Emmetropes and myopes differ little in their accommodation dynamics but strongly in their ciliary muscle morphology
Emmetropes and myopes differ little in their accommodation dynamics but strongly in their ciliary muscle morphology
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DOI：
10.1016/j.visres.2019.08.002
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发表时间：
2019-10-01
期刊：
影响因子：
1.8
通讯作者：
Strasser, Torsten
中科院分区：
文献类型：
--
作者：
Wagner, Sandra;Zrenner, Eberhart;Strasser, Torsten
先前的研究表明，近视和近视之间存在关联。因此，我们研究了正视眼和近视眼的调节过程，包括睫状肌(CM)的形态变化和不同调节需求下晶状体的功率变化。对18名正视眼和20名近视眼学生在远调节和近调节(2.5D、3D、4D)状态下用眼前段光学相干断层扫描仪进行颞叶CM成像。用偏心红外验光法记录远-近-远(S各15只；2.5维、3维、4维)的调节动力学。OCT图像使用定制开发的软件处理，便于分析选择性CM厚度(CMT)读数和CMT曲线。近视眼的前部CMT读数明显较小。近视眼CM在巩膜后距(SP)1.4 mm处开始增厚。近视眼的前CMT改变(Delta CMT)随着调节需求的增加而持续增加，而正视眼的Delta CMT仅从2.5D增加到3D。与正视眼相比，近视眼的Delta CMT较小，但相对于SP，CM运动增加。从远视力到近视力的调节变化以及从远视力到近视力的调节变化、速度、微波动、功率谱或调节滞后在两组之间没有显著差异。在4D时，较大的Delta CMT与较低的调节不适的晶状体改变有关。CM的形状、运动和厚度取决于屈光不正而有明显差异，而正视眼和近视眼在动态调节方面没有差异。进一步的分析是必要的，以评估CM的解剖形态或其肌肉内成分的易感性是否是近视发生的原因。
Previous work suggested an association between near vision and myopia. We therefore investigated the accommodation process in emmetropes and myopes regarding morphologic changes of the ciliary muscle (CM) and power changes of the lens for different accommodation demands. The temporal CM of 18 emmetropic and 20 myopic students was imaged via anterior segment optical coherence tomography during far and near accommodation (2.5D, 3D, 4D). Additionally, accommodation dynamics to the stimuli pattern far-near-far (15 s each; 2.5D, 3D, 4D) were recorded with eccentric infrared photorefraction. OCT images were processed using custom developed software facilitating the analysis of selective CM thickness (CMT) readings and CMT profiles. Anterior CMT readings were significantly smaller in myopes. Starting at 1.4 mm posterior to the scleral spur (SP), myopic CM became thicker than emmetropic. Anterior CMT changes (Delta CMT) continuously increased with accommodation demand in myopes while emmetropic Delta CMT only increased from 2.5D to 3D. Compared to emmetropes, myopes showed smaller Delta CMT but increased CM movement relative to SP. There were no significant differences between the groups for accommodation changes from far to near vision and vice versa, velocity, microfluctuations, power spectra or lag of accommodation. At 4 D, larger Delta CMT were associated with lower lens changes for disaccommodation. While CM shape, movement, and thickness showed distinct differences depending on refractive error, emmetropes and myopes did not differ in their dynamic accommodation. Further analysis is necessary to evaluate whether the CM's anatomical shape or predispositions in its intramuscular constituents are causative factors in myopigenesis.