暗视到明视状态下近视眼瞳孔直径和瞳孔中心位移变化

Changes of pupil diameter and pupillary centroid shift of myopia from scotopic to photopic condition

目的研究近视患者在暗视到明视状态下瞳孔中心位移情况以及瞳孔直径变化特点。方法采用病例系列观察研究方法,纳入2016年9—11月在天津市眼科医院屈光手术中心就诊的近视患者70例140眼,使用KR-1W视觉质量分析仪获得从暗视(0.017 lx)到明视(10.400 lx)下的瞳孔中心位移和轴向,并对其进行矢量分析,同时获得暗视和明视状态下的瞳孔直径参数。结果暗视和明视状态下双眼瞳孔直径均呈明显正相关(暗视:r s=0.85,P<0.001;明视:r=0.85;P<0.001),双眼间从暗视到明视瞳孔直径变化量呈明显正相关(r=0.75,P<0.001)。右眼在暗视、明视状态下瞳孔直径及瞳孔直径变化量均明显大于左眼,差异均有统计学意义(均P<0.05)。由暗视转变为明视状态,瞳孔中心主要向鼻上方向移位。68例受试者右眼瞳孔中心矢量位移在0.2 mm以内;66例受试者左眼瞳孔中心矢量位移在0.2 mm以内;所有受试者瞳孔中心矢量位移均在0.3 mm以内。瞳孔直径的变化量与年龄和性别均无明显相关性。双眼瞳孔中心位移与年龄、屈光度以及瞳孔直径变化量均无明显相关性。结论从暗视到明视状态下近视患者的双眼瞳孔中心位移具有对称性,主要向鼻上方移位。

Objective To study the pupillary centroid shift of myopia and characteristics of pupil diameter change from scotopic to photopic condition.Methods A case series study was carried out,140 eyes of 70 myopia patients from September to November 2016 in Tianjin Eye Hospital were enrolled.The pupillary centroid shift and pupil diameter parameters were measured by visual quality analyzer from scotopic(0.017 lx)to photopic(10.400 lx)condition.This study followed the Declaration of Helsinki.Results Under the scotopic and photopic conditions,the pupil diameter was positively correlated between the bilateral eyes(scotopic:r s=0.85,P<0.001;photopic:r=0.85,P<0.001),and the pupil diameter variation from scotopic to photopic condition was positively correlated between the bilateral eyes(r=0.75,P<0.001).The pupil diameter in scotopic and photopic conditions,and the change of pupil diameter in the right eyes were significantly higher than those in the left eyes(all at P<0.05).The pupillary centroid shift was within 0.2 mm in the left eyes of 94.2%(66/70)subjects and in the right eyes of 97.1%(68/70)subjects.The pupillary centroid shift of all subjects was within 0.3 mm.From scotopic to photopic condition,the pupil centroid was mainly shift to the nasal superior direction.There was no significant correlation between pupil diameter and age or gender.There was no significant correlation between pupillary centroid shift and age,diopter or pupil diameter.Conclusions The binocular pupillary centroid shift are symmetrical from scotopic to photopic condition in myopic eyes,and the pupil centroid mainly shift to nasal superior direction.