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[环喷托酯作为用于屈光不正测定的睫状肌麻痹剂]

[Cyclopentolate as a cycloplegic drug in determination of refractive error].

作者信息

Bolinovska Sofija, Popović Jovan

机构信息

Klinicki centar Vojvodine Novi Sad, Klinika za oane bolesti.

出版信息

Med Pregl. 2008 Jul-Aug;61(7-8):327-32. doi: 10.2298/mpns0808327b.

Abstract

Cycloplegia is loss of the power of accommodation with inhibition of a ciliary muscle. We obtain in this way the smallest refraction of the lens and make it possible to determine the presence and size of the particular refractive error in cycloplegia by using cyclopentolate. Cyclopentolate is a synthetic anticholinergic drug and antagonist of the muscarine receptors. If applied in the eye, it blocks the effect of cholinergic stimulation on the sphincter pupillae muscle and ciliary muscle. It provokes severe mydriasis (dilation of the pupil) and cycloplegia (paralysis of the accommodation). Cyclopentolate has been used occasionaly in diagnostic purposes: defining ocular refraction and in ophthalmoscopy. This is the prospective study which included 200 children (400 eyes) aged 3-18 years, carried out in one ambulatory ophthalmological examination. The results were analysed using standard statistical methods. The most often refractive error in the examined group of children is hyperopia with hyperopic astigmatism, then myopia with myopic astigmatism and mixtus astigmatism are the most often in the oldest group of children. The mean value of corneal astigmatism on the right eye was 1.24 D, on the left eye 1.23 D. Anisometropy was found in 40% children. The presence of myopia, myopic and astigmatism mixtus tended to increase, and hyperopia and hyperopic astigmatism tended to decrease toward older groups of children. Refractive error could result in a poor development of visual acuity, causing amblyopia and strabismus, and because of that represents an important public health problem. As one of amblyogenic risk factors in children, it can be prevented with screening program and appropriate treatment, thus providing prevention of amblyopia as one form of blindness.

摘要

睫状肌麻痹是指因睫状肌受抑制而失去调节能力。通过这种方式,我们能得到晶状体的最小屈光度,并使用环喷托酯来确定睫状肌麻痹时特定屈光不正的存在及程度。环喷托酯是一种合成抗胆碱能药物,也是毒蕈碱受体的拮抗剂。若将其应用于眼部,它会阻断胆碱能刺激对瞳孔括约肌和睫状肌的作用。它会引发严重的瞳孔散大(瞳孔扩张)和睫状肌麻痹(调节麻痹)。环喷托酯偶尔用于诊断目的:确定眼屈光状态及用于检眼镜检查。这是一项前瞻性研究,纳入了200名3至18岁的儿童(400只眼),在一次门诊眼科检查中进行。结果采用标准统计方法进行分析。在被检查的儿童组中,最常见的屈光不正为远视伴有远视散光,其次是近视伴有近视散光,而混合性散光在年龄最大的儿童组中最为常见。右眼角膜散光的平均值为1.24 D,左眼为1.23 D。40%的儿童存在屈光参差。近视、近视散光和混合性散光的发生率倾向于随着儿童年龄增长而增加,远视和远视散光则倾向于减少。屈光不正可能导致视力发育不良,引发弱视和斜视,因此是一个重要的公共卫生问题。作为儿童弱视的危险因素之一,通过筛查计划和适当治疗可以预防,从而预防弱视这种失明形式。

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