学龄前儿童眼部生物学参数及其与屈光状态的相关性研究

Relationship between ocular biometric parameter and refraction in preschool children

目的研究3～6岁学龄前儿童眼部生物学参数与屈光状态及其之间的关系。方法前瞻性临床研究。对2010年3-11月在徐州市眼病防治所应用为回顾性系列病例分析。在睫状肌麻痹状态下为103名3～6岁学龄前儿童进行检影验光，记录等效球镜度。运用ZEISS光学相干断层扫描仪（OCT）测量视网膜黄斑厚度，IOL—Master测量眼轴长度、角膜屈光力。黄斑区视网膜厚度记录以黄斑中心凹为圆心，记录1mm，3mm，6mm直径范围的中央、内环和外环的厚度，对数据进行统计学分析。结果89名（86．40％）儿童完成了相关的检查。学龄前儿童的平均等效球镜度为（＋1．33±1．01）D，眼轴长度为（21．98±0．71）mm，黄斑中央视网膜厚度为（189．01±25．49）μm，黄斑区各区域视网膜厚度不等，角膜屈光力为（43．52±1．56）D。不同年龄组等效球镜不同（F=3．23，P〈0．05），随着年龄的增长等效球镜度逐渐下降。等效球镜度与眼轴长度呈负相关（r=-0．46，P〈0．01），与黄斑中央视网膜厚度（r=0．02，P〉0．05）、角膜屈光力（r=0．08，P〉0．05）差异无统计学意义。结论3—6岁学龄前儿童等效球镜呈峰形分布。等效球镜度与年龄、眼轴长度有关，随着眼轴的延长、年龄的增加．远视等效球镜度逐渐下降。

Objective To study the relationship of ocular biometric parameter and refraction in preschool children at age 3 to 6 years. Methods Retrospective case series of 103 children from kindergarten of Xuzhou were recruited. Each child had a dilated eye examination including macular thickness measured by Optical Coherence Tomography （OCT）, axial length measurement using IOL-Master, and cycloplegic refraction. Macular thickness was presented with diameter for the central, inner, and outer macular regions being 1, 3, and 6ram, respectively. Results Of the eligible children, 89 children （86.40%） had high-quality data. The means of spherical equivalent refraction, central thickness, axial length and corneal refractive power were （＋1.33±1.01）D, （189.01±25.49）μm, （21.98±0.71）mm, （43.52±1.56）D, respectively. The refraction showed significant difference among different age groups （F =3.23, P 〈0.05）. There was negatively correlated between refraction and axial length（r =-0.46,P 〈0.01）. Refraction was not significant correlation with macular thickness （r =0.02, P 〉0.05） and corneal refractive power （r =0.08, P 〉0.05）. Conclusions A leptokurtic distributions of spherical equivalent refraction is presented in preschool children at age 3 to 6 years. Refraction is mainly affected by age, axial length. With the axial length and age increasing hyperopic refraction is decreasing.