应用双通道客观视觉质量分析系统观察近视者角膜像差对视觉质量的影响  

The effect of corneal aberrations on visual quality in myopia patients using OQAS visual quality analysis system

作　　者：邹泉 程蕾 宋超 袁萍 刘亚鲁 朱冉 Zou Quan;Cheng Lei;Song Chao;Yuan Ping;Liu Yalu;Zhu Ran(Department of Refractive Center,The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University,Xuzhou First People's Hospital,Institute of Eye Disease Prevention and Treatment of Xuzhou,Xuzhou 221002,China)

机构地区：[1]徐州医科大学附属徐州市立医院屈光中心,徐州市第一人民医院,徐州市眼病防治研究所,徐州221002

出　　处：《中华眼外伤职业眼病杂志》2022年第12期916-921,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：徐州市卫生健康委科技项目(XWKYSL20210257);徐州市第一人民医院"青苗工程"(QMHB2021018)

摘　　要：目的应用双通道客观视觉质量分析系统观察近视者角膜像差对视觉质量的影响。方法横断面研究。分析2021年12月至2022年5月于徐州市第一人民医院拟行角膜屈光术的近视者152例(152眼)的临床资料, 为避免双眼对称重复性, 均选取右眼纳入本研究。通过Pentacam眼前节分析仪观察角膜总体像差的均方根(RMS)、总低阶像差(LOA)、总高阶像差(HOA)、水平彗差Z(3, 1)、垂直彗差Z(3, -1)、球差Z(4, 0)、水平三叶草差Z(3, 3)和斜轴三叶草Z(3, -3)等;光学质量检测采用双通道客观视觉质量分析系统(OQAS分析仪)。通过多元线性回归分析, 以影响因素作为自变量, 调制传递函数截止频率(MTF cut off)作为因变量, 建立预测模型。采用受试者操作特征(ROC)曲线评估各影响因素的预测效果, 并找到合适的临界点。结果本研究入组患者年龄为18~33(25.49±6.73)岁, 男89例, 女63例, 通过多元线性回归分析得出球镜、柱镜、Z(3, 1)、Z(3, -1)、Z(4, 0)、Z(3, 3)和Z(3, -3)均是近视者视觉质量的影响因素。通过Spearman的相关分析, 视觉质量与RMS、LOA、HOA、Z(3, -3)均呈负相关, 与球镜、柱镜、Z(3, 1)、Z(3, -1)、Z(4, 0)、Z(3, 3)呈正相关。针对球镜、柱镜、Z(3, 1)、Z(3, -1)、Z(4, 0)、Z(3, 3)和Z(3, -3)共7项构造ROC曲线, Z(3, -1)对应的AUC值为0.808(95%CI:65.77%~95.76%)。影响近视者视觉质量多元回归方程分别为:MTF cut off=41.682-6.261×Z(3, -3)-8.217×Z(3, -1)-13.569×Z(3, 1)+1.787×Z(3, 3)+18.657×Z(4, 0)+0.008×球镜+12.335×柱镜。结论低阶像差和高阶像差均是影响近视者视觉质量的重要因素, Z(3, -1)对于视觉质量的诊断价值比较高。利用角膜像差的多元线性回归方程可以较为便捷的估算出近视者的MTF cut off值, 对近视者的视觉质量作出预测, 在临床工作中具有指导意义。ObjectiveeTo observe the effect of corneal aberrations on visual quality in myopia patients using OQAS visual quality analysis system.MethodsThis was a cross-sectional study.The clinical data of 152 eyes of 152 patients who were willing to undergo refractive surgery in Xuzhou First People's Hospital from Dec.2021 to May 2022 were analyzed.In order to avoid binocular symmetry repeatability,the right eyes were selected to be included in this study.Pentacam was used for the root mean square(RMS),total low-order aberration(LOA)and total higher order aberration(HOA),horizontal coma[Z(3,1)],vertical coma[Z(3,-1)],spherical aberrations[Z(4,0)],horizontal clover[Z(3,3)],oblique axis clover[Z(3,-3)],etc.Dual channel objective visual quality analysis system(OQAS analyzer)was used for optical quality detection.Through multiple linear regression analysis,the prediction model was established with the influencing factors as the independent variable and the MTF cutfrequency as the dependent variable.The ROC curve was used to evaluate the predictive effect of each influencing factor and find the appropriate critical point.ResultsThe age of the patients enrolled in this study was(25.49±6.73)years old,ranged 18-33 years.There were 89 males and 63 females.Through multiple linear regression analysis,it was found that spherical lens,cylindrical lens,Z(3,1),Z(3,-1),Z(4,0),Z(3,3)and Z(3,-3)were all the factors affecting the visual quality of myopia patients.According to Spearman's correlation analysis,visual quality was negatively correlated with RMS,LOA,HOA and Z(3,-1),and positively correlated with spherical mirror,cylindrical mirror,Z(3,1),Z(3,-1),Z(4,0)and Z(3,3).The multiple regression equations affecting the visual quality of myopic patients were:mtfcutoff=41.682-6.261×Z(3,-3)-8.217×Z(3,1)-13.569xZ(3,1)+1.787×Z(3,3)+18.657×Z(4,0)+0.008x spherical lens+12.335×cylindrical lens.The ROC curve was constructed for 7 items of spherical mirror,cylindrical mirror,Z(3,1),Z(3,-1),Z(4,0),Z(3,3)and Z(3,-3).TheAUC value corresponding to

关 键 词：近视 角膜像差 视觉质量 影响因素 

分 类 号：R778.11[医药卫生—眼科]