摘要
目的研究近视儿童近距注视下的调节滞后和隐斜量，分析近视儿童调节滞后与近隐斜的关系及相关因素。方法受试者为250名近视儿童，等效球镜屈光力范围为-0．50—5．25D。采用MEM动态检影法测量受试者右眼近距的调节滞后；分别采用Howell测量法（HT）和改良Thorington测量法（MTY）测量近隐斜；通过问卷调查受试者父母的屈光状态。各重复测量三次，取均值。结果受试者近距调节滞后为（＋0．97±0．43）D，近隐斜为（-0．94±4．55）。（外隐斜，HT）和（-1．71±4．85）^△（外隐斜，MTT）。伴近内隐斜者占28．0％（HT）和22．8％（MTT）。伴近内隐斜者的调节滞后和内隐斜呈正相关（r=0．353，P=0．003，HT；r=0．461，P〈0．001，MTT）；受试者调节滞后和近视程度呈负相关（r=0．241，P〈0．001）。23％近视者父母均为近视，其调节滞后显著大于其父母组儿童（F=4．90，P=0．009）。结论近视儿童在近距注视状态下调节滞后较高。近隐斜状态和遗传因素都可能影响近视儿童的调节滞后，调节滞后量与近视程度可能存在相互作用。临床上应将近距调节反应和隐斜测量纳入儿童的常规视功能检查项目。
Objective To investigate accommodative lag, near heterophoria and the relationship between lag of myopic children and relative factors on phoria. Methods A total of 250 children with myopia ranging from -0.50D to -5.25D spherical equivalent participated in this study. Accommodative lag was measured for the right eye of each subject using the Monocular Estimate Method （MEM） of dynamic retinoscopy with a visual target at 33 cm from the eye, and near phoria was measured in random sequence using two standardized clinical procedures： （1） Howell test （2） modified Thorington test. Each measurement was performed three times on every child, and the mean value was used for analysis. Questionnaires related to parents＇ myopia status were also obtained. Results The accom- modative lag of the children was （0.97± 0.43）D. The mean near phoria for myopic children was （-0.94 4.55） （exophoria） with the Howell test and （-1.71 4.85） （exophoria） with the modified Thorington test. For the modified Howell test, percentage of near esophoria for myopic children was 28.0%, while 22.8% esophoria was observed for the modified Thorington test. Near esophoria of myopic children showed significant correlation with accommodative lags （r =0.353, P =0.003, HT; r =0.461, P 〈0.001, MTT）. Lagof myopic children showed significant correlation with myopia （r=-0.241, P 〈0.001）. 23% of the children had two myopic parents and this group showed a higher accommodative lag than the others （children with one myopic parent and with both parents emmetropic, F =4.90, P =0.009）. Conclusions The high proportion of children with large accommodative lag is found in Chinese myopic children. Near esophoria and hereditary factor may be the factors contributing to accommodative lag of myopic children. Probably there is some interaction between accommodative lag and myopia. It is a significant guideline to measure accommodation and near phoria for myopic children in clinic.
出处
《中国实用眼科杂志》
CSCD
北大核心
2011年第10期1018-1022,共5页
Chinese Journal of Practical Ophthalmology
基金
国家“十一五”科技支撑计划项目（2007BAI18809）
关键词
近视儿童
调节滞后
近隐斜
Myopic children
Accommodative lag
Near phoria
