3种方法界定儿童青少年近视检出率及其一致性评价  

Prevalence of myopia and consistency evaluation of three myopia assessment methods among children and adolescents

作　　者：徐梓航 胡媛媛[1,2,3] 温莹 吴紫云[1,2] 于明坤 陶芳标 毕宏生 XU Zihang;HU Yuanyuan;WEN Ying;WU Ziyun;YU Mingkun;TAO Fangbiao;BI Hongsheng(Ophthalmology and Optometry Medical School,Shandong University of Traditional Chinese Medicine,Jinan(250014),China;不详)

机构地区：[1]山东中医药大学眼科与视光医学院,济南250014 [2]山东省眼病防治研究院 [3]山东中医药大学附属眼科医院 [4]山东中医药大学第一临床医学院 [5]安徽医科大学公共卫生学院儿少卫生与妇幼保健学系

出　　处：《中国学校卫生》2023年第5期747-750,755,共5页Chinese Journal of School Health

基　　金：国家重点研发计划项目(2019YFC1710200);山东省中西医结合专病防治项目(YXH2019ZXY001);山东省医药卫生科技发展计划项目(202107020948)。

摘　　要：目的 评价筛查性近视、非睫状肌麻痹客观验光近视以及睫状肌麻痹客观验光近视3种方法界定儿童青少年近视检出率及其一致性,为探讨不同界定方法一致性的影响因素提供参考。方法 纳入2020年9月山东省一项基于学校的横断面研究中7所学校3 868名6~17岁的儿童青少年,分析筛查性近视、非睫状肌麻痹客观验光近视以及睫状肌麻痹客观验光近视在不同年龄和总体儿童青少年中的检出率,以睫状肌麻痹后等效球镜≤-0.50 D为近视金标准,采取Kappa检验和ROC曲线下面积对一致性进行评价。结果 儿童青少年睫状肌麻痹客观验光近视率和筛查性近视率分别为36.7%和38.3%。非睫状肌麻痹客观验光近视率为62.4%,且该方法测试的小学和初中的近视率高于筛查性和睫状肌麻痹客观验光。3 868名受试者中,筛查性近视、非睫状肌麻痹客观验光近视与近视金标准结果一致的人数分别有3 628(93.8%)和2 862名(74.0%),受试者与近视金标准结果一致,Kappa值分别为0.87和0.51,ROC曲线下面积分别为0.94(95%CI=0.93~0.95)和0.79(95%CI=0.78~0.81);与其他亚组相比,8~17岁、初中和高中、居住在城市、日常生活视力足矫、散光度≤1.50 D的儿童青少年应用筛查性近视的一致性较高(P值均<0.05)。结论 筛查性近视与睫状肌麻痹客观验光近视的一致性较高,非睫状肌麻痹客观验光近视的一致性较低。Objective To evaluate the prevalence and consistency of screening myopia,non-cycloplegic myopia and cycloplegic myopia in children and adolescents,and to provide references for exploring the factors affecting the consistency of different definition methods.Methods A total of 3868 children and adolescents aged 6 to 17 years from seven schools were included in a schoolbased cross-sectional study in Shandong Province in September 2020.The prevalence of screening myopia,non-cycloplegic refraction,and cycloplegic refraction at different ages and all children and adolescents were analyzed.With cycloplegic spherical equivalent≤-0.50 D as the gold standard for myopia,and Kappa test and area under the ROC curve were used to evaluate the consistency.Results The prevalence of cycloplegic myopia and screening myopia were 36.7%and 38.3%among children and adolescents.The prevalence of non-cycloplegic myopia was 62.4%,which was significantly higher than screening myopia and cycloplegic myopia two methods in primary and junior high schools.Among 3868 subjects,there were 3628(93.8%)subjects with screening myopia and 2862(74.0%)subjects with non-cycloplegic myopia who were consistent with the gold standard for myopia.The Kappa values of screening myopia and non-cycloplegic myopia were 0.87 and 0.51,and the area under the R0C curve was 0.94(95%CI=0.93-0.95)and 0.79(95%CI=0.78-0.81).Compared with other groups,children and adolescents aged 8 to 17 years,in junior or high school,urban residence,better presenting distance visual acuity,and astigmatism≤1.50 D had a higher consistency in the application of screening myopia(P<0.05).Conclusion The consistency between screening myopia and cycloplegic myopia is high,and the consistency between non-cycloplegic objective myopia is low.

关 键 词：近视 患病率 视力普查 儿童 青少年 

分 类 号：R778.11[医药卫生—眼科] R179[医药卫生—临床医学]