不同屈光状态的青少年眼球生物学参数观察

The observation of ocular biometry for adolescent in different refractive states.

目的探究远视、正视及近视三种不同屈光状态下睫状肌麻痹验光前后屈光度数的变化情况,各组眼生物学参数差异,分析屈光不正度和生物学参数之间的关系。方法选取眼视光门诊就诊的7~18岁就诊及健康查体的青少年共609例(609眼),男276眼,女333眼。远视组204例(204眼),正视组202例(202眼),近视组203例(203眼),使用Topcon电脑验光仪测量睫状肌麻痹前后的屈光不正度,根据麻痹睫状肌后等效球镜度分为远视组、正视组和近视组,采用lenstar生物测量仪获得眼生物学参数。睫状肌麻痹前后的球镜(diopter of sphere,DS)、柱镜(diopter of cylinder,DC)、等效球镜度(spherical equivalent,SE)数据采用Wilcoxon分析,3组间生物学参数采用单因素ANOVA分析,采用Spearman相关分析来得到3组屈光不正度与生物学参数之间的相关关系,建立近视组回归方程。结果3组麻痹睫状肌前后DS、DC及SE差异均有统计学意义(P<0.05),麻痹睫状肌前后的3组DS变化量(0~3.00D)较DC变化量(0~0.5D)差异有统计学意义(P<0.05),DC变化量较小,由远视及近视,DS和SE变化量逐渐减小(P<0.05)。3组的眼轴长、前房深度、晶状体厚度、玻璃体腔长度、眼轴/平均角膜曲率半径比、眼轴/平坦角膜曲率半径比等差异有统计学意义(P<0.05);平坦角膜曲率、陡峭角膜曲率、角膜厚度差异无统计学意义(P>0.05)。3组球镜度、等效球镜度与眼轴长、眼轴/平均角膜曲率半径比、眼轴/平坦角膜曲率半径比呈负相关(P<0.05),与角膜曲率无相关(P>0.05)。近视回归方程:SD=24.292-8.435 AL/FCRC。结论7~18岁青少年从远视及近视,眼轴、前房深度、玻璃体腔长度逐渐加长,晶状体厚度逐渐减小,球镜度与平坦角膜轴率比相关程度较高。

Objective To investigate the changes of diopters before and after cycloplegia and the differences of biological parameters,and to analyze the correlation between refractive errors and biological parameters among hyperopia,emmetropia and myopia.Methods A retrospective case series was conducted on 609 cases(609 eyes)of healthy ado-lescents,who were aged 7-18 and visited the optometry clinic of our hospital and needed health examination were recrui-ted,including 276 male eyes and 333 female eyes.These adolescents were divided into hyperopia group(204 eyes),em-metropia group(202 eyes)and myopia group(203 eyes),according to the spherical equivalent(SE)diopters after cy-cloplegia.The biological parameters of the eyes were obtained by Lenstar biometrics.The diopter of Sphere(DS),diopter of cylinder(DC)and SE before and after cycloplegia were analyzed by Wilcoxon.One-way ANOVA analysis was used to analyze the biological parameters of the three groups,and Spearman correlation analysis was used to obtain the correlation between refractive errors and biological parameters of the three groups,and the regression equation of myopia between DS and AL/FCRC was also established.Results Among three groups,the differences in DS,DC and SE before and after cycloplegia were statistically significant(P<0.05).The changes(0-3.00D)of DS were significantly different from those(0-0.5D)of DC(P<0.05).The changes of DC were small.From hyperopia to myopia,the changes of DS and SE significantly decreased(P<0.05).The differences of axial length(AL),anterior chamber depth(ACD),lens thickness(LT),vitreous cavity length(VCL),axial length/mean corneal curvature radius ratio(AL/MCRC),and axial length/flat corneal curvature radius ratio(AL/FCRC)among three groups were statistically significant(P<0.05).There was no significant difference in flat corneal curvature,steep corneal curvature or central corneal thickness(P>0.05).The DS and SE of the three groups were significantly negatively correlated with AL,the AL/MCRC,and the AL/FCRC(P<0.05);but there was no correlation with the corneal curvature(P>0.05).The regression equation for myopia was established as SD=24.292-8.435 AL/FCRC.Conclusion Among 7-18 year old adolescents,from hyperopia to myopia,the axial length,anterior chamber depth and vitreous cavity length gradually lengthen,while the lens thickness gradually decreases.The correlation between DS and AL/FCRC is relatively high.