한국산학기술학회논문지 (Journal of the Korea Academia-Industrial cooperation Society)

  • 제11권9호
  • /
  • Pages.3406-3411
  • /
  • 2010
  • /
  • 1975-4701(pISSN)
  • /
  • 2288-4688(eISSN)
한국산학기술학회 (The Korea Academia-Industrial cooperation Society)
권호 표지
DOI QR코드

DOI QR Code

타각적 조절 반응 평가의 임상 기술들의 비교

Comparison of clinical techniques to assess objectively accommodative response

  • 투고 : 2010.08.09
  • 심사 : 2010.09.08
  • 발행 : 2010.09.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

조절반응의 평가는 옵토메트리 검사의 중요한 일부분이다. 본 연구는 조절반응의 타각적인 검사방법인 자동굴절계와 MEM 검영법 및 Nott 동적검영법으로 측정한 검사결과의 상관성과 차이를 비교하고자 하였다. 본 연구의 취지에 동의하는 19~29사이(평균나이 $22.22{\pm}2.43$세)의 정상시력을 가진 27명의 대학생을 선정하여 4D(25cm)의 조절 자극이 주어진 상태에서 자동굴절계(Shin-Nippon NVision-K 5001)와 MEM 검영법 및 Nott 동적검영법을 실시하여 조절 반응을 측정하였다. 4D의 조절자극에 대한 조절반응은 자동굴절계(Shin-Nippon NVision-K 5001) $3.70{\pm}0.25D$, MEM 검영법 $3.58{\pm}0.30D$ 그리고 Nott 동적검영법 $3.77{\pm}0.29D$로 각각 측정되었다. 3가지 검사는 상호간에 높은 상관성이 있었다(p<0.05). MEM 검영법은 Nott 동적검영법보다 $0.19{\pm}0.13D$ 더 낮게 측정되었고(p<0.05), 자동굴절계(Shin-Nippon NVision-K 5001)보다 $0.12{\pm}0.24D$ 더 낮게 측정되었다(p<0.05). Nott 동적검영법과 자동굴절계(Shin-Nippon NVision-K 5001)로 측정한 값은 유의한 차이가 없었다(p>0.05). MEM 검영법으로 측정한 조절반응은 Nott 동적검영법이나 자동굴절계로 측정한 값보다 더 낮았다. 저자는 조절반응을 평가할 때, MEM 검영법을 제외한 Nott 동적검영법과 자동굴절계(Shin-Nippon NVision-K 5001)는 상호 대체하여 사용할 수 있다고 주장한다.

Assessment of the accommodative response is an essential part of the optometric examination. This study measured objectively the accommodation responses those were measured by Autorefractor, MEM retinoscopy and Nott dynamic retinoscopy, and investigate the correlation and difference the results. Twenty-seven college students with normal visual acuity aged 19 to 29 years (mean $22.7{\pm}2.43$ years) participated in this study. Their accommodative responses to accommodative demand of 4D (25cm) were measured with Shin-Nippon NVision-K 5001 Autorefractor, MEM retinoscopy and Nott dynamic retinoscopy. The accommodative responses to accommodative demand of 4D were $3.70{\pm}0.25D$ by Shin-Nippon NVision-K 5001 Autorefractor, $3.58{\pm}0.30D$ by MEM retinoscopy and $3.77{\pm}0.29D$ by Nott dynamic retinoscopy, respectively. There were high correlations among the three techniques (p<0.05). MEM retinoscopy was measured $0.19{\pm}0.13D$ lower than Nott dynamic retinoscopy (p<0.05) and it was measured $0.12{\pm}0.24D$ lower than Shin-Nippon NVision-K 5001 Autorefractor (p<0.05). There was no significant difference between Nott dynamic retinoscopy and Shin-Nippon NVision-K 5001 Autorefractor (p>0.05). MEM retinoscopy showed lesser accommodative responses than Nott dynamic retinoscopy and Shin-Nippon NVision-K 5001 Autorefractor. Author suggest that Nott dynamic retinoscopy may use Shin-Nippon NVision-K 5001 Autorefractor interchangeably to evaluate accommodative responses expect MEM retinoscopy.

