学龄前高度远视和低度远视儿童屈光发育比较

Comparative on Refractive Development of Preschool Children with High Hyperopia and Low Hyperopia

目的:比较学龄前高度远视和低度远视儿童的屈光发育特点。方法:回顾性系列病例研究。收集2020年7月至2021年12月在天津医科大学眼科医院就诊的学龄前远视性屈光不正儿童43例(86眼)。根据睫状肌麻痹后球镜度结果将儿童分为高度远视组27例(54眼),低度远视组16例(32眼),分别于基线和随访1年记录2组儿童的屈光度和眼球生物学参数,包括眼轴长度(AL)、角膜曲率半径、轴率比。采用自身配对t检验进行组内屈光度和眼球生物学参数分析;采用Wilcoxon符号秩检验进行组内最佳矫正视力比较;采用独立样本t检验进行组间眼生物学参数年变化量的差异分析。结果:与基线值[(8.37±1.84)D]相比,高度远视组等效球镜度(SE)年降低量为(0.72±0.41)D(t=-9.26,P<0.001)。高度远视组AL年增长量[(0.31±0.18)mm]与低度远视组年增长量[(0.21±0.09)mm]的差异有统计学意义(t=3.53,P=0.001),2组间角膜曲率半径年变化差异无统计学意义;高度远视组轴率比的年增长量(0.04±0.02)与低度远视组年增长量(0.02±0.03)的差异有统计学意义(t=3.23,P=0.002)。结论:与学龄前低度远视儿童相比,学龄前高度远视儿童的AL和轴率比的年增长幅度更大,这提示有必要对高度远视儿童进行密切随访。

Objective:To compare the characteristics of refractive development in preschoolers with high hyperopia and low hyperopia.Method:In this retrospective case-series study,a total of 43 preschool children(86 eyes)with hypermetropia who were admitted to Tianjin Medical University Eye Hospital from July 2020 to December 2021 were enrolled.According to the results of spherical diopter after ciliary paralysis,the children were divided into two groups:high hyperopia group 27 cases with 54 eyes and low hyperopia group 16 cases with 32 eyes.Recording the diopter and eye biologic parameters including axial length(AL),corneal curvature radius,axial length/corneal radius of curvature at baseline and follow-up of one year.Intra-group diopter and eye biological parameters were analyzed by self paired t test.Intra-group best corrected visual acuity was compared by Wilcoxon signed rank test.Independent sample t test was used to analyze the difference of changes in eye biological parameters between groups.Results:The annual decrease of equivalent spherical equivalent(SE)in high hyperopia group was(0.72±0.41)D(t=-9.26,P<0.001),compared to baseline(8.37±1.84)D.The difference of annual growths of AL in high hyperopia group[(0.31±0.18)mm]and low hyperopia group[(0.21±0.09)mm]was statistically significant(t=3.53,P=0.001).There was no significant difference between the annual changes of corneal curvature radius in the two groups.The annual increases of AL/corneal radius of curvature in high hyperopia group(0.04±0.02)was significantly different from that in low hyperopia group(0.02±0.03)(t=3.23,P=0.002).Conclusion:Compared with preschool children with low hyperopia,the annual increase of AL and AL/corneal radius of curvature was larger in preschool children with high hyperopia,suggesting that it is necessary to follow up children with high hyperopia closely.