背景:研究与基础间歇性外斜视(IXT)患者的调节和收敛以及轴向伸长相关的参数之间的关联,以及轴向长度(AL)增长的潜在临床预测因子。
方法:本研究共招募140名基础IXT患者。选择不同年龄段AL生长的中位数,将受试者分为A组(轴向伸长较慢组,n=69)和B组(轴向伸长较快的组,n=71)。在12个月的随访期间,比较和分析了显性和非显性眼的参数。参数,包括基线折射,偏差角,纽卡斯尔得分(NCS),调节振幅(AMP),住宿设施(AMF),宽松的反应,正或负相对调节(PRA/NRA),和近收敛点(NPC),通过单因素和多因素回归分析。
结果:轴向伸长较快组的受试者倾向于具有更多的近视球面当量(t=3.956,P<.001),优势眼的调节幅度更大(t=-2.238,P=.027),近收敛点(t=2.347,P=.020)比轴向伸长较慢组。对于占优势的眼睛,Logistic和线性回归分析显示,较多的负球形当量(OR=0.603,P<.001;β=-0.045,P<.001),较大的调节幅度(OR=1.201,P=.027;β=0.023,P=.010)和较小的收敛点(OR=0.883,P=.021;β=-0.012,P=.019)与较快的轴向伸长率相关。对于非占优势的眼睛,通过回归分析,更近视的球面当量(OR=0.682;P=.001;β=-0.029,P=.005)是与更快的轴向伸长率相关的唯一参数。
结论:在患有基本间歇性外斜视的儿童中,优势眼中更快的轴向伸长与更近视的球面等效物有关,更大的调节振幅,和较低的收敛点附近。除了眼轴长度之外,这些调节参数可以用作监测近视进展的潜在临床指标。
BACKGROUND: The aim of the study was to investigate the association of parameters related to accommodation and
convergence and axial elongation in basic intermittent exotropia (IXT) patients and the potential clinical predictors of axial length (AL) growth.
METHODS: A total of 140 basic IXT patients were recruited in this study. The medians of AL growth in different age brackets were chosen to divide the subjects into group A (slower axial elongation group, n = 69) and group B (faster axial elongation group, n = 71). Parameters of dominant and nondominant eyes were compared and analyzed during the 12-month follow-up period. The parameters, including baseline refraction, angle of deviation, Newcastle control score (NCS), accommodative amplitude (AMP), accommodative facility (AMF), accommodative response, positive or negative relative accommodation (PRA/NRA), and near point of
convergence (NPC), were analyzed via univariate and multivariate regression.
RESULTS: Subjects in the faster axial elongation group tended to have more myopic spherical equivalents (t = 3.956, p < 0.001), greater AMPs of dominant eyes (t = -2.238, p = 0.027), and fewer near points of
convergence (t = 2.347, p = 0.020) than in the slower axial elongation group. For dominant eyes, logistic and linear regression analysis revealed that more negative spherical equivalents (OR = 0.603, p < 0.001; β = -0.045, p < 0.001), greater AMPs (OR = 1.201, p = 0.027; β = 0.023, p = 0.010), and less near points of
convergence (OR = 0.883, p = 0.021; β = -0.012, p = 0.019) were correlated with the faster axial elongation. For nondominant eyes, a more myopic spherical equivalent (OR = 0.682; p = 0.001; β = -0.029, p = 0.005) was the only parameter correlated with faster axial elongation through regression analysis.
CONCLUSIONS: In children with basic IXT, faster axial elongation in the dominant eyes was associated with more myopic spherical equivalents, greater AMPs, and lower NPCs. These accommodative parameters can serve as potential clinical indicators for monitoring myopia progression in addition to AL.