근시 성인에서 조절마비 전후와 조절마비제에 따른 굴절 변화 비교
Comparative Study on the Efficacy of Different Cycloplegic Agents in Myopic Adults
3
조회
0
다운로드
7
인용
0
참고문헌
키워드
초록
목적: 근시인 성인을 대상으로 조절마비하 굴절검사의 필요성을 알아보고 조절마비제에 따른 굴절검사 결과를 비교하였다. 대상과 방법: 근시가 있는 20대 성인을 대상으로 제1약제(tropicamide 0.5%와 phenylephrine 0.5%), 제2약제(cyclopentolate 1%), 제3 약제(제1약제와 제2약제의 혼합)를 점안한 후 굴절검사를 시행하여 현성 굴절검사와 비교하고 약제간의 결과를 비교하였다. 조절력, 잔여조절력을 측정하고 초음파 생체계측을 시행하여 약제간에 비교하였다. 결과: 조절마비제 점안 후 현성 굴절검사에 비해 의미 있는 근시의 감소가 있었으며, 제1약제보다 제2약제나 제3약제 점안 후 근시 감소량이 많았다. 제2약제와 제3약제가 제1약제보다 조절력과 안축장 길이를 의미 있게 감소시켰으나, 잔여조절력은 세 약제간의 차이 가 없었다. 조절마비 전 조절력이 좋을수록, 제1약제 점안 후 잔여조절력이 많을수록, 제1약제보다 제2약제의 조절마비가 강하게 나타 났다. 결론: 근시인 성인에서도 조절마비하 굴절검사가 필요하며, 조절력이 좋고 tropicamide 점안 후 잔여조절력이 크면, cyclopentolate에 의한 조절마비가 필요한 것으로 생각된다.
Abstract
Purpose: To evaluate the efficacy of 3 cycloplegic regimens in adults with myopia. Methods: Refraction, accommodation amplitude, residual accommodation and biometric findings were assessed before and after instillation of regimen I (tropicamide 0.5% and phenylephrine 0.5%), regimen II (cyclopentolate 1.0%), and regimen III (combination of regimen I and II). Results: In myopic adults aged 22 to 26 years, cycloplegic refraction revealed less myopia than manifested refraction. Although there was no difference in residual accommodation among the 3 regimens, regimen II and III were more effective in reducing myopia, accommodation, and axial length. The difference in cycloplegic refraction between regimen I and II was more prominent in patients who had larger amplitude of accommodation and residual accommodation with regimen I. Conclusions: Cycloplegic refraction should be used even in adult myopes. For patients with stronger accommodation and larger residual accommodation with tropicamide, cycloplegic refraction with cyclopentolate may be used to ensure relaxation.
참고문헌 (30)
- Moon NJ, "The study on the necessity of cycloplegic refraction in school children", J Korean Ophthalmol Soc, 29, pp.377~385 (1988)
- Kim CK, "Changes in refractive finding after using cycloplegics in young adult", J Korean Ophthalmol Soc, 25, pp.341~345 (1984)
- Bannon RE, "The use of cycloplegics in refraction", Am J Optom Arch Am Acad Optom, 24, pp.511~568 (1947)
- Maoury SD, "Comparison of fixation targets during noncycloplegic retinoscopy", Am J Ophthalmol, 63, pp.865~ (1967)
- Hiatt RL, "Refraction using mydriatic, cycloplegic, and manifest techniques", Am J Ophthalmol, 76, pp.739~744 (1973)
- Hofmeister EM, "Comparison of tropicamid and cyclopentolate for cycloplegic refractions in myopic adult refractive surgery patients", J Cataract Refract Surg, 31, pp.694~700 (2005)
- 양석우, "굴절이상에 따른 조절마비검사 전 후의 시력변화 비교", 대한안과학회지, 47(9), pp.1454~1458 (2006), 대한안과학회
- Rosenfield M, "Repeatability of clinical measurements of the amplitude of accommodation", Ophthalmic Physiol Opt, 16, pp.247~249 (1996)
- Atchison DA, "Critical subjective measurements of amplitude of accommodation", Optom Vis Sci, 71, pp.699~706 (1994)
- Gettes BC, "Evaluation of five new cycloplegic drugs", AMA Arch Ophthalmol, 49, pp.24~27 (1953)
- Lancaster WZ, "New light on the theory of accommodation with practical application", Trans Am Acad Ophthalmol Otolaryngol, 19, pp.170~195 (1914)
- Ciuffreda KJ, "Near work induced transient myopia,In basic and clinical aspects", J Optom Vis Dev, 30, pp.5~20 (1999)
- Ciuffreda KJ, "Myopes show increased susceptibility to nearwork aftereffects", Invest Ophthalmol Vis Sci, 39, pp.1797~1803 (1998)
- Ciuffreda KJ, "Differential refractive susceptibility to sustained nearwork", Ophthalmic Physiol Opt, 22, pp.372~379 (2002)
- Wolffsohn JS, "Refractive error, cognitive demand and nearwork-induced transient myopia", 27, pp.363~370 (2003)
- Duane A, "Studies in monocular and binocular accommodation with their clinical applications", Trans Am Ophthalmol, 5, pp.865~ (1922)
- Priestley BS, "A new mydriatics and cycloplegic drug", Am J Ophthalmol, 34, pp.572~575 (1951)
- Gordon DM, "Cyclopentolate hydrochloride,In a new mydriatic and cycloplegic agent", Am J Ophthalmol, 38, pp.831~838 (1954)
- Miranda MN, "A comparison between cyclopentolate 1 percent and a combination of cyclopentolate 1 percent and tropicamaide 1 percent", Arch Ophthalmol, 87, pp.515~517 (1972)
- Stine GT, "Clinical investigation of a new cycloplegic and mydriatic drug", Eye Ear Nose Throat Mon, 22, pp.11~14 (1960)
- Milder B, "Tropicamide as a cycloplegic agent", wArch Ophthalmol, 66, pp.70~72 (1961)
- Choi O, "The studies on the residual accommodation of Koreans. II. The residual accommodation under 0.5 percent scopolamine and 1 percent cyclogyl cycloplegia", YonseiMed J, 5, pp.62~64 (1964)
- Ebri A, "Cost effectiveness of cycloplegic ,In agents results of a randomized controlled trial in Nigerian children", Invest Ophthalmol Vis Sci, 48, pp.1025~1031 (2007)
- 최영호, "소아 굴절검사방법에 따른 차이 비교 및 생활양식이 근시에 미치는 영향", 대한안과학회지, 46(11), pp.1841~1847 (2005), 대한안과학회
- Gao L, "The change in ocular refractive components after cycloplegia in children", Jpn J Ophthalmol, 46, pp.293~298 (2002)
- McBrien NA, "Atropine reduces experimental myopia and eye enlargement via a nonaccommodative mechanism", Invest Ophthalmol Vis Sci, 34, pp.205~215 (1993)
- Luft WA, "Variable effects of previously untested muscarinic receptor antagonists on experimental myopia", Invest Ophthalmol Vis Sci, 44, pp.1330~1338 (2003)
- Gwiazda J, "Baseline refractive and ocular component measures of children enrolled in the correction of myopia evaluation tria", Invest Ophthalmol Vis Sci, 43, pp.314~321 (2002)
- Saw SM, "Nearwork in early onset myopia", Invest Ophthalmol Vis Sci, 43, pp.332~339 (2002)
- Kim JC, "A study of prevailing features and causes of myopiaand visual impairment in urban school children", J Korean Ophthalmol Soc, 29, pp.165~181 (1988)