摘要
目的采用人工智能技术对儿童近视早期眼底的微量变化进行定性、定量分析,结合相关眼生物参数,探索近视发展的内在规律,为儿童近视防控工作中的早期发现、及时监测、适时调整提供敏感指标。方法横断面研究。对3907例18岁以下门诊顺序就诊儿童的眼底及相关生物参数进行采集,并按年龄分为6组,眼轴分为8组。分别采用SW‐9000眼科光学生物测量仪、SW‐8800眼底照相机,OSE‐2800眼科光学相干断层扫描仪和EVisionAI依未眼底智能分析云平台。依据SHI’标准中国眼健康档案及诊断体系,每一位患者每次就诊均按设计流程进行11项+眼生物参数进行完整的数据采集。近视早期眼底指标依次有垂直杯/盘(C/D)比、豹纹状改变和弧形斑。采用SPSS 19.0(SPSS Inc,Chicago,IL,USA)进行统计,包括χ2分析、ANOVA方差分析和多元逐步线性回归分析。结果3907例18岁以下儿童中,男生55.8%,女生44.2%;右眼和左眼分别50%。就诊高峰为6~11岁(64%)。眼轴23.5~25.5 mm占总人数的53.5%。眼轴25.5 mm以上各组占16.9%。垂直C/D比0.4~0.5占77%(χ2检验,P=0.000);眼轴24.5 mm以下各组呈现1级或无豹纹状改变,弧形斑多为生理改变;眼轴24.5~25.5 mm组呈现4级豹纹状改变;眼轴24.5 mm以上各组主要表现为3级弧形斑,26.5 mm以上眼轴为4级弧形斑(P组间=0.000,P总=0.000,P相关性<0.002)。结论24.5 mm眼轴可作为学龄儿童近视防控的监测关键拐点,豹纹状改变0.1、弧形斑1 PD视为诊断指标,豹纹状改变0.04~0.09、弧形斑2/3 PD视为病理性改变前期或高危期诊断指标。
Objective To use artificial intelligence(AI)technology to make qualitative and quantitative analysis of the trace changes of the fundus in the early stage of myopia in children and to provide sensitive criteria for the early de‐tection.Methods It was a cross-sectional study.The fundus and related biological parameters were collected and divided into 6 groups according to age.The ocular axial lengths were divided into 8 groups.According to the SHI'standard Chinese eye health archives and diagnostic system,11 items+eye biological parameters were collected for each patient per visit ac‐cording to the designed process.SPSS 19.0(SPSS Inc,Chicago,IL,USA)was used for statistical analysis,including x2 analysis,analysis of variance(ANOVA)and multiple stepwise linear regression analysis.Results Among 3907 children under 18 years of age,55.8%were male and 44.2%were female.Right and left eyes were 50%,respectively.The peak pe‐riod of consultation was between 6~11 years old(64%).The axial length between 23.5~25.5 mm was 53.5%,over 25.5 mm was 16.9%.The vertical C/D ratio was 0.4 to 0.5(77%,P<0.05).Tessellation changes less than 0.01 were found in 66.4%,and no crescent changes in 47.68%.The axial length below 24.5 mm showed 0.01 or no tessellation changes and in‐creased by more than 0.1 in the 24.5~25.5 mm group.The 2/3 PD cresent was found over 24.5 mm and the 1 PD was over 26.5 mm(P<0.05).Conclusions The 24.5 mm axis of the eye can be used as a key inflection point for monitoring myo‐pia progression in school-age children.The expansion of the posterior segment of the eye and the early pathological changes begin to appear and aggravate,like tessellation and cresent,especially when the axis of the eye is more than 26.5 mm,the pathological myopia diagnosed.Therefore,tessellation 0.1 and cresent 1 PD are considered as diagnostic criteria.While tessellation 0.04~0.09 and cresent 2/3 PD are considered as the early stage or high-risk stage of pathological changes.
作者
石一宁
方严
陈卓
王妮
左浩
Shi Yining;Fang Yan;Chen Zuo;Wang Ni;Zuo Hao(Shanxi Provin-cial People’s Hospital,Xian 710000,China;Department of Ophthalmology,the First Affiliated Hospital of Anhui University of Science and Technology,Huainan 232007,China;School of Pharmacy,Xi'an Medical College,Xian 710000,China;Xian Xincheng Shiyining Eye Clinic,Xian 710000,China)
出处
《临床眼科杂志》
2024年第2期97-101,共5页
Journal of Clinical Ophthalmology
关键词
儿童近视
初发近视
眼轴
眼生物参数
人工智能
Children myopia
Onset myopia
Axial length
Ocular parameters
Artificial intelligent
