快速序列视觉呈现方式阅读状态下不同屈光组调节反应的差异

The differences in accommodative responses during RSVP reading in groups with different refractive errors

目的研究快速序列视觉呈现方式(rapid serial visual presentation,RSVP)阅读状态下进展性近视、稳定性近视和正视之间调节反应的差异,探讨调节因素在近视发生、发展过程中的表达。方法45例受试者参加本实验,分为进展性近视、稳定性近视和正视组,各15例。阅读材料为位于距受试者左眼角膜平面25cm处的电脑显示屏上的一篇中文短文,通过RSVP软件呈现单个字符,字体大小为9pt,文字呈现速度为150字/min。使用SEIKO-WV500自动验光仪测量其开放视野阅读状态下左眼的调节反应。结果所有受试者在4D的调节刺激下,均存在一定程度的调节滞后,个体差异较大。进展性近视组的调节反应低于正视组[(2.32±0.43)Dvs(3.19±0.53)D,P<0.01],进展性近视组的调节反应亦低于稳定性近视组[(2.32±0.43)Dvs(3.07±0.34)D,P<0.01],而正视组和稳定性近视组差异无显著性(P=0.441)。结论近距离阅读状态下进展性近视有较高的调节滞后,远视性离焦造成的模糊斑可能是近视的发生发展的促成因素,随着近视发展的稳定,调节反应恢复至一般水平。

Objective To investigate the accommodative responses in progressive myopes, stable myopes and emmetropes when reading. Methods The accommodative responses of the left eye were measured with a Grand SEIKO-WV 500 autorefractor in 45 subjects （15 progressive myopes, 15 stable myopes and 15 emmetrepes）. Excerpts from Chinese novels were used as reading material and presented by rapid serial visual presentation with one character at a time on a computer screen at a distance of 25 cm. A 9-point character size was presented at a rate of 150 characters/ minute. Results All of the subjects showed some accommodative lag with the same accommodative stimuli of 4 D but had large individual variability. The accommodative responses for progressive myopes were lower than that for emmetropes [（2.32±0.43）D vs （3.19±0.53）D,P〈0.01]. The accommodative responses for progressive myopes were also lower than that for stable myopes [（2.32±0.43）D vs （3.07±0.34）D,P〈0.01]. However, there were no significant differences in accommodative responses between emmetropes and stable myopes （P=0.441）. Conclusion Progressive myopes show lower accommodative response at near, the high accommodative lag induced retinal image may be linked to myopia development, and the accommodative response will return to normal values when myopia progression stabilizes.