儿童视功能检查仪在学龄前儿童弱视筛查中的应用

Application of photoscreener in preschool amblyopia children

目的探讨儿童视功能检查仪在学龄前儿童弱视危险因素筛查中的可行性。方法回顾性分析河北医科大学第一医院眼科使用儿童视功能检查仪检查的371例(742只眼)学龄前儿童的临床资料,对其进行屈光状态及弱视危险因素的筛查,再行眼科常规散瞳和验光检查。应用流行病学调查筛检试验评价公式,将阿托品散瞳静态检影及临床检查结果与儿童视功能检查仪筛查资料分析结果进行相比较,得出儿童视功能检查仪筛查验光对学龄前儿童弱视致病因素普查的敏感度、特异度、阳性预测值、阴性预测值及Youden指数。结果应用儿童视功能检查仪检查的371例(742只眼)患者中,检查出远视眼者136例(272只眼),近视眼者25例(50只眼),散光者93例(186只眼),屈光参差者43例(86只眼),斜视者11例(22只眼),屈光间质混浊者1例(2只眼)。进行检影验光及临床检查的371例(742只眼)患者中,检查出远视眼者131例(262只眼),近视眼者24例(48只眼),散光者86例(172只眼),屈光参差者41例(82只眼),斜视者16例(32只眼),屈光间质混浊者1例(2只眼)。斜视者16例(32只眼)中,内斜视者6例(12只眼),间歇性外斜视者6例(12只眼),恒定性外斜视3例(6只眼),上斜肌不全麻痹者1例(2只眼)。屈光间质混浊者1例(2只眼),经裂隙灯显微镜检查确诊为先天性白内障。儿童视功能检查仪筛查敏感度为94.57%,特异度为80.53%;筛查敏感度最高的为远视96.18%,最低的为斜视68.75%;特异度最高的为斜视100%,最低的为散光86.67%。结论儿童视功能检查仪可用于学龄前儿童弱视危险因素的筛查,是一种安全、快速和有效的儿童眼病筛查方法。

Objective To explore the feasibility of the photoscreener in the screening of amblyopiogenic risk factor for preschool children.Methods It was a retrospective study.Three handred and seventy-one preschool children (742 eyes) aged from 1 to 6 years old were screened by photoscreener,then conventional cyloplegic retinoscopy was carried out by 1% atropine ointment.The results of cyloplegic retinoscopy,clinical examination and photoscreener examination were analyzed to get sensitivity,specificity, positive predictive value, negative predictive value and Youden index of photoscreener in screening risk factors of preschool amblyopia children.Resuluts In all 371 cases examinated by photoscreener,we found hyperopia in 136 cases (272 eyes),myopia in 25 cases (50 eyes),astigmatism in 93 cases (186 eyes), anisometropia in 43 cases (86 eyes),strabismus in 11 cases (22 eyes),refractive stromal opacity in 1 case (2 eyes).Cyloplegic retinoscopy and clinical examination observed hyperopia in131 cases (262 eyes), myopia in 24 cases (48 eyes),astigmatism in 86 cases (72 eyes),anisometropia in 41 cases (82 eyes), strabismus in 16 cases (32 eyes) including 6 cases (12 eyes) of esotropia,6 eyes(12 eyes) of intermittent exotropia,3 cases (6 eyes) of constant exotropia and 1 case (2 eyes) of incomplete superior oblique muscle paralysis.Refractive stromal opacity was found in 1 case (2 eyes) which was confirmed as congenital cataract by slit lamp microscope.The sensitivity of photoscreener was 94.57 %,specificity was 80.53 %.The highest sensitive factor by Photoscreener was hyperopia ( 96.18 %) and the lowest one was strabismus (68.75 %).The highest specific factor by photoscreener was strabismus (100 %) and the lowest one was astigmatism (86.67 %).Conclusions The photoscreener could be used in amblyopiogenic risk factor screening of preschool children.It is a safe,quick and effective method for preschool children oculopathy screening.