远视力联合小瞳计算机验光法在8岁儿童近视筛查中的应用  

Combined Use of Uncorrected Visual Acuity and Noncycloplegic Autorefraction for Myopia Screening in Children

作　　者：何鲜桂[1] 朱剑锋[1] 陆丽娜[1] 

机构地区：[1]上海市眼病防治中心,200040

出　　处：《中国学校卫生》2010年第8期960-962,共3页Chinese Journal of School Health

基　　金：上海市公共卫生优秀青年人才培养计划(项目编号:08GWQ036);上海市卫生局科技发展基金项目(项目编号:024062)

摘　　要：目的探讨远视力联合小瞳计算机验光法在儿童近视筛查中的可行性,以便为大规模儿童近视筛查工作提供科学依据。方法整群抽取上海市嘉定区中心城区某重点小学三年级6个班228名学生,按照知情同意原则,进行裸眼远视力检查和TOPCON-KR8800计算机自动验光仪散瞳前后屈光状态检查。结果共174名学生348只眼完成全部检查。裸眼视力<5.0有229只眼(65.8%);散瞳后近视(SE≤-0.50D)有112只眼(32.2%);小瞳计算机验光等效球镜度数(SE)较散瞳后验光SE向近视方向增大(0.54±0.46)D,散光度数绝对值差异无统计学意义。远视力筛查近视最佳界值为4.9,Youden指数为0.66;小瞳计算机验光(SE)筛查近视最佳界值为-0.50D,Youden指数为0.78;远视力联合小瞳计算机验光法筛查近视最佳界值为裸眼视力<5.0且小瞳SE<-0.50D,Youden指数为0.83。结论远视力联合小瞳计算机验光法在8岁儿童近视筛查中具有一定应用价值。Objective To evaluate the accuracy of the combined use of uncorrected visual acuity and noncycloplegic autorefraction in screening for myopia in children. Methods With random cluster sampling, 174 children aged 8 years were included after obtaining written informed consent from at least one parent. Uncorrected visual acuity was measured. Autorefraction was performed with the TOPCON-KR 8800 autorefractor before and after cycloplegia. Results Uncorrected visual acuity was presented in 229 eyes（65.8%）. There were 112 eyes （32.2%） with SE ≤-0.50D after cycloplegia. The equivalent spherical diaopter were more positive after cycloplegia with statistical significance than those before cycloplegia, the difference was （0.54±0.46）D, while the cylinder diopter had no significant change. When using uncorrected visual acuity to estimate myopia, the best cutoff point was 4.9, the Youden index was 0.66. When using noncycloplegic Autorefraction to estimate myopia, the best cutoff point was SE -0.50D, the Youden index was 0.78. When using noncycloplegic Autorefraction combined uncorrected visual acuity to estimate myopia, the best cutoff point were SE -0.50D, the Youden index was 0.83. Conclusion The combined use of uncorrected visual acuity and noncycloplegic autorefraction is a valuable method to estimate myopia in refractive error screening in children aged 8 years.

关 键 词：近视 诊断 计算机辅助 多相筛查 对比研究 儿童 

分 类 号：R770.421[医药卫生—眼科] R778.12[医药卫生—临床医学]