青少年近视散瞳前后眼球生物参数变化的分析

doi:10.6040/j.issn.1673-3770.0.2018.529

摘要/Abstract

摘要： 目的

分析和探讨不同程度青少年近视在散瞳前后屈光度和眼球生物参数的变化。

方法

收集在视光门诊就诊的青少年近视56例，所有受试者先行主客观验光、调节反应检测、光学生物测量仪Lenstar 900检测眼球生物参数。用0.5%托吡卡胺眼液行睫状肌麻痹后，再行验光、光学生物测量仪（Lenstar 900）检测眼球生物参数。将所有受试者按照近视程度分为轻度和中重度2组。分析两组间眼生物参数的差别及与年龄的关系；分析散瞳后两组屈光度及眼生物参数、屈光度变化与生物参数变化、年龄、调节反应等的关系。

结果

散瞳前两组间眼轴(AL)的差别有统计学意义，AL与年龄呈正相关关系；前房深度（AD）、晶状体厚度(LT)、瞳孔直径(PD)比较无统计学意义，与年龄不相关。散瞳后两组间屈光度差值、LT差值、AL差值、PD差值比较无统计学意义，AD差值有统计学意义。屈光度差值与AD差值有正相关关系。

结论

尽管轻度和中重度近视组散瞳前后眼内AD变化的差异明显，但是屈光度变化的差异不大。故多数近视患者可不必散瞳验光，建议先进行调节功能检查，如有异常再散瞳验光。

关键词: 近视, 睫状肌麻痹, 光学生物测量仪Lenstar, 前房深度, 晶状体厚度

Abstract: Objective

To analyze the changes in refraction and the ocular biometric parameters with cycloplegia in juveniles with different degrees of myopia.

Methods

Fifty-six juveniles with myopia, aged from 7 to 17 years, were enrolled from our optometry outpatient center. Before inducing cycloplegia, refraction, accommodation response, and ocular biometric parameters were measured in all subjects by optical biometry (Lenstar900). Refraction and the ocular biometric parameters were measured again after cycloplegia. The subjects were divided into two groups according to the degree of myopia: low myopia group and moderate-to-high myopia group. We analyzed the differences in the ocular biometric parameters between the two groups and the relationship of these parameters with the age. We also compared the differences in refraction and the ocular biometric parameters between before and after cycloplegia, and analyzed the relationship between those differences and the age and accommodation response.

Results

Before cycloplegia, there was a statistically significant difference in the axial length (AL) between the two groups, and AL showed a significant positive correlation with the age. There was no statistical difference in the aqueous depth (AD), lens thickness (LT), and pupil diameter (PD) between the two groups, and none of these parameters correlated with the age. The differences in the changes in refraction, LT, AL, and PD before and after cycloplegia between the two groups were not statistically significant; however, the difference in the changes in AD was statistically significant.

Conclusion

The differences in the changes in refraction before and after cycloplegia between the two groups were not statistically significant; however, the changes in the AD were significant. Therefore, it is not necessary to measure refraction with cycloplegia in juveniles with myopia; accommodation should be measured instead.

Key words: Myopia, Cycloplegia, Lenstar, Aqueous depth, Lens thickness

中图分类号:

R778.1+1

张丹凤. 青少年近视散瞳前后眼球生物参数变化的分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(5): 121-124.

Danfeng ZHANG. Changes in the ocular biometric parameters before and after cycloplegia in juveniles with different degrees of myopia[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(5): 121-124.

