摘要
目的 探讨Spot在学龄前儿童屈光筛查中的可配合性、屈光数值的准确性及在屈光性弱视危险因素筛查中的筛查效率。方法 前瞻性研究。144例1-5岁儿童先后进行Spot及眼科检查，Spot数值与睫状肌麻痹后视网膜检影结果进行配对t检验。数据的相关性采用Pearson相关分析，以2013年美国斜视与小儿眼科协会（AAPOS）规定的视觉筛查转诊指南作为金标准来评估Spot在屈光性弱视危险因素筛查中的敏感性、特异性、阳性预测值及阴性预测值。结果 入组144例儿童中96.5%的儿童[平均年龄（3.0±1.2）岁]能配合Spot检查，打印出的报告全部有屈光、眼位结果及评估建议，与睫状肌麻痹后检影比较，Spot表现为低估远视或高估近视（-1.32 D），高估散光（＋0.39 D）。Pearson相关系数表示Spot球镜度、柱镜度与睫状肌麻痹检影值均高度相关（r=0.884、0.728，P〈0.01）。Spot在屈光性弱视危险因素筛查中敏感性为90.9%，特异性为82.1%，阳性预测值为48.8%，阴性预测值为98%。结论 大多数学龄前儿童可配合Spot的检查，Spot可同时评估双眼的屈光状态，与检影结果有较高的一致性，同时在屈光性弱视危险因素的筛查中具有一定的临床应用价值。
Objective To evaluate the Spot vision screener for its testability and reliability of refractive data and its effectiveness in detecting refractive amblyopia risk factors in preschoolers. Methods This was a prospective study. One hundred forty-four children （mean age 3.0±1.2 years） were tested with Spot prior to an examination by a pediatric ophthalmologist. Agreement between screenings and cycloplegic refraction measurements were assessed using a t-test and a Pearson correlation for analysis. Sensitivity, specificity, positive predictive value, and negative predictive value for detection of refractive amblyopia risk factors were determined using the 2013 AAPOS vision screening committee referral guidelines. Results The Spot vision screener produced a computer printout result for 96.5% of the children, and provided refractive and eye position estimates in all computer printouts. Compared with cycloplegic retinoscopy, the device underestimated hyperopia or overestimated myopia （-1.32 D） and overestimated astigmatism（＋0.39 D）. The Pearson correlation coefficient for sphere and cylinder measures indicated good agreement between Spot and cycloplegic retinoscopy. Spot sensitivity was 90.9%, specificity was 82.1%, the positive predictive value was 48.8%, and the negative predictive value was 98% in detecting refractive amblyopia risk factors. Conclusion The Spot vision screener provides clinical data on a greater percentage of preschool children. The device is able to provide binocular refraction estimates and refractions with Spot agree more closely with cycloplegic refraction measurements. Spot is considered a useful device for screening refractive amblyopia risk factors.
出处
《中华眼视光学与视觉科学杂志》
CAS
CSCD
2016年第8期469-472,共4页
Chinese Journal Of Optometry Ophthalmology And Visual Science
关键词
儿童
学龄前
弱视
危险因素
屈光不正
筛查
Child, pre
Amblyopia
Risk factor
Refractive error
Screening
