Relative peripheral refractive errors in Chinese children with myopic anisometropia

AIM:To compare relative peripheral refractive errors(RPREs)in Chinese children with and without myopic anisometropia(MAI)and to explore the relationship between RPRE and myopia.METHODS:This observational cross-sectional study included 160 children divided into two groups according to the interocular spherical equivalent refraction(SER)difference≥1.0 D in the MAI group(n=80)and<1.0 D in the non-MAI group(n=80).The MAI group was further divided into two subgroups:ΔSER<2.0 D group and ΔSER≥2.0 D group.Basic ocular biometric parameters of axial length(AL),average keratometry(Ave K),cylinder(CYL),surface regularity index(SRI),and surface asymmetry index(SAI)were recorded.In addition,multispectral refraction topography was performed to measure RPRE,and the parameters were recorded as total refraction difference value(TRDV),refraction difference value(RDV)0-10,RDV10-20,RDV20-30,RDV30-40,RDV40-53,RDV-superior(RDV-S),RDV-inferior(RDV-I),RDV-temporal(RDV-T)and RDV-nasal(RDV-N).RESULTS:In the non-MAI group,the interocular differences of all parameters of RPRE were not significant.In the MAI group,the interocular differences of TRDV,RDV10-53,RDV-S,RDV-I,RDV-T,and RDV-N were significant.In subgroup analysis,the interocular differences of TRDV,RDV30-53,RDV-I,and RDV-T were significant in ΔSER<2.0 D group and ΔSER≥2.0 D group,but the interocular differences of RDV10-30,RDV-S and RDV-N were only significant in the ΔSER≥2.0 D group.In correlation analysis,ΔTRDV,ΔRDV 10-53,ΔRDV-S,and ΔRDV-N were negatively correlated with ΔSER but positively correlated with ΔAL.CONCLUSION:The more myopic eyes have larger hyperopic RPRE in Chinese children with MAI in certain retinal range,and partialΔRPRE is closely associated with ΔSER and ΔAL.

Correlation analysis and multiple regression formulas of refractive errors and ocular components

The multiple regression formulas and correlation of ocular components with refractive errors are presented by Gaussian optics. The refractive error changing rate for the cornea and lens power, the axial length, anterior chamber depth(ACD) and vitreous chamber depth(VCD) are calculated, including nonlinear terms for more accurate rate functions than the linear theory. Our theory, consistent with the empirical data, shows that the Pearson correlation coefficients for spherical equivalent(SE) and ocular components are highest for SE with axial length, ACD and VCD and weakest for corneal power, lens power and lens thickness. Moreover, our regression formulas show the asymmetric feature of the correlation that the axial length, ACD and VCD are more strongly correlated(with higher negative regression constants) with refractive errors in eyes with hyperopia than in eyes with myopia, particularly for severe hyperopia.

Human eye ocular component analysis for refractive state and refractive surgery

AIM： To analyze the clinical factors influencing the human vision corrections via the changing of ocular components of human eye in various applications; and to analyze refractive state via a new effective axial length.METHODS： An effective eye model was introduced by the ocular components of human eye including refractive indexes, surface radius（r1, r2, R1, R2） and thickness（t, T） of the cornea and lens, the anterior chamber depth（S1） and the vitreous length（S2）. Gaussian optics was used to calculate the change rate of refractive error per unit amount of ocular components of a human eye（the rate function M）. A new criterion of myopia was presented via an effective axial length.RESULTS： For typical corneal and lens power of 42 and 21.9 diopters, the rate function Mj（j=1 to 6） were calculated for a 1% change of r1, r2, R1, R2, t, T（in diopters） M1=＋0.485, M2=-0.063, M3=＋0.053, M4=＋0.091, M5=＋0.012, and M6=-0.021 diopters. For 1.0 mm increase of S1 and S2, the rate functions were M7=＋1.35, and M8=-2.67 diopter/mm, respectively. These rate functions were used to analyze the clinical outcomes in various applications including laser in situ keratomileusis surgery, corneal cross linking procedure, femtosecond laser surgery and scleral ablation for accommodation.CONCLUSION： Using Gaussian optics, analytic formulas are presented for the change of refractive power due to various ocular parameter changes. These formulas provide useful clinical guidance in refractive surgery and other related procedures.