图/表 4

表1

两组间生物参数比较（x ± s，mm）"

分组	前房深度(AD)	晶状体厚度(LT)	眼轴(AL)	瞳孔直径(PD)
轻度近视组（n=37）	3.22 $±$ 0.19	3.37 $±$ 0.18	24.06 $± 0.82$	5.92 $± 0.92$
中重度近视组（n=19）	3.26 $±$ 0.19	3.37 $±$ 0.17	25.78 $± 0.82$	5.54 $± 0.85$
t	-0.71	0.10	-7.44	1.50
P	0.50	0.92	＜0.001	0.14

表1

表2

表3

表4

参考文献 12

1	曾彩琼 . 近视发病机制的研究进展[J]. 临床眼科杂志, 2017, 25(6): 565-568. doi:10.3969/j.issn.1006-8422.2017.06.025 . doi: 10.3969/j.issn.1006-8422.2017.06.025
	ZENG Caiqiong . Current progress in the mechanism of myopia[J]. Journal of Clinical Ophthalmology, 2017, 25(6): 565-568. doi:10.3969/j.issn.1006-8422.2017.06.025 . doi: 10.3969/j.issn.1006-8422.2017.06.025
2	刘雯 . 近距离工作诱发暂时性近视对近视发展的影响[J]. 山东大学耳鼻喉眼学报, 2012, 26(3): 83-85.
	LIU Wen . Relationship of near-work-induced transient myopia and myopia development[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2012, 26(3): 83-85.
3	张海容，刁红星，陈翔 .复方托品酰胺对不同年龄段低度近视人员验光结果的影响[J].国际眼科杂志,2014,14(12):2295-2296.doi:10.3980/j.issn.1672-5123.2014.12.56 . doi: 10.3980/j.issn.1672-5123.2014.12.56
	Zhang HR , Diao HX , Chen X .Cycloplegic effects of 0.5 g/L tropicamide in various low myopia age groups[J].Guoji Yanke Zazhi(Int Eye Sci),2014,14(12):2295-2296.doi:10.3980/j.issn.1672-5123.2014.12.56 . doi: 10.3980/j.issn.1672-5123.2014.12.56
4	张琼, 张士胜, 吴彦霖, 等 . 散瞳对Lenstar LS900检测儿童眼球生物参数的影响[J]. 上海交通大学学报(医学版), 2015, 35(6): 847-850. doi:11.3969/j.issn.1674-8115.2015.06.013 . doi: 11.3969/j.issn.1674-8115.2015.06.013
	ZHANG Qiong , ZHANG Shisheng , WU Yanlin , et al . Effects of cycloplegia on children′s ocular parameters measured by Lenstar LS900[J]. Journal of Shanghai Jiaotong University(Medical Science), 2015, 35(6): 847-850.doi:11.3969/j.issn.1674-8115.2015.06.013 . doi: 11.3969/j.issn.1674-8115.2015.06.013
5	石海军 . 儿童前房深度与各屈光参数关系[J]. 国际眼科杂志, 2015, 15(6): 1020-1022. doi:10.3980/j.issn.1672-5123.2015.6.22 . doi: 10.3980/j.issn.1672-5123.2015.6.22
	SHI Haijun . Relationship between anterior chamber depth and refractive factors in children[J]. International Eye Science, 2015, 15(6): 1020-1022. doi:10.3980/j.issn.1672-5123.2015.6.22 . doi: 10.3980/j.issn.1672-5123.2015.6.22
6	虞林丽, 赵刚平, 廖珊, 等 . 应用Lenstar 900测量不同程度轴性近视生物参数分析[J]. 国际眼科杂志, 2014, 14(7): 1281-1283. doi:10.3980/j.issn.1672-5123.2014.07.30 . doi: 10.3980/j.issn.1672-5123.2014.07.30
	YU Linli , ZHAO Gangping , LIAO Shan , et al . Analysis on biometric measurements of Lenstar 900 in difference degrees of axial myopia[J]. Int Eye Sci, 2014, 14(7): 1281-1283. doi:10.3980/j.issn.1672-5123.2014.07.30 . doi: 10.3980/j.issn.1672-5123.2014.07.30
