CAJ | 학술논문

目的调查滕州市农村小学生的视力、立体视锐度及弱视和斜视的患病情况,并对Titmus立体视图检查法、视力检查法、Titmus立体视图联合视力检查法三种弱视筛选试验进行评价.方法应用随机整群抽样调查方法,共抽取滕州市8所农村小学,共有小学生2742人,年龄5～14岁,平均(9.3±2.3)岁.进行Titmus立体视图、裸眼视力、眼位及眼球运动检查,对任一眼裸眼视力<1.0者进行视网膜检影验光.结果 (1)小学生视力低常率为13.83%,从7岁至13岁视力低常率呈逐渐上升趋势;视力低常的首位原因为屈光不正,弱视,其中近视占79.67%(486眼/610眼);(2)弱视患病率为1.50%.97.5%(39/40)的弱视患儿为首次被筛查出来;斜视患病率为1.72%;(3)非弱视/斜视儿童的立体视锐度5岁年龄组为60″,6岁年龄组为50″,7岁及以上年龄组均为40″;弱视患者中立体视锐度异常者占77.5%(31140),斜视患者中立体视锐度异常者占28.3%(13/46);(4)Titmus立体视图联合视力检查法筛选弱视的特异度(99.47%)及粗一致性(99.06%)最高,误诊率(0.53%)最低;其次为Titmus立体视图检查法(特异度为97.98%;粗一致性为97.59%;误诊率为2.02%);视力检查法的特异度(87.47%)及粗一致性(87.66%)最低,误诊率(12.53%)最高.结论滕州市农村小学生视力低下的首位原因为近视;弱视和斜视是影响立体视觉发育的主要因素;Titmus立体视图联合视力检查法可提高学龄儿童弱视筛选的效率.
목적 조사등주시농촌소학생적시력、입체시예도급약시화사시적환병정황,병대Titmus입체시도검사법、시력검사법、Titmus입체시도연합시력검사법삼충약시사선시험진행평개.방법 응용수궤정군추양조사방법,공추취등주시8소농촌소학,공유소학생2742인,년령5～14세,평균(9.3±2.3)세.진행Titmus입체시도、라안시력、안위급안구운동검사,대임일안라안시력<1.0자진행시망막검영험광.결과 (1)소학생시력저상솔위13.83%,종7세지13세시력저상솔정축점상승추세;시력저상적수위원인위굴광불정,약시,기중근시점79.67%(486안/610안);(2)약시환병솔위1.50%.97.5%(39/40)적약시환인위수차피사사출래;사시환병솔위1.72%;(3)비약시/사시인동적입체시예도5세년령조위60″,6세년령조위50″,7세급이상년령조균위40″;약시환자중입체시예도이상자점77.5%(31140),사시환자중입체시예도이상자점28.3%(13/46);(4)Titmus입체시도연합시력검사법사선약시적특이도(99.47%)급조일치성(99.06%)최고,오진솔(0.53%)최저;기차위Titmus입체시도검사법(특이도위97.98%;조일치성위97.59%;오진솔위2.02%);시력검사법적특이도(87.47%)급조일치성(87.66%)최저,오진솔(12.53%)최고.결론 등주시농촌소학생시력저하적수위원인위근시;약시화사시시영향입체시각발육적주요인소;Titmus입체시도연합시력검사법가제고학령인동약시사선적효솔.
Objective To investigate the visual acuity, stereoacuity and the prevalence of amblyopia and strabismus ofprimazy school children in rural areas in Tengzhou, Shandong as well as to evaluate the effi-ciency of three methods in screening amblyopia. Methods In this population-based study, children aged 5 to 14 years old in primary school were randomly selected by a cluster sampling in which school shift was the sam- piing unit. Titmus stereo-test, visual acuity (VA), cover-test and ocular motility evaluation were examined for each child. Retinoscopy was performed for children with VA < 1.0 in either eye. Results ( 1 ) Of 2668 effec-tive examinatious,369 eases (13.83%) were poor eyesight. (2) The prevalence ofamblyopia and strabismus were 1.50% and 1.72% respectively. Out of 40 amblyopia children, 39 were screened at the first time. (3) The stereoacuity in normal children was 40″, 31 (77.5%) children with amblyopia showed abnormal stereoacuity,while 28.3% for strabismus. (4) Specificity and crude agreement of combined Titmus with VA were 99.47%and 99.06% ,which were highest in the three methods. The second was Titmus stereo-test with 97.98% and 97.59%, VA was the lowest. Conelusion The most important cause of poor eyesight in primary school chil-dren is myopia. Amblyopia and strabismus might have significantly effects on stereoacuity. The most efficient method of screening amblyopia was stereo-test combined with visual acuity.