高度近视患者对比敏感度与双眼视功能的相关性分析

Study of the correlation between contrast sensitivity and binocular vision in high myopia patients

目的探讨高度近视患者对比敏感度与双眼视功能的相关性,了解双眼视功能对高度近视患者对比敏感度的影响。方法横断面研究。收集2020年3月至2020年12月天津市眼科医院视光中心就诊的高度近视患者33例(66眼)。测量他们的眼动参数以及明视和暗视状态下的双眼对比敏感度,根据眼动参数所属功能指标类型将其分为调节与聚散功能指标,调节功能指标包括调节幅度(AMP)、单眼调节灵活度(MAF)、双眼调节灵活度(BAF),聚散功能指标包括远水平隐斜(DLP)、近水平隐斜(NLP)、正融像范围(PFV)、负融像范围(NFV)以及聚散灵活度(VF),其中PFV又包括远PFV破裂点、远PFV恢复点、近PFV破裂点、近PFV恢复点,NFV又包括远NFV破裂点、远NFV恢复点、近NFV破裂点、近NFV恢复点。采用Pearson双变量相关分析对不同状态下双眼对比敏感度与调节功能、聚散功能指标的双变量相关性进行分析,并采用典型相关分析来分析高度近视患者双眼对比敏感度与调节、聚散功能指标之间的关系。结果研究对象的等效球镜度数左眼为(-9.51±2.71)D、右眼为(-10.00±2.88)D。双变量相关分析结果显示,调节功能指标中,左眼AMP与暗视18.0 c·d^(-1)的对比敏感度呈负相关(r=-0.406,P=0.019);聚散功能指标中,近PFV破裂点与暗视1.5 c·d^(-1)(r=0.458)、3.0 c·d^(-1)(r=0.441)的对比敏感度均呈正相关(均为P<0.05);近PFV恢复点与明视3.0 c·d^(-1)(r=0.351)、6.0 c·d^(-1)(r=0.396)的对比敏感度均呈正相关(均为P<0.05),与暗视1.5 c·d^(-1)(r=0.449)、3.0 c·d^(-1)(r=0.537)、12.0 c·d^(-1)(r=0.375)的对比敏感度均呈正相关(均为P<0.05);VF与明视1.5 c·d^(-1)(r=0.358)以及暗视3.0 c·d^(-1)(r=0.458)的对比敏感度均呈正相关(均为P<0.05)。除上述指标外,调节功能和聚散功能的其他指标与对比敏感度均无相关性(均为P>0.05)。典型相关分析结果显示,仅聚散功能指标与暗视对比敏感度的第一对典型相关系数具有统计学意义(P=0.008),典型相关系数为0.912。聚散功能指标U 1主要由NLP、近NFV恢复点、近PFV破裂点、近PFV恢复点决定;暗视对比敏感度V_(1)主要由暗视1.5 c·d^(-1)、暗视6.0 c·d^(-1)对比敏感度决定。典型结构分析结果显示,U_(1)与近PFV破裂点、暗视1.5 c·d^(-1)对比敏感度呈较强正相关;V_(1)与近PFV破裂点、暗视1.5 c·d^(-1)对比敏感度呈较强正相关。结论高度近视患者的聚散功能与暗视状态下的对比敏感度存在一定关联,着重改善双眼视功能可能会提高高度近视患者的对比敏感度,提升整体视觉质量。

Objective To explore the correlation between contrast sensitivity and binocular visual function in individuals with high myopia,aiming to understand how binocular visual function impacts contrast sensitivity in this population.Methods In this cross-sectional study,a total of 33 patients(66 eyes)with high myopia attending the Optometric Center of Tianjin Eye Hospital from March to December 2020 were included.They were measured for oculomotor parameters as well as binocular contrast sensitivity in photopic and scotopic conditions.According to the type of functional indicators to which the oculomotor parameters belong,they were divided into two groups:accommodation and vergence.The oculomotor parameters of accommodation include accommodative amplitude(AMP),monocular accommodative facility(MAF)and binocular accommodative facility(BAF);the oculomotor parameters of vergence include distance lateral phoria(DLP),near lateral phoria(NLP),positive fusional vergence(PFV),negative fusional vergence(NFV),and vergence facility(VF),among them,PFV includes the near and distance PFV breaking points and recovery points,and NFV includes the near and distance NFV breaking points and recovery points.Pearson bivariate correlation analysis was used to analyze the bivariate correlations between binocular contrast sensitivity and the oculomotor parameters of accommodation and vergence.In addition,canonical correlation analysis was used to analyze the associations between binocular contrast sensitivity and accommodation and vergence indicators in patients with high myopia.Results The spherical equivalent refraction of the participants was(-9.51±2.71)D in the left eye and(-10.00±2.88)D in the right eye.The bivariate correlation analysis showed that among the oculomotor parameters of accommodation,the AMP of the left eye was negatively correlated with the contrast sensitivity at 18 c·d^(-1) under scotopic conditions(r=-0.406,P=0.019);among the oculomotor parameters of vergence,the near PFV breaking point was positively correlated with the contrast sensitivity at 1.5 c·d^(-1)(r=0.458)and 3.0 c·d^(-1)(r=0.441)under scotopic conditions(both P<0.05),the near PFV recovery point was positively correlated with the contrast sensitivity at 3.0 c·d^(-1)(r=0.351)and 6.0 c·d^(-1)(r=0.396)under photopic conditions(both P<0.05)and positively correlated with contrast sensitivity at 1.5 c·d^(-1)(r=0.449),3.0 c·d^(-1)(r=0.537)and 12.0 c·d^(-1)(r=0.375)under scotopic conditions(all P<0.05),and VF was positively correlated with contrast sensitivity at 1.5 c·d^(-1)(r=0.358)under photopic conditions and 3.0 c·d^(-1)(r=0.458)under scotopic conditions(both P<0.05).Except for the above indicators,other oculomotor parameters of accommodation and vergence were not correlated with contrast sensitivity(all P>0.05).Canonical correlation analysis showed that only the oculomotor parameters of vergence were correlated with the first pair of canonical correlation coefficients of contrast sensitivity under scotopic conditions(P=0.008)and the canonical correlation coefficient was 0.912.The oculomotor parameters of convergence U_(1) were mainly determined by NLP,near NFV recovery point,near PFV breaking point,and near PFV recovery point.Contrast sensitivity V 1 under scotopic conditions was mainly determined by contrast sensitivity at 1.5 c·d^(-1) and 6.0 c·d^(-1) under scotopic conditions.The typical structural analysis showed that there was a strong positive correlation of U_(1) with near PFV breaking point and contrast sensitivity at 1.5 c·d^(-1) under scotopic conditions;there was a strong positive correlation of V_(1) with near PFV breaking point and contrast sensitivity at 1.5 c·d^(-1) under scotopic conditions.Conclusion There is an association between vergence and contrast sensitivity under scotopic conditions among high myopia patients.Improving binocular visual function may enhance contrast sensitivity and overall visual quality in high myopia patients.