学龄期近视进展儿童调节功能的客观检查和分析

目的对学龄期近视进展儿童进行调节功能的客观检查与分析,观察调节功能与近视进展之间的相关性。方法选取2017年至2018年在首都医科大学附属北京同仁医院视光学门诊定期就诊的71名学龄期儿童为研究对象,根据受试者近年的屈光度进展速度,按≤0.50 D·a^-1、>0.50～1.00 D·a^-1、>1.00～1.50 D·a^-1、>1.50 D·a^-1分为4组,使用人眼调节分析仪对受试者进行调节功能的客观测量与分析,记录不同调节刺激视标下4组的客观调节反应值和客观调节微波动值,并作对比。结果在所有调节视标上,各组随着调节刺激幅度增加,客观调节反应值也逐渐增加,4组在不同调节刺激视标下的客观调节反应值及平均的客观调节反应值差异均无统计学意义(均为P>0.05)。≤0.50 D·a^-1、>0.50～1.00 D·a^-1、>1.00～1.50 D·a^-1、>1.50 D·a^-1近视进展速度组调节微波动值分别为(62.2±5.6)D、(62.5±5.3)D、(66.5±6.0)D和(58.0±6.5)D,4组间差异有统计学意义(F=6.424,P=0.001),在+0.50～-0.50 D、-2.00 D调节刺激视标下,4组的客观调节微波动值比较差异均有统计学意义(均为P<0.05),在其余调节刺激视标下差异均无统计学意义(均为P>0.05)。结论对于学龄期儿童的近视进展速度,客观调节微波动值相对于客观调节反应值可能是一个更为敏感的相关指标。

Examination and analysis of accommodative function in school-age children with myopia progressive

Objective　To examine and analyze the accommodative function in school-age children with myopia progression by an Objective method，and to investigate the relationship between accommodative function and myopia progression.Methods　A total of 71 school-age children treated at certain points were recruited from the Optometry Clinic of the Capital Medical University Affiliated Beijing Tongren Hospital.The subjects were divided into 4 groups according to the myopia progression in recent years，which was ≤0.50 D·a^-1，>0.50-1.00 D·a^-1，>1.00-1.50 D·a^-1 and >1.5 D·a^-1.Their accommodative function was examined by Nidek AA-1 accommodative analyzer，and Objective accommodative response and Objective accommodative microfluctuation of 4 groups were recorded respectively and compared among groups.Results　At all the accommodative stimulated targets，the values of Objective accommodative response increased gradually with increase of the amplitude of accommodation stimulation in the four groups.There was no significant difference in the values of Objective accommodative response and average accommodative response among four groups （all P>0.5）.The values of accommodative microfluctuation of group ≤0.50 D·a^-1，>0.50-1.00 D·a^-1，>1.00-1.50 D·a^-1 and >1.5 D·a^-1 were （62.2±5.6）D，（62.5±5.3）D，（66.5±6.0）D，and （58.0±6.5）D，respectively，and there was significant difference in the values of Objective accommodative microfluctuation in the four groups （F=6.424，P=0.001）.There were significant differences in the value of Objective accommodative microfluctuation among four groups at targets of +0.50 D~-0.50 D，-2.00 D （all P>0.05），and there were no significant difference at other targets.Conclusion　For myopia in school-age children，accommodative microfluctuation may be a more sensitive indicator than accommodative response.