pupil diameter. Significant difference was shown between 6.5mm and 4.0mm pupil diameter （P〈 0.05 ）. RMSh was normally distributed among hyperopic children. The third order aberration was more frequent type in HOA and the ratio was both 80.2% at 6.5mm and 4.0mm pupil diameter. C7 was the most frequent dominating type among all the patients. When the pupil was dilated from 4.0mm to 6.5mm, RMSh, RMS3 and RMS4 increased 1.36-fold, 1.42-fold and 1.45-fold, respectively. The frequency of spherical aberration and coma increased as the pupil got larger. Various dominating types of HOA had no significant effects on SCVA （P〉0.05）. There was no correlation between SCVA and RMSh. The variable factors, such as gender, hyperopic and astigmatism diopters had no significant effects on the RMSh （P〉0.05）. Conclusions The distribution of the RMSh was widely ranged among hyperopic children, and some children expressed higher value of RMSh. As the pupil diameter got larger, the RMS value of HOA significantly increased. Vertical coma was more frequent dominating type of HOA among hyperopic children. （Ophthalmol CHN, 2006, 15： 187-190）