Prevalence and inconformity of refractive errors and ocular biometry of 3573 medical university freshman students for 4 consecutive years

AIM:To evaluate the prevalence of refractive errors and ocular biometry in 3573 freshman students at Tianjin Medical University for 4 consecutive years.METHODS:In this university-based, cross-sectional study, comprising 3573 students, visual acuity(VA), slitlamp examination, non-cycloplegic auto-refraction, and ocular biometry were recorded.RESULTS:The prevalence of myopia increased annually, from 2017 to 2020 were 93.5%, 94.5%, 95.9%, and 96.2%, respectively(P=0.03), and the prevalence of high myopia was 25.7%, 26.9%, 28.6%, and 28.6%, respectively. Males tended to have a higher percentage of total astigmatism than females, with astigmatism ≥0.75 and ≥1.0 D criteria. The percentage of with-the-rule astigmatism, against-therule astigmatism, and oblique astigmatism was 90.3%, 5.8%, and 3.9%, respectively, with astigmatism ≥1.00 D criteria. The mean spherical equivalent, axial length(AL), central corneal thickness(CCT), anterior chamber depth(ACD), lens thickness(LT), corneal radius(CR), and lens position(LP) were 4.37±2.52 D, 25.28±1.24 mm, 539.49±34.98 μm, 3.31±0.34 mm, 3.47±0.21 mm, 7.8±0.28 mm, and 5.04±0.32 mm, respectively. With diopter increase in myopia, the AL became longer, CR became steeper, ACD became deeper, LT became thinner, and LP became more posterior(all P<0.01). Females had a shorter AL, thinner CCT, smaller CR, shallower ACD, thicker lens, and more anterior LP than males(P<0.01). The 64% of high myopia had AL≥26 mm, meanwhile, 5.8% mild myopia and 21.1% moderate myopia had AL≥26 mm. With AL≥26 mm, mild and moderate myopia compared to high myopia, AL was shorter(26.51±0.46 vs 26.87±0.70 mm), CR was larger(8.10±0.3 vs 7.85±0.23 mm) and LT was thinner(3.39±0.19 vs 3.45±0.19 mm, P<0.001).CONCLUSION:The prevalence of myopia and high myopia is significantly high in freshman students. The majority of astigmatism is with-the-rule. Inconformity of refractive errors and ocular biometry existed in some students. Attention should be paid to the ocular biometry of myopia.

Ocular image-based deep learning for predicting refractive error:A systematic review

