Journal of Korean Ophthalmic Optics Society (한국안광학회지)

The Korean Ophthalmic Optics Society (한국안광학회)
권호 표지
DOI QR코드

DOI QR Code

Comparison between Stimulus and Response AC/A Ratios for Each Phoria with Additional Spherical Power

사위별 가입렌즈에 따른 자극 AC/A비와 반응 AC/A비의 비교

  • Lee, Se-Hee (Dept. of Optometry and Vision Science, Catholic University of Daegu) ;
  • Yu, Dong-Sik (Dept. of Optometry and Vision Science, Kyungwoon University) ;
  • Son, Jeong-Sik (Dept. of Optometry and Vision Science, Kyungwoon University) ;
  • Kwak, Ho-Weon (Dept. of Optometry and Vision Science, Kyungwoon University)
  • 이세희 (대구가톨릭대학교 안경광학과) ;
  • 유동식 (경운대학교 안경광학과) ;
  • 손정식 (경운대학교 안경광학과) ;
  • 곽호원 (경운대학교 안경광학과)
  • Received : 2014.07.30
  • Accepted : 2014.09.18
  • Published : 2014.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The accommodative response and the near horizontal phoria were examined with additional spherical power to analyze the stimulus and response AC/A ratios that suggest reference data for the binocular vision. Methods: The open-field autorefractometer (Nvision-K 5001, Shin nippon) and modified thorington method (MIM card; Muscle Imbalance Measure card, Bernell) at 40 cm were utilized to measure the accommodative response and the near horizontal phoria for 81 persons ($20.89{\pm}1.92$ years old) with additional spherical power. The stimulus and the response AC/A ratios were calculated by gradient AC/A method. Results: The exophoria group showed the highest accommodative response ($1.92{\pm}0.26D$) at 40 cm, followed by orthophoria group and esophoria group($1.72{\pm}0.26D$ and $1.62{\pm}0.42D$, respectively) Meanwhile, the esophoria group showed the biggest ocular deviation for the near ($23.24{\Delta}$) followed by the orthophoria group and exophoria group ($19.76{\Delta}$ and $15.14{\Delta}$, respectively). The biggest difference of the stimulus and the response AC/A ratios was $1.72{\Delta}$ for the exophoria group with -2.00 D, while the one was $3.43{\Delta}$ for the esophoria group with +1.00 D. There was a significant difference between AC/A ratios for the exophoria group with -2.00 D, -1.00 D and the esophoria group with +3.00 D, +2.00D, +1.00D and -1.00D. Conclusions: The difference between stimulus and response AC/A was greater when increased minus spherical power for the exophoria group, while it was greater when increased plus spherical power for the esophoria group. Furthermore, the difference for the esophoria group was a greater than the one for the exophoria group.

목적: 각 사위 그룹에서 가입렌즈에 따른 조절반응량과 근거리 수평사위도의 변화를 측정하여 자극 AC/A비와 반응 AC/A비를 조사하였다. 이에 자극 AC/A비와 반응 AC/A비를 비교 분석하여 임상에서의 양안시 검사 및 처방시에 유용한 자료로 제시하고자 한다. 방법: 평균 만 $20.89{\pm}1.92$세, 81명을 대상으로 주시거리 40 cm에서 개방형 자동굴절계(Nvision-K 5001, Shin nippon)와 수정된 토링톤 시표(MIM card; Muscle Imbalance Measure card, Bernell)를 이용하여 양안시 상태에서 조절반응량과 근거리 수평사위도를 측정하였다. 그리고 측정된 값을 토대로 자극 AC/A비와 반응 AC/A비를 경사 AC/A법으로 계산하였다. 결과: 주시거리 40 cm에서 조절반응량은 외사위 그룹이 $1.92{\pm}0.26$ D로 가장 크고, 정위 그룹 $1.72{\pm}0.26$ D, 내사위 그룹 $1.62{\pm}0.42$ D 순으로 작아졌고, 근거리 수평사위도의 변화폭은 내사위 그룹이 $23.24{\Delta}$로 가장 크고, 정위 그룹 $19.76{\Delta}$, 외사위 그룹 $15.14{\Delta}$ 순으로 작게 나타났다. 가입렌즈에 따른 자극 AC/A비와 반응 AC/A비의 차이는 외사위 그룹에서는 -2.00 D 렌즈를 가입하였을 때, $1.72{\Delta}/D$로 가장 컸고 내사위 그룹에서는 +1.00 D 렌즈를 가입하였을 때 $3.43{\Delta}/D$로 가장 크게 나타났다. 외사위 그룹에서 -2.00 D, -1.00 D 렌즈를 가입하였을 때, 내사위 그룹에서는 +3.00 D, +2.00 D, +1.00 D, -1.00 D 렌즈를 가입하였을 때 각각 통계적으로 유의한 차이를 보였다. 결론: 자극 AC/A비와 반응 AC/A비를 비교하였을 때, 외사위 그룹에서는 (-) 렌즈를 가입하였을 때의 차이가 더 크고, 내사위 그룹에서는 (+) 렌즈를 가입하였을 때의 차이가 더 크게 나타났다. 또한 내사위 그룹의 자극 AC/A비와 반응 AC/A비의 차이가 외사위 그룹의 차이보다 더 크게 나타났다.

