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目的观察学龄期近视患者近距离阅读后高阶像差的变化,并结合近视屈光度的随访研究,探讨阅读后高阶像差的变化与近视发展的关系。设计横断面病例系列研究。研究对象学龄期单纯性近视患者115例(230眼)。方法被检者近距离(20cm)阅读1小时,用Allegretto波前像差仪测量患者阅读前后的波前像差,观察高阶像差的变化,并与被检者一年中屈光度的变化做相关分析；按高阶像差阅读前后变化量的四分位数由低到高将被检者分为四组,探讨高阶像差阅读前后变化不同程度组间近视屈光度(一年中)的变化有无差异。主要指标屈光度,高阶像差均方根(RMS)值。结果近距离阅读前后总体高阶像差的变化(ΔRMSh)及3～4阶高阶像差变化(ΔRMS3～4)均有统计学意义(P均＜0．05)。阅读前后总体高阶像差的变化(ΔRMSh)及3阶高阶像差的变化(ΔRMS3)与一年中近视屈光度的变化(Δ屈光度)呈正相关(P均＜0．05)。大瞳孔(6mm)状态下阅读后总体高阶像差增高较多者一年中近视屈光度增加较多。结论近距离阅读后高阶像差增高。大瞳孔状态下近距离阅读后高阶像差的增高可能与近视发展有关。(眼科,2006,15：317-320)
Objective To observe the changes of higher-order aberrations after short-term reading in school-age myopic patients, and to investigate the relationship between the higher-order aberrations and the development of myopia after reading with the follow-up study of myopia. Design cross-sectional case series. Subjects 115 cases of simple age-related myopia (230 eyes). Methods The subjects were examined for one hour at close range (20cm). Allegretto wavefront aberrometer was used to measure the wavefront aberrations before and after reading. The aberrations of higher order aberrations were observed. Correlation analysis; According to the high-order aberration reading before and after the change of quartiles from low to high will be divided into four groups were seized to explore changes in higher-order aberrations before and after different degrees of myopia diopter (one year) Is there any difference in change? The main indicators of diopter, higher order root mean square (RMS) value. Results The changes of total high-order aberrations (ΔRMSh) and high-order aberrations of 3 ~ 4 orders (ΔRMS3 ~ 4) before and after short-distance reading were statistically significant (all P <0.05). The changes in total high-order aberrations (ΔRMSh) and the third-order high-order aberrations (ΔRMS3) before and after reading were positively correlated with changes in diopter (Δ diopter) in one year (all P <0.05). Large pupil (6mm) state after reading the higher overall higher-order aberrations more in one year more myopic refraction. Conclusions High-order aberrations increase after short-distance reading. Large pupil state after close reading high-order aberrations may be related to the development of myopia. (Ophthalmology, 2006,15: 317-320)