近视患者明暗瞳孔下Kappa角的变化及分析

Changes and Analysis of Angle Kappa under Photopic and Mesopic Pupils in Myopia Patients

目的:研究近视患者双眼暗视至明视状态下Kappa角水平偏移量及垂直偏移量的变化规律。方法:横断面研究。选取2020年11月至2021年12月在宁夏医科大学总医院门诊近视中心明确诊断为近视的患者,并采用单纯随机抽样的方法抽取120例(240眼),采用博士伦Orbscan Ⅱ角膜地形图仪分别于暗视及明视条件下进行检查,记录明暗视下瞳孔直径大小、Kappa角的大小及水平偏移量和垂直偏移量。采用配对t检验比较左右眼在暗视和明视下的瞳孔直径和Kappa角大小;采用散点分布图分析双眼在明暗视下Kappa角的象限分布。结果:左右眼在暗视状态下的瞳孔直径均明显大于明视状态下的瞳孔直径,差异有统计学意义(t=13.67,P<0.001;t=13.48,P<0.001)。暗视与明视状态下左眼的Kappa角均大于右眼的Kappa角,差异有统计学意义(t=4.15,P=0.021;t=5.27,P=0.008)。由暗视转向明视状态时,双眼Kappa角的分布呈现镜像对称,水平方向主要向鼻侧位移,垂直方向主要向上方位移。右眼矢量位移(0.168±0.100)mm,左眼矢量位移(0.171±0.069)mm;87.5%右眼矢量位移小于0.3 mm,92.5%左眼矢量位移小于0.3 mm,绝大多数近视患者的矢量位移在0.3 mm以内。结论:从暗视至明视状态下,随着瞳孔缩小,近视患者的Kappa角分布主要向鼻上方位移。

Objective:To study the changes of horizontal and vertical shifts of angle Kappa in myopic patients from mesopic condition to photopic condition.Methods:In this cross-sectional study.A total of 120 patients(240 eyes)who were diagnosed with myopia at the Outpatient Myopia Center of Ningxia Medical University General Hospital from November 2020 to December 2021 were selected by simple random sampling and examined under mesopic condition and photopic condition using a Bausch&Lomb Orbscan Ⅱ corneal topographer.Then records the diameter of the photopic and mesopic pupils,the angle of angle kappa under photopic and mesopic pupils,and the horizontal and vertical displacement.Paired t-test was used to compare the pupil diameter and angle Kappa of the left and right eyes under photopic and mesopic conditions;the quadrant distribution of the angle Kappa of both eyes under photopic and mesopic conditions was analyzed by scatter plot.Results:The pupil diameters of both eyes under mesopic condition were significantly larger than those under photopic condition,with significant differences(t=13.67,P<0.001;t=13.48,P<0.001).The angle Kappa of the left eyes were larger than that of the right eyes in both mesopic and photopic conditions,and both were significantly different(t=4.15,P=0.021;t=5.27,P=0.008).When shifting from mesopic condition to photopic condition,the distribution of angle Kappa in both eyes showed mirror symmetry,with horizontal displacement mainly deviating to the nasal side and vertical displacement mainly deviating to the superior side.The mean vector displacement of right eyes was 0.168±0.100 mm,87.5% of the right eyes had a vector displacement of less than 0.3 mm.The mean vector displacement of left eyes was 0.171±0.069 mm,92.5% of the left eyes had a vector displacement of less than 0.3 mm.The vast majority of myopic patients have a vector displacement of 0.3 mm or less.Conclusion:From mesopic to photopic condition,pupil diameters become small and the angle Kappa distribution in myopic patients mainly shift to nasal and superior direction.