间歇性外斜视与近视发展关系的研究

Relationships between Intermittent Exotropia and Myopia Development

目的探讨间歇性外斜视(IXT)与近视发展的关系。方法将56例IXT患者分为3组,儿童组24例(3～9岁)、少年组15例(10～18岁)、成人组17例(19～39岁)。应用红外自动验光仪测定在单眼视和双眼同时视状态下的等效球镜屈光度和调节反应,各年龄组进行比较,并与年龄进行相关性分析。结果各组单眼和双眼同时视状态下屈光度比较差异均有统计学意义(P<0.05);双眼同时视和单眼视状态下的屈光度变化(△R)在成人组[(1.31±0.38)D]较儿童组的[(0.47±0.43)D]和少年组的[(0.62±0.27)D]均明显增加,差异有统计学意义(P<0.05)。△R和年龄呈正相关(r=0.699,P=0.000);调节反应与年龄呈负相关(r=-0.407,P=0.002)。调节反应量(AR)成人组[(-1.87±1.35)D]较儿童组的[(-0.78±1.00)D]和少年组的[(-0.82±1.28)D]调节超前趋势显著增加,差异有统计学意义(P=0.012)。结论 IXT患者为维持双眼视轴平行做出过度的调节,表现为调节超前,可能是导致IXT患者出现调节性近视的潜在因素。儿童的相对调节与相对辐辏幅度较大,调节性近视不明显;而成人调节力和融合力下降,可能更易出现调节性近视。

Objective To study the relationship between intermittent exotropia and development of myopia. Methods Fifty-six patients with intermittent exotropia were divided into three groups agewise： children（24 patients aged 3～9 years old）,adolescents（15 patients aged 10～18 years old）,and adults（17 patients aged 19～39 years old）.GRAND-SEIKO WAM-5500 auto-refractor was used to measure accommodative response and the spherical refractive error under binocular and monocular viewing conditions. Results Binocular and monocular spherical refractive error（△R） in adults[（1.31±0.38）D] was significantly increased compared with those in children[（0.47±0.43）D] and in adolescents[（0.62±0.27）D]（P0.05）.△R was positively correlated with age（r=0.699,P=0.000）,while accommodative response was negatively correlated with age（r=-0.407,P=0.002）.Accommodative response（AR） was significantly higher in adult patients [（-1.87±1.35）D] than in children[（-0.78±1.00）D] and in adolescents[（-0.82±1.28）D]（P=0.012）. Conclusion With reduced accommodative and fusional amptitudes,adults are more likely to develop phoria myopia,compared with children and adolescents.