ackground:Uncorrected refractive error is a major cause of vision impairment worldwide and its increasing prevalent necessitates effective screening and management strategies.Meanwhile,deep learning,a subset of Artificial Intelligence,has significantly advanced ophthalmological diagnostics by automating tasks that required extensive clinical expertise.Although recent studies have investigated the use of deep learning models for refractive power detection through various imaging techniques,a comprehensive systematic review on this topic is has yet be done.This review aims to summarise and evaluate the performance of ocular image-based deep learning models in predicting refractive errors.Main text:We search on three databases(PubMed,Scopus,Web of Science)up till June 2023,focusing on deep learning applications in detecting refractive error from ocular images.We included studies that had reported refractive error outcomes,regardless of publication years.We systematically extracted and evaluated the continuous outcomes(sphere,SE,cylinder)and categorical outcomes(myopia),ground truth measurements,ocular imaging modalities,deep learning models,and performance metrics,adhering to PRISMA guidelines.Nine studies were identified and categorised into three groups:retinal photo-based(n=5),OCT-based(n=1),and external ocular photo-based(n=3).For high myopia prediction,retinal photo-based models achieved AUC between 0.91 and 0.98,sensitivity levels between 85.10%and 97.80%,and specificity levels between 76.40%and 94.50%.For continuous prediction,retinal photo-based models reported MAE ranging from 0.31D to 2.19D,and R^(2) between 0.05 and 0.96.The OCT-based model achieved an AUC of 0.79–0.81,sensitivity of 82.30%and 87.20%and specificity of 61.70%–68.90%.For external ocular photo-based models,the AUC ranged from 0.91 to 0.99,sensitivity of 81.13%–84.00%and specificity of 74.00%–86.42%,MAE ranges from 0.07D to 0.18D and accuracy ranges from 81.60%to 96.70%.The reported papers collectively showed promising performances,in particular the retinal photo-based and external eye photo-based DL models.Conclusions:The integration of deep learning model and ocular imaging for refractive error detection appear promising.However,their real-world clinical utility in current screening workflow have yet been evaluated and would require thoughtful consideration in design and implementation.

儿童近视发生前后的屈光度和眼生物参数变化:安阳儿童眼病研究

目的分析小学生5年间的屈光度和眼生物参数变化趋势,探讨其在近视发生前后的变化规律。方法采用队列研究方法,以“安阳儿童眼病研究”中的1年级小学生为研究对象,共纳入1986人,其中男生1126人,女生860人,均取右眼数据进行分析。每年采用1%环戊通滴眼液进行睫状肌麻痹后电脑验光获得等效球镜度(SE),采用眼生物测量仪测量眼轴长度(AL)、前房深度、晶状体厚度、平均角膜曲率(Km)等,采用Bennett公式计算晶状体屈光力(LP)。根据随访时近视发生情况将受检者分为持续近视组、非近视组和新发近视组,又根据发病年龄将新发近视组细分为8岁近视组、9岁近视组、10岁近视组、11岁近视组和12岁近视组,比较各组屈光度和眼生物参数在不同随访时间点的差异。结果随着年龄增加,所有儿童的屈光度均逐渐向近视漂移、眼轴逐渐增长,各组内相邻随访年龄间SE和AL比较,差异均有统计学意义(均P<0.05)。在相同随访年龄下,近视发生越早,其近视屈光度数越高,AL越长;各相邻组间SE比较差异均有统计学意义(均P<0.05);8~12岁随访年龄下各相邻组间AL比较,差异均有统计学意义(均P<0.05)。在非近视组,屈光度以缓慢均匀的速度向正视漂移,5年平均SE变化速度为(-0.23±0.27)D/年,AL亦缓慢均匀增长,5年平均增长速度为(0.18±0.13)mm/年;在新发近视组中,近视发生前第3年、第2年和第1年的SE年变化量分别为(-0.32±0.25)、(-0.45±0.33)和(-0.98±0.44)D,AL年增长量分别为(0.25±0.12)、(0.32±0.15)和(0.48±0.19)mm,SE和AL变化速度均在近视发生前开始加快,并于近视发生后变缓,各近视前后不同时间段SE和AL变化速度总体比较差异均有统计学意义(均P<0.001)。新发近视组中发生近视时男生的AL为(24.11±0.70)mm,明显长于女生的(23.60±0.66)mm,差异有统计学意义(t=159.71,P<0.001)。LP随年龄增加而下降,9岁前下降速度较快,9岁后下降速度变缓。持续近视组和8~11岁近视组的LP平均下降速度分别为(-0.48±0.19)、(-0.44±0.20)、(-0.49±0.16)、(-0.51±0.18)、(-0.48±0.19)D/年,明显快于12岁近视组的(-0.42±0.17)D/年和非近视组的(-0.37±0.15)D/年,差异均有统计学意义(均P<0.05)。各组不同随访年龄Km比较差异均无统计学意义(均P>0.05)。结论AL在儿童近视发生的前3年内开始加速增长,在近视发生后增长速度逐渐变缓,但仍明显快于非近视儿童;在此过程中,LP下降起到一定的代偿作用,Km无显著变化。相同年龄下男生发生近视时的AL比女生长。AL是近视防控的重要指标,评估时要考虑性别差异,更要关注AL的增长速度。

