中文简体与繁体引起的眼调节反应和近距离工作致暂时性近视回退的比较

背景近视的流行病学研究发现，中国香港和台湾地区的近视发病率高于中国大陆。中国台湾、香港地区的通用文字为中文繁体字，而大陆使用的则是中文简体字，通用阅读文字的不同是否与近视发生率的差异有关，繁体字和简体字阅读状态是否与近视发生存在关联值得关注。目的检测同种字体随着字号增大所引起调节反应的量和近距离工作导致暂时性近视（NITM）回退水平的变化规律，探讨因中文字构架差异所诱导的调节发生的异同及其内在的关系。方法选取22名受试者，其中男15名，女7名；年龄24～29岁；等效球镜屈光度为＋O．50—-6．00D，平均等效球镜屈光度为（-1．86＋2．34）D。采用快速序列视觉呈现方式（150字／min）（RSVP）软件提供9pt、12pt的中文简体和繁体阅读视标，GRANDSEIKO—WV5500型红外自动验光仪测量受试者的调节反应；受试者配戴全矫等效球镜随机阅读眼前（角膜平面）33cm处计算机显示屏上的中文简体字与繁体字（调节刺激为3D），字号包括9pt和12pt，在阅读2min时测量调节反应，阅读每种文字10rain测量调节反应，阅读10rain后闭眼休息10s测远用屈光度数，再间隔58、10s继续测远用屈光度数。采用单因素方差分析比较不同字体和不同字号对于调节反应和NITM的影响。结果中文简体与中文繁体引起的调节反应量均表现为调节滞后，滞后量分别为（1．11±0．38）、（0．95±0．43）、（1．18±0．33）、（1．06±0．28）D，其中简体12pt与繁体9pt引起的调节滞后量差异有统计学意义（t=5．56，P=0．02）。4种视标均引起一定的NITM，分别为（-0．45±0．45）、（-0．47±O．46）、（0．45±O．82）、（-0．46＋0．78）D，各视标引起的NITM回退水平的总体差异无统计学意义（F：0．01，P=0．99）。结论短时间阅读简体中文与繁体中文因在调节滞后机制方面存在差异，可能与地区近视发生率的差异有关，而在NITM回退机制上可能与地区近视发生率差异无关。

Accommodative response and nearwork-induced transient myopia induced by simplified and traditional Chinese characters

Background Epidemiologic studies found that the incidence of myopia is higher in Hong Kong and Taiwan regions of China than that of the mainland. So whether the general reading words with traditional Chinese characters and simplified characters is associated with myopia deserves attention. Objective This study was to test the accommodative responses and the regression levels of nearwork-induced transient myopia （NITM） induced by traditional complex Chinese characters and modern simplified ones in the same size, and to explore the differences and inherent relationship of the accommodative regulations based on the structures of the two types of Chinese character in causing reading triggered myopia. Methods Twenty two volunteers aged 24-29 years were included in this study with informed consent. The corrected vision of both eyes from each subject was ~〉 1.0 with a mean spherical equivalence of （-1.86＋2.34） D. Accommodative response was tested with 4 different reading texts using the rapid sequence visual presenting model with the GRAND SEIKO-WV5500 infrared autorefractor, and this procedure was performed after full correction of refractive error. An initial test of looking at a certain distance was performed （ as baseline） , and then the subjects read intensively at the targets for l0 minutes at 33 cm to calculate the accommodative responses. After a 10 second pause,the ocular refractive status was obtained exactly at 15 seconds,20 seconds. The one-way ANOVA method was used to determine the effects of the different font types and sizes on the adjustive responses and the causation of NITM. Results Accommodative response induced by simplified and traditional Chinese characters showed an accommodative lag of （ 1.11 ：tO. 38 ）, （0.95-＋0.43）, （ 1.18-＋0. 33 ） and （ 1.06：t0. 28 ） D, showing a significant difference among the 9 pt and 12 pt simplified and traditional Chinese characters （ F = 1.62, P= 0. 19 ） , and significantly different accommodative lag values between 12 pt simplified characters and 9 pt traditional characters was found （ t = 5.56,P = 0. 02）. NITM induced by the four different targets were （ -0.45 ：tO. 45 ）, （ -0.47 ：t 0. 46） , （0.45：t0. 82） and （-0.46：t0. 78 ）D in the 4 types of characters,without a significant difference among them （F= 0. 01, P = 0. 99）. Conclusions Near-distanee reading causes accommodative lag regardless of the type of reading texts. The target demonstrated stimuli spatial frequency and font size play an impact on accommodative responses. NITM appears when one reads simplified or traditional Chinese for 10 minutes. The accommodative lag and NITM trend might be responsible for the onset or regression of myopia,yet it is not supportive for the hypothesis that reading traditional Chinese causes more strain since there is no difference between the two.