兰州市5～12岁学龄儿童屈光状态与屈光参数相关性研究

目的:了解兰州市城关区5～12岁学龄儿童屈光状态分布的流行病学现状,分析眼轴长度(axial length,AL)、水平、垂直角膜曲率(K1,K2)、前房深度(anterior chamber depth,ACD)及角膜直径(corneal diameter,W-W值)各屈光参数与屈光状态之间的关系。方法:通过光学相干生物测量仪(IOL-Master,Zeiss)获得学龄儿童813人1626眼的AL,K1,K2,ACD,W-W值,年龄:5～12(平均8.46±2.30)岁,经电脑验光(Topcon)后所有眼根据等效球镜度数(SE)被分为高度近视、中度近视、低度近视、正视及远视5组,采用SPSS 19.0统计学软件分析不同年龄、不同屈光度组之间各生物学参数的相关关系。结果:(1)5～12岁不同年龄组:裸眼视力(uncorrected visual acuity,UCVA)具有明显差异性(P<0.05),屈光状态具有明显差异性(P<0.05),近视比率随着年龄不断上升;(2)不同年龄组之间:AL和ACD随着年龄不断增大,各组之间均有统计学意义(P<0.05);不同屈光度组之间:AL在高度、中度及低度近视组间均有统计学意义(P<0.05),ACD在低度与中度近视组及低度与高度近视组之间有统计学意义(P<0.05),K1,K2,W-W值在低度与高度近视组及中度与高度近视组之间有统计学意义(P<0.05);(3)屈光度与AL呈负相关(r=-0.764,P<0.01),屈光度与ACD呈负相关(r=-0.498,P<0.01),屈光度与K1,K2及AL相关性较小。结论:兰州市城关区5～12岁学龄儿童屈光发育中,AL的增加对屈光度的改变有着最主要的作用,轴性近视在5～12岁学龄儿童群体占主要的成分,同时,K1,K2,ACD,WW值对屈光度的改变也有影响。7～8岁可以认为是学龄儿童从正视化向近视化发展的主要阶段。

Correlation between diopters and refractive parameters among 5 to 12 years old school-age children of Lanzhou city

AIM: To investigate the epidemiological status of refractive state among school-age children of 5 to 12 years in Chengguan district of Lanzhou city, and to analyze the correlation with axial length(AL), horizontal and vertical corneal refractive power(K1, K2), anterior chamber depth(ACD)and corneal diameter(W-W).

METHODS: The value of AL, K1, K2, ACD and W-W of 813 school-age children(1626 eyes)aged 8.46±2.30 years old(5-12 years)were measured by IOL-Master, refractive error was measured by computer refractor. The eyes were divided into 5 groups according to different mean spherical equivalent(SE)diopter: high myopia, moderate myopia, low myopia, emmetropia and hyperopia. The correlation between diopter and different refractive parameters of different ages and different diopter groups were analyzed respectively, the SPSS 19.0 was used for the statistical analysis.

RESULTS: There were statistically significant difference(P<0.05)in uncorrected visual acuity and refractive state among the different groups of 5-12 years school-age children, the prevalence of myopia tended to increase with the age. There were statistically significant difference in AL and ACD among the different age groups(P<0.05), AL and ACD increased with the age. There were statistically significant difference in AL among three myopic groups(P<0.05). There were statistically significant difference in ACD between low myopia and moderate myopia, low myopia and high myopia(P<0.05). There were statistically significant difference in corneal refractive power and corneal diameter between low myopia and high myopia, moderate myopia and high myopia(P<0.05). SE was negatively correlated with AL(r=-0.764, P<0.01)and ACD(r=-0.498, P<0.01), but had week correlation with corneal refractive power or corneal diameter.

CONCLUSION: The increase of AL plays an important role in the changes of refractive among school-age children of 5-12 years, AL is the main morphological variable related to myopia. Meanwhile, refractive changes may be affected by corneal refractive power(K1, K2), ACD and corneal diameter(W-W). 7-8 years old can be regarded as the main phase from emmetropization to myopization of school-age children.