小瞳验光在4~6岁视力低常儿童近视眼筛查中的应用

目的 分析上海市长宁区学龄前儿童散瞳前、后屈光度的差异, 研究在非睫状肌麻痹状态下进行大规模儿童近视眼筛查的可行性。方法 整群抽取35所区属公立幼儿园4~6岁儿童进行视力、屈光筛查, 视力低常患儿行散瞳验光, 比较各年龄组散瞳前、后屈光状态, 建立散瞳前、后等效球镜的线性回归方程, 并探讨在非睫状肌麻痹状态下近视眼筛查的最佳阳性界值。结果 各年龄组儿童散瞳前、后等效球镜差异具有统计学意义, 且存在线性相关。在非睫状肌麻痹状态下, 4岁儿童近视眼筛查的最佳阳性界值为等效球镜<-1.00D, 5~6岁儿童为等效球镜<-0.75D。结论 小瞳验光对于大规模儿童近视眼的初步筛查是有效可行的。

Use of noncycloplegic autorefraction for myopia screening in 4~6-year-old children with poor eyesight.

Objective To analyze the difference between the spherical equivalent (SE) before and after cycloplegia in preschool children and explore the effectiveness and feasibility of noncycloplegic autorefraction (NCAR) for large-scale myopia screening in children. Methods A cluster sampling method was used to select children aged 4 to 6 from 35 kindergartens in Changning district.The visual acuity (VA) and noncycloplegic autorefraction were measured in every child and cycloplegia autorefraction was measured in children with poor eyesight.Statistical analysis and linear regression analysis were conducted.The best positive cutoff points and their corresponding sensitivities and specificities for NCAR were also explored. Results SE was more positive after cycloplegia with statistical significance than that before cycloplegia, the linear correlation was proved between the SE before and after cycloplegia.When using NCAR to estimate myopia, the best positive cutoff point was SE less than -1.00D in children aged 4 years old and SE less than -0.75D in children aged 5~6 years old, respectively. Conclusion NCAR is an effective and feasible method for large-scale myopia screening in preschool children.