CAJ | 학술논문

目的探讨睫状肌麻痹对双眼开放视野自动验光仪与传统电脑验光仪的测量结果差异的影响.方法连续收集北京同仁医院就诊的304位中小学生.对受试者分别在睫状肌麻痹前后进行传统电脑验光仪(Accuref-K9001,以下简称K9001验光仪)与双眼开放视野自动验光仪(WAM-5500,以下简称WAM验光仪)的客观验光.求得球镜、等效球镜(SE)与散光轴的符合率(定义为:度数相差≤0.50 D,轴向相差≤20°);根据两种验光仪SE的平均值与差值绘制Bland-Altman图并进行分布情况分析.结果睫状肌麻痹前,两种验光仪球镜、SE与散光轴的符合率分别为77.3％、78.6％与66.0％;睫状肌麻痹后相应的符合率增至为94.4％、95.1％与69.5％.睫状肌麻痹前两种验光仪SE的平均差值为0.12D,且与SE的平均值(睫状肌麻痹后)存在正相关关系(r(pearson)=0.21,P＜0.001);睫状肌麻痹后SE的平均差值为-0.08 D.K9001验光仪睫状肌麻痹前后自身SE差值较WAM验光仪大(0.51 D与0.31 D,P＜0.001).睫状肌麻痹前两种验光仪SE差值的分布情况为:WAM较K9001偏负0.25 D以上(1组)的共51例(16.8％),差异在0.25 D以内(2组)的共160例(52.6％),WAM较K9001偏正0.25 D以上(3组)的共93例(30.6％).睫状肌麻痹后,1组共69例(22.7％),2组增至213例(70.1％),3组减少至22例(7.2％).结论双眼开放视野自动验光仪较传统电脑验光仪测量值偏正.开放视野验光仪能在一定程度上减少仪器性近视,在临床筛查与科研领域将具有更广阔的应用前景.
목적 탐토첩상기마비대쌍안개방시야자동험광의여전통전뇌험광의적측량결과차이적영향.방법 련속수집북경동인의원취진적304위중소학생.대수시자분별재첩상기마비전후진행전통전뇌험광의(Accuref-K9001,이하간칭K9001험광의)여쌍안개방시야자동험광의(WAM-5500,이하간칭WAM험광의)적객관험광.구득구경、등효구경(SE)여산광축적부합솔(정의위:도수상차≤0.50 D,축향상차≤20°);근거량충험광의SE적평균치여차치회제Bland-Altman도병진행분포정황분석.결과 첩상기마비전,량충험광의구경、SE여산광축적부합솔분별위77.3％、78.6％여66.0％;첩상기마비후상응적부합솔증지위94.4％、95.1％여69.5％.첩상기마비전량충험광의SE적평균차치위0.12D,차여SE적평균치(첩상기마비후)존재정상관관계(r(pearson)=0.21,P＜0.001);첩상기마비후SE적평균차치위-0.08 D.K9001험광의첩상기마비전후자신SE차치교WAM험광의대(0.51 D여0.31 D,P＜0.001).첩상기마비전량충험광의SE차치적분포정황위:WAM교K9001편부0.25 D이상(1조)적공51례(16.8％),차이재0.25 D이내(2조)적공160례(52.6％),WAM교K9001편정0.25 D이상(3조)적공93례(30.6％).첩상기마비후,1조공69례(22.7％),2조증지213례(70.1％),3조감소지22례(7.2％).결론 쌍안개방시야자동험광의교전통전뇌험광의측량치편정.개방시야험광의능재일정정도상감소의기성근시,재림상사사여과연영역장구유경엄활적응용전경.
Objective To compare the refractive results between open-field auto ref/keratometer and conventional autorefractor,and to investigate the effect of cycloplegic to this difference. Methods Three hundred and four primary and secondary school students were consecutively enrolled in Beijing Tongren Hospital.Non-cycloplegic and cycloplegic objective refractions were performed for each subject by conventional autorefractor (Accuref-K9001,S(h)in Nippon,Japan) and binocular,open-field auto ref/keratometer (Grand Seiko Co.,Ltd.,Hiroshima,Japan ).The coincidence rate of sphere,spherical equivalent (SE) and axis (defined as difference of diopter ≤0.50 D,difference of axis degree ≤20°) were calculated ; Bland-Altman and distribution analysis were performed according to mean and difference of SE.Results The coincidence rate of sphere,SE and axis were 77.3％,78.6％ and 66.0％ before cycloplegic and increased to 94.4％,95.1％ and 69.5％ after cycloplegic,respectively.The difference (95％ CI) of SE before cycloplegic between these two refractometers was 0.12 (-1.04 to 1.29 ) D and was positively correlated with the mean of SE (after cycloplegic) (rpearson =0.21,P ＜ 0.001 ).The difference (95％ CI) of SE after cycloplegic was-0.08 (-0.60 to 0.45) D.The difference (95％ CI) of SE of K9001 autorefractor before and after cycloplegic was larger than that of WAM autorefractor [ 0.51 (-0.83-1.84) D and 0.31 (-0.66 to 1.28) D,P＜0.001]. Before cycloplegic,SE measured by WAM autorefractor showed myopic more than 0.25 D than K9001 ( group 1 ) was found in 51 ( 16.8％ ) subjects; difference within 0.25 D was found in 160 ( 52.6％ ) subjects; hyperopic more than 0.25 D ( group 3) was found in 93 ( 30.6％ ) subjects.After cycloplegic,69 ( 22.7％ ) subjects were found in group 1,and subjects increased to 213 ( 70.1％ ) and decreased to 22 (7.2％) in group 2 and group 3,respectively.Conclusion The binocular, open-field auto ref/keratometer provides more hyperopic readings than conventional autorefractor.It will be useful in both clinical screening and scientific research because it produces less instrument myopia than that of conventional autorefractor.