高阶像差在屈光性弱视中的评价分析

Analysis of Ocular Higher-order Aberrations in Refractive Amblyopia

目的比较高阶像差在屈光性弱视眼与矫正视力正常眼中的分布特征,探讨高阶像差在弱视眼中的作用机制,评价高阶像差在弱视诊断和治疗中的作用。方法使用德国Wave Light公司的Allegro Wave Analyzer像差分析仪对74眼进行像差检查,将检查结果中的Zernike多项式的像差均方根值(RMS)的分布情况进行统计,根据矫正视力分成视力正常组和弱视组进行组间比较。结果两组间相比,RMS4、RMS5、RMS6和RMSh的差异有统计学意义(P<0.05),弱视组明显高于视力正常组。两组的高阶像差均方根值均以RMS3为主,依次呈递减趋势。彗差和y轴彗差在两组间的差异具有统计学意义(P<0.05)。结论高阶像差增高和弱视形成有关。彗差、尤其是y轴彗差对矫正视力有重要的影响,提示弱视诊断应包括高阶像差的内容。

Objective To compare the distribution of ocular higher-order aberrations in control group and amblyopia group and to explore the mechanism of the higher-order aberrations in refractive amblyopia. Methods The root-mean-square （RMS） values of the higher-order aberrations were measured 3 times across 6.5 mm dilated pupil of 74 eyes using Allegro Wave Analyzer. The results were compared in normal control group and amblyopia group which were determined by the best corrected visual acuity. Results RMS4, RMS5, RMS6 and RMSh in amblyopia were all significantly greater than those in control group. RMS values presented a degressive trend from RMS3 to RMS6, and RMS3 was the dominant higher-order aberration in the two groups. Coma and y-axis coma had significant differences in the two groups. ConcJusion The high level of higher-order aberrations is related to amblyopia. Coma, particularly y-axis coma plays an important part in the corrected vision. It suggests that the diagnosis of amblyopia should include ocular higher-order aberrations.