目的 探讨不同用眼工具在近距离使用时对近视儿童调节微波动（accommodative microfluctuations）的影响。方法 招募2023年2月至2024年5月在湖南省人民医院眼视光中心就诊的7~12岁近视儿童102例（男42人,女60人）,按不同用眼时间分为20 min组（46人）,40 min组（56人）;按不同用眼工具分为书本组（35人）,平板组（33人）,手机组（34人）。参与者接受视力、裂隙灯检查及眼轴测量等一般检查后,进行调节微波动高频分量值（high-frequency component,HFC）和瞳孔直径的第1次测量,随后在正常光照下规范近距离用眼。用眼结束后,立即进行第2次HFC及瞳孔直径测量。获得的数据分析采用单因素重复测量方差分析（analysis of variance,ANOVA）。结果 在近距离用眼20 min后,注视大于5 m、50 cm、33 cm视标时测得的HFC值及Δ值三组比较均无统计学意义,在注视1 m视标时测得的HFC的Δ值有统计学意义。40 min近距离用眼后,手机、平板和书本阅读引起的HFC的Δ值三者之间无显著统计学差异,20 min与40 min不同时间近距离用眼对注视大于5 m处视标时HFC的Δ值存在显著性差异。结论 7~12岁近视儿童20 min内近距离用眼书本相对平板、手机会使调节微波动更加紧张;随着用眼时间从20 min增加到40 min,7~12岁近视儿童的调节微波动逐渐从不稳定趋于稳定。
Abstract
Objective To explore the effects of different tools on accommodative microfluctuations (AMFs) in myopic children during near work. Methods A randomized controlled trial was conducted. A total of 102 myopic children aged 7 to 12 (42 males and 60 females) who visited the Optometry Center of Hunan Provincial People's Hospital from February 2023 to May 2024 were recruited. They were divided into the 20 minutes group (46 cases) and the 40 minutes group (56 cases) according to different eye-using time, And divided into the book group (35 cases), the tablet group (33 cases), and the mobile phone group (34 cases) according to different tools. Participants first underwent general examinations, including vision tests, slit-lamp examinations, and axial length measurements. Subsequently, while engaging in near-vision tasks, participants had their accommodative microfluctuations high-frequency component values (HFC) and pupil diameter measured for the first time using Acomoref2. Then, they were required to read some words on a book, tablet or mobile phone at a near distance under normal lighting conditions. Then, the HFC and pupil diameter were immediately measured for the second time. One way repeated measures analysis of variance (ANOVA) was used for data analysis. Results After 40 minutes of near work, the changes in AMFs caused by reading on mobile phones, tablets, and books were the same, and there was no significant statistical difference among the three groups. After 20 minutes of near work, there was no statistical significance in the HFC when looking at the targets at infinity, 50 cm, and 33 cm among the three groups. However, there was a significant difference in the change value of HFC when looking at the target at 1 m. There was a significant difference in the change of HFC when looking at the target at infinity between 20 minutes and 40 minutes near work. Conclusion For myopic children aged 7-12, reading books at a close distance within 20 minutes makes the accommodative microfluctuations more tense compared to using tablets or mobile phones. As the near work time increases from 20 minutes to 40 minutes, the accommodative microfluctuations of myopic children aged 7-12 gradually changes from unstable to stable.
关键词
近视儿童 /
调节微波动 /
屏幕时间 /
近距离用眼 /
数字设备
Key words
myopic children /
accommodative microfluctuations /
screen time /
near work /
digital devices
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基金
湖南省教育厅科学研究项目“ASK1通路在腺苷A2A受体介导的青光眼视网膜神经节细胞保护中的作用”（24B0080）
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