3～12岁儿童静态屈光度的估算模型

目的：构建3～12岁儿童静态屈光度与主要屈光参数间的回归模型。方法：横断面研究。研究分两部分：①建立回归模型：随机选取2014年7月至2016年6月于长沙爱尔眼科医院进行屈光检查的245例 儿童,测量其眼轴长度（AL）、角膜曲率（Km）及前房深度（ACD）,行睫状肌麻痹检影验光并计算晶 状体屈光力（LP）。分析静态屈光度（SE）与屈光参数的相关性并建立回归模型。②验证回归模型：另 随机选取2016年7-12月于长沙爱尔眼科医院进行屈光检查的43例儿童,测量上述屈光参数,行睫 状肌麻痹检影验光（SE实测）,计算LP和静态屈光度（SE估算）,通过Bland-Altman分析比较SE实测与SE估算 的一致性。结果：①建立回归模型：SE与AL、Km及LP的相关系数分别是-0.95、-0.83和-0.62 （均P<0.001）;其回归模型为SE=110.56-2.51×AL-0.97×Km-0.44×LP（R2 =0.95,F=2534.52, P<0.001）。②验证回归模型：SE实测与SE估算存在明显相关性（r=0.97,P<0.001）,95%一致性界限范围 为-1.00～0.63 D,平均误差为-0.19 D（95%可信区间：-0.28～-0.10 D）,81.40%的点落在临床可接 受范围内（-0.55～0.55 D）。结论：AL是屈光度的最主要影响因素,其次是角膜曲率和晶状体屈光力; 屈光度回归模型可较准确估算3～12岁儿童的静态屈光度。

Establishment of Main Refractive Parametric Regression Models in Schoolchildren Aged 3 to 12 Years

Objective: To establish a correlation model between static refraction and the main refractive parameters of children aged 3-12 years. Methods: This cross sectional study was divided into two parts. In part one, in Changsha Aier Eye Hospital from July 2014 to June 2016, 245 children were randomly selected and measurements were taken of their axial length (AL), corneal curvature (Km) and anterior chamber depth, spherical equivalent refractive (SE) and calculated lens power (LP). The correlations between refraction and the refractive parameters were analyzed to establisha correlative mathematical model.In part two, in Changsha Aier Eye Hospital from July to December 2016, 43 children were randomly selected to measure the above refractive parameters and their cycloplegic refraction (SEmeasured). The lens power and static refraction (SEcalculated) were calculated. The consistency between SEmeasured and SEcalculated was compared by Bland-Altman analysis. Results: The correlation model was established as follows: The correlation coefficients between SE and AL, Km and LP were -0.95, -0.83 and -0.62, respectively (all P<0.001). SE=110.56-2.51×AL-0.97×Km-0.44×LP (R2 =0.95, F=2534.52, P<0.001). There was a significant correlation between SEmeasured and SEcalculated (r=0.97, P<0.001), the 95% limit of agreement was -1.00-0.63 D, average error was -0.19 D (95% consistency limit: -0.28 to -0.10 D), and 81.40% of the data points were within the clinically acceptable range (-0.55 to 0.55 D). Conclusions: The axial length is the most important factor in refraction besides corneal curvature and lens power. The refraction correlation model can accurately estimate the static refraction of children from 3 to 12 years old.