轴率比在儿童中低度近视诊断的应用

Diagnostic Value of Axial to Corneal Curvature Ratio in Children with Low Myopia and Moderate Myopia

目的:评价眼轴与角膜曲率半径的比值(轴率比)在诊断低度近视与中度近视的应用。方法:回顾性分析586例2015年12月至2018年9月期间就诊于福建省第二人民医院眼科的低中度近视儿童的眼轴、平均角膜曲率半径等,计算轴率比,睫状肌麻痹后主觉验光的等效球镜度数(spherical equivalent, SE)。低度近视为?0.50~?3.00 D,中度近视?3.00~?6.00 D。以低度近视的95%百分位数作为低度近视的上限,行正态性检验、秩相关分析及ROC曲线分析。结果:低度近视组与中度近视组轴率比和SE均呈非正态分布,低度近视组轴率比为(3.062 ±0.098),与轴率比 = 3有统计学差异(P 【0.01);低度近视组SE为(?1.58 ±0.75) D;中度近视组轴率比为(3.205 ±0.126),与轴率比=3有统计学差异(P 【0.01);中度近视组SE为(?4.17 ±0.78) D;两组之间轴率比有统计学差异(P 【0.01)。以低度近视轴率比的95%参考值3.199作为区分低、中度近视的临界值与诊断近视的金标准睫状肌麻痹下主觉验光相比,轴率比诊断中度近视的灵敏度为0.630,特异度为0.950,准确度为89.1%,Kappa系数为0.619,ROC曲线下面积为0.876 (P 【0.01)。结论:轴率比在低度近视和中度近视诊断中具有一定价值。

AIM: To evaluate the application of the ratio of axial radius to corneal curvature in the diagnosis of low and moderate myopia. METHODS: This retrospective clinical study included 586 children with refractive errors, aged 8 to 14 years old, who were admitted to the second people’s Hospi-tal of Fujian Province from December 2015 to September 2018. All subjects underwent meas-urements for distance vision, axial length (AL), the average radius of the corneal curvature (CR), etc. Then the AL/CR radio and spherical equivalent (SE) from cycloplegic refraction were calcu-lated. ?3.00 D ≤ SE ≤ ?0.50 D was defined as low myopia, ?6.00 D ≤ SE