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[不同近视矫正方式对周边屈光的影响:基于注视方向]

[The influence of different means of myopia correction on peripheral refraction depending on the direction of gaze].

作者信息

Tarutta E P, Tarasova N A, Milash S V, Proskurina O V, Markosian G A

机构信息

Helmholtz Moscow Research Institute of Eye Diseases, 14/19 Sadovaya-Chernogryazskaya St., Moscow, Russian Federation, 105062.

出版信息

Vestn Oftalmol. 2019;135(4):60-69. doi: 10.17116/oftalma201913504160.

Abstract

INTRODUCTION

Peripheral defocus was experimentally found to control the development of refraction.

PURPOSE

To evaluate peripheral refraction (PR) of myopic eyes in terms of different means of correction and the direction of gaze.

MATERIAL AND METHODS

The study examined 128 patients (256 eyes) aged 8-14 years (average 11.07±0.39 years) with myopia from -1.0 to -7.0 (average -3.57±0.27 D). PR was measured without correction, in perifocal (PF), monofocal (MF), progressive glasses (PAL), monofocal soft contact lenses (ΜCL) and after orthokeratological (OCL) correction with the gaze directed straightforward or head angled outward, inward, upward and downward; all measurements were performed using binocular open-field auto ref/keratometer.

RESULTS

PR profile without correction and with contact (OCL, ΜCL) correction does not depend on the direction of the gaze. In glasses, peripheral defocus is different with straightforward and skewed gaze directions. OCL forms a significant myopic defocus throughout the periphery of the retina. When using MCL, hyperopic defocus increases in all zones except the extreme temporal. In MF glasses, hyperopic defocus is formed and enhanced in all areas, significantly greater with skewed gaze than with straightforward. In PALs, myopic defocus is formed with gaze directed upward and downward, as well as at the extreme temporal periphery of the retina with straightforward gaze. In all other zones, hypermetropic defocus increases. In PF, in most zones myopic defocus is formed with all gaze directions. The greatest inhibitory effect on myopia progression is provided by OCL (YPR=0.28 D/year) and PF glasses (YPR=0.26 D/year).

CONCLUSION

In contrast to correction with contact lenses, PR in glasses does depend on the direction of gaze. The inhibitory effect of the optics correlates with correction of hypermetropic defocus in myopic eyes.

摘要

引言

通过实验发现周边离焦可控制屈光的发展。

目的

根据不同的矫正方式和注视方向评估近视眼的周边屈光(PR)。

材料与方法

本研究检查了128例年龄在8至14岁(平均11.07±0.39岁)、近视度数为-1.0至-7.0(平均-3.57±0.27 D)的患者(256只眼)。在未矫正状态下、佩戴周边离焦(PF)眼镜、单焦点(MF)眼镜、渐进多焦点眼镜(PAL)、单焦点软性角膜接触镜(ΜCL)以及角膜塑形术(OCL)矫正后,测量PR,注视方向分别为直视、头部向外倾斜、向内倾斜、向上倾斜和向下倾斜;所有测量均使用双目视野自动验光/角膜曲率计进行。

结果

未矫正状态下以及佩戴接触镜(OCL、ΜCL)矫正时,PR曲线不依赖于注视方向。佩戴眼镜时,周边离焦在直视和斜视方向上有所不同。OCL在整个视网膜周边形成显著的近视性离焦。使用ΜCL时,除最颞侧区域外,所有区域的远视性离焦均增加。在MF眼镜中,所有区域均形成并增强远视性离焦,斜视注视时比直视时显著更大。在PAL中,向上和向下注视时以及直视时在视网膜最颞侧周边形成近视性离焦。在所有其他区域,远视性离焦增加。在PF中,大多数区域在所有注视方向下均形成近视性离焦。对近视进展的最大抑制作用由OCL(YPR = 0.28 D/年)和PF眼镜(YPR = 0.26 D/年)提供。

结论

与佩戴接触镜矫正相比,眼镜矫正时的PR确实依赖于注视方向。光学矫正的抑制作用与近视眼远视性离焦的矫正相关。

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