儿童眼压与屈光度的相关性研究

Intraocular pressure association with refractive error in Children

目的探讨儿童眼压与年龄、屈光度之间的关系。方法前瞻性病例对照研究。收集昆明爱尔眼科医院小儿眼科门诊就诊的1013例3~15岁儿童的右眼检查资料。按睫状肌麻痹后进行检影验光的等效球镜度(SE)计算,将患儿分为远视组(SE>+0.75 D)、近视临床前期(SE≤+0.75 D且>-0.50 D)、轻度近视组(-3.0 D≤SE≤-0.5 D)和中度近视组(-6.0≤SE<-3.0 D)。按年龄分成<7岁组、7~9岁组和>9岁组。使用非接触式眼压计测量眼压(IOP),使用AL-Scan眼球生物测量仪行眼轴(AL)、角膜中央厚度(CCT)测量。IOP使用校正公式[校正眼压(mmHg)=实际所测眼压+(520-中央角膜厚度)/43.48]进行校正,按校正IOP分成4组:IOP<14 mmHg、14≤IOP<18 mmHg、18≤IOP≤21 mmHg和IOP>21 mmHg。分析不同年龄和屈光度状态下IOP的变化。结果IOP与CCT有正相关性,r=0.41,P<0.001。矫正后的IOP均值为(15.01±2.86)mmHg、SE的均值为(-0.43±2.55)D。<7岁组的IOP最低(P<0.05)。7~9岁组和>9岁组之间IOP无统计学差异。随着远视向近视变化,IOP逐渐升高,差异有统计学意义。远视组、近视临床前期组、轻度近视组和中度近视组4组间两两比较IOP,差异均有统计学意义。按不同眼压值分组,随着IOP升高,眼轴值相应增长,SE亦向近视发展,差异均有统计学意义。结论儿童眼压与CCT相关。<7岁组IOP较低。儿童期随年龄的增长,屈光度从远视逐渐向近视发展的过程中,IOP逐渐升高。近视度数越高,AL逐渐增长,IOP也越高。

Objective To discuss the correlation among intraocular pressure(IOP)and age,refractive error in children.Methods A prospective study of 1013 children aged from 3 to 15 years old in the Kunming Aier Hospital from August 2000 to April 2021.Refraction was measured by cycloplegic retinoscopy.IOP was measured by non-contact tonometry.Ocular biometry including AL and CCT was measured by AL-Scan.Only the right eye date was used.Refracive error was categorized into four groups:hypermetropia(spherical equivalent refraction(SE)>+0.75 D),pre-myopia(SE>+0.75and SE>-0.5),low myopia(-3.0≤SE≤-0.50),moderate myopia(-6.0≤SE<-3.0 D).For age,All children was divided into three group:group 1,<7 year of age;group 2,7-9;group 3,>9 year of age.IOP levels were divided into four groups:group1 IOP<14 mmHg,goup 214≤IOP<18 mmHg,group 318≤IOP≤21 mmHg,goup 4 IOP>21 mmHg.Analysis of variance(ANOVA)was performed to determine the significance of the changes.Results The mean IOP was(15.01±2.86)mmHg,the SE was(-0.43±2.55)D.The IOP of<7 year of age was lowest.There was no statistically significant difference in IOP between 7-year-old and 15-year-old.The IOP of hypermetropia was lowest.The IOP of moderate myopia was highest.The SE of IOP<14 mmHg group was(+0.14±2.77)D.The SE of IOP>21 mmHg group was(-1.86±2.15)D.Conclusions Hypermetropia was associated with lower IOP.The IOP of SE≤-0.50 D was higher than hypermetropia.With age older,the refractive error was decreasing from hyperopia to myopia,while IOP increased gradually.More higher IOP was assoiated with higher myopia.