儿童近视进展与调节功能的关系

目的：研究儿童在近视进展过程中调节功能的变化,分析调节功能在近视进展中的作用。方法：观察随访21名进展性近视儿童,年龄（11.1±1.5）岁,分别在入组及2年随访时测量受试者调节功能参数,如远距调节灵活度、动态调节刺激-反应曲线（ASRC）。结果：21名受试者2年后,平均近视进展（-1.55±0.58）D,差异有统计学意义（t=12.24,P＜0.01）。随访前后,远距调节灵活度、ASRC相关参数（ASRC斜率、0～6 D的调节滞后面积、客观调节幅度）差异均无统计学意义（P＞0.05）。调节滞后量仅在调节刺激为4 D时的差异有统计学意义（t=-2.018,P=0.048）,其余0～6 D调节刺激下调节滞后量差异均无统计学意义（P＞0.05）。多元线性回归分析发现,近视进展仅与年龄呈正相关（R2=0.186,P=0.029）。结论：在儿童近视进展过程中,调节功能保持相对稳定。近视进展与调节参数无关,受年龄影响,年龄越小,近视进展越快。

Study on the relationship between myopia progression and accommodative functions in children

Objective: To study the changes of accommodative parameters in myopic children during their myopia progression and analyze their roles in myopia progression. Methods: Totally 21 myopic children with mean age of (11.1±1.5) years old were enrolled in this study. Distance accommodative facility and dynamic accommodative stimulus-response curve (ASRC) of right eyes were measured upon enrollment and at 2-year follow-up. Results: Myopia of 21 children significantly progressed (-1.55±0.58) D in 2 years (t=12.24, P<0.01). There were no statistical differences in distance accommodative facility and ASRC related parameters between baseline and 2-year visit (all P>0.05). Accommodative lag was statistically significant only when accommodative stimulus was 4 D (t=-2.018, P=0.048) and there were no statistical differences under other accommodation stimuli (all P>0.05). Multilinear regression analysis found myopia progression was only positively correlated with age (R2=0.186, P=0.029), but not related to accommodative parameters at baseline. Conclusion: During myopia progression in children, accommodative function remains relatively stable. Myopia progression is not related to accommodative parameters, but affected by age. The younger the child, the faster myopia progresses.