目的 检测近视眼在不同阅读距离的调节刺激下的调节反应、调节反应/调节刺激（AR/AS）坡度、调节性辐辏/调节刺激（AC/AS）、调节性辐辏/调节反应（AC/A）等参数，研究这些参数在正视眼、稳定性近视眼和进展性近视眼中的表达，探讨调节反应等参数在近视发生发展中的作用。 方法 38位志愿者，正视组16位（本组屈光度在-0.25~+0.50D），稳定近视组13位，进展近视组9位。改良的精工500红外自动验光仪测量在不同调节刺激水平（1D，2D，3D）下的调节反应和调节性辐辏，绘制调节反应/调节刺激（AR/AS）曲线图和调节性辐辏/调节刺激（AC/AS）曲线图。计算AR/AS坡度和AC/AS坡度。计算获得反应性AC/A。比较不同组的以上参数。结果 进展性近视组的AR/AS斜率显著低于正视组（p<0.05）, 进展性近视组的AC/AS斜率显著高于稳定性近视组的AC/AS斜率（p=0.008）。进展性近视的AC/A高于正视组和稳定性近视组,差异有高度统计学意义（p<0.01）。相对于正视组，近视组在高调节刺激水平（2D，3D）下虽然表现出较高的调节滞后量，但经统计学分析，差异无显著性意义。在1D的调节刺激水平下，正视组、稳定性近视组和近视进展组的调节反应差异无统计学意义（p>0.05）。进展性近视组在(2D,3D)的高调节刺激水平下所表现的调节反应显著低于正视组（p<0.05）。结论 进展性近视组在高调节需求下有较低的调节反应，较高的调节滞后导致视网膜模糊像，长期的视网膜模糊像可能是引发眼轴近视化发展的主要因素。

Expression of accommodative response
in development of myopia

XU Dan LU Fan YAN Jing WANG Qing QU Jia JIANG Baichuan*
school of optometry and ophthalmology,Wenzhou medical college, Wenzhou 325023,China
*myopia research institute at Wenzhou medical college. NOVA.U.S.A
[Abstract] Objective This study is designed to evaluate the accommodative response under different accommodative stimulu among myopies. The investigated parameters are included slope of accommodative response/accommodative stimulus (AR/AS),slope of accommodative convergence/accommodative stimulus (AC/AS) as well as slope of accommodative convergence/accommodative response(AC/A). The expression of accommodative responses were analyzed and compared among emmetropia, steady myopia and progression myopia to order to explore their role in myopia development. Method Thirty eight volunteers with 16 emmetropia(EMM),13 stable myopia(SM) and 9 progressive myopia(PM) were enrolled for this study. SEIKO-500 auto refractor was used to measure the accommodative response and accommodative convergence in three accommodative stimulus conditions (1D.2D.3D),the AR/AS and AC/AS curves were plotted and the slopes were used to calculate the responsive AC/A. These data were compared among groups. Result The slope of AR/AS in progressive myopia was lower than that in emmetropia(p<0.05).The slope of AC/AS in progressive myopia was higher than that in stable myopia(p<0.01).The AC/A in progressive myopia is higher than that in emmetropia and stable myopia(p<0.01).Compare to emmetropia, myopia showed slightly higher accommodative lag in high accommodative demand(2D,3D)although no significant statistics difference. However, progressive myopia showed significant lower accommodative response than emmtropia in high accommodative demand (2D,3D)(P<0.05). Conclusion progressive myopia shows lower accommodative response in high accommodative demand. High accommodative lag induces retinal image blur and the associated high levels of defocus blur at near may lead to myopia shift or development.