成人眼屈光状态与眼球径线的相关性探讨

目的 探讨成人眼屈光状态与眼球前后径(antero-posterior axis,APA)、水平径(horizontal diameter,HD)的相关性.方法 228例398眼屈光检测,以等效球镜计分为近视组:屈光度小于0 D者179眼;正视组:屈光度0～ 0.75 D者152眼;远视组:屈光度大于 0.75 D者67眼.采用CT活体测量的方法.测量APA、HD.统计分析屈光与眼球径的相关性.结果 近视组屈光等效球镜值为-0.25～-31.00D,APA为22.20～32.80 mm,平均(27.00±2.13)mm;HD为21.70～30.10 mm,平均(25.58±1.34)mm.屈光变化(Y)与APA变化(X1)、HD的变化(X2)均呈负相关(r值分别为-0.752 5、-0.276 6,F值分别为231.092 5、14.657 5,P值均<0.001.Y=52.245 2-2.188 7X.、Y=25.9587-1.282 3 X2).远视组屈光等效球镜值为 1.00～ 8.00 D.APA为20.40～27.4. Mm.平均(24.07±1.34)mm.HD为20.20～28.80mm,平均(24.83±1.53)mm.屈光变化(Y)与APA的变化(X3)呈负相关(r值为-0.359 3,F值为9.636 5,P<0.01,Y=5.618 5-3.799 3X3),与HD比值无相关性(r值为-0.237 5,F值为3.8853,P>0.05).结论 人眼近视眼屈光与APA、HD均呈负相关;远视眼屈光与眼球APA呈负相关,而与HD不相关.     

Association between ocular dominance and refraction

PURPOSE: To investigate the association between ocular dominance and refraction. METHODS: A retrospective study of the cycloplegic refraction of 2453 consecutive patients with a mean age of 46 +/- 12 years (range: 18 to 79 years) was performed. One thousand one hundred fifty-seven (47%) patients were men and 1296 (53%) were women. Patients who had previous eye surgery, ocular disease, or > 2 lines of best spectacle-corrected visual acuity (BSCVA) difference between eyes were excluded. Motor ocular dominance was determined using the hole-in-the-card test. RESULTS: The right and left eyes were dominant in 67% (1650) and 33% (803) of patients, respectively. Males had a higher right eye dominance (70%) than females (65%) (P = .0168) with a mean cycloplegic spherical equivalent refracton (SE) of -2.12 diopters (D) and -2.38 D, respectively. This higher rate of right eye dominance in males was seen at all levels of SE refractive error. Mean BSCVA was 20/19 in both right and left eyes (P>.05) with a mean SE of -2.25 +/- 3.63 D and -2.26 +/- 3.66 D in the right and left eyes, respectively. Neither mean SE difference nor BSCVA difference between eyes was found to correlate with motor eye dominance. CONCLUSIONS: Gender appears to be a factor when testing ocular dominance but not SE refractive error. The hole-in-the-card dominance test is a method that is easy to perform for both patients and clinicians.     

Post-operatory biometry and refraction results estimated and refraction surprises--clinical study

Preoperative biometry has a major influence on the success or failure of IOL implantation procedures. The paper wishes to demonstrate the significance of this manoeuvre for the refraction and visual outcome and for the postoperative satisfaction rate of the patients. The clinical study has rulled out for one year period and a number of 239 patients suffered a IOL implantation procedure (cataract or lens extraction for refractive purposes). The preoperative biometry was always necessary. We used one of the existing IOL power calculation formula (SRK II, SRK T, Holladay). The surgeon decided about the IOL power, always after discussing with the patient their postoperative refractive expectations. The postoperative refraction was, in the majority of cases, the estimated refraction and the errors were similar with those from the literature. Refractive surprises of several diopters were registered in high myopic and hyperopic eyes or in cases of coexisting ocular diseases which have modified the anatomical parameters of the eye. In conclusion, small errors in calculation can have large effects on visual outcome. This problem will be solved in the future, because the field is evolving rapidly driven by a new understanding of the anatomy of the eye and new hardware for measuring that anatomy.     

