Cook Anne, White Sarah, Batterbury Mark, Clark David
Manchester Royal Eye Hospital, Manchester, United Kingdom.
Invest Ophthalmol Vis Sci. 2003 Mar;44(3):953-60. doi: 10.1167/iovs.02-0124.
This investigation studied the factors involved in the development of refractive error (RE) in premature infants unaffected by retinopathy of prematurity (ROP).
Premature infants enrolled in the national ROP screening program were recruited and examined at 32, 36, 40, 44, and 52 weeks' postmenstrual age. At each examination, axial length (AXL), anterior chamber depth (ACD), and lens thickness (LT) were measured on the A-scan biometer. Corneal curvature (CC) was recorded with a video-ophthalmophakometer, and refractive state was determined with routine cycloplegic refraction. Multilevel modeling techniques were used to determine the relationships between all the variables throughout the study period, as well as individual growth rates.
Sixty-eight premature infants were included. AXL and ACD showed linear patterns of growth, whereas LT changed little over the study period. CC showed a quadratic growth pattern, and unlike the previous variables, correlated well with refractive state. Premature infants were myopes at the start of the study, with refraction becoming emmetropic as they neared full term and then hypermetropic toward the end of the study.
Most of the components of refractive status showed linear patterns of growth during this early phase of ocular development. CC displayed a more complex pattern of growth, which correlated well with refractive state. Compared with full-term infants examined around term, this group has shorter AXLs, shallower anterior chambers, and more highly curved corneas. In addition, less of the expected hypermetropia developed in the premature group, which seems mainly due to the differences in ACD and corneal curvature.
本研究探讨未患早产儿视网膜病变（ROP）的早产儿屈光不正（RE）发生发展的相关因素。
招募参加全国ROP筛查项目的早产儿，在孕龄32、36、40、44和52周时进行检查。每次检查时，使用A超生物测量仪测量眼轴长度（AXL）、前房深度（ACD）和晶状体厚度（LT）。使用视频眼晶状体屈光计记录角膜曲率（CC），并通过常规睫状肌麻痹验光确定屈光状态。采用多水平建模技术确定整个研究期间所有变量之间的关系以及个体生长速率。
纳入68例早产儿。AXL和ACD呈线性生长模式，而LT在研究期间变化不大。CC呈二次生长模式，与屈光状态的相关性良好，这与之前的变量不同。早产儿在研究开始时为近视，随着接近足月，屈光变为正视，然后在研究结束时变为远视。
在眼发育的这一早期阶段，屈光状态的大多数组成部分呈线性生长模式。CC呈现出更复杂的生长模式，与屈光状态相关性良好。与足月时检查的足月儿相比，该组早产儿的眼轴较短、前房较浅、角膜曲率较高。此外，早产儿组预期的远视程度较低，这似乎主要是由于ACD和角膜曲率的差异。
