Szostek Nicola, Buckhurst Hetal, Purslow Christine, Drew Thomas, Collinson Avril, Buckhurst Phillip
Eye and Vision Research Group, School of Health Professions, University of Plymouth, Plymouth PL4 8AA, UK.
School of Optometry and Vision Sciences, Cardiff University, Cardiff CF24 4HQ, UK.
Vision (Basel). 2018 Aug 21;2(3):34. doi: 10.3390/vision2030034.
Objective and subjective methods of assessing time taken for accommodative change (ToAC) include accommodative dynamics (AD) and accommodative facility (AF). This study investigates the validity of novel metrics derived from the AD-profile and explores their relationship with AF. AD were assessed using a modified open-field autorefractor in 43 healthy adults. Non-linear regression curves were fitted to the data to derive: latency-of-accommodation (nLoA) and -disaccomodation (nLoD), Time-for-accommodation (ToA) and -disaccommodation (ToD), and objective-ToAC (oToAC). Latencies were also calculated through visual inspection of the AD data as in previous studies (pLoA and pLoD). AF was used to assess subjective-ToAC. Statistical analysis explored the relationships between the AD-metrics and AF. Subjects were assessed on three visits to examine intra- and inter-observer repeatability. nLoA and nLoD were greater than pLoA ( = 0.001) and pLoD ( = 0.004) respectively. nLoA and nLoD also demonstrated greater intra- and inter-observer repeatability than pLoA and pLoD. AF demonstrated a moderate, inverse correlation with ToA ( = 0.02), ToD ( = 0.007), and oToAC ( = 0.007). ToD was the single best accommodative predictor of AF ( = 0.011). The novel method for deriving latency was more repeatable, but not interchangeable with the techniques used in previous studies. ToD was the most repeatable metric with the greatest association with AF.
评估调节变化所需时间（ToAC）的客观和主观方法包括调节动力学（AD）和调节灵活度（AF）。本研究调查了从AD曲线得出的新指标的有效性，并探讨了它们与AF的关系。使用改良的开放式自动验光仪对43名健康成年人进行AD评估。对数据拟合非线性回归曲线以得出：调节潜伏期（nLoA）和放松调节潜伏期（nLoD）、调节时间（ToA）和放松调节时间（ToD），以及客观ToAC（oToAC）。潜伏期也如先前研究那样通过目视检查AD数据来计算（pLoA和pLoD）。AF用于评估主观ToAC。统计分析探讨了AD指标与AF之间的关系。对受试者进行了三次检查以检验观察者内和观察者间的重复性。nLoA和nLoD分别大于pLoA（P = 0.001）和pLoD（P = 0.004）。nLoA和nLoD在观察者内和观察者间的重复性也高于pLoA和pLoD。AF与ToA（P = 0.02）、ToD（P = 0.007）和oToAC（P = 0.007）呈中度负相关。ToD是AF的最佳单一调节预测指标（P = 0.011）。推导潜伏期的新方法更具重复性，但与先前研究中使用的技术不可互换。ToD是最具重复性的指标，与AF的关联最大。
