便携式电脑验光仪筛查屈光不正的可行性探讨

目的 探讨便携式电脑验光仪的准确性及用其筛查屈光不正的可行性.设计诊断试验.研究对象2008年6月至9月南通大学附属医院眼科就诊的屈光不正患者65例（130眼）.方法 对所有病例分别行SHIN-NIPPON SRH-2000便携式电脑验光仪验光及视网膜检影.主要指标屈光值（球镜度数、柱镜度数及轴向）的差异性检验、相关分析及受试者工作特征（ROC）曲线分析.结果 以视网膜检影为金标准,电脑验光的球镜度数轻度偏正,其中睫状肌麻痹后电脑验光与检影的差值为（＋0.33±0.56）D,呈高度正相关（r=0.98,P〈0.01）,差异有统计学意义（t=6.87,P〈0.01） 电脑验光的柱镜度数轻度偏负,其中睫状肌麻痹后电脑验光与检影的差值为（-0.23±0.45）D,呈中度正相关（r=0.81,P〈0.01）,差异有统计学意义（t=-5.85,P〈0.01）.电脑验光在睫状肌麻痹前后比较无统计学差异（球镜度数t=1.31,P=0.26 柱镜度数t=-0.28,P=0.78）.电脑验光对散光的检出率高,但主要是≤0.75D的低度散光,且与视网膜检影的轴向差值多数≤150.以视网膜检影的等效球镜为参考指标,电脑验光的ROC曲线下面积〉0.95（睫状肌麻痹后为0.984,睫状肌麻痹前为0.979）.结论 便携式电脑验光仪筛查屈光不正的准确性与视网膜检影一致,可用在群体眼病流行病学调查中筛查屈光不正.

The feasibility and practicability of portable auto-refractometer in screening for refractive error

Objective To investigate the accuracy of portable auto-refractometer and its feasibility and practieabifity in screening for refractive error. Design Diagnosis test. Participants 65 patients （130 eyes） with refractive error at Department of Ophthalmology, the Affiliated Hospital of Nantong University from June to September, 2008. Methods All participants were measured with SHIN-NIPPON SRH-2000 pollable auto-refrartometer and cycloplegic retinoscopy. Main Outcome Measures Diopter, difference test, correlation analysis, receiver operating characteristic （ROC） curve. Results Compared with eycloplegic retinoscopy, the degree of spherical power measured using auto-refraetometer showed slightly positive. The variation of auto-refraction with cycloplegia was （＋0.33±0.56） D, indicating a high correlation （r=0.98, P〈0.01） and the difference showed significantly （t=6.87, P〈0.01）. The degree of cylindrical power measured using auto-refractometer showed slightly negative. The variation of auto-refraction with cycloplegia was （-0.23±0.45） D, indicating significant difference （t=-5.85, P〈0.01） and there was a moderate correction （r=0.81, P〈0.01）. There was no difference in the degree of spherical power and cylindrical power measured by auto-refraction before and after cycloplegia （t=1.31, P=0.26; t=-0.28, P=0.78）. It showed that portable auto-refraction was inclined to discover the astigmatism, mostly with low astigmatism （≤0.75D） and the deviation of cylinder axis from retinoscopy was mostly lower than 150. Based on the spherical equivalent refraction of retinoscopy, the areas under ROC curve of auto-refraction with and without cycloplegia were 0.984 and 0.979, respectively. Conclusion SHIN-NIPPON SRH-2000 portable auto-refractometer indicates comparatively high accuracy. With the feature of simply operating and easyly carring, it has good feasibility in refraction screening.