目的：分析6-48月龄婴幼儿Spot屈光异常情况，为婴幼儿屈光不正矫正及弱视早期防治提供依据。

方法：对6-48月龄婴幼儿使用Spot双目视力筛查仪进行自然状况下验光，根据Spot屈光筛查仪4岁以下儿童转诊标准，收集屈光异常婴幼儿临床资料； 使用睫状肌麻痹剂视网膜检影验光，并对验光结果进行统计分析。

结果：根据转诊标准共收集Spot屈光度异常婴幼儿168例336眼。其中远视及散光异常占比高，分别为38.4%和28.6%，而近视占比低(12.2%)。168例Spot屈光度异常婴幼儿中，屈光参差(≥1.00 D)共90例，其中散光性屈光参差41例(45.6%)、远视性屈光参差33例(36.7%)，近视性屈光参差16例(17.8%)占比最少。共109例Spot屈光度异常婴幼儿完成睫状肌麻痹剂视网膜检影验光。对其Spot屈光度与睫状肌麻痹后检影验光结果差异及相关性分析结果显示，两者散光度差异为0.34±0.64 D(P<0.001)，远视度差异为-2.10±1.27 D(P<0.001)，近视度差异为-0.43±0.91 D(P=0.023)； 虽然二者结果存在统计学差异，但二者散光度、远视度及近视度均呈正相关(r=0.694、0.762、0.909)。

结论：6-48月龄婴幼儿Spot屈光异常主要以散光、远视异常和屈光参差为主，近视异常较少； 对Spot筛查异常者应进一步睫状肌麻痹剂视网膜检影验光，给予配镜矫正，有效防止婴幼儿屈光性弱视。

METHODS: Infants and young children aged 6 to 48 months were examined for refraction by Spot vision screener for natural optometry. Clinical data of infants and young children with refractive abnormalities were collected, Ciliary muscle paralysis agent was used for retinoscopy and optometry, and the results were statistically analyzed.

RESULTS: A total of 168 cases(336 eyes)with abnormal Spot refractive outcomes were collected, with a high proportion of hyperopia and astigmatism abnormalities, 38.4% and 28.6%, respectively, while the proportion of myopia was low(12.2%). There were 90 cases of anisometropia(≥1.00 D), among which 41 cases(45.6%)were astigmatic anisometropia, 33 cases(36.7%)were hyperopic anisometropia, and 16 cases(17.8%)were myopic anisometropia, accounting for the least proportion. A total of 109 infants and young children with Spot refractive abnormalities completed ciliary muscle paralysis retinal optometry. The analysis of the difference and correlation between Spot diopter and post ciliary muscle paralysis optometry results showed that the difference in astigmatism was 0.34±0.64 D(P<0.001), the difference in hyperopia was -2.10±1.27 D(P<0.001), and the difference in myopia was -0.43±0.91 D(P=0.023). Although there was a statistical difference between the two results, astigmatism, hyperopia, and myopia were highly positively correlated, respectively(r=0.694, 0.762, 0.909).

CONCLUSION: The main refractive abnormalities in infants and young children aged 6 to 48 months are astigmatism, hyperopia, and anisometropia, with fewer abnormalities in myopia. For screening abnormalities, further ciliary muscle paralysis agent retinoscopy and optometry should be performed, and glasses correction should be given to effectively prevent refractive amblyopia in infants and young children.