洪伯廷2006-07-262018-07-122006-07-262018-07-122002http://ntur.lib.ntu.edu.tw//handle/246246/26722近視為我國眼科學上或視覺健康上重大的問題，由於其流行病上的高頻度，加上高度近視，其世界上任何報告皆高，所以成為我國45 歲以上視力障礙的主要原因。 近視伴有很多與隅角開放性青光眼相類似之病徵：( 1 ）眼軸的長度；( 2 ) 視神經纖維與視神經乳頭凹陷以及有關變化；( 3 ）近視中開放性青光眼之頻度高，而反過來，開放性青光眼也具有高頻度的近視。兩者互相關係以及臨床上之分別，在預防失明上，即眼健康上具有其重要性，尤其在近視高頻度的台灣，將是應予深入研究之必要。 此次計畫獲得的結果件另表文獻，而其重要結論為：金山鄉中老年人的篩檢顯示網膜症為第二重要失明之原因，其中與近視或網膜退化有密切關係。另一重要進行的近視流行病學之再一次全國性10 , 889 名學童近視篩檢也再度顯示了比起前次1995 年之近視罹息率提高。為防止近視之繼續增加，其預防設施應再柱下，即應要對更小之幼雅園年齡之小孩進行視力篩檢” 另一方面，對高度近視之視神經應用影像分析儀顯示近視之特徵為視神經盤之面積較健眼為大，並與眼軸長度有密切關係，但是與視神經盤內之凹陷或rim 面積，則無特別有意義之分別。後者兩項視神經變化，可以作為開放性青光眼與近視之鑑別診斷。 最後，為對形成近視有密切關係之調節機能，則與美國A & M 大學藥物毒物研究合作，研究Dopamine對抗劑在調節上之作用。(1) Current Issues in Myopia Although myopia has been present in humans for a long time, the last few decades of the 20th century brought about an explosion in the prevalence of myopia worldwide, especially in developing Asian countries. Because of the rapidly increasing rates of this disease, it may be considered an epidemic of global proportions that warrants extensive research in the future. Therefore, myopia is equally important as a social issue of public health, as well as a problem that needs to be researched heavily on epidemiology, therapy as well as in advance etiological study. Only recently we have began to realize the importance of myopia in the impairment of visual function. Myopia affects the young and the old in their visual dysfunction, thereby greatly affecting a continuum in the community and its associated socioeconomic development. Thus, the solution to the problem of myopia requires much more than a simple corrective lens. As there is currently very little information available regarding the etiological molecular biology of myopia, it is essential for future research to focus on this field too. In this presentation, the author shall briefly review the current status of myopia from an epidemiological standpoint, myopia and its relationship to visual impairment, and recent studies regarding a new therapeutic approach using multiple focal lenses along with topical medication. (2) Epidemiologic Study of the Prevalence and Severity of Myopia Among Schoolchildren in Taiwan in 2000 A nationwide survey was performed in 2000 to determine the prevalence and severity of myopia among schoolchildren in Taiwan and to compare these findings with the results of the last survey performed in 1995. We first divided the whole island into regions according to developmental grade scores and then sampled with the probability proportional to the size of the population within each stratum. A total of 10,889 students were enrolled. The prevalence and severity of myopia in schoolchildren in Taiwan in 2000 increased compared to 1995, with the most severe increases occurring in younger age groups. Thus, preventing schoolchildren developing myopia at a young age may slow down the increase in severity of myopia in Taiwan. (3) Visual Impairment Among the Middle-Aged and Elderly Population in Chin-Shan Township, Taipei County To investigate the status and causes of visual impairment in middle-aged (40 to 65 years old) and elderly (>65 years old) people in Taiwan. Cataract was the most frequent cause of visual impairment and retinopathy was the second most frequent cause for the middle-aged and aged population of Chin-Shan Xiang, Taipei County, in 1992 and 1994. (4) Evaluation of Optic Disc Changes in Severe Myopia In glaucoma diagnosis, morphometry of the intra- and parapapillary structures can help to differentiate nonnal eyes with ocular hypertension from those with early glaucomatous optic nerve atrophy. However, these typical features are not valid in highly myopic eyes, where the optic disc has a distinctly different ophthalmoscopic appearance. The use of stereophotography with computerized planimetry to measure the size of the optic disc and neuroretinal rim has enhanced the assessment of the optic nerve in glaucoma. (5) Effects of Dopamine Antagonists in Human Eye Accommodation The purpose of this study was to evaluate the effects of dopamine antagonists in accommodation of the human eye. The dopamine antagonist drugs used in this experiment include 0.5% metoclopramide and 0.25% droperidol. Eighteen healthy subjects were enrolled; they were randomly assigned, in double-masked fashion, to receive topical administration of single drop of either 0.5% metoclopramide or 0.25% droperidol in one eye, with the fellow eye receiving isotonic saline as control. The accommodative abilities of both eyes were measured before instillation, and also at 3 and 6 hr after instillation of drugs, respectively. We studied the latency of reaction, the rate of accommodation, the average accommodative power, the rate of recovering and the total recovering time as the five parameters for evaluation the accommodative ability of each eye. The results showed that there were significant changes in two parameters: the rate of accommodation and rate of recovering.application/pdf7134724 bytesapplication/pdfzh-TW國立臺灣大學醫學院眼科原發性隅角開放性青光眼近視軸長台大醫院POAGmyopiaaxial lengthNTUH[SDGs]SDG3journal articlehttp://ntur.lib.ntu.edu.tw/bitstream/246246/26722/1/902314B002149.pdf