7	黄佳, 瞿小妹, 褚仁远, 等 . 青少年近视在不同阅读距离调节状态下眼前段结构的变化[J]. 眼视光学杂志, 2008, 10(2): 92-95. doi:10.3760/cma.j.issn.1674-845X.2008.02.004 . doi: 10.3760/cma.j.issn.1674-845X.2008.02.004
	HUANG Jia , QU Xiaomei , CHU Renyuan , et al . Analysis of the anterior segment of the eyes of adolescent myopes when accommodation is induced by different reading distances[J].Chinese Journal of Optometry & Ophthalmology, 2008, 10(2): 92-95. doi:10.3760/cma.j.issn.1674-845X.2008.02.004 . doi: 10.3760/cma.j.issn.1674-845X.2008.02.004
8	胡红梅 . 探讨不同程度近视眼在不同调节状态下OCT测量的眼前段结构的变化[J]. 中外医学研究, 2018, 16(11): 165-166. doi:10.14033/j.cnki.cfmr.2018.11.081 . doi: 10.14033/j.cnki.cfmr.2018.11.081
9	戴怡康, 傅伟才, 陆玮瑜, 等 . 不同遗传背景儿童在不同调节状态下眼前节结构的变化[J]. 上海交通大学学报(医学版), 2016, 36(1): 80-82, 88.doi:10.3969/j.issn.1674-8115.2016.01.016 . doi: 10.3969/j.issn.1674-8115.2016.01.016
	DAI Yikang , FU Weicai , LU Weiyu , et al . Changes in the anterior segment of eyes of children with different genetic background under different accommodations[J]. Journal of Shanghai Jiaotong University(Medical Science), 2016, 36(1): 80-82, 88. doi:10.3969/j.issn.1674-8115.2016.01.016 . doi: 10.3969/j.issn.1674-8115.2016.01.016
10	He JC . A model of the effect of lens development on refraction in schoolchildren[J]. Optom Vis Sci, 2017, 94(12): 1129-1137. doi:10.1097/OPX.0000000000001146 . doi: 10.1097/OPX.0000000000001146
11	Gwiazda J , Norton TT , Hou W , et al . Longitudinal changes in lens thickness in myopic children enrolled in the correction of myopia evaluation trial (COMET)[J]. Curr Eye Res, 2016, 41(4): 492-500. doi:10.3109/02713683.2015.1034372 . doi: 10.3109/02713683.2015.1034372
12	杜满, 李晓凤, 陈世久, 等 . 散瞳前后儿童眼球生物测量参数的变化[J]. 世界最新医学信息文摘, 2017, 17(86): 22-24. doi:10.19613/j.cnki.1671-3141.2017.86. 010 . doi: 10.19613/j.cnki.1671-3141.2017.86.010
	DU Man , LI Xiaofeng , CHEN Shijiu , et al . The changes of children′s ocular biometric parameters before and after mydriasis[J]. World Latest Medicine Information, 2017, 17(86): 22-24. doi:10.19613/j.cnki.1671-3141.2017.86.010 . doi: 10.19613/j.cnki.1671-3141.2017.86.010

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	r	P
前房深度(AD)	-0.221	0.119
晶状体厚度(LT)	0.011	0.939
眼轴(AL)	0.352	0.008
瞳孔直径(PD)	-0.120	0.380

分组	屈光度	前房深度(AD)	晶状体厚度(LT)	眼轴(AL)	瞳孔直径(PD)
轻度近视组（n=37）	-0.25 (-0.38~0.00)	-0.04 (-0.06～-0.02)	0.02 (0.01~0.05)	-0.01 (-0.02～0.01)	-1.92 (-2.73～-1.34)
中重度近视组（n=19）	-0.25 (-0.25~0.00)	-0.02 (-0.04～-0.01	0.01 (0.01~0.03)	0.00 (-0.01～0.01)	-2.06 (-2.50～-1.89)
Z	-0.75	-2.39	-0.96	-1.19	-1.04
P	0.45	0.02	0.34	0.24	0.30