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中国3至6岁学龄前儿童眼轴显著增长伴随较小屈光变化:深圳幼儿园眼科研究

Guo, X., Fu, M., Ding, X., Morgan, I.G., Zeng, Y., He, M.

期刊名称:Ophthalmology

卷期:2017年第124卷第12期

关键词:
小屈 眼科 深圳

摘要

摘要:目的:旨在记录一组中国学龄前儿童眼生物测量学分布,评估其与屈光状态的关系。设计:基于人口的横断面研究。研究对象:共有来自8所代表性幼儿园的113336岁的学龄前儿童。方法:睫状肌麻痹前采用部分相干激光干涉仪(IOL Master,德国OberkochenCarl Zeiss Meditec公司)获得包括眼轴长度(AL),前房深度(ACD)和角膜曲率半径(CR)。计算晶体度数(LP)和AL-CR率。使用自动矫正器(KR8800;日本东京拓普康公司(Topcon Corp.TokyoJapan))测量睫状肌麻痹屈光度(31%环戊酯),并计算等效球镜(SER)。评估生物特征和屈光参数,如年龄和性别。主要观察指标:眼部生物测量分布及其与屈光度的关系。结果:1127名成功散瞳验光的儿童(99.5%)平均SER1.37±0.63屈光度(d)。近视患病率从3岁时的0%上升到6岁时的3.7%(95%可信区间,1.0-6.5%)。生物统计学参数遵循高斯分布,AL22.39±0.68mmCR7.79±0.25mmLP24.61±1.42D;和非高斯分布,ACD3.34±0.24mmAL-to-CR比值为2.88±0.06 ACDAL-CR比从3岁增加到6岁,CR维持稳定,而LP下降。总的来说,SER略有下降。对于SER方差, AL分别为18.6%和AL-CR比例为39.8%,而校正年龄和性别后ALCRLP80.0%。结论:中国青少年以轻度远视为主, 6岁以下近视率低。 AL增加1mm仅与0.45D的近视变化有关。 LP下降减少了通常与AL增加相关的近视变化,并在这个年龄组屈光发展中发挥关键作用。

PURPOSE:To document the distribution of ocular biometry and to evaluate its associations with refraction in a group of Chinese preschoolers.DESIGN:Population-based cross-sectional study.PARTICIPANTS:A total of 1133 preschoolers 3 to 6 years of age from 8 representative kindergartens.METHODS:Biometric measurements including axial length (AL), anterior chamber depth (ACD), and corneal radius of curvature (CR) were obtained from partial-coherence laser interferometry (IOL Master; Carl Zeiss Meditec, Oberkochen, Germany) before cycloplegia. Lens power (LP) and AL-to-CR ratio were calculated. Cycloplegic refraction (3 drops of 1% cyclopentolate) was measured using an autorefractor (KR8800; Topcon Corp., Tokyo, Japan), and spherical equivalent refraction (SER) was calculated. Biometric and refractive parameters were assessed as a function of age and gender. Multiple regression analysis was performed to explore the associations between refraction and ocular biometry.MAIN OUTCOME MEASURES:Ocular biometric distributions and their relationships to refraction.RESULTS:Among the 1127 children (99.5%) with successful cycloplegic refraction, mean SER was 1.37±0.63 diopters (D). Prevalence of myopia increased from 0% at 3 years of age to 3.7% (95% confidence interval, 1.0%-6.5%) at 6 years of age. Biometric parameters followed Gaussian distributions with means of 22.39±0.68 mm for AL, 7.79±0.25 mm for CR, and 24.61±1.42 D for calculated LP; and non-Gaussian distributions with means of 3.34±0.24 mm for ACD and 2.88±0.06 for AL-to-CR ratio. Axial length, ACD, and AL-to-CR ratio increased from 3 to 6 years of age, CR remained stable, whereas LP declined. Overall, SER declined slightly. For the SER variance, AL explained 18.6% and AL-to-CR ratio explained 39.8%, whereas AL, CR, and LP accounted for 80.0% after adjusting for age and gender.CONCLUSIONS:Young Chinese children are predominantly mildly hyperopic, with a low prevalence of myopia by the age of 6 years. An increase of 1 mm in AL was associated with only 0.45 D of myopic change. Decreases in LP reduce the myopic shifts that normally would be associated with increases in AL, and thus play a key role in refractive development in this age group.


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