Keywords

References

  1. Sheedy JE, Shaw-McMinn PG. Diagnosing and treating computer-related vision problems, 1st Ed. Burlington: Elsevier Health Sciences. 2003;91.
  2. Sheedy JE. Vision problems at video display a survey of optometrists. J Am Optom Assoc. 1992;63(10):687-692.
  3. Sung PJ. Optometry, 2nd Ed. Seoul: daihakseolim. 2002; 277:290.
  4. Scheiman M, Wick B. Clinical management of binocular vision, 3rd Ed. Philadelphia:Lippincot williams & Wilkins. 2008;4-6.
  5. Manas L, Schulman P. The variation in the accommodation- convergence accommodation ratio upon periodic testing. J Optom Arch Amer Acad Optom. 1954;31(8):385-395. https://doi.org/10.1097/00006324-195408000-00001
  6. Kim JD, Alexander J, Searbrick H. Accommodative response difference between binocular and monocular viewing for difference refractive error types. Invest Opthalmol Vis Sci. 2001;42(4):S2114.
  7. Rainey BB, Goss DA, Kidwell M, Feng B. Reliability of the response AC/A ratio determined using nearpoint autorefraction and simultaneous heterophoria measurement. Clin Exp Optom. 1998;81(5):185-192. https://doi.org/10.1111/j.1444-0938.1998.tb06733.x
  8. Mutti DO, Jones LA, Moeschberger ML, Zadnik K. AC/A ratio, age, and refractive error in children. Invest Ophthalmol Vis Sci. 2000;41(9):2469-2478.
  9. Gwiazda J, Grice K, Thorn F. Response AC/A ratios are elevated in myopic children. Ophthalmic Physiol Opt. 1999;19(2):173-179. https://doi.org/10.1046/j.1475-1313.1999.00437.x
  10. Kim HK, Lee KB, Kim CJ, Baek SS, Kim HS, Leem HS, et al. Comparison of accommodative response and response AC/A ratio in emmetropic and myopic children. J Korean Ophthalmic Opt Soc. 2012;14(4):353-362.
  11. Rainey BB, Schroeder TL, Goss DA, Grosvenor TP. Inter-examiner repeatability of heterophoria test. Optom Vis Sci. 1988;75(10):719-726.
  12. Mitchell S, Bruce W. Clinical management of binocular vision: heterophoric, accommodative, and eye movement disorders, 3rd Ed. Philadelphia: Lippincott Williams & Wilkins. 2008;9-12.
  13. Oh TS, Choi HC. Analysis methods of social science data, 1st Ed. Seoul: Nanam. 2010;163-167.
  14. Momeni-Moghaddam H, Goss DA, Sobhani M. Accommodative response under monocular and binocular conditions as a function of phoria in symptomatic and asymptomatic subjects. Clin Exp Optom. 2013;97(1):36-42.
  15. Tassinari JT. Monocular estimate method retinoscopy: central tendency easures and relationship to refractive status and heterophoria. Optom Vis Sci. 2002;79(11):708-714. https://doi.org/10.1097/00006324-200211000-00008
  16. Goss DA, Rainey BB. Relationship of accommodative response and nearpoint phoria in a sample of myopic children. Optom Vis Sci. 1999;76(5):292-294. https://doi.org/10.1097/00006324-199905000-00016
  17. Seidemann A and Schaeffel F. An evaluation of the lag of accommodation using photorefraction. Vision Research. 2003;43(4):419-430. https://doi.org/10.1016/S0042-6989(02)00571-0
  18. Kim JH, Ryu KH, Kim IS. The study on relation between asthenopia of lateral phoria and fusional reserve. J Korean Ophthalmic Opt Soc. 2006;11(4):329-335.
  19. Kim DY. Binocular vision, 1st Ed. Seoul: Shinkwang. 2010:326.
  20. Park SJ, Kwak HB, Lee SH, Kwak HW. A Study and analysis of accommodative convergence/accommodation ratio by measuring methods. J Korean Ophthalmic Opt Soc. 2013;18(2):117-123. https://doi.org/10.14479/jkoos.2013.18.2.117
  21. Kim EH, Berangere GD, VicciVR, Alvarez TL. The relationsihp between phoria and the ratio of convergence peak velocity to divergence peak velocity. Invest Ophthanlmol Vis Sci. 2010;51(8):4017-4027. https://doi.org/10.1167/iovs.09-4560

Cited by

  1. Comparison between Response AC/A and CA/C Ratio according to Additional Spherical Powers and Prism Powers vol.20, pp.3, 2015, https://doi.org/10.14479/jkoos.2015.20.3.341
  2. The Change of the Near Eye Position according to the Spectacle and Contact Lens Wearing vol.3, pp.4, 2015, https://doi.org/10.15205/kschs.2015.3.4.435
  3. Six-month follow-up of Binocular Visual Function after Vision Therapy in Intermittent Exotropia with Three Types vol.25, pp.1, 2014, https://doi.org/10.14479/jkoos.2020.25.1.89