目的：比较正常组、近视前期组、轻度近视组的双眼及单眼调节功能，研究近视前期组调节功能的特征，为延迟/阻止近视的发生，有效降低近视发生率提供临床依据。方法：横断面描述性研究。选取2021-10/2023-02学校视力筛查提示视力异常和/或高危，转诊至翠竹街道社区健康服务中心青少年近视防控中心复查的儿童179人，其中男92人，女87人，年龄6-12(平均8.55±1.66)岁。根据睫状肌麻痹后的屈光度数分为：正常组(+0.75 D<SE≤+2.00 D)、近视前期组(-0.50 D<SE≤+0.75 D)、轻度近视组(-3.00 D≤SE≤-0.50 D)，双眼近视分组以屈光度数低的眼定义组别。检查双眼的正、负相对调节(PRA、NRA)、调节灵活度(AF)，单眼的AF、调节幅度(AA)等。比较不同组别年龄、双眼及单眼调节功能。结果：不同组间性别构成比无差异(χ2=0.167，P=0.920)。正常组和近视前期组年龄无差异(P=0.310)，轻度近视组和正常组、近视前期组有差异(P=0.018、<0.01)； 双眼NRA、PRA、AF正常组和近视前期组均有差异(P<0.01)，近视前期组和轻度近视组均无差异(P>0.05)。单眼AF在正常组与近视前期组均有差异(P<0.01)，在近视前期和轻度近视组中均无差异(P>0.05)； 单眼AA在各组中均有差异(P<0.05)。结论：近视前期屈光度数在正常范围，双眼的NRA、PRA，单眼、双眼的AF已经显著下降，降至与轻度近视组无明显差异； 单眼的AA在近视前期已经下降，和轻度近视组有明显差异。对近视前期儿童应进行调节功能检查，将异常的视功能通过视觉训练恢复或许是防控近视前期进展到近视的一个途径。

AIM: To compare the binocular and monocular accommodation among normal group, premyopia group and mild myopia group, and to study the characteristics of accommodation in the premyopia group, thus providing clinical evidence for the delay/prevention of myopia and the effective decrease of the incidence of myopia.METHODS: Cross-sectional descriptive study. A total of 179 children who had abnormal/high-risk visual acuity indicated by the vision screening in school from October 2021 to February 2023 were selected, including 92 males and 87 females, aged from 6 to 12(mean 8.55±1.66)years old, then they were referred to the Juvenile Myopia Prevention and Control Center in Cuizu Community Health Service Center. They were divided into normal group(+0.75 D<SE≤+2.00 D), the premyopia group(-0.50 D<SE≤+0.75 D)and the mild myopia group(-3.00 D≤SE≤-0.50 D)according to the diopters after cycloplegia, and binocular myopia grouping is defined by the eye with lower diopter. Binocular positive relative accommodation(PRA), negative relative accommodation(NRA), accommodative facility(AF), and monocular AF and amplitude of accommodation(AA)were examined. The age, binocular and monocular accommodation of different groups were compared.RESULTS: There were no difference in the sex ratio of different groups(χ2=0.167, P=0.920). There was no difference in age between the normal group and the premyopia group(P=0.310), but there were differences between the mild myopia group and the normal group and premyopia group(P=0.018, <0.01); Binocular NRA, PRA, and AF had significance between the normal group and the premyopia group(P<0.01), while there was no significance between the premyopia group and the mild myopia(P>0.05). Monocular AF had significance between the normal group and the premyopia group(P<0.01), while there was no significance between the premyopia group and the mild myopia group(P>0.05); The monocular AA had significance among the three groups(P<0.05).CONCLUSION: Although the diopters was normal, binocular NRA, PRA, monocular and binocular AF had significantly decreased in the premyopia group, and there was no significant difference compared with mild myopia group; monocular AA had decreased in the premyopia group and it was also significantly different from the mild myopia group. The accommodation function should be examined in premyopic children. Recovering the abnormal visual function through visual training may be a way to prevent and control premyopia from progressing to myopia.

中国眼谷视功能诊疗技术与转化应用实验室“视功能医学创新奖”项目