儿童近视进展与调节功能的关系

doi:10.3969/j.issn.2095-9400.2020.06.006

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摘要目的：研究儿童在近视进展过程中调节功能的变化，分析调节功能在近视进展中的作用。方法：观察随访21名进展性近视儿童，年龄（11.1±1.5）岁，分别在入组及2年随访时测量受试者调节功能参数，如远距调节灵活度、动态调节刺激-反应曲线（ASRC）。结果：21名受试者2年后，平均近视进展（-1.55±0.58）D，差异有统计学意义（t=12.24，P＜0.01）。随访前后，远距调节灵活度、ASRC相关参数（ASRC斜率、0～6 D的调节滞后面积、客观调节幅度）差异均无统计学意义（P＞0.05）。调节滞后量仅在调节刺激为4 D时的差异有统计学意义（t=-2.018，P=0.048），其余0～6 D调节刺激下调节滞后量差异均无统计学意义（P＞0.05）。多元线性回归分析发现，近视进展仅与年龄呈正相关（R2=0.186，P=0.029）。结论：在儿童近视进展过程中，调节功能保持相对稳定。近视进展与调节参数无关，受年龄影响，年龄越小，近视进展越快。

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关键词 ：近视, 动态调节刺激-反应曲线, 调节滞后, 调节幅度, 远距调节灵活度

Abstract：Objective: To study the changes of accommodative parameters in myopic children during their myopia progression and analyze their roles in myopia progression. Methods: Totally 21 myopic children with mean age of (11.1±1.5) years old were enrolled in this study. Distance accommodative facility and dynamic accommodative stimulus-response curve (ASRC) of right eyes were measured upon enrollment and at 2-year follow-up. Results: Myopia of 21 children significantly progressed (-1.55±0.58) D in 2 years (t=12.24, P<0.01). There were no statistical differences in distance accommodative facility and ASRC related parameters between baseline and 2-year visit (all P>0.05). Accommodative lag was statistically significant only when accommodative stimulus was 4 D (t=-2.018, P=0.048) and there were no statistical differences under other accommodation stimuli (all P>0.05). Multilinear regression analysis found myopia progression was only positively correlated with age (R2=0.186, P=0.029), but not related to accommodative parameters at baseline. Conclusion: During myopia progression in children, accommodative function remains relatively stable. Myopia progression is not related to accommodative parameters, but affected by age. The younger the child, the faster myopia progresses.

Key words： myopia accommodative stimulus-response curve accommodative lag accommodative amplit-ude distance accommodative facility

收稿日期: 2019-10-26

基金资助:国家国际科技合作专项项目（2014DFA30940）。

通讯作者: 陈浩，主任医师，教授，Email：chenhao@mail.eye.ac.cn。

作者简介: 陈云云（1983-），女，浙江瑞安人，主治医师，硕士。

链接本文:

https://xb.wmu.edu.cn/CN/ 10.3969/j.issn.2095-9400.2020.06.006 或 https://xb.wmu.edu.cn/CN/Y2020/V50/I6/461

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