低度近视学龄儿童眼成像质量、屈光和结构参数的相关研究

The Correlation of Visual Quality,Eye Refraction and Structural Parameters in Schoolchildren with Low Myopia

目的:分析低度近视学龄儿童全眼波前像差与近视屈光度、角膜曲率、眼轴等参数的相关性。方法:系列病例研究。纳入180名8~13岁、等效球镜度为-0.50^-3.00D低度近视儿童,进行主觉验光,IOLMaster测量眼轴(AL)、角膜曲率半径(平坦径线角膜曲率半径R1,陡峭径线角膜曲率半径R2,平均角膜曲率半径R),WASCA波前像差仪测量像差。多元线性回归分析像差的影响因素,采用Pearson相关、Spearman相关分析波前像差、屈光度及结构参数的相关性。结果:近视屈光度与像差不相关,显著影响总高阶像差的主要因素是角膜曲率和年龄(R2:B=-0.054,t=-2.986,P=0.003;年龄:B=0.009,t=2.176,P=0.031),其中角膜曲率主要影响四阶像差,年龄主要影响三阶像差。眼轴与高阶像差、四阶像差、球差相关(r=-0.147、-0.333、-0.358,均P<0.05),R1(r=-0.249、-0.421、-0.435,均P<0.001)和R2(r=-0.260、-0.377、-0.392,均P<0.001)也与高阶像差、四阶像差、球差存在相关性。AL/R与球镜度、等效球镜度相关(r=-0.490、-0.527,均P<0.001)。结论:低度近视学龄儿童成像质量可能主要受人眼结构而非屈光状态的影响。

Objective:To study the correlation between wavefront aberrations and refractive conditions,corneal curvature,and axial length in schoolchildren with low myopia.Methods:This was a case series study.One hundred and eighty schoolchildren 8 to 13 years old,with a spherical equivalent(SE)of-0.50--3.00 D,were recruited.Refractive error,calculated as the SE,axial length(AL),and corneal curvature radius(R,radius of the flat meridian--R 1,radius of the steep meridian--R 2)were measured by IOLMaster,and wavefront aberrations were measured by a WASCA Hartmann-Shack aberrometer.Multiple linear regression was used to analyze the factors influencing aberrations.Pearson correlation and Spearman correlation were used to investigate the correlation among myopia,structural parameters and aberrations.Results:Refractive errors and aberrations had no close correlation.Multiple linear regression analysis showed that total higher-order aberrations(RMSh)was significantly affected by corneal curvature and age(R2:B=-0.054,t=-2.986,P=0.003;Age:B=0.009,t=2.176,P=0.031).The curvature radius mainly affected fourth-order aberrations and age mainly affected third-order aberrations.AL was related to RMSh,fourth-order aberrations and spherical aberrations(r=-0.147,-0.333,-0.358,all P<0.05).R1 and R2 were related to RMSh,fourth-order aberrations,and spherical aberrations too(R1:r=-0.249,-0.421,-0.435,all P<0.001;R2:r=-0.260,-0.377,-0.392,all P<0.001).AL/R was related to spherical error and SE(r=-0.490,-0.527,P<0.001).Conclusions:The imaging quality of schoolchildren with low myopia may be influenced mainly by ocular structure rather than refractive condition.