Weizhong Lan, Zhikuan Yang, Wen Liu, Xiang Chen, Jian Ge
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China.
Ophthalmic Physiol Opt. 2008 Jan;28(1):57-61. doi: 10.1111/j.1475-1313.2007.00536.x.
To investigate the possible relationship between myopia progression and near accommodative lag.
A 1-year longitudinal study was carried out to measure the accommodative response and myopia progression in 62 children with mild and progressing myopia at two visits: they were 10.81 +/- 1.60 years old with refractive error -1.70 +/- 0.76 D on entry. Repeated measurements included refractive error, ocular biometry and accommodative response at 33 cm. The refractive error was determined by autorefraction after cycloplegia; ocular biometry by A-scan ultrasonography; and accommodative response by an open-field autorefractor. Results were based on the right eye and analysed by paired t-test and Pearson's correlation coefficient.
Myopia progression in the year was -0.72 +/- 0.37 D (p < 0.001) with a range from -0.06 to -1.96 D. The change of axial length and vitreous depth were 0.41 +/- 0.25 mm (p < 0.001) and 0.36 +/- 0.24 mm (p < 0.001), respectively. The near lag was 0.76 +/- 0.29 D on entry and 0.72 +/- 0.38 D 1 year later (p = 0.79). No statistically significant correlations were found between near lag vs myopia progression and the change of ocular biometry as a whole (p > 0.10 for all). There was no significant difference in myopia progression between myopic children with greater than, compared to less than the mean amount of near lag (p = 0.36).
This study demonstrates no statistically significant relationship between myopia progression and near accommodation lag in children with mild and progressing myopia. There is no evidence that near lag provides a stimulus to progression in this stage of myopia.
探讨近视进展与近调节滞后之间的可能关系。
对62名患有轻度进行性近视的儿童进行了为期1年的纵向研究，在两次就诊时测量其调节反应和近视进展情况：入组时他们的年龄为10.81±1.60岁，屈光不正为-1.70±0.76D。重复测量包括屈光不正、眼生物测量以及在33cm处的调节反应。屈光不正通过睫状肌麻痹后的自动验光仪测定；眼生物测量通过A超超声检查；调节反应通过开放式自动验光仪测定。结果基于右眼，并通过配对t检验和Pearson相关系数进行分析。
该年度近视进展为-0.72±0.37D（p<0.001），范围为-0.06至-1.96D。眼轴长度和玻璃体深度的变化分别为0.41±0.25mm（p<0.001）和0.36±0.24mm（p<0.001）。入组时近调节滞后为0.76±0.29D，1年后为0.72±0.38D（p=0.79）。近调节滞后与近视进展以及整体眼生物测量变化之间未发现统计学上的显著相关性（所有p>0.10）。近调节滞后大于或小于平均量的近视儿童之间，近视进展无显著差异（p=0.36）。
本研究表明，在患有轻度进行性近视的儿童中，近视进展与近调节滞后之间无统计学上的显著关系。没有证据表明近调节滞后在该阶段的近视进展中起到刺激作用。