眼用药物药代动力学模型研究进展

视力与生活质量息息相关。临床上倾向于使用侵入性较小的外用和全身给药方式治疗青光眼等眼部常见疾病。眼部许多的生理生化屏障包括泪液周转、角膜渗透、血-眼屏障等,限制药物在眼部的渗透与分布,造成眼内药代动力学特征不明确,常用眼部房室模型来描述药物在眼内处置动力学。经典眼房室模型以角膜或玻璃体为中央室,将眼部其他组织整体视为外周室,而基于生理的药代动力学(PBPK)模型则引入眼部血流量变化、转运体对药物转运影响、血-眼屏障等因素,可提供更多药物在眼部的处置细节,有助于辅助眼用新药的开发和指导眼部疾病药物治疗。文章综述了不同给药方式时眼部用药的药代动力学特征,经典房室模型和PBPK模型及其在临床眼部用药方案设计中的应用。

优势眼的特征及转换在眼部疾病治疗中的意义

优势眼是指两眼在视物时起主导作用的眼,在双眼视功能和融合功能中发挥重要作用,其形成机制较为复杂。根据优势眼检查方法的原理不同,可分为注视性、运动性和知觉性优势眼3种类型,每一类优势眼的检查方法有所不同。由于双眼疾病进展不平衡引起的视力或视功能的改变,可能会导致优势眼的转换,进而影响双眼视觉平衡及治疗效果。因此,忽视优势眼的定位或错误判断会改变双眼间长期建立的视觉平衡,对视觉质量和生活质量带来不同程度影响。这种现象主要体现在屈光不正配镜矫正、屈光手术、斜视矫正手术、弱视训练方法和白内障人工晶状体度数的测定等过程中。基于优势眼的眼别进行医疗方案的制定,对患者良好双眼视觉的重建和生活质量的改善尤其重要。然而,优势眼在双眼视功能中的作用目前尚未完全明确,临床医生也缺乏对其重要性的足够认知。本文就优势眼的形成机制、检查方法和优势眼转换的临床意义等相关的最新研究进展进行综述。

眼睑成形术对眼表及屈光状态的影响

目的:探讨眼睑成形术对患者眼表及屈光状态的影响方法:回顾性研究。选取2022-01/2023-06在我院眼科行眼睑成形术的患者70例108眼。其中诊断为上睑下垂的患者行提上睑肌缩短术40例48眼,诊断为眼睑皮肤松弛/单睑的患者行双眼重睑成形术30例60眼。比较各组患者手术前后眼表疾病指数(OSDI)评分、术眼泪河高度(TMH)、泪液分泌试验(SⅠt)、泪膜破裂时间(BUT)、角膜荧光染色(FL)评分、角膜散光(Cyl)、角膜表面规则指数(SRI)、角膜表面非对称指数(SAI)、角膜平均曲率(Km)、总散光值(C)。结果:提上睑肌缩短术组患者手术前后OSDI评分、BUT、SⅠt、FL比较均有差异(均P<0.05),TMH比较无差异(P>0.05)。术后1 mo,OSDI评分、BUT、SⅠt、FL与术前比较均有差异(均P<0.05)。重睑成形组患者手术前后OSDI评分、BUT、SⅠt、FL、TMH比较均无差异(均P>0.05)。提上睑肌缩短手术组和重睑成形组患者手术前后Cyl、SRI、SAI、Km、C比较均无差异(均P>0.05)。结论:提上睑肌缩短手术对于上睑下垂患者早期眼表有所影响,早期应予以保护角膜的措施,而重睑成形术对患者早期眼表无明显影响;眼睑成形术对于所有患者屈光状态均无明显影响。

