摘要目的:探讨远像光屏显示器是否对儿童近距离用眼所致短暂性近视(NITM)有抑制效果。方法:采用前瞻性自身对照研究，2022年3月至2023年3月在天津市眼科医院招募120名儿童志愿者，年龄4~12岁，平均(5.0±2.2)岁，受试者有屈光不正者足矫戴镜后进行试验。依据调节反应将受试者分为调节超前组16例32眼、调节等同组48例96眼和调节滞后组56例112眼；按照受试者有无近视分为近视组20例40眼和非近视组100例200眼。采用随机数字表法决定受试者先使用iPad或远像光屏显示器观看视频影像30 min，2次观看之间休息2 h后交换。记录2种方式观看视频前后的视力、屈光度、晶状体厚度、NITM度数及恢复时间。比较不同调节类型、不同屈光类型通过2种方式观看视频后视力、晶状体厚度、NITM度数和恢复时间。结果:观看远像光屏显示器后NITM度数和恢复时间分别为(0.00±0.36)D和(25.33±15.48)s，观看iPad后分别为(-0.20±0.40)D和(33.33±17.68)s。与观看iPad后相比，通过远像光屏显示器观看视频后即刻远视力较好、近视屈光度数较低、晶状体厚度较薄、NITM度数较低、恢复时间较短，差异均有统计学意义( t＝-7.688、7.824、-4.210、2.331、-2.887，均 P<0.05)。观看远像光屏显示器和iPad后，调节超前组、调节等同组和调节滞后组视力变化、晶状体厚度变化、NITM度数和NITM恢复时间总体比较差异均无统计学意义( H＝0.584、4.923、1.514、2.634，均 P>0.05； H＝3.265、1.884、1.606、1.922，均 P>0.05)。观看远像光屏显示器和iPad后，近视与非近视组视力变化、晶状体厚度变化、NITM度数和NITM恢复时间总体比较差异均无统计学意义( Z＝-1.555、-1.700、-0.254、-2.336，均 P>0.05； Z＝-1.125、-0.446、-1.033、-0.759，均 P>0.05)。 结论:使用远像光屏显示器能减轻看近所产生的NITM，且能缩短NITM恢复时间，对不同屈光状态及不同调节类型儿童均有效。

abstractsObjective:To investigate whether a distant-image screen display has an inhibitory effect on children's nearwork-induced transient myopia (NITM).Methods:A prospective self-controlled study was conducted.From March 2022 to March 2023, 120 pediatric volunteers, aged 4 to 12 years, with a mean age of (5.0±2.2) years, were recruited at Tianjin Eye Hospital.Subjects with refractive errors underwent tests wearing corrective lenses.Subjects were categorized based on accommodative response into three groups: accommodative lead (16 subjects, 32 eyes), accommodative equivalent (48 subjects, 96 eyes), and accommodative lag (56 subjects, 112 eyes). Subjects were also divided by myopia status into myopic (20 subjects, 40 eyes) and non-myopic (100 subjects, 200 eyes) groups.Using a random number table, the subjects were assigned to first view video images for 30 minutes on either an iPad or a distant light screen display.After a two-hour rest between the two sessions, the viewing modality was switched.Visual acuity, refractive power, lens thickness, NITM degree, and NITM recovery time were recorded before and after viewing videos via both modalities.Visual acuity, lens thickness, NITM degree, and recovery time following video viewing via the two modalities across different accommodation types and refractive types were compared.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Tianjin Eye Hospital (No.2022099), and all guardians of the subjects provided informed consent for this study.Results:The NITM degree and recovery time after watching videos on a distant-image screen display were (0.00±0.36)D and (25.33±15.48) seconds, respectively.The NITM degree and recovery time after watching videos on an iPad were (-0.20±0.40)D and (33.33±17.68) seconds, respectively.Compared with watching videos on an iPad, watching videos on a distant-image screen display resulted in better immediate distance vision, lower myopic refractive power, thinner lens thickness, lower NITM degree, and shorter recovery time, with statistically significant differences ( t=-7.688, 7.842, -4.210, 2.331, -2.887; all P<0.05). After viewing the distant-image screen display and iPad, there was no significant difference in the overall comparison of visual acuity change, lens thickness change, NITM degree and NITM recovery time among the accommodative lead, accommodative equivalent and accommodative lag groups ( H=0.584, 4.923, 1.514, 2.634; all P>0.05. H=3.265, 1.884, 1.606, 1.922; all P>0.05), and there was also no significant difference between the myopic and non-myopic groups ( Z=-1.555, -1.700, -0.254, -2.336; all P>0.05. Z=-1.125, -0.446, -1.033, -0.759; all P>0.05). Conclusions:The use of a distant-image screen display can reduce the NITM caused by near viewing and shorten the NITM recovery time, which is effective for children with different refractive states and accommodative types.