Association between stature, ocular biometry and refraction in an adult population in rural Myanmar: the Meiktila eye study

Purpose: To study the association between adult stature and ocular biometric parameters and refraction. Methods: In a population‐based cross‐sectional ophthalmic survey of 2418 adults (≥40 years old) living in the rural villages in central Myanmar, height and weight were measured using a standardized protocol, and body mass index was calculated. Non‐cycloplegic refraction and corneal curvature were determined by an autorefractor. Ultrasound pachymetry was performed and ocular biometry, including axial length, anterior chamber depth, lens thickness and vitreous chamber length were measured using A‐mode ocular ultrasonography. Results: Height and weight were significantly correlated with age, gender and all the ocular biometric parameters, except lens thickness. After adjusting for age and gender, taller and heavier persons had eyes with longer axial length, deeper anterior and vitreous chambers, and flatter and thicker corneas than shorter persons. Height was not significantly correlated with refraction, and heavier persons tended to be less myopic (P < 0.001). Multivariate linear regression models revealed consistent results with the findings for association between height, weight and ocular biometry and refractive error. Conclusions: Adult stature is independently associated with vitreous chamber length and corneal radius in this Burmese population. Heavier persons were slightly hyperopic.     

Ocular biometry and refraction in Mongolian adults

OBJECTIVE: To describe the variation in ocular biometry and its association with refraction in adult Mongolians. METHODS: The study included 1800 subjects, aged 40 years or more, who were selected in two Mongolian provinces-H?vsg?l and Omn?gobi-to participate in this population survey. Axial length (AL) and its components, as well as noncycloplegic autorefraction and corneal power (CP), were measured. RESULTS: Of those selected, 1617 subjects (90.0%) were examined. Mean +/- SD of AL was 23.13 +/- 1.15 mm. There was a very small but significant increase in mean AL with age (0.05 mm per decade, P = 0.03). Autorefraction was performed on 620 of 675 subjects of those examined in Omn?gobi. The age and gender standardized prevalences of myopia (< -0.5 D), emmetropia, hyperopia (> +0.5 D), astigmatism (< -0.5 D of cylinder) and anisometropia (>1.0 D difference between eyes) were 17.2%, 49.9%, 32.9%, 40.9%, and 10.7%, respectively. Prevalence of myopia showed no clear trend with increasing age, whereas hyperopia, astigmatism, and anisometropia all increased monotonically. Multiple regression models revealed that AL (P < 0.001) and VCD (P < 0.001) were the strongest determinants of refractive error. CONCLUSIONS: In this cross-sectional study of adult Mongolians, a much lower prevalence of myopia was found than in other East Asian populations studied to date. The mean AL differed little between age groups, in marked contrast to data on Chinese people.     

Macular pigment and ocular biometry

This study is designed to investigate the relationship between macular pigment optical density (MPOD) and ocular biometric parameters. The following details were recorded for 180 healthy subjects: demographic profile; best-corrected visual acuity; refractive status; ocular biometric parameters [axial length (AL), anterior chamber depth (ACD), lens thickness (LT) and vitreous chamber depth (VCD)]; ocular dominance; MPOD; serum lutein (L) and zeaxanthin (Z). The mean MPOD (+/-SD) was 0.307 (0.155) and 0.305 (0.149) in the right and left eyes, respectively. No demonstrable relationship was observed between MPOD and AL, ACD or VCD [AL: r=0.091, p=0.225; ACD: r=0.091, p=0.227; VCD: r=0.146, p=0.051]. There was a significant and inverse relationship between LT and MPOD (r=-0.204; p=0.008), which was attenuated to non-significance after correction for age and height (r=-0.058; p=0.466). This study fails to identify an association between MPOD and ocular biometric parameters. This is an important negative finding, which allows investigators to study MP, and its relationship with potentially important variables, without the need to correct for ocular biometric parameters.     