키워드

참고문헌

  1. Millodot M, "Dictionary of optometry and visual science, 6th ed". Butterworth-Heinemann, pp .3, 2004.
  2. Scheiman M, Wick B., "Clinical Management of Binocular Vision: Heterophoric, Accommodative, and Eye Movement Disorders". JB Lippincott Company, pp.19-26 1994.
  3. Locke, C. L. and Somers, W., "A comparison study of dynamic retinoscopy techniques". Optom. Vis. Sci. 66, pp. 540-544, 1989. https://doi.org/10.1097/00006324-198908000-00009
  4. Rosenfield,M., Portello, J. K., Blustein, G. H. and Jangs, C., "Comparison of clinical techniques to assess the near accommodative response". Optom. Vis. Sci. 73,pp. 382-388, 1996. https://doi.org/10.1097/00006324-199606000-00005
  5. Bennett, A. G. and Rabbetts, R. B., "Clinical Visual Optics, 2nd edn", Butterworths, London, pp. 396, 1989.
  6. Nott, I. S., "Dynamic skiametry, accommodation and convergence". Am. J. Physiol. Opt. 6, pp. 490-503, 1925.
  7. Nott, I. S., "Dynamic skiametry. Accommodative convergence and fusion convergence". Am. J. Physiol. Opt. 7, pp. 366-374, 1926.
  8. Rouse, M. W., London, R. and Allen, D. C. An evaluation of the monocular estimate method of dynamic retinoscopy. Am. J. Optom. Physiol. Opt. 59, 234-239, 1982. https://doi.org/10.1097/00006324-198203000-00006
  9. Haynes, H. M., "Clinical observations with dynamic retinoscopy". Optom. Wkly. 51, pp. 2306-2309, 1960.
  10. Rouse, M. W., Hutter, R. F. and Shiftlett, R., "A normative study of the accommodative lag in elementary school children". Ophthal. Physiol. Opt. 61, pp 693-697, 1984.
  11. McClelland JF, Saunders KJ, "The repeatability and validity of dynamic retinoscopy in assessing the accommodative responses". Ophthal Physiol Opt 23, pp 243-250, 2003. https://doi.org/10.1046/j.1475-1313.2003.00113.x
  12. Anderson HA, Hentz G, Glasser A, Stuebing KK, Manny RE, "Minus lens-stimulated accommodative amplitude decreases sigmoidally with age : A study of objectively measured accommodative amplitudes fromage 3". Invest Ophthalmol Vis Sci 49(7), pp 2919-2926, 2008. https://doi.org/10.1167/iovs.07-1492
  13. 신진아, "안기능과 임상굴절". 서울, 한미의학, pp. 113, 2003.
  14. Davies LN, Mallen EAH, Wolffsohn JS, Gilmartin B, "Clinical evaluation of the Shin-Nippon NVision-K 5001 / Grand Seiko WR-5100K Autorefractor". Optom Vis Sci 80(4), pp. 320-324, 2003. https://doi.org/10.1097/00006324-200304000-00011
  15. Win-Hall DM, Ostrin LA, Kasthurirangan S, Glasser A, "Objective accommodation measurement with the Grand Seiko and Hartinger Coincidence Refractometer". Optom Vis Sci 84(9), pp. 879-887, 2007. https://doi.org/10.1097/OPX.0b013e3181559ace
  16. Cacho, M. P., Garcia, A., Garcia, J. R. and Lopez, A., "Comparison between MEM and Nott dynamic retinoscopy". Optom. Vis. Sci. 76, pp. 650-655, 1999. https://doi.org/10.1097/00006324-199909000-00023
  17. Schor, C. M. and Narayan, V., "Graphical analysis of prism adaptation, convergence accommodation and accommodative convergence". Am. J. Optom. Physiol. Opt. 59, pp. 774-784, 1982. https://doi.org/10.1097/00006324-198210000-00003