【摘要】：目的了解青少年不同屈光狀態(tài)隱斜視分布情況,并分析近視眼與隱斜視及各近距離眼動參數(shù)之間可能存在的關(guān)系,探討隱斜視及近距離眼動參數(shù)在近視發(fā)生發(fā)展中的可能作用。方法選取經(jīng)遮蓋試驗篩選的隱斜視青少年73人146只眼,進行屈光度、近距離水平隱斜度及AC/A、調(diào)節(jié)滯后量等眼動參數(shù)的測量。依屈光狀態(tài)分為遠視、正視、近視組,統(tǒng)計各組隱斜視分布情況。再將近視組按-0.25D--2.00D、-2.00D--4.00D、-4.00D--6.00D分為A、B、C三組,分別對這三組中內(nèi)、外隱斜視的各眼動參數(shù)進行比較。然后對近視眼組的屈光度及隱斜度與各眼動參數(shù)進行相關(guān)性分析。結(jié)果146只眼中,遠視11只眼,正視21只眼,近視117只眼,遠視眼中內(nèi)隱斜占36.36%,外隱斜占63.64%；正視眼中內(nèi)隱斜占9.52%,外隱斜占90.48%；近視眼中內(nèi)隱斜占25.44%,外隱斜占74.56%。在近視眼A組,內(nèi)隱斜的AC/A、調(diào)節(jié)滯后量分別為(5.00±0.89)△/1D、(-0.54±0.29)D,外隱斜的AC/A、調(diào)節(jié)滯后量分別為(3.45±1.78)△/1D、(-0.20±0.54)D,兩者之間AC/A及調(diào)節(jié)滯后量比較差異有統(tǒng)計學(xué)意義(P0.05)；B組中,內(nèi)隱斜的AC/A、調(diào)節(jié)滯后量分別為(4.67±2.25)△/1D、(-0.67±0.26)D,外隱斜的AC/A、調(diào)節(jié)滯后量分別為(3.28±1.26)△/1D、-0.27±0.65)D,兩者之間AC/A及調(diào)節(jié)滯后量比較差異有統(tǒng)計學(xué)意義(P0.05)；C組中,內(nèi)隱斜的AC/A、調(diào)節(jié)滯后量分別為(4.00±0.00)△/1D、(-0.60±0.14)D,外隱斜的AC/A、調(diào)節(jié)滯后量分別為(2.63±1.11)△/1D、(-0.13±0.47)D,兩者之間AC/A及調(diào)節(jié)滯后量比較差異有統(tǒng)計學(xué)意義(P0.05)。近視屈光度與AC/A及調(diào)節(jié)滯后量呈正相關(guān)(r=0.420,p0.05；r=0.384,p0.05)。近視眼中,內(nèi)隱斜度與AC/A呈正相關(guān)(r=0.778,p0.05),與調(diào)節(jié)滯后量呈正相關(guān)(r=-0.453,p0.05)；外隱斜度與AC/A呈負相關(guān)(r=0.233,p0.05),與調(diào)節(jié)滯后量呈正相關(guān)(r=0.241,p0.05)。結(jié)論在近視眼患者中,內(nèi)隱斜的AC/A、調(diào)節(jié)滯后量均大于外隱斜。AC/A、調(diào)節(jié)滯后量與近視度數(shù)及內(nèi)隱斜度呈正相關(guān)。推測內(nèi)隱斜可能比外隱斜更易加快近視發(fā)展,且內(nèi)隱斜度越大,近視發(fā)展越快。外隱斜度與AC/A呈負相關(guān),與調(diào)節(jié)滯后量呈正相關(guān),較大度數(shù)的外隱斜因伴隨較大的調(diào)節(jié)滯后量對近視發(fā)展起重要作用。我們可以嘗試通過優(yōu)化組合矯正隱斜視和屈光不正或通過訓(xùn)練甚至手術(shù)早期矯正斜視達到個性化優(yōu)化眼動參數(shù)減緩近視發(fā)展的目的。
[Abstract]:Objective to investigate the distribution of implicit strabismus in different refractive states of adolescents, and to analyze the possible relationship between myopia, esotropia and close-range eye movement parameters, and to explore the possible role of oculomorphism and close-range oculomotor parameters in the occurrence and development of myopia. Methods one hundred and forty-six eyes of 73 adolescents with esotropia who were selected by shading test were selected to measure the eye movement parameters such as diopter, close-range level steepness and AC/A, adjustment lag. They were divided into hyperopia, emmetropia and myopia groups according to their refractive state. The myopia group was divided into three groups according to -0.25D- 2.00D-2.00D-4.00D-4.00D- 6.00D, and the parameters of eye movement in these three groups were compared. Then, the correlation between diopter and implicit slope of myopia group and eye movement parameters was analyzed. Results in 146 eyes, 11 eyes, 21 eyes, 117 eyes, 36.36%, 63.64%, 9.52%, 90.48%, 25.44% and 74.56%, respectively. In myopia group A, the AC/A, regulatory lag was (5.00 鹵0.89) / 1 D, (-0.54 鹵0.29) D, and the AC/A, regulatory lag was (3.45 鹵1.78) / (-0.20 鹵0.54) D, respectively. There was a significant difference in AC/A and regulatory lag between the two groups (P0.05). The lag of AC/A, regulation was (4.67 鹵2.25) / 1D, (-0.67 鹵0.26) Drespectively, and that of occult AC/A, was (3.28 鹵1.26) / -0.27 鹵0.65 Drespectively. There was a significant difference in AC/A and regulatory lag between the two groups (P0.05). The regulatory lag of AC/A, was (4.00 鹵0.00) / 1D, (-0.60 鹵0.14) D, and that of AC/A, was (2.63 鹵1.11) / 1D, (-0.13 鹵0.47) D, respectively. There was significant difference between the two groups (P0.05). There was a positive correlation between myopic diopter and AC/A and the amount of regulatory lag (r = 0.420 / 0. 05 / 0. 384p / 0.05). In myopia, the implicit slope was positively correlated with AC/A (r = 0.778 / p0.05), and with the amount of regulatory lag (r = 0.453p / 0.05), and was negatively correlated with AC/A (r = 0.233p / 0.05) and with the amount of regulatory lag (r = 0.241p0.05). Conclusion in myopia patients, the AC/A, regulatory lag of implicit oblique is higher than that of extroversion. Ac / A, the regulatory lag is positively correlated with myopia degree and implicit inclination. It is suggested that the development of myopia may be more accelerated by the implicit oblique than that by the external oblique, and the greater the implicit slope is, the faster the myopia develops. There was a negative correlation between implicit slope and AC/A and a positive correlation with the amount of adjustment lag. The larger degree of oblique factor accompanied by a larger amount of regulatory lag played an important role in the development of myopia. We can try to optimize the parameters of eye movement to slow the development of myopia by optimizing the combination of correction of esotropia and ametropia or by training and even early surgery to correct strabismus.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2011
【分類號】：R778.11

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