年龄和散光程度对儿童子午线性弱视诊断的影响  

The effects of the age and degree of astigmatism on the diagnosis of meridional amblyopia in children

作　　者：李辉[1] 许江涛[1] 蒋晓明[1] 周莹[1] 

机构地区：[1]昆明市儿童医院眼科,650000

出　　处：《中国斜视与小儿眼科杂志》2013年第1期1-5,共5页Chinese Journal of Strabismus & Pediatric Ophthalmology

摘　　要：目的了解年龄和散光程度对子午线性弱视诊断的影响,明确引起儿童子午线性弱视的散光度临界值。方法收集2008年至2011年在我院眼科门诊就诊,以散光为主要屈光异常的4～8岁儿童共1005人(1910只眼)为研究对象。纳入标准:球镜值≤±3.00D,散光度绝对值≥1.00D,双眼球镜差值≤1.50D,双眼柱镜差值≤1.00D。分析不同年龄和散光程度对诊断子午线弱视的影响。结果矫正视力≥0.9共144只眼,平均散光度(1.49±0.58)D,95%可信区间(1.39,1.58)D;矫正视力0.8共373只眼,平均散光度(1.47±0.66)D,95%可信区间(1.40,1.54)D;矫正视力=0.7共498只眼,平均散光度(1.73±0.74)D,95%可信区间(1.67,1.80)D;三组间进行比较,矫正视力≥0.9与矫正视力=0.8两组间比较无统计学差异,矫正视力≥0.9和矫正视力0.8两组与矫正视力=0.7组比较有统计学差异(P<0.05)。轻度弱视组的散光度均值为(1.82±0.86)D,95%可信区间为(1.77,1.86)D;中度弱视组的散光度均值为(2.61±1.10)D,95%可信区间为(2.50,2.71)D;两组间比较有统计学差异(P<0.05,P=0.000)。相同矫正视力情况下,≤6岁组的平均散光度较>6岁组稍高;相同散光度的情况下,不同年龄组的矫正视力不同,年龄越小,矫正视力越低。结论矫正视力≥0.8的散光儿童中的散光度多不>1.50D。散光度≥1.75D可引起轻度弱视,散光度>2.50D可以引起中度子午线性弱视。诊断子午线性弱视时应综合考虑矫正视力、散光度和年龄三因素的影响。Objective To assess the diagnostic value of age and diopter of cylinder for meridional amblyopia for chinese children.To investigate the referral criteria of diopter of cylinder to detect meridional amblyopia. Methods A total of 1005 children with astigmatism （aged 4-8 years, 1910 eyes） were recruited. The diopter of cylinder≥1.00D and sphere ≤3.00D were present in one or both eyes. The difference of sphere between both eyes was less 1.50D. The difference of astigamatism between both eyes was less 1.00D. All diopter of cylinders were caculated by the absolute value. Results Best-corrected visiual acuity （BCVA）≥0.9 were present in 144 eyes, the mean diopter of cylinder was 1.49D （95% confidence interval （CI）,1.39 to 1.58）. BCVA=0.8 were 373 eyes, and the mean diopter of cylinder was 1.47D （95% CI, 1.40 to 1.54）. BCVA=0.7 were 498 eyes,and the the mean diopter of cylinder was 1.73D （ 95% CI,1.67 to 1.80）. As for BCVA〉~0.9, BCVA=0.8, BCVA=0.7, there was no statistic significances of cylinder between BCVA ≥0.9 and BCVA=0.8.BCVA=0.7 has statistic difference of cylinder with the other two groups. The mean astigmatism in mild meridional amblyopia was 1.82D （95%CI, 1.77 to 1.82）. The mean asitigmatism in moderate amblyopia was 2.61D（95%CI,2.5 to 2.71）. Under the same BC＇VA, the astigmatism of children under 6 years of age was higher than children age 6 or older.Under the same cylinder, more younger, more better BCVA. Conclusions As for children of BCVA≥0.8, most of their diopter of cylinder were less 1.50D. The diopter of cylinder ≥1.75D could cause mild amblyopia. The diopter of cylinder≥2.50D could cause moderate amblyopia. The age and the degree of astigmatism and the BCVA might be infulential factors in the diagnosis of meridional amblyopia.

关 键 词：儿童 散光 子午线性弱视 可信区间 

分 类 号：R777.44[医药卫生—眼科]