5~6岁学龄前儿童睫状肌麻痹后散光的分析
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国家自然科学基金面上项目(81673198,81803258)


Effects of cycloplegia on astigmatism in 5~6 years old preschool children
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    摘要:

    目的:探究1%盐酸环喷托酯滴眼液对5~6岁学龄前儿童散光度数及散光轴向的影响。方法:2017年9月—2018年3月选取南京市雨花台区出生于2011年9月—2012年8月的儿童1 920例进行横断面研究,采用Canon RF10型全自动电脑验光仪对所有儿童进行睫状肌麻痹前电脑验光检查,记录其屈光度,具体包括球镜度、柱镜度和轴向,再使用1%盐酸环喷托酯滴眼液进行睫状肌麻痹,全自动电脑验光仪复查,记录相应屈光度。采用Thibos矢量分析方法将散光成分分解为J0和J45成分,均取右眼分析睫状机麻痹前后屈光度和散光的变化情况。结果:1 882例完成睫状肌麻痹前全自动电脑验光仪检查(受检率=98.92%),1 344例完成睫状肌麻痹后全自动电脑验光仪检查(散瞳率=71.41%),本研究仅纳入1 344例样本。睫状肌麻痹前后5~6岁学龄前儿童主要表现为顺规散光,其次为斜轴散光,最后为逆规散光。睫状肌麻痹后等效球镜度向远视漂移,平均漂移1.48 D[(1.48±1.31)D]。睫状肌麻痹后总散光轻度增加,J0成分除近视组(P=0.444)外均增加,J45成分在任一屈光度分组中均保持不变。Bland-Altman图示睫状肌麻痹前后散光评估一致性较好,J0的95%可信区间为-0.24~+0.32,J45的95%可信区间为-0.15~+0.15。结论:睫状肌麻痹对散光有一定程度的影响,尤其是顺规散光和逆规散光,非睫状肌麻痹是测量学龄前儿童散光直接可信的方法。

    Abstract:

    Objective:To investigate the effect of 1% cyclopentolate on the power and axis of astigmatism in 5~6 years old preschool children. Methods:From September 2017 to March 2018,a cross-sectional study was carried out in 1 920 children born between September 2011 and August 2012 in Yuhuatai District. The noncycloplegic refractive status inculding spherical power,astigmatic power,and axis angle were measured using an autorefractor Canon RF10. After cycloplegia was indued by 1.0% cyclopentolate,the refractive status was rechecked. The vector method modified by Thibos was used to analysis asitgmatism. Data only from right eye was analyzed. Results:A total of 1 882 children(response rate 98.92%)had complete data from noncycloplegic autorefraction,1 344 children(cycloplegic rate 71.41%)had complete data from cycloplegic autorefraction,so 1 344 children were included in this study. Astigmatism in 5~6 years old children before and after cycloplegia was mainly manifested as with-the-role(WTR),followed by oblique astigmatism,and then against-the-role(ATR). Spherical equivalent(SE)values in cycloplegic refraction were significantly more hyperopic than those in noncycloplegic refraction by mean difference of(1.48 ± 1.31)diopters(P < 0.001). The J0 values increased significantly in cycloplegic refraction except the myopic group(P=0.444),while the J45 values had no significant change in any refractive groups(all P < 0.05). Blande-Altman plots demonstrated the agreement of astigmatism before and after cycloplegia,the 95% confidence interval of the J0 and J45 were -0.24~+0.32 and -0.15~+0.15,respectively. Conclusion:Cycloplegia has a mild effect on astigmatism,especially in the WTR and ATR astigmatisms,but do not reach clinical significant. Non-cycloplegia is still a reliable tool to measure astigmatism for preschool children.

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童浩海,郝庆丰,王子衿,陈雨曦,崔 健,沈亚明,刘 虎.5~6岁学龄前儿童睫状肌麻痹后散光的分析[J].南京医科大学学报(自然科学版),2020,(7):1011-1015

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  • 收稿日期:2019-11-23
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  • 在线发布日期: 2020-08-05
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