VX120多功能眼检查仪的客观验光与主观验光结果的一致性分析

目的比较使用VX120多功能眼检查仪检测的客观验光与主观验光结果的一致性。 方法收集2018年3月至2018年4月在首都医科大学附属北京同仁医院就诊拟行屈光矫正术的患者71例(142只眼)。采用CANON全自动验光仪和VX120多功能眼检查仪分别进行客观验光检查，包括球镜光度(S)、柱镜光度(C)、等效球镜光度(SE)、水平和垂直方向的柱镜光度(J0)及45°柱镜光度(J45)；再结合综合验光仪进行主观验光检查校正。采用Rosner-Glynn-Lee法对双眼检查数据进行校正，采用配对秩和检验对不同设备的测量值进行组间比较；对无统计学意义的数据再采用组内相关系数和Bland-Altman 95%一致性界限法衡量其一致性。 结果VX120多功能眼检查仪在明视模式和暗视模式下所测S的中位水平分别为-5.63(-7.25，-4.25)和-5.75 (-7.00, -4.25); VX120在明视模式和暗视模式所测C的中位水平分别为-0.75 (-1.50，-0.50)和-0.75 (-1.50，-0.50)；VX120在明视模式和暗视模式下所测SE的中位水平分别为-6.19(-8.09，-4.63)和-6.20 (-7.84，-4.53)；VX120在明视模式和暗视模式下所测J0的中位水平分别为-0.02(-0.22，0.21)和0.03(-0.15，0.30)；VX120在明视和暗视模式下所测J45的中位水平分别为0.04(-0.22，0.34)和0.04(-0.22，0.34)。主观验光所测S的中位数为-5.50(-7.00，-4.25)，C的中位数为-0.50 (-1.00，-0.25)，SE的中位数为-6.02 (-7.50, -4.50)，J0的中位数为0.00 (-0.21，0.10)，J45的中位数为0.00 (-0.21，0.10)。CANON全自动验光仪所测S的中位水平为-5.62 (-7.37，-4.50)，C的中位水平为-0.62 (-1.12，0.00)，J0的中位水平为0.00(-0.20，0.03)，J45的中位水平为0.00(-0.10, 0.08)。主观验光与VX120在明视模式下验光所测的J0和J45，差异无统计学意义(Z＝-0.11，1.64；P>0.05)。两者所测J0和J45的组内相关系数分别为0.92(95%CI＝0.88，0.96)和0.93(95%CI＝0.89，0.97)，一致性较好。Bland-Altman 95%一致性分析显示，数据点多分布在95%可信区间内，两者一致性较好。主观验光与VX120在暗视模式验光所测的S和J45，差异无统计学意义(Z＝1.71，-0.24；P>0.05)；两者所测的S和J45的组内相关系数分别为0.99(95%CI＝0.98, 1.00)和0.90 (95%CI＝0.86，0.94)，一致性较好。Bland-Altman 95%一致性分析显示，数据点多分布在95%可信区间内，两者一致性较好。 结论VX120多功能眼检查仪在暗视模式和明视模式下检测的客观验光结果与主观验光结果的差异在临床可接受范围内，且可为主观验光提供参考依据。

The consistency analysis of differences between subjective optometry and objective optometry results from VX120 multi-diagnostic unit

ObjectiveThe aim of this study was to compare the consistency of spherical diameter, column diameter by VX120 multi-diagnostic unit and subjective refraction. MethodsThe refractive surgery patients (71 cases of 142 eyes) from March 2018 to April 2018 in Beijing Tongren Hospital affiliated with Capital Medical University were collected, and analyzed differences between the results from VX120 multi-diagnostic scotopia mode and bright mode of objective optometry, and subjective optometry correction comprehensive refractometer, including spherical mirror photometry (S), column lenticular luminosity (C), equivalent spherical mirror luminosity (SE), column mirror luminosity with horizontal and vertical level (J0) and column mirror luminosity with 45°(J45). The refraction data were corrected by Rosner-Glynn-Lee method. The clustered signed rank test was used to compare the measurements of different devices. If there was not shown statistical difference, the consistency using intra-class correlation coefficient and the Bland-Altman 95% limits of agreement were performed. ResultsS measured by VX120 with clear vision and VX120 with dark vision were -5.63 (-7.25, -4.25) and -5.75 (-7.00, -4.25), respectively. C measured by VX120 with clear vision and VX120 with dark vision was -0.75 (-1.50, -0.50) and -0.75 (-1.50, -0.50), respectively. SE measured by VX120 with clear vision and VX120 with dark vision was -6.19 (-8.09, -4.63) and -6.20 (-7.84, -4.53), respectively. J0 measured by VX120 with clear vision and VX120 with dark vision was -0.02 (-0.22, 0.21) and 0.03 (-0.15, 0.30), respectively. J45 measured by VX120 clear vision and VX120 dark vision was 0.04 (-0.22, 0.34), 0.04 (-0.22, 0.34), respectively. S, C, SE, J0 and J45 measured by subjective optometry were -5.50 (-7.00, -4.25), -0.50 (-1.00, -0.25), -6.02 (-7.50, -4.50), 0.00 (-0.21, 0.10), and 0.00 (-0.21, 0.10), respectively. S, C, J0 and J45 measured by CANON were -5.62 (-7.37, -4.50), -0.62 (-1.12, 0.00), 0.00 (-0.20, 0.03) and 0.00 (-0.10, 0.08), respectively. There was no statistic difference between VX120 with clear vision and subjective optometry for J0 and J45 (Z=-0.11, 1.64; P>0.05). The interclass correlation coefficients with 95% confidence intervals of J0 and J45 was 0.92 (95%CI=0.88, 0.96) and 0.93 (95%CI=0.89, 0.97), respectively. In addition, Bland-Altman plots showed that data points were in the confidence intervals, indicating that parameters measured by subjective optometry and VX120 were in accord with each other. There was no statistic difference between VX120 with dark vision and subjective optometry for S and J45 (Z=1.71, -0.24; P>0.05). The interclass correlation coefficients with 95% confidence intervals of S and J45 was 0.99 (95%CI=0.98, 1.00) and 0.90 (95%CI=0.86, 0.94) respectively. What′s more, Bland-Altman plots showed that data points were in the confidence intervals, indicating that parameters measured by subjective optometry and VX120 with dark vision were in accord with each other. ConclusionThe difference between the optometry results from VX120 with dark vision and VX120 with bright vision mode and the subjective optometry was within the clinical acceptable range, which could provide an effective objective basis for the subjective optometry. There was no significant difference between VX120 and objective optometry, two devices could be considered clinically equivalent for refractive measurement.