目的 探讨调节对近视眼视网膜周边离焦量的影响。方法 纳入近视患者105例，将睫状肌麻痹前、后的多光谱屈光地形图数据进行配对分析，采用两因素方差分析比较不同组间睫状肌麻痹前后的视网膜周边离焦量变化值的差异。结果 睫状肌麻痹前、后的视网膜周边离焦量比较：除RDV-15°无明显改变之外，其余参数值均出现远视性漂移。在睫状肌麻痹后，RDV-15°、RDV-30°、RDV-45°表现为越偏离黄斑中心凹、差距越大。低、中、高度组的变化量比较：ΔTRDV、ΔRDV-45、ΔRDV-I、ΔRDV-N在3组间的差异有统计学意义，低度、中度近视眼的变化量大于高度近视眼的变化量（均为P＜0.05），低度与中度组的变化量无统计学差异。结论 调节可影响近视眼视网膜周边离焦量，对中低度近视眼的影响大于高度近视眼。

Objective To investigate the effect of accommodation on peripheral refraction in children and adolescents with myopia. Methods One hundred and five teenagers with myopia were consecutively recruited in this study. According to their refraction, participants were divided into low, moderate, and high myopia groups. Peripheral refraction of each participant was captured before and after cycloplegia by multispectral refractive topography (MRT, Thondar, Shenzhen), statistics such as TRDV, RDV-15, RDV-30, RDV-45, RDV-S, RDV-I, RDV-T, RDV-N, etc., were achieved from the right eyes of all participants for further analysis. A paired t-test was employed to assess the differences in peripheral retinal defocus values between pre- and post-cycloplegia conditions. Additionally, a two-way ANOVA was conducted to examine the variations in peripheral retinal defocus values across the three groups. Results The peripheral retinal defocus values of myopic participants exhibited significant changes before and after cycloplegia. Specifically, while RDV-15° remained relatively stable with no significant alteration, the other parameters, including TRDV, RDV-30°, RDV-45°, RDV-S, RDV-I, RDV-T, and RDV-N, all demonstrated a hyperopic shift (all P < 0.001). Among these measurements, the difference values of RDV-15°, RDV-30°, and RDV-45° before and after cycloplegia revealed a trend: the greater the distance of the peripheral refraction from the fovea, the more pronounced the difference between the pre- and post-cycloplegia values. Comparing the changes in peripheral retinal defocus values before and after cycloplegia among the three groups of low, moderate, and high myopia revealed that the differences in four parameters—ΔTRDV, ΔRDV-45°, ΔRDV-I, and ΔRDV-N—were statistically significant across the groups (all P < 0.05). Specifically, the magnitude of change in eyes with low or moderate myopia was greater than that in eyes with high myopia. However, there was no statistically significant difference in the changes between eyes with low and moderate myopia. Conclusion Following cycloplegia, peripheral refraction exhibited a pronounced hyperopic shift, accompanied by an increase in eccentricity among children and adolescents with myopia. This change was more substantial in eyes with low and moderate myopia compared to those with high myopia.

国家自然科学基金项目（编号：82360214）；广西自然科学基金主动健康与常见病多发病联合专项资助（项目任务书编号：2023GXNSFAA026114）