摘要
目的分析儿童青少年常见快速视力筛查方法的准确性,探讨视力筛查的最佳方案。方法选取2021年云南省3个市/县各2所小学2~4年级学生进行标准对数视力表远视力筛查、非睫状肌麻痹下使用电脑验光仪验光,对裸眼视力<5.0或电脑验光等效球镜(SE)≤-0.50D且未佩戴眼镜无眼病的168名(336只眼)小学生进行散瞳获得散瞳后屈光度,作为屈光度金标准,比较散瞳前和散瞳后的电脑验光屈光度。依据远视力检查和电脑验光仪验光结果,按照以下4种方案分析比较近视患病率、灵敏度、特异度及约登指数。4种方案分别是:单独满足裸眼视力<5.0即为近视和电脑验光仪验光等效球镜(SE)≤-0.50D即为近视的2个方案,及同时满足2个条件及满足2个条件之一的2个方案。结果与散瞳前比较,散瞳后屈光度右眼从(-1.34±1.15)下降到(-0.85±1.06)、左眼从(-1.12±1.15)下降到(-0.61±1.29),差异均有统计学意义(t=5.91、7.89,均P<0.05)。睫状肌麻痹后出现大量的假性近视,右眼电脑验光后近视146只眼,假性近视29只眼,混合性近视32只眼,左眼假性近视性率为19.86%,混合性近视率为21.92%;左眼睫状肌麻痹电脑验光后近视135只眼,假性近视31只眼,混合近视21只眼,左眼假性近视率为22.96%,混合性近视率为15.56%。金标准即睫状肌麻痹后的电脑验光,近视221只眼,近视率为65.8%,方案一、方案二、方案三及方案四近视率分别为91.1%(306只眼)、83.0%(279只眼)、80.1%(269只眼)及94.6%(318只眼),其中方案三最接近于金标准,方案四中近视率最高。4种方案与金标准比较,差异均有统计学意义(χ^(2)=51.12、111.65、132.95及25.24,均P<0.05)。4种方法的灵敏度均较高,均高于98.0%;4种方法的特异度均较低。方案三的阳性预测值和阴性预测值分别为80.7%和94.0%,与金标准比较,约登指数在4种方案中最高,即方案三准确性最高。结论目前未散瞳的快速筛查方法对
Objective To analyze the accuracy of common rapid vision screening methods for children and adolescents,and explore the best vision screening program.Methods In 2021,students from grade 2 to grade 4 of two primary schools in three cities/counties in Yunnan Province were selected for standard logarithmic visual acuity screening,and computer optometry was used for optometry without cili-ary muscle paralysis.168 pupils(336 eyes)with naked eye vision<5.0 or computer optometry equivalent spherical lens(SE)≤-0.50D and no eye disease without glasses were dilated to obtain post-mydriasis diopter,which was used as the gold standard of diopter.The comput-er optometry diopter before and after mydriasis was compared.The prevalence,sensitivity,specificity and Yoden index of myopia were ana-lyzed and compared according to the results of far-vision examination and computer optometry.The four schemes are respectively:two schemes that meet the naked eye vision<5.O,namely myopia,and two schemes that meet the two conditions and one of the two conditions simultaneously.Results Compared with that before mydriasis,the diopter of the right eye decreased from(-1.34±1.15)to(-0.85±1.06)after mydriasis,and that of the left eye decreased from(-1.12±1.15)to(-0.61±1.29).The difference was statistically signifi-cant(t=5.91,7.89,all P<0.05).A large number of pseudomyopia appeared after cycloplegia.146 eyes were pseudomyopia after com-puter optometry in the right eye,29 eyes were pseudomyopia,32 eyes were mixed myopia,the rate of pseudomyopia in the left eye was 19.86%,and the rate of mixed myopia was 21.92%;After computer optometry,135 eyes were myopia,31 eyes were pseudomyopia,and 21 eyes were mixed myopia.The rate of pseudomyopia in the left eye was 22.96%,and the rate of mixed myopia was 15.56%.The golden standard refers to computer optometry after cycloplegia.221 eyes are nearsighted,with a myopia rate of 65.8%.The myopia rates of scheme 1,scheme 2,scheme 3 and scheme 4 are 91.1%(306 eyes),83.0%(279 eyes),80.1%(269 eyes)and 94.6%(318
作者
马子雪
常利涛
谢雪妮
张金娇
黄达峰
李茜茜
肖洁
罗筱
黄莹
MA Zi-xue;CHANG Li-tao;XIE Xue-ni;ZHANG Jin-jiao;HUANG Da-feng;LI XI-xi;XIAO jie;LUO Xiao;HUANG Ying(School of Public Health,Kunming Medical University,Kunming,Yunnan 650500,China)
出处
《中国妇幼保健》
CAS
2023年第12期2172-2176,共5页
Maternal and Child Health Care of China
基金
国家自然科学基金项目(81960593)。
关键词
视力筛查
散瞳
金标准
假性近视
Vision screening
Mydriasis
Gold standard
Pseudomyopia
