眼科 ›› 2012, Vol. 21 ›› Issue (5): 323-326.

• 论著 • 上一篇    下一篇

9~10岁学生近视状态与调节因素的关系

冯祎   刘丽娟   唐萍   郭寅   孟梦   

  1. 100730 首都医科大学附属北京同仁医院 北京同仁验光配镜中心(冯祎、唐萍、孟梦);北京同仁眼科中心 北京市眼科研究所(刘丽娟、郭寅)
  • 收稿日期:2012-03-21 出版日期:2012-09-25 发布日期:2012-09-28
  • 通讯作者: 唐萍,Email: tp2200@sina.com

Relationship between myopia and accommodative parameters in 9~10 years old children

 FENG  Yi,   Liu-Li-Juan,   Tang-Ping,   Guo-Yin,   Meng-Meng   

  1. Beijing Tongren Optometric Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
  • Received:2012-03-21 Online:2012-09-25 Published:2012-09-28
  • Contact: TANG Ping, Email: tp2200@sina.com

摘要: 目的 分析9~10岁青少年近视状态与眼调节功能的相关性,试图探索预防、治疗、矫正青少年近视较佳方案。设计 横断面研究。 研究对象 小学三四年级9~10岁、裸眼视力<0.9并近视屈光度≤-0.25 D的学生114例223眼。方法 对以上小学生进行眼前段和眼底检查,调节幅度、调节灵活度及正、负相对调节检查,复方托吡卡胺滴眼液(美多丽)散瞳后行屈光度检查,根据近视屈光程度(散光以等效球镜度计算)将受试者分为A组-0.25~-1.25 D(115眼)、 B组-1.50~-2.50 D(70眼)、 C组-2.75~ -4.50 D(38眼),分别进行调节相关参数与近视屈光状态间Pearson相关性检验以及单因素方差分析。主要指标 近视屈光度,调节参数(调节幅度、调节灵活度、正相对调节、负相对调节)。结果 223眼近视屈光度为(-1.57±1.03)D(-0.25~-4.50 D)。调节幅度与近视屈光度呈正相关(r=0.22,P=0.001)。正相对调节与近视屈光度呈负相关(r=-0.25,P=0.000)。调节灵活度和负相对调节与近视屈光度不具有显著相关性(r= 0.03、0.06,P=0.65、0.34)。对三组屈光度间学生的调节因素进行两两比较,显示调节幅度中A组与B组和C组相比较差异具有统计学意义(F=2.16、2.21,P=0.00、0.00);正相对调节中A组与B组和C组比较差异具有统计学意义(F=-0.45、 -0.53,P=0.01、0.02);B组的调节幅度和正相对调节与C组相比差异无统计学意义(F=0.06、-0.09,P=0.95、0.72)。结论 调节参数中调节幅度和正相对调节对近视的发展具有参考价值,通过视觉训练改善调节的异常,可能对部分调节滞后的儿童具有辅助治疗作用。(眼科, 2012, 21: 323-326)

关键词: 近视, 调节, 青少年

Abstract: Objective To study the relationship between myopia and accommodative parameters in 9~10 years old children and explore a program for myopia treatment and prevention. Design Cross sectional study. Participants 114 children (223 eyes) aged 9~10 years, with visual acuity(VA)≤0.9 and refraction≤-0.25 D were enrolled in this study. Methods The participants were investigated a comprehensive examination including VA, slip lamp, cycloplegia refraction and fundus, amplitude of accomodation(AMP), positive relative accomodation(PRA), negative relative accomodation(NRA) and accomodative facility(AF) were measured in all children. Participants were divided into 3 groups according to the refraction: Group A (-0.25~-1.25 D), Group B (-1.50~-2.50 D) and Group C (-2.75~ -4.50 D). Data was analyzed in each group with Pearson correlation and ANOVA. Main Outcome Measures Myopia refraction, accommodation(AMP, AF, PRA, NRA). Results The mean refractive error was -1.57±1.03 D(range:-0.25~-4.50 D). Refraction was correlate with AMP (r=0.22, P=0.001), PRA(r=-0.25,P=0.00), and not associated with NRA(r=0.03, P=0.65), AF (r=0.06, P=0.34). Compared three groups of accommodative parameters, AMP were significant different in Group A from Group B and C (F=2.16, 2.21; P=0.00, 0.00) , and PRA were significant different in Group A from Group B and C (F=-0.45, -0.53; P=0.01, 0.02), no significant difference between Group B and C(F=0.06, -0.09; P=0.95, 0.72). Conclusion In this survey, AMP and PRA were both correlated with myopia progression. It is supposed that visual training may improve the accommodative abnormality at the onset of myopia, and then get certain auxiliary therapeutic effect in children with partial accommodative lag. (Ophthalmol CHN, 2012, 21: 323-326)

Key words: myopia, accommodation, adolescent