8~15岁近视性屈光参差者调节及双眼视功能的相关研究

Studies on the function of accommodation and binocular vision in myopic anisometropia between 8 and 15 years old

目的对8~15岁近视性屈光参差者进行调节及双眼视功能检查,以明确近视性屈光参差者调节及双眼视功能的关系,为近视性屈光参差的防控提供可靠的依据。方法收集近视性屈光参差者60名,低度屈光参差者(1.00D≤双眼等效球镜差<2.50D)30名,中高度屈光参差者(双眼等效球镜差≥2.50D)30名。其中同期检查的对照组30名(双眼等效球镜差<1.00D),对三组人群进行双眼视功能(近立体视功能、Worth 4点),调节功能(调节幅度,调节灵活度,正负相对调节以及调节反应),水平隐斜视的检查。结果调节幅度和负相对调节在三组间差异无统计学意义。近立体视,Worth 4点,正相对调节和调节反应在三组间差异均有统计学意义,正相对调节在低参差组和高参差组均与对照组差异有统计学意义(t=4.34,6.81;P=0.021,0.000);调节反应在低参差组和高参差组的高度数眼均与对照组差异有统计学意义(t=5.73,20.12;P=0.032,0.000),高参差组与对照组相比,调节灵活度下降且差异有统计学意义(t=5.34,P=0.015)。高参差组和低参差组的远、近距离眼位与对照组相比,差异均有统计学意义(P<0.05)。结论低参差组和高参差组在远/近距离的眼位(隐斜度)均较对照组大,随着近视性屈光参差的程度加大,对双眼视功能损害也加重。近视性屈光参差患者双眼间调节参数也发现部分异常,低参差组和高参差组中高度数眼的调节反应较对照组落后,正相对调节在低参差组和高参差组均较对照组小,调节灵活度在高参差组中明显下降。以上调节参数的改变与近视性屈光参差存在相关性。

Objective To investigate the relationship between myopic anisometropia and the function of accommodation and binocular vision in students age from 8 to 15,so as to find a way to prevent and control the progression of myopic anisometropia.Methods Sixty students with myopic anisometropia were recruited in JiangXi Provincial Hospital,The subjects were assigned into the low anisometropia group with the 1.00D≤spherical equivalent difference<2.50D and the high anisometropia group with spherical equivalent difference≥2.50D,and other 30 individuals with spherical equi valent difference<1.00D were enrolled as the control group.The function of binocular vision(near stereopsis,Worth 4 dots)and accomodation(amplitude of accomodation,accomodative facility,positive and negative relative accomodation and fused cross cylinder),and lateral phoria were examined in three groups.Results There were no significant differences in AMP and NRA among three groups,Near stereopsis,Worth 4 dots,PRA,FCC and AF were significantly different among groups,The PRA in high and low myopic anisometropia was significantly lower than that of control group(t=4.34,6.81;P=0.021,0.000).The FCC in high myope eye of high and low myopic anisometropia was significantly lower than that of control group(t=5.73,20.12;P=0.032,0.000).The accommodative facility(AF)in the high myopic anisometropia was lower significantly than that of control group(t=5.34,P=0.015).The lateral far/near phoria in high and low myopic anisometropia had significant increase compared with control group(P<0.05).Conclusion Compared with control group,the horizontal phoria of the myopic anisometropia group was larger in the far/near distance.With the increase of myopic anisometropia,the damage to binocular visual function was also aggravated.Some abnormalities were also found in the accomodation parameters between the two eyes of patients with myopic anisometropia.The FCC of high myope eye of high and low anisometropia group lagged behind that of control group,PRA was smaller in high and low anisometropia group than that of control group,and AF decreased significantly in the high anisometropia group.The above changes of accomodative parameters were correlated with myopic anisometropia.