McBrien N A, Adams D W
Department of Optometry Vision Sciences, Candiff University, Wales, United Kingdom.
Invest Ophthalmol Vis Sci. 1997 Feb;38(2):321-33.
To investigate the refractive and biometric changes associated with adult-onset and adult-progression of myopia in an occupational group.
The sample population consisted of 251 clinical microscopists aged 21 to 63 years. Subjects had their refraction and ocular dimensions measured on four occasions during a 2-year period, and a total of 166 subjects (332 eyes) completed the longitudinal aspect of the study. Refraction was measured objectively with a Canon R-1 autorefractor and subjectively by an optometrist using standard procedures. Corneal curvature and axial ocular dimensions were measured with a keratometer and A-scan ultrasonography, respectively.
Of eyes emmetropic at the start of the study, a total of 39% underwent a myopic change in refraction greater than 0.37 diopter (D), with a mean change of -0.58 +/- 0.04 D (mean +/- standard error of the mean; n = 37). This was associated with an elongation of the vitreous chamber of 0.26 +/- 0.05 mm (P < 0.01). Eyes emmetropic at the start of the study that did not undergo a refractive change > 0.37 D (n = 58) during the 2-year study period had a mean change in refraction of 0.02 +/- 0.03 D (P = 0.69) associated with a change in vitreous chamber depth of 0.05 +/- 0.02 mm. Changes in corneal curvature, anterior chamber depth, or lens thickness between the initially emmetropic groups were not significant. The median age of onset of myopia in initially emmetropic eyes was 26.3 years. Of eyes that were myopic at the start of the study, 48% progressed further into myopia by 0.37 D or more during the 2-year period. The mean increase in myopia for the "myopia progressor" group was 0.77 +/- 0.03 D (n = 108 eyes) compared to -0.01 +/- 0.02 D (n = 115 eyes; P = 0.49) for myopes who did not undergo a refractive change > 0.37 D during the study period. The only significant difference in ocular component dimension changes during the study period for these two initially myopic groups was elongation of the vitreous chamber depth (0.24 +/- 0.04 mm versus 0.03 +/- 0.03 mm, P < 0.01). The average age of the myopes who progressed further into myopia during the study was 29.3 years. Axial length-corneal radius ratio at the start of the study was not significantly different between initially emmetropic eyes in which adult onset myopia developed or emmetropic eyes that remained refractively stable. The incidence of adult myopia development during a 2-year period in this occupational group was 45%.
The structural cause of adult-onset and adult-progression of myopia is vitreous chamber elongation.
研究一个职业群体中与成人期近视发病及成人期近视进展相关的屈光和生物测量变化。
样本群体由251名年龄在21至63岁的临床显微镜操作员组成。受试者在2年期间接受了4次验光和眼部尺寸测量，共有166名受试者（332只眼）完成了研究的纵向部分。使用佳能R - 1自动验光仪客观测量屈光，验光师采用标准程序进行主观测量。分别用角膜曲率计和A超超声测量角膜曲率和眼轴尺寸。
在研究开始时正视的眼中，共有39%的眼屈光发生近视性变化，变化大于0.37屈光度（D），平均变化为 -0.58±0.04 D（平均值±平均值的标准误差；n = 37）。这与玻璃体腔延长0.26±0.05 mm相关（P < 0.01）。在2年研究期间，研究开始时正视且屈光变化未超过0.37 D（n = 58）的眼，屈光平均变化为0.02±0.03 D（P = 0.69），玻璃体腔深度变化为0.05±0.02 mm。最初正视组之间的角膜曲率、前房深度或晶状体厚度变化无显著差异。最初正视眼中近视发病的中位年龄为26.3岁。在研究开始时为近视的眼中，48%在2年期间近视进一步进展超过0.37 D。“近视进展者”组近视平均增加0.77±0.03 D（n = 108只眼），而在研究期间屈光变化未超过0.37 D的近视者为 -0.01±0.02 D（n = 115只眼；P = 0.49）。在这两个最初近视的组中，研究期间眼部组成部分尺寸变化的唯一显著差异是玻璃体腔深度延长（0.24±0.04 mm对0.03±0.03 mm，P < 0.01）。在研究期间近视进一步进展的近视者的平均年龄为29.3岁。在成人期发生近视的最初正视眼与屈光保持稳定的正视眼之间，研究开始时的眼轴长度 - 角膜半径比无显著差异。该职业群体在2年期间成人近视发病的发生率为45%。
成人期近视发病及成人期近视进展的结构原因是玻璃体腔延长。