Correlation of vitreous chamber depth with ocular biometry in high axial myopia

Purpose:The proportion of axial length (AL) occupied by vitreous chamber depth (VCD), or VCD:AL, consistently correlates to ocular biometry in the general population. Relation of VCD:AL to ocular biometry in high myopia is not known. The purpose of this study is to evaluate the relation of VCD and VCD:AL to ocular biometry of highly myopic eyes.Methods:This was a cross-sectional retrospective study of records of 214 myopic eyes (<−1 D SE, aged 20–40 years) attending the refractive surgery services. High axial myopia was defined as AL >26.5 mm. Eyes with posterior staphyloma and myopic maculopathy were excluded. Records were assessed for measurements of AL, central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), white to white diameter (WTW), and vitreous chamber depth (VCD). Groups were formed based on increasing AL, while the sum of CCT, ACD, and LT was recorded as anterior segment depth (AS). The main outcome measure was the correlation of VCD and VCD:AL to ocular biometry. A comparison was also performed based on of degree of axial myopia.Results:Mean age of the patients was 27.0 ± 5.2 years. VCD showed a very strong correlation with AL (R = 0.98, P < 0.001) but did not correlate to any anterior parameter. VCD:AL showed moderate negative relation with AS (R = −0.43, P < 0.001) and ACD (R = −0.3, P < 0.001), while it had a weakly negative relation with LT (R = −0.18, P = 0.006). VCD:AL showed strong negative relation (R > ~0.7) with AS in all individual groups of AL. Among anterior parameters, WTW showed the most consistent relation with ocular biometry.Conclusion:VCD:AL is a better correlate of ocular biometry in high myopia as compared to VCD. However, the correlation is weaker than that noted by previous studies done on the general population. Longitudinal studies of VCD:AL in the younger age group is recommended.     

Lenstar在眼球生物学测量中的应用

准确的眼球生物学测量是人工晶状体(IOL)及各类屈光手术研究的关键.Lenstar作为一种新型的眼球生物学测量仪,其非接触性测量方式、简便的操作、较多的测量指标及高精确性等特点使其逐渐应用于临床及科研中.本文就Lenstar的测量原理、特点,Lenstar测量眼轴长度、前房深度、角膜曲率、中央角膜厚度、晶状体厚度、玻璃体腔深度、视网膜厚度、脉络膜厚度、虹膜水平直径、瞳孔直径、视轴偏斜角度,以及用于IOL度数计算的相关研究及应用等作一综述.     

Ethnic differences in refraction and ocular biometry in a population-based sample of 11-15-year-old Australian children

PURPOSE: To examine the prevalence of refractive error and distribution of ocular biometric parameters among major ethnic groups in a population-based sample of 11-15-year-old Australian children. METHODS: The Sydney Myopia Study examined 2353 students (75.3% response) from a random cluster-sample of 21 secondary schools across Sydney. Examinations included cycloplegic autorefraction, and measures of corneal radius of curvature, anterior chamber depth, and axial length. RESULTS: Participants mean age was 12.7 years (range 11.1-14.4); 49.4% were female. Overall, 60.0% of children had European Caucasian ethnicity, 15.0% East Asian, 7.1% Middle Eastern, and 5.5% South Asian. The most frequent refractive error was mild hyperopia (59.4%, 95% confidence interval (CI), 53.2-65.6), defined as spherical equivalent (SE) +0.50 to +1.99 D. Myopia (SE-0.50 D or less) was found in 11.9%, 95% (CI 6.6-17.2), and moderate hyperopia (SE> or =+2.00 D) in 3.5%, 95% (CI 2.8-4.1). Myopia prevalence was lower among European Caucasian children (4.6%, 95% CI 3.1-6.1) and Middle Eastern children (6.1%, 95% CI 1.3-11.0) than among East Asian (39.5%, 95%, CI 25.6-53.5) and South Asian (31.5%, 95%, CI 21.6-41.4) children. European Caucasian children had the most hyperopic mean SE (+0.82 D) and shortest mean axial length (23.23 mm). East Asian children had the most myopic mean SE (-0.69 D) and greatest mean axial length (23.86 mm). CONCLUSION: The overall myopia prevalence in this sample was lower than in recent similar-aged European Caucasian population samples. East Asian children in our sample had both a higher prevalence of myopia and longer mean axial length.     

