Yahaya Nur Adibah, Mohd-Ali Bariah, Norazman Fatin Nur Najwa, Syed Mohd Dardin Syarifah Faiza, Mohamad Shahimin Mizhanim, Mohamad Fadzil Norliza
Optometry and Vision Science Programme, Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia.
Optometry and Vision Science Programme, Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia.
J Optom. 2025 May 17;18(3):100558. doi: 10.1016/j.optom.2025.100558.
This study aimed to determine the changes in binocular vision (BV) and accommodation in Malay myopic children following long-term wear of Defocus Incorporated Multiple Segments (DIMS) spectacle lenses for 24 months.
Twenty-three Malay myopic children aged 7-12 years were enrolled in this prospective, self-controlled study. DIMS spectacle lenses were prescribed, and analyses were conducted at baseline, 12, and 24 months. Assessments included stereopsis, near point of convergence (NPC), phoria, positive/negative fusional vergence (PFV/NFV), amplitude of accommodation (AA), accommodative lag, positive/negative relative accommodation (PRA/NRA), and accommodative convergence to accommodation (AC/A) ratio. Visual acuity (VA), cycloplegic refraction (SER) and axial length (AL) were monitored. Data were analyzed using repeated-measures analysis of variance (ANOVA) within-subject or the Friedman test, with Bonferroni correction applied. p < 0.05 was considered statistically significant.
Statistically significant changes were observed after 24 months, including median changes in NPC (receded by 2 cm, p < 0.001), AA (reduced by 1.67D, p = 0.002), distance PFV break (increased by 8Δ, p = 0.026) and recovery (increased by 6Δ, p = 0.033), distance NFV break (no change, p = 0.043), stereopsis (improved by 10″, p < 0.001), accommodative lag (reduced by 0.25D, p = 0.002), and AC/A ratio (increased by 1Δ/D, p < 0.001). Additionally, distance and near VA improved (p < 0.001), while SER and AL increased (p < 0.001).
Wearing DIMS spectacle lenses for 24 months resulted in changes in BV and accommodation while slowing myopia progression. Regular NPC monitoring is recommended to maintain optimal BV function and visual comfort in children wearing DIMS lenses.
本研究旨在确定马来西亚近视儿童长期佩戴离焦整合多区域(DIMS)眼镜片24个月后双眼视觉(BV)和调节功能的变化。
23名7至12岁的马来西亚近视儿童参与了这项前瞻性自我对照研究。佩戴DIMS眼镜片,并在基线、12个月和24个月时进行分析。评估包括立体视、近点集合(NPC)、隐斜、正/负融合性聚散(PFV/NFV)、调节幅度(AA)、调节滞后、正/负相对调节(PRA/NRA)以及调节性集合与调节(AC/A)比值。监测视力(VA)、睫状肌麻痹验光(SER)和眼轴长度(AL)。数据采用重复测量方差分析(ANOVA)或Friedman检验进行分析,并应用Bonferroni校正。p < 0.05被认为具有统计学意义。
24个月后观察到具有统计学意义的变化,包括NPC的中位数变化(后退2 cm,p < 0.001)、AA(降低1.67D,p = 0.002)、远距离PFV破裂点(增加8Δ,p = 0.026)和恢复点(增加6Δ,p = 0.033)、远距离NFV破裂点(无变化,p = 0.043)、立体视(改善10″,p < 0.001)、调节滞后(降低0.25D,p = 0.002)以及AC/A比值(增加1Δ/D,p < 0.001)。此外,远距离和近距离VA改善(p < 0.001),而SER和AL增加(p < 0.001)。
佩戴DIMS眼镜片24个月导致BV和调节功能发生变化,同时减缓了近视进展。建议定期监测NPC,以维持佩戴DIMS镜片儿童的最佳BV功能和视觉舒适度。