眼轴与角膜曲率半径的比值评估儿童青少年近视的准确性研究

Accuracy of the ratio of axial length to corneal radius in the assessment of myopia in children and adolescents

摘要:

目的：探讨眼轴(AL)与平均角膜曲率半径(CR)比值(AL/CR值，简称轴率比)评估儿童青少年近视的准确性。方法：横断面研究。收集2022-01/10在绍兴市上虞人民医院眼科门诊就诊的4-16岁儿童青少年340例680眼，对所有患者进行睫状体麻痹后验光获得等效球镜度数(SE)，检查记录患者AL、平均CR，并计算AL/CR值。结果：所有患者接受睫状体麻痹后验光检查，共检出近视(SE≤-0.50 D)609眼(89.6%)，远视(SE≥+0.50 D)58眼(8.5%)，正视(-0.50 D<SE<+0.50 D)13眼(1.9%)，不同屈光状态患者组间SE、AL、AL/CR值比较均有差异(P<0.01)，CR无差异(P>0.05)。所有受检者屈光参数：SE +8.75--8.75(平均-2.25±2.38)D； AL 19.91-27.54(平均24.41±1.22)mm； CR 7.17-8.71(平均7.83±0.27)； AL/CR值2.50-3.50(平均3.12±0.14)，相关性分析显示SE与AL/CR、AL有较强的负相关(r=-0.891，P<0.01； r=-0.758，P<0.01)，SE与CR无明显相关性(r=0.067，P>0.05)，AL与CR呈正相关关系(r=0.483，P<0.01)。SE与AL/CR、AL的线性关系分别为SE=45.026-15.162×AL/CR，R2=0.794，SE=33.741-1.474×AL，R2=0.574。以睫状肌麻痹验光结果为金标准，AL/CR值诊断近视的灵敏度为0.962，特异度为0.839，误诊率为0.169，漏诊率为0.038，准确度为94.85%，Kappa系数为0.742，ROC曲线下面积为0.972。结论：AL/CR值对近视的定性诊断价值较高，对近视监测具有一定的临床意义，可用于指导近视防控等相关眼科临床工作。

Abstract:

AIM: To explore the accuracy of the ratio of axial length(AL)to the average corneal radius(CR)(AL/CR value, i.e., axial ratio)in assessing myopia in children and adolescents.METHOD:Cross-sectional study. A total of 340 cases(680 eyes)of children and adolescents aged 4-16 years old were collected from the ophthalmology clinic of Shangyu People's Hospital of Shaoxing between January 2022 and October 2022. All patients were subjected to optometry after cycloplegia to obtain spherical equivalent(SE), check and record the patient's AL, average CR, and calculate the AL/CR value.RESULTS:All subjects in this study underwent optometry after cycloplegia, and a total of 609 eyes(89.6%)were found to have myopia(SE≤-0.50 D), 58 eyes(8.5%)with hyperopia(SE≥+0.50 D)and 13 eyes(1.9%)with emmetropia(-0.50 D