近视人群不同注视眼位下的眼压变化

目的：研究近视人群在不同注视眼位下的眼压变化。方法：系列病例研究。选择2019 年12 月至 2020年1月在校的暨南大学单纯性近视大学生为研究对象。根据等效球镜度（SE）分为低度、中度、 高度近视组。对所有研究对象进行眼部检查，获取眼轴长度（AL）、中央前房深度（ACD）、中央角膜 厚度（CCT）及角膜曲率（K1、K2）等参数。采用iCare回弹式眼压计测量双眼原在位放松状态下的基 础眼压（IOPP）及分别注视9个不同眼位（集合、上、下、左、右、左上、左下、右上、右下）5 min后的 眼压，每个注视眼位间隔休息5 min。采用独立样本t检验、单因素方差分析及相关性检验对数据进 行分析。结果：最终纳入研究对象60例（60眼），其中低、中、高度近视组分别为21、28、11眼。左 右眼IOPP差异无统计学意义（t=0.835，P=0.406），以右眼为研究眼。3组间SE、AL差异有统计学意 义（F=139.789，P<0.001；F=21.917，P<0.001），而组间IOPP、ACD、CCT、K1、K2差异均无统计学 意义。近视眼人群向9个不同眼位注视5 min后的眼压值与IOPP（13.80±3.92）mmHg]差异无统计学 意义。3组的IOPP、下方眼位眼压（IOPD）与SE均无相关性，IOPP与AL均无相关性。低、中度近视组 的集合眼位眼压（IOPC）与SE之间无相关性，高度近视组的IOPC与SE呈正相关（r=0.713，P=0.014）。 结论：不同注视眼位下的眼压与IOPP之间无差异，IOPP与SE之间无明显相关性，但高度近视者更应 科学合理用眼，避免长时间近距离用眼。

The Change in Intraocular Pressure with Different Positions of Gaze in Myopia

Objective: To study the change in intraocular pressure with different positions of gaze in myopia groups. Methods: This was a series case study of myopic subjects who were recruited in Jinan University from December 2019 to January 2020. They were divided into three groups: Low myopia, moderate myopia and high myopia according to the spherical equivalent (SE). Routine eye examinations were performed, includimg axial length (AL), anterior chamber depth (ACD), central corneal thickness (CCT), corneal curvature K1-value (K1) and corneal curvature K2-value (K2). The iCare rebound tonometer was used to obtain the primary intraocular pressure (IOPP) in the relaxed state and the average binocular intraocular pressure at 9 different positions of gaze after 5 minutes (including convergence, upward, downward,leftward, rightward, left upward, left downward, right upward and right downward). Subjects rested for 5 minutes after testing at each position of gaze. An independent t-test, analysis of variance and association analysis were used to analyze data. Results: A final 60 volunteers (60 eyes) were involved in the study, including 21 eyes, 28 eyes, and 11 eyes in the low, moderate, and high myopia groups, respectively. There was no significant difference in data between the two eyes so the right eye was chosen in this study (t=0.835, P=0.406). There was a statistically significant difference in AL and spherical equivalent (SE) among the three groups (F=139.789, P<0.001; F=21.917, P<0.001). But there was no significant difference in the remaining parameters. After 5 minutes of gazing, there was no significant difference in the change in intraocular pressure between the three groups at the nine positions of gaze. No statistically significant correlations were observed in the three groups between the IOPP or intraocular pressure during the downward gaze position (IOPD) and SE. The correlation between IOPP and AL was not statistically significant in the three groups. No statistically significant correlations were observed in the low or moderate myopia groups between IOPC (convergence) and SE, contrary to high myopia (r=0.713, P=0.014). Conclusions: There is no difference in intraocular pressure between positions of gaze and primary intraocular pressure. There is no correlation between primary intraocular pressure and myopia in this study, but high myopes are advised to avoid spending long periods of time on near vision work.