摘要
目的探讨近视患者双眼不等像症与屈光度、眼轴差异的关系,以及可能造成不等像症的因素。方法选取2021年5-8月在川北医学院附属医院眼科门诊进行验光检查的322例近视患者,年龄4~40岁,利用ARK-510A电脑验光仪、Dk-700全自动综合验光仪进行综合验光,光学生物测量仪进行眼轴长度的测量,双眼影像不等检查图进行不等像范围的检查,记录以下参数:性别、年龄、屈光度(球镜、柱镜、等效球镜度)、眼轴长度及双眼不等像范围。采用Spearman秩相关、卡方检验、多元线性回归等统计学方法分析不等像与屈光度及眼轴长度差异的关系,同时针对不等像症绘制屈光度及眼轴长度差值的ROC曲线。结果共纳入322例(男性159例、女性163例)近视患者,年龄(17.77±7.69)岁,其中不等像症的发生率为15.22%(49例)。单因素分析中,取所有近视患者参数差值的绝对值纳入分析,双眼球镜差值(r=0.449,P<0.001)、柱镜差值(r=0.596,P<0.001)、等效球镜差值(r=0.479,P<0.001)及眼轴长度差值(r=0.417,P<0.001)与不等像范围均呈正相关关系。多因素分析发现,柱镜与等效球镜差值对不等像范围的影响更大,回归方程为:Y=0.009-0.626X_(1)(柱镜差值)-0.22X_(2)(等效球镜差值)(F=159.17,P<0.001,调整后的R^(2)=0.496)。风险因素分析发现,当双眼球镜相差-2.00 D以上、柱镜及等效球镜相差-1.00 D以上时,可使不等像症的患病风险提高。诊断分析发现,柱镜差值(AUC=0.778,95%CI:0.69~0.87,P<0.001;敏感性=53.06%,特异性=99.63%)对不等像症诊断的参考价值最高。结论屈光参差不一定导致不等像症,柱镜及等效球镜差值是导致不等像症的关键因素,临床诊疗中需高度重视。
Objective To explore the relationship of aniseikonia with differences of diopter and axial length in myopia patients, and the possible factors causing aniseikonia. Methods A total of 322 myopia patients(4~40 years old) were selected from May to August, 2021, who underwent optometry in the Ophthalmology Outpatient Department of the Affiliated Hospital of North Sichuan Medical College. ARK-510 A autorefractor and Dk-700 optometry system were used for optometry. IOL-Master 700 was used for the measurement of axial length. Aniseikonia were evaluated by binocular aniseikonia test. Gender, age, diopter(sphericity, cylindricity and spherical equivalent), axial length and range of aniseikonia were recorded. Spearman test, chi-square test and multiple linear regression were used to analyze the aniseikonia with the differences of diopter and axial length. At the same time, receiver operating characteristic(ROC) curve of the differences of diopter and axial length was drawn for aniseikonia. Results A total of 322 patients(159 males and 163 females) were included, at an age of(17.77±7.69) years, and the overall prevalence rate of aniseikonia was 15.22%(49 cases). In univariate analysis, the absolute values of all parameter were included in the analysis, the differences of sphericity(r=0.449, P<0.001), cylindricity(r=0.596, P<0.001), spherical equivalent(r=0.479, P<0.001) and axial length(r=0.417, P<0.001) were all positively correlated with range of aniseikonia. Multivariate analysis indicated that the difference between cylindricity and spherical equivalent showed greater effect on the range of aniseikonia, and the regression equation was Y=0.009-0.626X;(cylindrical difference)-0.22 X;(spherical equivalent difference)(F=159.17, P<0.001, adjusted R^(2)=0.496). In the analysis of risk factors, when the difference of sphericity was more than-2.00 D, and that of cylindricity and spherical equivalent was more than-1.00 D, the risk of aniseikonia was increased. In the diagnostic analysis, the difference of cylindricity(AUC=0.778
作者
刘梦
代诚
李宾中
LIU Meng;DAI Cheng;LI Binzhong(School of Basic Medicine,North Sichuan Medical College,Nanchong,Sichuan Province,637000,China;Faculty of Optometry,North Sichuan Medical College,Nanchong,Sichuan Province,637000,China)
出处
《陆军军医大学学报》
CAS
CSCD
北大核心
2022年第10期1074-1078,F0003,共6页
Journal of Army Medical University
基金
南充市2020年市校科技战略合作专项(20SXQT0152)。
关键词
不等像
屈光参差
球镜
柱镜
等效球镜
aniseikonia
anisometropia
sphericity
cylindricity
spherical equivalent
