透镜诱导的屈光参差对人类视觉发育过程中调节和聚散的影响。
The effect of lens-induced anisometropia on accommodation and vergence during human visual development.
机构信息
Champalimaud Translational Centre for Eye Research, Bausch and Lomb School of Optometry, L.V. Prasad Eye Institute, Hyderabad, India.
出版信息
Invest Ophthalmol Vis Sci. 2011 Jun 1;52(6):3595-603. doi: 10.1167/iovs.10-6214.
PURPOSE
Clear and single binocular vision, a prerequisite for normal human visual development, is achieved through accommodation and vergence. Anisometropia is associated with abnormal visual development, but its impact on accommodation and vergence, and therefore on the individual's visual experience, is not known. This study determined the impact of transiently induced anisometropia on accommodative and vergence performance of the typically developing human visual system.
METHODS
One hundred eighteen subjects (age range, 2.9 months to 41.1 years) watched a cartoon movie that moved between 80 and 33 cm under six different viewing conditions: binocular and monocular, and with ±2 diopters (D) and ±4 D of lens-induced anisometropia. Twenty-one subjects (age range, 3.1 months to 12.1 years) also watched the movie with 11% induced aniseikonia. Accommodation and vergence were recorded in both eyes using a videoretinoscope (25 Hz).
RESULTS
The main effect of viewing condition was statistically significant for both accommodation and vergence (both P < 0.001), with monocular accommodative and vergence gains statistically significantly smaller than the binocular and four induced anisometropia conditions (P < 0.001 for both accommodation and vergence). The main effect of age approached significance for accommodation (P = 0.06) and was not significant for vergence (P = 0.32). Accommodative and vergence gains with induced aniseikonia were not statistically significantly different from the binocular condition (both P > 0.5).
CONCLUSIONS
Accommodative and vergence gains of the typically developing visual system deteriorated marginally (accommodation more than vergence) with transiently induced anisometropia (up to ±4 D) and did not deteriorate significantly with induced aniseikonia of 11%. Some binocular cues remained with ±4 D of induced anisometropia and 11% induced aniseikonia, as indicated by the accommodative and vergence gains being higher than in monocular viewing.
目的
清晰且单一的双眼视觉是人类正常视觉发育的前提，这一过程是通过调节和辐辏来实现的。屈光参差与异常的视觉发育有关，但它对视功能的调节和辐辏的影响，以及对个体视觉体验的影响尚不清楚。本研究旨在确定短暂性诱导性屈光参差对正常发育的人类视觉系统的调节和辐辏功能的影响。
方法
118 名受试者（年龄范围：2.9 个月至 41.1 岁）观看一部动画片，该片在 80cm 到 33cm 之间移动，在 6 种不同的观看条件下进行：双眼和单眼，以及±2 屈光度（D）和±4D 的透镜诱导性屈光参差。21 名受试者（年龄范围：3.1 个月至 12.1 岁）还观看了 11%诱导的像差的电影。双眼使用视频视网膜镜（25Hz）记录调节和辐辏。
结果
观看条件的主要影响对视功能的调节和辐辏都具有统计学意义（均 P <0.001），与双眼和四种诱导性屈光参差条件相比，单眼调节和辐辏增益明显较小（调节和辐辏均 P <0.001）。年龄的主要影响接近调节功能的统计学意义（P=0.06），但对辐辏功能无统计学意义（P=0.32）。诱导像差的调节和辐辏增益与双眼条件无统计学差异（均 P>0.5）。
结论
正常发育的视觉系统的调节和辐辏增益随着短暂性诱导性屈光参差（最高达±4D）略有恶化（调节比辐辏更严重），但在 11%的诱导像差下没有明显恶化。一些双眼线索在±4D 的诱导性屈光参差和 11%的诱导性像差下仍然存在，这表明调节和辐辏增益高于单眼观察。
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