目的：基于免散瞳眼底彩照，应用眼底定量分析AI系统自动识别并量化近视患者眼底特征改变，分析其与等效球镜(SE)、眼轴(AL)及年龄的相关性，为近视进展监测及个性化防控策略制定提供客观依据。

方法：采用横断面研究方法，纳入2023年3月至2023年12月18-50岁近视筛查患者，根据SE将患者分为三组：-3.00 D结果：本研究共纳入近视患者664例664眼(均选取右眼)，其中男320例，女344例，平均年龄22.70±6.77岁。根据SE将患者分为三组：-3.00 DP =0.219、0.221)。根据AL将患者分为三组：AL<24.5 mm组133例133眼(男58例，女75例，平均年龄22.04±6.40岁)，24.5 mm≤AL<26.5 mm组386例386眼(男181例，女205例，平均年龄22.95±6.93岁)，AL≥26.5 mm组145例145眼(男81例，女64例，平均年龄22.63±6.70岁)，不同AL组患者的性别、年龄比较均无差异(P=0.091、0.404)。SE≤-6.00 D组及AL≥26.5 mm组患者视盘直径、视杯直径、血管平均弯曲度及血管平均管径显著小于-3.00 DP<0.05/<0.017)； 偏相关性分析显示FTD、PPA与视盘面积比及PPA与视盘宽度比与AL呈正相关，与SE呈负相关(均P<0.001)； 年龄与FTD呈正相关，与血管平均管径呈负相关(均P<0.001)。

结论：SE及AL是驱动近视眼底结构改变的关键因素，主要影响视盘及视网膜血管改变。眼底定量分析AI系统联合免散瞳眼底照相技术可实现对近视相关眼底改变的客观量化评估，为大规模近视筛查及防控效果评估提供可靠技术支持。

METHODS:A cross-sectional study was conducted enrolling myopic patients aged 18-50 y who underwent myopia screening from March 2023 to December 2023. Patients were stratified into three groups based on SE: the -3.00 D RESULTS:A total of 664 patients(664 eyes, all right eyes)were enrolled in this study, consisting of 320 males and 344 females, with a mean age of 22.70±6.77 y. Patients were categorized into three groups based on SE: the -3.00 DP=0.219, 0.221, respectively). Regarding AL, patients were divided into three subgroups: the AL<24.5 mm group(133 patients, 133 eyes, 58 males, 75 females, mean age 22.04±6.40 y), the 24.5 mm≤AL<26.5 mm group(386 patients, 386 eyes, 181 males, 205 females, mean age 22.95±6.93 y), and the AL≥26.5 mm group(145 patients, 145 eyes, 81 males, 64 females, mean age 22.63±6.70 y), with no significant differences in gender or age observed among AL subgroups(P=0.091, 0.404, respectively). Optic disc diameter, cup diameter, mean vascular curvature, and mean vascular diameter in the SE≤-6.00 D and AL≥26.5 mm groups were significantly smaller than in the -3.00 DP<0.05/0.017). Partial correlation analyses demonstrated that FTD, PPA-to-optic disc area ratio, and PPA-to-optic disc width ratio were positively correlated with AL and negatively correlated with SE(all P<0.001). Age was positively correlated with FTD and negatively correlated with mean vascular diameter(all P<0.001).

CONCLUSION: Refractive error and AL are key determinants of myopia-related fundus structural changes, primarily affecting optic disc morphology and retinal vascular characteristics. The integration of non-mydriatic fundus photography with the AI-powered quantitative fundus analysis system enables objective quantification of myopia-related fundus alterations, providing reliable technical support for large-scale myopia screening and for evaluating the effectiveness of myopia prevention and control strategies.