摘要:
Objective To evaluate the relationship between the rate of development of juvenile myopia, the position of the eye, accommodation, the myopia, the corneal curvature and the outdoor activities , and provide evidence of myopia prevention and treatment .Methods Collected from May 2012 to March 2016 in Inner Mongolia Region People′s Hospital optometry clinic teen-agers with complete data reviewed 386 cases (772 eyes).In age from 6 to 13 years old.Cycloplegic refraction measured by spherical equivalent -0.75 D of myopia or more was defined as the onset of myopia .Be wearing best corrected visual acuity maximum positive lens of the principle of prescription glasses .A year later review of the refractive state of the patient , for statistical analysis .Results The comparison results between the eye position display , exophoria person increase in myopia degree is the average (0.82±0.16) D, (0.62±0.14) D and (0.71±0.19) D, as those who, through the single factor variance analysis between the three groups there were statistically significant differences ( F=42.87, P0.05) .Regulation mode comparison results shows , accommodative lag myopia increased the average speed for (0.91±0.36) D, (0.52±0.22) D and (0.67±0.15) D, through the single factor variance analysis , differences between the three groups have statistical significance ( F=36.76, P0.05) .Whether parents with myopia comparison results shows , both parents myopia myopia increased speed are the average of (0.98±0.15) D, (0.73±0.14) D and (0.53±0.09) D; after the single factor variance analysis , differences between the three groups have statistical significance ( F=347.76, P44 D points into three groups, diopter increased degree respectively (0.72±0.23) D, (0.74±0.25) Dand (0.81±0.34) D, through the single factor variance analysis , differences between the three groups of no statistical significance ( F=2.17, P>0.05); size and diopter corneal curvature increases little correlation .Outdoor activity time comparison results shows, the time for outdoor activities according to the 2 h/d divided into three groups, diopter increased degree respectively (1.02±0.24) D, (0.70±0.18) D and (0.41±0.14) D, through the single factor variance analysis , among the three groups there were statistically significant differences ( F=122.71, P<0.05); Further pairwise comparisons of outdoor activities time more than 2 h/d myopia increased speed is lower than 1-2 h/d and <1 h/d, the difference is statistically significant ( t=-10.78,-15.46;P<0.05);outdoor activities time 1 h/d-2 h/d myopia development speed is lower than the time <1 h/d( t=-9.85, P<0.05) .Conclusion Juvenile exophoria , accommodative lag , and parents myopia are the development of myopia factors , outdoor activities are the impediment of myopia , the size of corneal curvature was correlated little with the increase of the refractive degree .%目的:评估青少年近视眼发展速度与眼位、调节方式、父母是否患有近视眼、角膜曲率及户外活动时间的关系,为青少年近视眼的预防及矫治提供依据。方法采集2012年5月至2016年3月在内蒙古自治区人民医院视光学门诊就诊且复查资料完整的学龄儿童386例(772只眼),年龄6~13岁,平均年龄(9.51±1.78)岁。通过散瞳验光测得的等效球镜屈光度为-0.75D 以上的近视眼被定义为发病的近视眼,予以配戴最佳矫正视力的最大正镜化为原则处方的眼镜。一年后复查患者的屈光状态,按照眼位、调节方式、父母是否患有近视眼、角膜曲率及户外活动时间进行分组,并计算前后两次屈光度的差值。近视眼进展程度指标的数据描述采用均数±标准差( x珋±s)表示,组间比较采用方差分析,当差异有统计学意义时,进一步采用LSD-t法两两比较。结果眼位为外隐斜视、眼球正位及内隐斜视的患者近视眼屈光度的增加值分别为(0.82±0.16)D、(0.62±0.14)D及(0.71±0.19)D。经单因素方差分析,三组之间的差异有统计学意义( F=42.87,P<0.05)。进一步两两比较,外隐斜视组与眼球正位组、外隐斜视组与内隐斜视组间的比较,差异有统计学意义(t=3.75,3.16;P<0.05)。而将内隐斜视组与眼球正位组患者的近视眼发展速度进行组间比较,差异无统计学意义( t=1.94, P>0.05)。调节方式为调节滞后、调节超前及调节正常的患者近视眼屈光度的增加值分别为(0.91±0.36)D、(0.52±0.22)D及(0.67±0.15)D。经单因素方差分析,三组之间的差异有统计学意义(F=36.76, P<0.05)。进一步两两比较,调节滞后组与调节正常组、调节滞后组与调节超前组间的比较差异有统计学意义( t=6.81,7.21;P<0.05)。而将调节超前组与调节正常组进行组间比较,差异无统计学意义( t=-1.78,P>0.05)。家族史中父母均患有近视眼、父母单方患有近视眼及父母均无近视眼的患者近视眼屈光度的增加值分别为(0.98±0.15)D、(0.73±0.14)D及(0.53±0.09)D。经单因素方差分析,三组之间的差异有统计学意义( F=347.76,P<0.05)。父母均患有近视眼组与父母单方患有近视眼组、父母均患有近视眼组与父母均无近视眼组间的比较,差异有统计学意义( t=14.36,29.56;P<0.05)。将父母单方患有近视眼组与父母均无近视眼组的患者进行组间比较,差异有统计学意义( t=14.37,P<0.05)。角膜曲率测试值为<43 D、43~44 D及>44 D三组患者近视眼屈光度的增加值分别为(0.72±0.23)D、(0.74±0.25)D及(0.81±0.34)D。经单因素方差分析,三组之间的差异无统计学意义(F=2.17,P>0.05)。说明角膜曲率的大小与患者近视眼屈光度数的增加相关性不大。户外活动时间<1h/d、1h/d~2h/d及>2h/d三组患者近视眼屈光度的增加值分别为(1.02±0.24)D、(0.70±0.18)D及(0.41±0.14)D。经单因素方差分析,三组之间的差异有统计学意义( F=122.71,P<0.05)。进一步两两比较,户外活动时间>2 h/d的患者近视眼屈光度增加的速度低于1 h/d~2 h/d者和<1 h/d者,差异有统计学意义( t=-10.78,-15.46;P<0.05)。户外活动时间在1h/d~2h/d者近视眼发展速度低于户外活动时间<1h/d者,差异有统计学意义( t=-9.85,P<0.05)。结论青少年外隐斜视、调节滞后及父母患有近视眼是促进近视眼发展的因素,户外活动是抑制近视眼发展的因素,角膜曲率的大小与屈光度的增加相关性不大。