Age-specific distribution of oculometric parameters and myopia in children aged 8-12y

AIM:To describe the distribution of ocular biometrics and to evaluate its associations with refractive error and to assess the contribution from ocular parameters to refractive error among Chinese myopic children.METHODS:This cross-sectional study evaluated subjects aged 8-12y.Keratometry,ocular biometry,and cycloplegic autorefraction were performed on each subject.Spherical equivalent refraction(SER)and ocular biometrics were assessed as a function of age and gender.The Pearson correlation analysis between SER and ocular biometrics was carried out.Multiple linear regression was performed to analyze the association between SER and ocular parameters.RESULTS:A total of 689 out of 735 participants(321 boys,48.1%)were analyzed,with a mean SER of-2.98±1.47 diopter(D).Axial length(AL),anterior chamber depth(ACD),corneal radius of curvature(CR),horizontal visible iris diameter(HVID),central corneal thickness(CCT)and lens power(LP)showed normal distribution.The AL,AL/CR ratio,ACD and CR increased from 8 to 12y of age,while SER and LP decreased,HVID and CCT remained stable.There was no difference in gender.SER decreased by 0.929 D for every 1 mm increase in AL and decreased by 1.144 D for every 0.1 increase in AL/CR ratio.The Pearson correlation coefficient between SER and AL was-0.538(P<0.01)and-0.747(P<0.01)between SER and AL/CR ratio.For the SER variance,AL explained 29.0%,AL/CR ratio explained 55.7%,while AL,CR,ACD and LP explained 99.3%after adjusting for age and gender.CONCLUSION:The AL,CR,ACD and LP are the most important determinants of myopic refractive error during myopia progression.

高眼压对眼屈光影响的研究进展

高眼压(OH)可致多种眼组织结构及功能损害,其中对眼屈光的影响,临床早有认识。OH对眼屈光的影响,与屈光间质透明性和形态结构,以及眼轴改变有关。因眼压(IOP)升高快慢、程度等不同,眼屈光变化有可逆和不可逆不同特征。眼屈光呈不可逆变化者,也常伴视觉传输损伤,并对后者病情评估有一定参考价值。IOP变化致眼轴改变,与巩膜重塑和脉络膜血流灌注变化有关,对近视发生发展和白内障术后屈光误差有一定影响。本文就OH所致屈光间质和眼轴改变的表现,以及对眼屈光影响的特征等研究进展进行总结,以期加深OH对眼屈光影响的认识,并为预防不可逆性眼屈光改变,指导视觉传输损伤的病情评估和轴性近视发生发展的防控等提供参考。

Improving refractive outcomes in cataract surgery: A global perspective

This review summarises the current evidence base and provides guidelines for obtaining good refractive outcomes following cataract surgery. Important background information is also provided. In summary, the requirements are:(1) standardisation of biometry equipment used for axial length and keratometry measurement and the use of optical or immersion ultrasound biometry;(2) sutureless cataract surgery with "in the bag" intraocular lens(IOL) placement;(3) an appropriate 3rd, 4th or 5th Generation IOL power formula should be used;(4) IOL formula constants must be optimized;(5) under certain conditions, the refractive outcome of the 2nd eye can be improved based on the refractive error of the first eye; and(6) results should be audited for refinement and to ensure that standards are met.

