小児眼における屈折と高次収差の関係および調節麻痺薬の高次収差に及ぼす影響

Influence of refractive error and cycloplegia on higher-order aberrations in children

要約　目的：屈折異常と調節麻痺薬の点眼が小児の高次収差に及ぼす影響の報告。対象と方法：矯正視力が0.8以上の41名71眼を対象とした。年齢は3〜15歳で，中央値は6歳であった。遠視22眼，正視25眼，近視24眼で，塩酸シクロペントレートの点眼前後の高次収差をwave-front analyzerで解析した。結果：遠視眼でのコマ様収差と全高次収差は正視眼よりも有意に大きく，遠視眼での球面様収差は正視眼と近視眼よりも有意に大きかった。調節麻痺薬の点眼により，遠視眼では球面様収差と全高次収差が有意に増加し，正視眼では有意の変化がなく，近視眼ではコマ様収差，全高次収差，角膜高次収差が有意に増加した。Zernike多項式については，点眼後の遠視群ではC（3，−3），C（3，−1），C（4，0）に，近視群ではC（3，−1），C（4，−2），C（5，−3）に，それぞれ有意な変化があった。結論：調節麻痺薬の点眼により，屈折異常のある小児の高次収差に変化が生じた。

Abstract.　Purpose：To report the influence of refractive error and cycloplegia on higher-order aberrations（HOAs）in children. Cases and Method：This study was made on 71 eyes of 41 children who had corrected visual acuity of 0.8 or over. The age ranged from 3 to 15 years, with 6 years as the median. The series comprised 22 eyes with hyperopia, 25 eyes with emmetropia, and 24 eyes with myopia. Higher-order aberrations were analyzed using a wave-front analyzer before and after instillation of 1％ cyclopentolate. Results：Eyes with hyperopia showed significantly greater coma-like aberrations and Ocular HOAs than eyes with emmetropia. Spherical-like aberrations was significantly greater in eyes with hyperopia than in eyes with emmetropia or myopia. Instillation of cycloplegics resulted in significant increase in spherical-like aberrations and Ocular HOAs in eyes with hyperopia, no changes in eyes with emmetropia, and increase in coma-like aberrations, ocular HOAs and corneal HOAs in eyes with myopia. There were significant changes in Zernike terms regarding C（3, −3）, C（3, −1）and C（4, 0）in eyes with hyperopia, and C（3, −1）, C（4, −2）and C（5, −3）in eyes with myopia. Conclusion：Instillation of cycloplegics showed changes in higher-order aberration in children with refractive errors.