Pandian Ashok, Sankaridurg Padmaja R, Naduvilath Thomas, O'Leary Daniel, Sweeney Deborah F, Rose Kathryn, Mitchell Paul
Vision Co-operative Research Centre, Level 4 Rupert Myers Building, Sydney, NSW 2052, Australia.
Invest Ophthalmol Vis Sci. 2006 Nov;47(11):4725-31. doi: 10.1167/iovs.05-1078.
To compare accommodative facility in eyes with myopia to that in eyes with emmetropia or hyperopia and to determine whether accommodative facility can be used to predict an association with myopia.
In the Sydney Myopia Study, year-1 school children (6.7 +/- 0.4 years) were assessed for accommodative facility at distance (3 m) and near (33 cm) with semiautomated flippers. Spherical equivalent refractive error (RE) was defined as myopia (< or = -0.50 D), emmetropia (> -0.50 D, but < +1.50 D), and hyperopia (> or = +1.50 D) based on postcycloplegia readings. Only right eye data were considered. Differences between groups were analyzed with the Brown-Forsythe F test after adjustment for age and gender. Multiple comparisons were adjusted with the by the Games-Howell
Of the 1328 right eyes assessed, 20 (1.5%) eyes were myopic, 977 (73.6%) were emmetropic, and 331 (24.9%) were hyperopic. At distance, mean facility was less for myopic eyes at 5.5 +/- 2.0 cycles per minute (cpm) in comparison to 6.9 +/- 1.7 cpm for eyes with emmetropia or hyperopia (P = 0.005). Myopic eyes recorded greater positive and negative accommodative response times than did emmetropic or hyperopic eyes (P < 0.05). There were no differences among the groups in near facility. The area under the receiver operating characteristic (ROC) curve for distance facility was 0.692 (P = 0.003, 95% CI, 0.580-0.805).
Myopic eyes have reduced accommodative facility at distance, and accommodative responsiveness to both positive and negative defocus is slow. However, accommodative facility as a test does not have sufficient power to discriminate eyes with myopia from other refractive errors.
比较近视眼中的调节灵活度与正视眼或远视眼中的调节灵活度，并确定调节灵活度是否可用于预测与近视的关联。
在悉尼近视研究中，使用半自动翻转拍对一年级学童（6.7±0.4岁）在远距离（3米）和近距离（33厘米）的调节灵活度进行评估。根据睫状肌麻痹后的读数，将等效球镜屈光不正（RE）定义为近视（≤ -0.50 D）、正视（> -0.50 D，但< +1.50 D）和远视（≥ +1.50 D）。仅考虑右眼数据。在对年龄和性别进行调整后，使用布朗 - 福赛斯F检验分析组间差异。多重比较采用Games - Howell法进行调整。
在评估的1328只右眼中，20只（1.5%）为近视，977只（73.6%）为正视，331只（24.9%）为远视。在远距离时，近视眼中的平均调节灵活度为每分钟5.5±2.0个周期（cpm），低于正视眼或远视眼的6.9±1.7 cpm（P = 0.005）。与正视眼或远视眼相比，近视眼中记录的正负调节反应时间更长（P < 0.05）。近距离调节灵活度在各组之间没有差异。远距离调节灵活度的受试者工作特征（ROC）曲线下面积为0.692（P = 0.003，95% CI，0.580 - 0.805）。
近视眼中远距离的调节灵活度降低，对正负离焦的调节反应均较慢。然而，作为一种检测方法，调节灵活度没有足够的能力将近视与其他屈光不正区分开来。