近视眼预测模型的建立及其预测性能的研究进展

近视眼在全球范围内发病率不断增加,尤其在中国,近视眼防控至关重要。精准预测近视眼并及早干预,对减缓近视发展、减轻社会负担具有重要意义。本文综述了近年来近视眼预测模型及其预测性能的研究进展,包括基于屈光度及眼生物学特征构建的模型,如利用屈光度、眼轴等参数及百分位数曲线进行预测;结合环境因素的模型,探讨了学龄儿童近视眼与发病年龄、父母近视眼、教育及多种生活环境因素的关系;基于遗传因素的模型,通过评估父母近视眼状况及全基因组关联研究发现的单核苷酸多态性等进行预测。此外,本文还介绍了人工智能在近视眼预测中的应用,如机器学习和深度学习算法可预测眼轴增长变化及屈光度。这些研究进展为建立更加精准的近视眼预测模型提供了参考,有助于实现精准和个性化的近视眼防控。

耳穴贴压联合眼周经皮穴位电刺激在6~12岁儿童轻度近视中的应用研究

目的观察耳穴贴压联合眼周经皮穴位电刺激在6~12岁儿童轻度近视中的应用效果。方法采用随机数字表法将2022年11月—2023年4月在石家庄市某小学的132例轻度近视儿童平均分为3组,分别为耳穴贴压组、眼周经皮穴位电刺激组、联合组,每组44例。3组患儿均给予常规护理,在此基础上,耳穴贴压组给予耳穴贴压治疗,眼周经皮穴位电刺激组给予眼周经皮穴位电刺激治疗,联合组给予耳穴贴压联合眼周经皮穴位电刺激治疗。3组患儿干预疗程均为每4周1个疗程,1个疗程后暂停1周,再进行第2个疗程,共2个疗程。比较3组患儿治疗前、治疗1个疗程后、治疗2个疗程后的裸眼远视力、屈光度、调节灵敏度及眼局部症状总积分,观察其对轻度近视儿童的治疗效果。结果干预结束后,共脱落8例患儿,最终纳入124例,分别为耳穴贴压组41例,眼周经皮穴位电刺激组41例,联合组42例。3组患儿治疗前的裸眼远视力、屈光度、调节灵敏度及眼局部症状总积分经比较,差异均无统计学意义(P>0.05)。3组患儿第1疗程及第2疗程干预结束后的裸眼远视力、屈光度、调节灵敏度及眼局部症状总积分经比较,差异有统计学意义(P<0.05)。组间比较3组患儿的裸眼远视力、屈光度及眼局部症状总积分,差异具有统计学意义(P<0.05),其中联合组与耳穴贴压组、眼周经皮穴位电刺激组相比差异具有统计学意义(P<0.05)。结论3种干预措施均可有效改善儿童轻度近视患儿的裸眼远视力、屈光度、调节灵敏度及眼局部症状,对轻度近视儿童具有治疗和防控近视进展的作用,疗效良好,且联合治疗对于儿童轻度近视的治疗及防控效果优于单一的耳穴贴压治疗或眼周经皮穴位电刺激治疗。

术前眼球生物学参数对原发性闭角型青光眼患者术后屈光状态的影响

目的探讨术前眼球生物学参数对原发性闭角型青光眼患者术后屈光状态的影响。方法回顾性收集2019年1月至2022年12月医院收治的63例接受青光眼-白内障联合手术的原发性闭角型青光眼患者的临床资料,均完成3个月随访,根据患者术后屈光状态分为屈光误差组(37例,术后等效球镜度-术前预留屈光度<-0.50 D或>0.50 D)和无屈光误差组(26例,-0.50 D≤术后等效球镜度-术前预留屈光度≤0.50 D)。所有患者入院时均接受眼球生物学检查,并记录患者基线资料,分析术前眼球生物学参数对原发性闭角型青光眼患者术后屈光状态的影响。结果屈光误差组年龄、体重指数、性别、酗酒史、高血压与无屈光误差组比较,差异无统计学意义(P>0.05);屈光误差组原发性闭角型青光眼类型、术前持续高眼压与无屈光误差组比较,差异有统计学意义(P<0.05);屈光误差组术前玻璃体腔长度(VCL)、眼轴长度(AL)、前房厚度(ACD)参数均高于无屈光误差组,晶状体厚度(LT)低于无屈光误差组(P<0.05);经logistic回归分析,结果显示,术前LT参数是原发性闭角型青光眼患者术后屈光状态的保护因素(OR<1,P<0.05),术前VCL、AL、ACD是原发性闭角型青光眼患者术后屈光状态的危险因素(OR>1,P<0.05)。结论术前VCL、AL、ACD参数较高,LT参数较低可增加原发性闭角型青光眼患者术后屈光误差发生风险,临床可术前采取有效干预措施,有利于减少患者术后屈光误差的发生。

