人眼调节功能客观检查技术的初步应用与评估

目的 探讨人眼调节功能客观检查技术的初步应用,评估并分析这种新技术检查结果对于临床诊断的价值.方法 多种人眼调节功能检查的比较研究.检查仪器为日本Nidek公司ARK-730(内置软件AA-1).检查对象为26例疑有调节异常可能的门诊患者,男性20例,女性6例,年龄(21±6)岁,用Kappa一致性检验比较仪器自动诊断结果和临床印象以及最终的综合印象之间的一致性.结果 仪器自动诊断、临床印象、综合印象的调节异常检出率分别为61.5%、46.2%、61.5%,仪器自动诊断结果与临床印象之间的一致性程度弱(κ=0.244,P=0.191);仪器自动诊断结果与综合印象之间的一致性程度为中度(κ=0.513,P=0.009);临床印象与综合印象之间的一致性程度为高度(κ=0.698,P=0.000).结论 调节功能的客观检查技术相对于以前的主观检查技术是一种补充和进步.对于传统方法不能确定的部分可疑患者,通过此项检查可以进一步提高诊断的准确度.目前仪器的自动诊断程序有进一步优化的空间,客观检查结合临床资料的综合判定更具有实用价值.

Primary application and evaluation of a technology for objective measurement of accommodation of human eyes

Objective To evaluate the practical value of a new technology for objective measurement of accommodation of human eyes. Methods It was a comparative study of some techniques for measuring the accommodation of human eyes. Twenty-six outpatients (20 male, 6 female, 10-37 years old) that were suspected to be abnormal in accommodation were examined with Nidek ARK-730 ( with software AA-1 inside). The measurement results from the instrument were compared by Kappa test with the clinical impression and comprehensive impression based on measurement results and clinical information. Results The abnormality rate of accommodation of the patients were 61.5% ,46. 2% ,61.5% from the instrument, clinical impression and comprehensive impression respectively. The agreement was weak with Kappa value 0. 244 between results from the instrument and clinical impression. The agreement was mild with Kappa value 0. 513 between results from the instrument and comprehensive impression. The agreement was high with Kappa value 0. 698 between results from clinical impression and comprehensive impression. Conclusions The new technology is a progress and complementary to the traditional technology for accommodation examination. With the help of the new technology, some complicated patients could be diagnosed. The diagnose procedure of the instrument remains to be improved. The comprehensive impression based on measurement results and clinical information has more practical value.