杭州市区不同角膜曲率儿童屈光参数分布与屈光状态相关性分析

目的调查生长发育前期不同角膜曲率的学龄儿童AL/CR值、AL等屈光参数的分布情况,分析其与屈光状态的相关性。方法选取2022年9月至2022年11月杭州市区四年级(9~10岁)近视筛查的2,214名(4,428眼)儿童。根据9~10岁学龄儿童角膜曲率半径(CCR)的均值,分为低角膜曲率组(CCR≥7.92)1,568眼和高角膜曲率组(CCR<7.92)2,860眼,每组再根据睫状肌麻痹后等效球镜(SE)分为远视组(SE>+0.50D)、正视组(-0.50D<SE≤+0.50D)和近视组(SE≤-0.50D)。测量裸眼远视力(UCDVA)、睫状肌麻痹电脑验光、眼轴长度(AL)、水平角膜曲率(K1)、垂直角膜曲率(K2),并计算角膜曲率半径和眼轴长度/角膜曲率半径比值(AL/CR)。比较低角膜曲率组和高角膜曲率组屈光状态和屈光参数差异。结果儿童高角膜曲率比例(64.59%)高于低角膜曲率比例(35.41%),女生高角膜曲率比例(74.34%)高于男生(55.50%)。在任何屈光状态下,高角膜曲率组较低角膜曲率组AL更短(P<0.001),AL/CR值更小(P<0.001)。相同屈光状态不同角膜曲率的儿童,其AL/CR值的差异均有统计学意义(P<0.001)。远视儿童AL/CR值中位数为2.95,正视儿童AL/CR值中位数为3.00,近视儿童AL/CR值中位数为3.11。结论在任何屈光状态下,低角膜曲率儿童较高角膜曲率儿童的SE值更小,AL更长。AL/CR值可以作为识别学龄期儿童屈光状态的可获得指标,但也需结合儿童的角膜曲率。

Objective To analyze the distribution of axis length/corneal radius of curvature ratio(AL/CR)value,axis length(AL),and other refractive parameters in school-age children with different corneal curvature during early growth and development,and their correlation with refractive status.Methods A total of 4,428 eyes of 2,214 fourth-grade school-age children(9~10 years old)in Hangzhou who underwent myopia screening in school from September 2022 to November 2022 were included in the study.According to the mean corneal curvature radius(CCR)of school-aged children aged 9~10 years,the children were divided into the low corneal curvature group(CCR≥7.92,1,568 eyes)and the high corneal curvature group(CCR<7.92,2,860 eyes).According to the spherical equivalent(SE),each group was further divided into the hyperopia group(SE>+0.50D),the emmetropia group(-0.50D<SE≤+0.50D)and the myopia group(SE≤-0.50D).Uncorrected distance visual acuity(UCDVA),cycloplegic computer refraction,and AL were measured.Horizontal corneal curvatures(K1),vertical corneal curvatures(K2),and AL/CR value was calculated.The differences in refractive status and refractive parameters between the low and high corneal curvature groups were compared.Results The proportion of high corneal curvature in children(64.59%)was higher than that of low corneal curvature(35.41%),and the proportion of high corneal curvature in girls(74.34%)was significantly higher than that in boys(55.50%).In any refractive state,the high corneal curvature group had shorter AL(P<0.001)and lower AL/CR value(P<0.001)than the low corneal curvature group.There were significant differences in AL/CR value among children with different corneal curvatures under the same refractive state(P<0.001).The median AL/CR value of hyperopic children was 2.95,emmetropic children was 3.00,and myopic children was 3.11.Conclusion In any refractive state,children with low corneal curvature had smaller SE values and longer AL for children with higher corneal curvature.AL/CR value can be used as an available index to identify the refractive status of school-age children,but it also needs to be combined with children's corneal curvature.