调节聚散系统交互作用的相关性

Correlation of the Interactions between Accommodation and Vergence in Different Refraction Groups

目的:探讨正视眼和早发性近视眼刺激性调节性集合/调节比值(AC/A值)、刺激性集合性调节/集合比值(CA/C值)、反应性AC/A以及反应性CA/C之间的差异及相互关系。方法:病例对照研究。选取2016年10月至2017年1月在温州医科大学附属眼视光医院视光门诊就诊的9~14岁早发性近视患者27例为早发性近视组,另选取20例正视者作为正视组,在双眼视状态使用精工自动红外验光仪和改良式Thorington法分别测量25cm处5个调节刺激水平和6个聚散刺激水平下的调节反应和隐斜量,计算2组的刺激性AC/A、刺激性CA/C、反应性AC/A以及反应性CA/C值。数据采用t检验和Pearson相关性分析进行统计分析。结果:正视组、早发性近视组的反应性AC/A分别为(4.07±1.47)^Δ/D、(5.13±1.95)^Δ/D,差异有统计学意义(t=2.12,P=0.04)。正视组、早发性近视组的刺激性AC/A和反应性AC/A值之间均呈正相关(正视组:r=0.903,P<0.001;早发性近视组:r=0.880,P<0.001)。正视组的反应性AC/A和反应性CA/C呈负相关(r=-0.450,P=0.04),早发性近视组这2个参数间无相关性(r=-0.367,P=0.06)。结论:早发性近视眼的反应性AC/A高于正视眼。AC/A和CA/C之间的负相关性只见于正视眼的反应性比率之间,提示单AC/A值不能全面评估调节系统和聚散系统之间的交互作用。

Objective:To investigate stimulus and response accommodative convergence to accommodation(AC/A)and stimulus and response convergence accommodation to convergence(CA/C)ratios between different refractive groups and heterophoria groups.The correlations between the four parameters were also investigated.Methods:In this case control study,20 emmetropes(EMM)and 27 early-onset myopes(EOM)aged 9 to 14 years participated in this descriptive study from October 2016 to January 2017 at Eye Hospital,Wenzhou Medical University.The accommodative response and phoria through five accommodative stimuli and 6 convergence stimuli levels were measured at 25 cm under binocular viewing conditions with a Grand Seiko WAM-5500 autorefractor and a modified Thorington card.Data were analyzed using t-tests and Pearson correlation analysis.Results:Response AC/A ratios of the EMM and the EOM groups were 4.07±1.47^Δ/D and 5.13±1.95^Δ/D,respectively;the difference between the two groups was significant(t=2.12,P=0.04).A significant linear correlation was found between the stimulus and response AC/A ratios in both the EMM and EOM groups(r=0.903,P<0.001;r=0.880,P<0.001).A negative correlation was found between the response AC/A and CA/C ratios in the EMM group(r=-0.450,P=0.04),while no correlation was found between these two ratios in the EOM group(r=-0.367,P=0.06).Conclusions:EOM has a higher response AC/A ratio compared to EMM.The negative correlation between AC/A and CA/C was only found between the response ratios of EMM,indicating that the AC/A ratio cannot provide a true representation of both cross-link interactions.