小瞳孔电脑验光在儿童屈光不正筛查中的可行性探讨

Feasibility of microcoria optometry in screening for ametropia in school-age children

目的：探讨小瞳孔电脑验光在儿童屈光不正筛查中的可行性。方法：学龄儿童217名。一年级组（6-9岁）94人、四年级组（10-12岁）123人。采用电脑验光仪RM-8000筛查儿童屈光度,评估小瞳孔验光在筛查中的准确度。结果：不同年龄组：散瞳前后一年级组球镜及柱镜差异,四年级组球镜差值均有统计学意义（P〈0.05）,四年级组柱镜差值无统计学意义（P〉0.05）;不同屈光类型：散瞳前后近视组球镜、等效球镜差值分别为0.263±0.618,0.216±0.653D,有统计学意义（P〈0.01）;远视组球镜、等效球镜差值分别为0.947±0.946,1.039±0.984D,有统计学意义（P=0.000）。两组柱镜差值均无统计学差异（P〉0.05）。小瞳孔电脑验光选择≤-1.00D,≥-0.50D分别作为儿童近视,远视诊断界值准确度较好,Youden指数分别为0.672,0.580。结论：小瞳孔下验光可作为筛查儿童屈光不正的有效方法,但若为验光配镜,学龄儿童必须散瞳。

AIM ： To discuss the feasibility of microcoria optometry in screening for children am etropia. METHODS： Totally 217 school- age children were selected,included 94 first- grade students（ 6 - 8 years old） and 123 fourth- grade students（ 9 - 12 years old）.Refractive diopter was measured with autom atic refractor RM-8000 to evaluate the accuracy of m icocoria optometry in screening ametropia. RESULTS： After cycloplegia, both the mean sphere diopter and cylinder diopter in grade one students changed significantly（ P〈0. 05）,the m ean sphere diopter in grade four students changed significantly（ P〈0. 05）,while the mean cylinder diopter had no statistical difference（ P〉0. 05） in grade four students. Different refractive type： before and after mydriasis spherical myopia,spherical equivalent difference was 0. 263 ± 0. 618 and 0. 216±0. 653 D,with statistical significance（ P〈0. 01）;In hyperopia group, spherical m yopia, spherical equivalent difference was 0. 947±0. 946 and 1. 039±0. 984 D,with statistical significance（ P = 0. 000）. The lenticular difference betw een the two groups were not statistically different（ P〉0. 05）. Choosing small pupil com puter optom etry for ≤- 1. 00 D, ≥- 0. 50 D child myopia or hyperopia could get more accurate value of diagnostic cutoffs,Youden index was 0. 672 and 0. 580. CONCLUSION： Microcoria optometry can be as a effective method of screening of children w ith am etropia,but if for optometry,school- age children must accept mydriasis.