Mutti Donald O, Sinnott Loraine T, Lynn Mitchell G, Jordan Lisa A, Friedman Nina E, Frane Sara L, Lin Wendy K
College of Optometry, The Ohio State University, Columbus, Ohio.
School of Optometry, University of California, Berkeley, Berkeley, California *
Optom Vis Sci. 2018 Nov;95(11):976-985. doi: 10.1097/OPX.0000000000001296.
The study fills an important gap by providing a longitudinal description of development of the major structural and optical components of the human eye from 3 months to nearly 7 years of age. Normative development data may provide insights into mechanisms for emmetropization and guidance on intraocular lens power calculation.
The purpose of this study was to describe the pattern of development of refractive error and the ocular components from infancy through early childhood.
Cycloplegic retinoscopy (cyclopentolate 1%), keratophakometry, and ultrasonography were performed longitudinally on between 162 and 293 normal birth weight infants at 0.25, 0.75, 1.5, 3, 4.5, and 6.5 years of age.
Refractive error and most ocular components displayed an early exponential phase of rapid development during the first 1 to 2 years of life followed by a slower quadratic phase. Anterior and vitreous chamber depths, axial length, and crystalline lens radii increased at every visit. The crystalline lens thinned throughout the ages studied. The power of the cornea showed an early decrease, then stabilized, whereas the crystalline lens showed more robust decreases in power. The crystalline lens refractive index followed a polynomial growth and decay model, with an early increase followed by a decrease starting at 1 to 2 years of age. Refractive error became less hyperopic and then was relatively stable after 1 to 2 years of age. Axial lengths increased by 3.35 ± 0.64 mm between ages 0.25 and 6.5 years, showed uniform rates of growth across the range of initial values, and were correlated with initial axial lengths (r = 0.44, P < .001).
Early ocular optical and structural development appears to be biphasic, with emmetropization occurring within the first 2 years of infancy during a rapid exponential phase. A more stable refractive error follows during a slower quadratic phase of growth when axial elongation is compensated primarily by changes in crystalline lens power.
该研究通过提供从3个月至近7岁儿童人眼主要结构和光学组件发育的纵向描述，填补了一个重要空白。规范的发育数据可能为正视化机制提供见解，并为人工晶状体屈光力计算提供指导。
本研究的目的是描述从婴儿期到幼儿期屈光不正和眼内组件的发育模式。
对162至293名正常出生体重的婴儿在0.25、0.75、1.5、3、4.5和6.5岁时进行了散瞳检影法（1%环戊通）、角膜曲率测量和超声检查。
屈光不正和大多数眼内组件在生命的前1至2年呈现快速发育的早期指数阶段，随后是较慢的二次阶段。前房和玻璃体腔深度、眼轴长度和晶状体半径在每次检查时均增加。在整个研究年龄范围内，晶状体变薄。角膜屈光力早期下降，然后稳定，而晶状体屈光力下降更为明显。晶状体折射率遵循多项式生长和衰减模型，早期增加，然后在1至2岁时开始下降。屈光不正从远视程度减轻，然后在1至2岁后相对稳定。眼轴长度在0.25岁至6.5岁之间增加了3.35±0.64mm，在初始值范围内呈现均匀的生长速率，并且与初始眼轴长度相关（r = 0.44，P <.001）。
早期眼的光学和结构发育似乎是双相的，正视化发生在婴儿期的前2年内的快速指数阶段。在生长较慢的二次阶段，当眼轴伸长主要通过晶状体屈光力的变化得到补偿时，屈光不正更加稳定。