角膜屈光手术对角膜生物力学影响的研究进展

角膜屈光手术是目前屈光手术的主流术式,随着全飞秒、全激光手术方式的发展,手术变得更加安全精准,不仅角膜创伤小,术后恢复时间也进一步缩短。角膜具有屈光特性和典型的生物软组织力学特性,角膜力学特性不仅参与维持角膜形态,影响角膜手术尤其屈光手术的效果及预后,而且还与部分角膜疾病的发生和发展密切相关。近年来生物力学研究发展迅速,其在眼部疾病的诊疗中发挥着越来越重要的作用。角膜生物力学的变化与术前角膜的形态、不同手术方式的选择、术后角膜厚度的改变等多种因素相关,但手术导致的角膜自身形态改变是不可逆的,若术后角膜生物力学的变化较大,可能会引起医源性角膜扩张、继发性圆锥角膜等并发症的发生。为了规避术后角膜扩张风险和指导个性化的术式选择,了解角膜生物力学特性的影响至关重要。文章对角膜的基础结构、角膜生物力学特性、生物力学测量方法和不同术式及不同角膜瓣厚度术后生物力学变化的研究进展进行综述,为近视患者的个性化精准治疗提供理论指导。

IOL Master 700与Tomey OA⁃2000测量4~12岁儿童眼球生物学参数的对比研究

目的研究应用IOL Master 700与Tomey OA⁃2000测量4~12岁儿童眼球生物学参数的异同,分析两种仪器在学龄(前)儿童屈光发育建档中检测结果是否具有一致性。方法前瞻性病例对照研究。选取我院2021年9月屈光发育建档的4~12岁学龄(前)儿童共163例(326只眼),分别采用IOL Master 700和Tomey OA⁃2000进行眼球生物学参数测量,获得眼轴长度(AL)、中央角膜厚度(CCT)、中央前房深度(ACD)、晶状体厚度(LT)、角膜平坦曲率(Kf)、角膜陡峭曲率(Ks)、角膜横径(WTW)、瞳孔直径(P),采用配对t检验、Pearson相关性分析、Bland⁃Altman法对两组数据进行比较。结果IOL Master 700和Tomey OA⁃2000两种设备对AL、CCT、ACD、LT、Kf、Ks检出率均为100%;WTW的检出率:IOL Master 700为99.40%,Tomey OA⁃2000为98.79%;P检出率IOL Master 700为100%,Tomey OA⁃2000为98.79%。IOL Master 700和Tomey OA⁃2000对AL、CCT、ACD、LT、Kf、Ks、WTW、P测量的平均差值分别为:(-0.0059±0.1322)mm、(12.374±7.195)μm、(-0.017±0.076)mm、(-0.075±0.078)mm、(-0.043±0.249)D、(-0.055±0.417)D、(-0.016±0.580)mm、(0.081±1.010)mm(t=-0.809,31.053,-3.947,-17.185,-3.106,-2.367,-0.501,-1.457;P=0.419,0.001,0.001,0.001,0.002,0.019,0.617,0.146)。Pearson相关性分析显示:IOL Master 700与Tomey OA⁃2000在AL、CCT、ACD、LT、Kf、Ks的测量中具有较高的相关性:r=0.992、0.976、0.958、0.930、0.984、0.963,WTW和P中等相关:r=0.435、0.445(均P<0.001)。采用Bland⁃Altman法对两种设备测量的眼球生物学参数进行一致性分析,结果显示两种设备检测的眼球生物学参数在95%LoA内一致性均良好,尤其是AL值。结论IOL Master 700与Tomey OA⁃2000用于儿童青少年眼球生物学参数测量平均差值不具有临床意义,两组数据具有较高的一致性;尤其是AL值,应用于大规模学龄儿童屈光发育筛查建档及近视防控效果随访时,检查结果具有一致性。筛查时两台设备可同时进行,以提高筛查效率。

