Mravicic Ivana, Lukacevic Selma, Barisic Ante, Patel Sudi, Biscevic Alma, Ahmedbegovic-Pjano Melisa, Gabric Nikica
Eye Clinic "Svjetlost", Zagreb, Medical School University of Rijeka, Croatia.
Specialty Eye Hospital Svjetlost, Sarajevo, Bosnia and Herzegovina.
Mater Sociomed. 2025;37(1):37-42. doi: 10.5455/msm.2025.37.37-42.
Falls impose a heavy financial burden on society, and the incidence is age-related. The correction of refractive errors has been mooted as a valuable procedure to prevent falls. However, depth perception, estimated by stereo acuity tests, is reduced in the older population and has been cited as contributing to the higher incidence of falls in the elderly.
To explore the clinical relationship between age, interocular differences in the corrected distance and near logMAR visual acuities, refractive errors, axial (eyeball) lengths, pupil sizes, and higher-order ocular aberrations (HOAs) on clinical measures of stereoacuity and aniseikonia in asymptomatic presbyopic habitual spectacle wearers.
Total amount of 91 subjects underwent clinical assessment of i) subjective refractive error, ii) stereoacuity at 6m and 40cm (Randot Stereotests), iii) aniseikonia at 6m (Awaya test along vertical and horizontal meridian) iv) higher order aberrations (Hartman-Shack aberrometer) v) eyeball length and pupil size (IOL master 700). The Pythagorean theorem was applied to each pair of aniseikonia values to calculate the resultant aniseikonia (AR).
Mean (±sd,95%CI) age of the subjects was 56.2years (±8.10,54.6-57.9). Root mean square (RMS) interocular differences (±sd,95%CI) in spherical refractive errors, axial lengths and pupil sizes were 0.66D(±0.93,0.47-0.85), 0.24mm (±0.33,0.17-0.31), 0.15mm (±0.11,0.12-0.17). The median (mode, interquartile range) values for AR were 2.8(1.0,1.3-4.0). Significant correlations (p<.01) were revealed between: a) log distance stereoacuity (y1), age (x1) and RMS difference in the corrected distance logMAR visual acuity (x2). b) log near stereoacuity (y2), RMS differences in the corrected distance (x2) and near visual acuities (x3). These key associations are best described by: y1=0.011x1+1.101x2+1.553 (r² =0.169, n=91); y2=1.715x2+1.883x3+1.725 (r² = 0.239, n=91).
Stereoacuity is age-related, influenced by interocular differences in the corrected visual acuities but not related to interocular differences in pupil sizes, HOAs or clinical measures of aniseikonia in older habitual spectacle wearers. Assessment of stereoacuity and aniseikonia, in older persons is useful when advising to prevent accidental mis-location and falls.
跌倒给社会带来沉重的经济负担，且发病率与年龄相关。矫正屈光不正已被提议作为预防跌倒的一项重要措施。然而，通过立体视敏度测试估计的深度感知在老年人群中会降低，这被认为是导致老年人跌倒发生率较高的一个因素。
探讨年龄、矫正远视力和近视力的眼间差异、屈光不正、眼轴（眼球）长度、瞳孔大小以及高阶像差（HOAs）与无症状老花眼习惯性佩戴眼镜者的立体视敏度和不等像的临床测量之间的临床关系。
91名受试者接受了以下临床评估：i）主观屈光不正，ii）6米和40厘米处的立体视敏度（兰多立体视测试），iii）6米处的不等像（阿瓦亚垂直和水平子午线测试），iv）高阶像差（哈特曼 - 夏克像差仪），v）眼球长度和瞳孔大小（IOL master 700）。对每对视像不等值应用毕达哥拉斯定理来计算合成不等像（AR）。
受试者的平均（±标准差，95%置信区间）年龄为56.2岁（±8.10，54.6 - 57.9）。球镜屈光不正、眼轴长度和瞳孔大小的眼间均方根（RMS）差异（±标准差，95%置信区间）分别为0.66D（±0.93，0.47 - 0.85）、0.24毫米（±0.33，0.17 - 0.31）、0.15毫米（±0.11，0.12 - 0.17）。AR的中位数（众数，四分位间距）值为2.8（1.0，1.3 - 4.0）。在以下各项之间发现了显著相关性（p <.01）：a）对数远立体视敏度（y1）、年龄（x1）和矫正远视力对数最小分辨角（logMAR）的RMS差异（x2）。b）对数近立体视敏度（y2）、矫正远视力（x2）和近视力（x3）的RMS差异。这些关键关联最好用以下公式描述：y1 = 0.011x1 + 1.101x2 + 1.553（r² = 0.169，n = 91）；y2 = 1.715x2 + 1.883x3 + 1.725（r² = 0.239，n = 91）。
立体视敏度与年龄相关，受矫正视力的眼间差异影响，但与老年习惯性佩戴眼镜者的瞳孔大小、高阶像差或不等像的临床测量无关。在为老年人提供预防意外错位和跌倒的建议时，评估立体视敏度和不等像是有用的。
