摘要
目的探讨手持电脑验光仪在自然状态下和散瞳情况下屈光测量结果与散瞳视网膜检影结果的一致性。评价其在儿童屈光筛查工作中的应用价值。方法对124例2～17岁儿童共248只眼分别进行自然状态下和散瞳后NIDEKAR-20手持电脑验光仪验光，同时行散瞳后视网膜检影验光。结果（1）散瞳后NIDEK验光结果与视网膜检影结果的Pearson相关分析显示，两者球镜值之间、柱镜值之间均高度相关（r=0．989，0．934，P〈0．001），差异均有统计学意义（P〈0．001）。其中，球镜差值绝对值≤0．50D的占80．2％，≤1．00D的累计94．8％，柱镜差值绝对值≤0．50D的占76．2％，≤1．00D的累计95；6％；（2）自然状态下NIDEK电脑验光结果与散瞳视网膜检影结果的球镜值之间、柱镜值之间均高度相关（r=0．904，0．926，P〈0．001），差异均有统计学意义（P〈0．001）。球镜差值绝对值≤0．50D的占30．7％，≤1．00D的累计53．2％，柱镜差值绝对值≤0．50D的占77．0％，≤1．00D的累计95．6％。其中，低度近视、正视及远视者两值差异较中-高度近视者大。进一步按年龄分组分析，学龄前儿童自然状态下电脑验光球镜值与散瞳视网膜检影结果差异最大，两组学龄儿童的球镜值与散瞳视网膜检影结果差异相对较小。结论散瞳情况下，NIDEK手持电脑验光结果与散瞳视网膜检影结果一致性好；自然状态屈光筛查，学龄儿童球镜度≥±1．50D、柱镜度≥±1．00D，建议进一步散瞳验光确定屈光不正程度，对于学龄前儿童，则建议散瞳后再进行屈光筛查。NIDEK手持电脑验光仪具有操作容易、携带方便等优点，与人工检影结果有较高一致性，在儿童屈光筛查工作中具有一定的临床应用价值。
Objective To explore the agreement of the hand-held automated refractometer （NIDEK AR-20） and retinoscopy in examining refraction, to evaluate the value of clinical application of hand-held automated refractometer in refraction screening in children. Methods Firstly, 248 eyes of 124 children （2 to 17 years old） were examined using hand-held refractometer under both mesopic situation with natural pupil size and under pupil dilated situation. Secondly, retinoscopy was performed respectively under pupil dilated situation. Results 1.Both the spherical diopter and the cylinder diopter obtained by hand-held refractometer and retinoscopy under pupil dilated situation presented good correlations （r =0.989, 0.934, P 〈0.001）. Significant differences of both the spherical diopter and the cylinder diopter were found between the two methods （P 〈0.001）. 80.2% of the differences of spherical diopter between the two methods were within 0.50D, while accumulated 94.8% were within 1.00D. 76.2% of the differences of cylinder diopter between the two methods were within 0.50D, while accumulated 95.6% were within 1.00D. 2.Both the spherical diopter and the cylinder diopter obtained by hand-held refractometer and retinoscopy under natural pupil situation presentedgood correlations （r =0.904, 0.926, P 〈0.001）. Significant differences of both the spherical diopter and the cylinder diopter were found between the two methods （P 〈0.001）. 30.7% of the differences of spherical diopter between the two methods were within 0.50D, while accumulated 53.2% were within 1.00D. 77.0% of the differences of cylinder diopter between the two methods were within 0.50D, while accumulated 95.6% were within 1.00D. The differences in middle-high hypermetropia subjects were larger than in myopia, stigrnatism and low hypermetropia subjects. Further analysis were conducted by age group, the refraction of pre-school students obtained by hand-held refractometer and retinoscopy under pupil dilated situation hold the biggest difference; the differences between refractometer and retinoscopy in two school-age children was relatively small. Conclusions There is a good agreement between hand-held automated refractometer and retinoscopy under dilated pupil situation;it is suggested to re-examine the status of refractive error of school-age children under dilated pupil situation when the spherical diopter ≥±1.50D or the cylinder diopter ≥±1.00D obtained under natural situation with hand-held automated refractometer. As to the preschool children, it is critical to perform refraction screening （using hand-held automated refractometer） under dilated pupil. Because of its easy manipulation, portable design and good agreement with retinoscopy, the hand-held automated refractometer （NIDEK AR-20） is considered a useful instrument in the refraction screening in children.
出处
《中国实用眼科杂志》
CSCD
北大核心
2012年第11期1348-1352,共5页
Chinese Journal of Practical Ophthalmology
关键词
手持电脑验光仪
视网膜检影
屈光
筛查
儿童
Hand-held automated refractometer
Retinoscopy
Refraction
Screening
Children
