眼轴长度与角膜曲率半径比值在儿童青少年近视评估中的效能

Efficiency of the ratio of axial length to corneal curvature radius in the evaluation of myopia in children and adolescents

摘要:

目的：评估眼轴长度与角膜曲率半径比值(AL/CR)在儿童青少年近视诊断中的价值。

方法：收集2022-01/2023-12在北海市第二人民医院视光门诊初次就诊的儿童青少年2 182例4 364眼的屈光度及眼生物学参数，并进行分析。

结果：受试者工作特征曲线(ROC曲线)分析显示，AL/CR诊断近视具有更高的曲线下面积(AUC=0.925，95%CI为0.917-0.933)，且AL/CR=3.053时，Youden指数最大，随着AL/CR界值变小，近视诊断的灵敏度呈升高趋势，特异度则有所下降。与筛查性近视相比，AL/CR=3.053诊断近视的灵敏度偏低，但特异度较高，尤其在远视和近视前期者中表现更明显。

结论：AL/CR对于近视诊断的准确性优于眼轴长度及平均角膜曲率，且具有更高的特异度； 随着AL/CR界值变小，其诊断近视的灵敏度增加，但特异度下降。在远视和近视前期者中，AL/CR对于近视诊断的特异度高于筛查性近视。

Abstract:

AIM: To evaluate the value of the ratio of axial length to corneal radius of curvature(AL/CR)in the diagnosis of myopia in children and adolescents.

METHODS: The refraction and ocular biometric parameters of 2 182 cases of children and adolescents(4 364 eyes)who initially visited the optometry clinic of the Second People's Hospital of Beihai from January 2022 to December 2023 were collected and analyzed.

RESULTS: The receiver operating characteristic curve(ROC curve)showed that AL/CR had a higher area under the curve(AUC=0.925, 95%CI: 0.917-0.933)in diagnosing myopia. When AL/CR was 3.053, the Youden index was the largest. As the threshold of AL/CR decreased, the sensitivity of myopia diagnosis increased, while the specificity decreased. Compared with screening myopia, the sensitivity of AL/CR=3.053 in diagnosing myopia was low, but the specificity was high, especially in the cases of hyperopia and pre-myopia.

CONCLUSION: The accuracy of AL/CR in diagnosing myopia is superior to that of axial length and average corneal curvature, with higher specificity. As the threshold of AL/CR decreases, the sensitivity of diagnosing myopia increases, but the specificity decreases. In cases of hyperopia and pre-myopia, the specificity of AL/CR in diagnosing myopia is higher than that of screening myopia.