OCULAR SURVEY OF DEAF-MUTE CHILDREN

Through routine ocular examination of 279 Deaf-mute students in Lie De School in Guangzhou in 1988 by visual chart, Yu Zi Ping Pseudoi-sochromatic plate, portable slit lamp and direct ophthalmoscope, 100 persons (35.8%) were found to have ocular defects in one or both eyes. The incidence of ocular defects was higher than that of the normal populations. Amoung the ocular abnormalities, fundus defects occupied 28.6%, error of refraction, 17.9%. 17.9% of the eyes had the vision lower than 1.0 and the error of refraction was the main cause. Cases of hereditary syndromes were found:Usher syndrome, 2 cases; Goldenhar syndromes, 2 cases (brother and sister); Waardenburg syndrome,1 case; von Recklinghausen’s syndrome, 1 case. In comparing with the other articles, the ocular defect,visual disturbance, error of refraction, way of examination as well as types and charcteristics of some syndromes were briefly dicussed. The importance of special examinations for diagnosis, early correction of refractive error, avoidance of consanguineal marriage amoung deaf-mutes were emphazsed.

多种功能弱视综合治疗仪治疗小儿屈光性弱视的效果

目的探讨多种功能弱视综合治疗仪治疗小儿屈光性弱视的效果。方法选取2022年2月至2023年2月淄博市妇幼保健院收治的76例屈光性弱视患儿作为研究对象,按照抽签法分为参照组(38例)与试验组(38例)。参照组采用常规矫正治疗,试验组在参照组基础上采用多种功能弱视综合治疗仪。比较两组眼调节功能、矫正视力及屈光度。结果治疗后,试验组眼调节功能优于参照组(P<0.05)。治疗后,试验组矫正视力高于参照组(P<0.05)。治疗后,试验组屈光度低于参照组(P<0.05)。结论多种功能弱视综合治疗仪治疗小儿屈光性弱视,可提高患儿视力水平,有效改善眼调节功能。

乌鲁木齐市中小学生近视与眼部生物学参数调查分析

目的:调查研究乌鲁木齐市中小学生近视与眼部生物学参数差异。方法:横断面调查。于2021-09/11采取立意抽样的方法选取乌鲁木齐市4所学校7~18岁中小学生2 495人进行相关眼部检查。比较不同年龄段、性别、民族学生眼部生物学参数和屈光状态的差异,并分析纳入学生等效球镜度(SE)与眼部生物学参数的相关性。结果:纳入学生视力不良检出率为80.36%,近视检出率为55.91%,散光检出率为42.96%,其中低度近视检出率为63.80%,中度近视检出率为27.60%,高度近视检出率为8.60%。不同年龄、民族学生视力不良、近视及散光检出率、SE及部分眼部生物学参数均有差异(均P<0.05),其中维吾尔族、哈萨克族学生视力不良、近视及散光检出率明显低于汉族学生。男生视力不良、近视检出率均低于女生,散光检出率高于女生。Spearman相关分析显示,眼轴长度、轴向长度与轴率比、前房深度、瞳孔直径与SE呈负相关(r_(s)=-0.664、-0.724、-0.320、-0.086,均P<0.001);晶状体厚度与SE呈正相关(r_(s)=0.147,P<0.001)。结论:乌鲁木齐市中小学生近视患病率较高,不同年龄、民族儿童青少年眼球生物学参数存在差异性。