Rosenfield M, Ciuffreda K J, Hung G K, Gilmartin B
Department of Vision Sciences, State University of New York/State College of Optometry, NY 10010.
Ophthalmic Physiol Opt. 1994 Jul;14(3):265-77. doi: 10.1111/j.1475-1313.1994.tb00007.x.
Part I of this review considered basic aspects of tonic accommodation (TA), i.e. the accommodative response observed under degraded stimulus conditions. Part II considers accommodative adaptation, i.e. the apparent change in TA following periods of sustained fixation, and clinical aspects of both baseline TA and accommodative adaptation. It is suggested that the apparent post-task shift in TA reflects the slow rate of decay of the stimulus-mediated adaptive accommodative response, while the actual level of tonic innervation to the ciliary muscle remains relatively constant. The clinical implications of both TA and accommodative adaptation are discussed with regard to night, space and instrument myopia and refractive error development, notably nearwork-induced myopia. It is concluded that the evidence for any association between this form of myopia and either TA or accommodative adaptation is equivocal, and furthermore it seems likely that TA plays only a minor role in influencing the closed-loop steady-state accommodative response.
本综述的第一部分探讨了张力性调节（TA）的基本方面，即在退化刺激条件下观察到的调节反应。第二部分探讨了调节适应，即持续注视一段时间后TA的明显变化，以及基线TA和调节适应的临床方面。有人认为，TA在任务后的明显变化反映了刺激介导的适应性调节反应的缓慢衰减率，而睫状肌的实际张力神经支配水平保持相对恒定。文中讨论了TA和调节适应在夜间、空间和器械性近视以及屈光不正发展（尤其是近距离工作引起的近视）方面的临床意义。得出的结论是，这种形式的近视与TA或调节适应之间存在关联的证据并不明确，而且TA在影响闭环稳态调节反应方面似乎仅起次要作用。
