Abbott M L, Schmid K L, Strang N C
School of Optometry, Queensland University of Technology, Brisbane, Australia.
Ophthalmic Physiol Opt. 1998 Jan;18(1):13-20.
While the accommodation system has been implicated in myopia development, the nature of this relationship remains obscure. This study investigated the differences in accommodation stimulus response curves between adult myopes and emmetropes. Myopic subjects were classified according to age of onset and stability of their myopia. Accommodation stimulus response curves were measured using three different methods: (i) real targets presented at viewing distances of 4 m to 0.25 m, (ii) a target at 4 m viewed through negative lenses of increasing power, and (iii) a target at 0.25 m viewed through positive lenses of decreasing power. A Canon Autoref R-1 measured the accommodation responses at 5 levels of demand (increasing from 0 D to 4 D in 1 D steps). We found significant differences between the three methods used to stimulate an accommodation response in all subject groups, for example, accommodation lags at high accommodative demands were greatest for the negative lens series and least for the positive lens series. In addition, while differences between early-onset myopes, late-onset myopes and emmetropes were not observed, we did observe differences when myopic subjects were reclassified according to whether their myopia was progressing or stable. A reduced accommodation response to negative lens-induced accommodative demand was found in progressing myopes but not in stable myopes. These results provide further evidence for the link between myopia progression and inaccurate accommodation. The data also suggest that adult myopes with stable refractive errors show accommodation responses similar to that of emmetropes.
虽然调节系统与近视发展有关，但其关系的本质仍不清楚。本研究调查了成年近视患者和正视者之间调节刺激反应曲线的差异。近视受试者根据近视的发病年龄和稳定性进行分类。使用三种不同方法测量调节刺激反应曲线：（i）在4米至0.25米的视距呈现真实目标，（ii）通过逐渐增加屈光度的负透镜观察4米处的目标，（iii）通过逐渐降低屈光度的正透镜观察0.25米处的目标。佳能自动验光仪R-1在5个需求水平（从0D以1D步长增加到4D）测量调节反应。我们发现，在所有受试者组中，用于刺激调节反应的三种方法之间存在显著差异，例如，在高调节需求下，负透镜系列的调节滞后最大，正透镜系列的调节滞后最小。此外，虽然未观察到早发性近视、迟发性近视和正视者之间的差异，但当根据近视是进展性还是稳定性对近视受试者重新分类时，我们确实观察到了差异。进展性近视患者对负透镜诱导的调节需求的调节反应降低，而稳定性近视患者则没有。这些结果为近视进展与调节不准确之间的联系提供了进一步证据。数据还表明，屈光不正稳定的成年近视患者的调节反应与正视者相似。