学龄前儿童眼部生物学参数及其与屈光状态的相关性研究

目的 研究3～6岁学龄前儿童眼部生物学参数与屈光状态及其之间的关系.方法 前瞻性临床研究.对2010年3～11月在徐州市眼病防治所应用为回顾性系列病例分析.在睫状肌麻痹状态下为103名3～6岁学龄前儿童进行检影验光,记录等效球镜度.运用ZEISS光学相干断层扫描仪(OCT)测量视网膜黄斑厚度,IOL-Master测量眼轴长度、角膜屈光力.黄斑区视网膜厚度记录以黄斑中心凹为圆心,记录1 mm,3 mm,6 mm直径范围的中央、内环和外环的厚度,对数据进行统计学分析.结果 89名(86.40％)儿童完成了相关的检查.学龄前儿童的平均等效球镜度为(+1.33±1.01)D,眼轴长度为(21.98±0.71) mm,黄斑中央视网膜厚度为(189.01±25.49) μm,黄斑区各区域视网膜厚度不等,角膜屈光力为(43.52±1.56)D.不同年龄组等效球镜不同(F =3.23,P＜0.05),随着年龄的增长等效球镜度逐渐下降.等效球镜度与眼轴长度呈负相关'(r=-0.46,P＜0.01),与黄斑中央视网膜厚度(r=0.02,P＞0.05)、角膜屈光力(r=0.08,P＞0.05)差异无统计学意义.结论 3～6岁学龄前儿童等效球镜呈峰形分布.等效球镜度与年龄、眼轴长度有关,随着眼轴的延长、年龄的增加,远视等效球镜度逐渐下降.     

Comparison of ocular biometry and refractive outcome between ANTERION and IOL Master 700

Purpose:To assess the comparability of ocular biometry measurements and refractive outcomes between ANTERION and IOL Master 700.Methods:This comparative prospective study was conducted from December 2020 to February 2021. A total of 225 patients who had cataracts were enrolled for the study and different parameters such as anterior keratometry (Steep K, Flat K) with axis, Sim K, central corneal thickness (CCT), aqueous depth (AQD), lens thickness (LT), and axial length (AL), white-to-white (WTW) were evaluated in IOL master 700 first and then with ANTERION. Finally, 203 patients completed the 6-week follow-up and the postoperative refraction was done at the 6^th week. To assess the agreement between the devices, intraclass coefficient (ICC) and Bland–Altman analysis with 95% limits of agreement (LoA) were used. To analyze the agreement for postoperative residual refractive error between the two devices, Kappa statistics were used.Results:The mean difference for steep K, flat K, and Sim K between ANTERION and IOL Master 700 were − 0.18 +/−0.26 D, −0.13+/− 0.28D, −0.15 +/−0.23, respectively. The CCT, ACD, and LT also showed excellent agreement (ICC > 0.9) but the similarity for the keratometry axis was not up to the mark (ICC = 0.794). For postoperative refractive outcomes, the Kappa value was 0.437, indicating moderate agreement.Conclusion:ANTERION showed a good agreement for the majority of parameters with IOLMaster 700 in measuring ocular biometry, except for the keratometry. The accuracy of the intraocular lens power calculations was clinically acceptable with both biometers though the IOL power given by ANTERION remained slightly on the hypermetropic side.     

Steady-state accommodation and ocular biometry in late-onset myopia

The steady-state accommodative responses of emmetropes and late-onset myopes was measured for an array of numbers located at +1, +3 and +5 dioptres using an objective infra-red optometer. Responses were compared for passive (reading numbers) and active (adding numbers) conditions. For the passive condition, the late-onset myopes showed a significantly lower accommodative response than the emmetropic group. No significant differences were found between the two groups for the active condition. Ocular biometric characteristics were also measured in emmetropes, late-onset myopes and early-onset myopes using keratometry and ultrasonography. No significant differences in corneal curvature, anterior chamber depth and crystalline lens thickness were found between the groups. Late-onset myopes exhibited significantly deeper vitreous chambers than emmetropes, which more than accounted for the difference in refractive error between the two refractive groups. We conclude that, while significant differences exist in the accommodative responses of late-onset myopes and emmetropes, late-onset myopia is due predominantly to elongation of the vitreous chamber.