摘要
目的评估国产手持式视力筛查仪筛查弱视的效果。方法对2011年3月至4月上海市静安区江宁街道7所托幼机构1 027名学龄前儿童,采用国产手持式视力筛查仪进行屈光检查。弱视与年龄、性别间的关系采用卡方检验进行分析,弱视与非弱视之间的屈光度比较采用t检验,屈光检查结果与弱视的关系通过受试者工作特征曲线进行分析,计算Kappa值,并在屈光参差及远视屈光度两项指标中取敏感度和特异度之和最大、且Kappa值大于0.4的点,作为cut-off值。结果 44名儿童被确诊为弱视。弱视的发病与年龄、性别的关联无统计学意义(χ2=0.62,2.12;P>0.05)。弱视儿童和非弱视儿童的屈光参差度数、球镜度数、散光度数等3项指标分别为(1.67±1.04)D、(2.97±2.31)D、(3.11±3.39)D和(0.38±0.30)D、(1.64±0.57)D、(0.75±0.46)D。二者差异均有统计学意义(t=23.01,11.88,18.86;P<0.05)。屈光检查筛查弱视的受试者工作特征曲线图显示屈光参差、球镜、散光3项指标的受试者工作特征曲线下面积分别为0.92、0.89、0.21。屈光参差和球镜的屈光度可以用作筛查弱视的指标。当屈光参差在0.88 D或远视屈光度在2.50 D作为弱视筛查的标准(cut-off值)。敏感性分别为77.3%、72.7%,特异性分别99%、98.8%,准确性分别为93.4%,93.3%。Kappa值均大于0.4。结论国产手持式视力筛查仪用于学龄前儿童弱视筛查的效果较好。
Objective To evaluate the value of a domestic hand-held vision screening device in the screening of amblyopia in preschool children.Methods A total of 1 027 preschool children from 7 childcare centers in Jiangning community,Jingan District,Shanghai were enrolled into this study.They were subjected to refractive amblyopia screening with HAR-800 handheld autorefractor used from Wuhan Min Kang Medical Equipment Co.,Ltd.Data on amblyopia in different age groups and two gender groups were analyzed with the chi-square test while data on refractive amblyopia and non-amblyopia were analyzed by t-test.The relationship between amblyopia and refractive outcome was analyzed by receiver operating characteristic,ROC.Amblyopia screening sensitivity specificity, and consistency index Kappa values were calculated.Results Amblyopia was detected in 44 children.Prevalence of amblyopia was different neither between age groups (χ2=0.62, P >0.05) nor between genders (χ2 =2.12,P >0.05).Anisometropia,spherical refractive error and astigmatism of amblyopia was (1.67±1.04)D, (2.97±2.31)D and (3.11±3.39)D.Anisometropia , spherical refractive error and astigmatism of non-amblyopia was (0.38 ±0.30) D,(1.64 ±0.57) D and (0.75±0.46)D.The difference was statistically significant (t=23.01,11.88,18.86;P <0.05).The area under ROCs of anisometropia, spherical refractive error and astigmatism was 0.92, 0.89, and 0.21 respectively .Anisometropia and spherical refractive error were associated with amblyopia.When anisometropia more than 0.88 D and spherical refractive error more than 2.50 D were used as criteria of amblyopia, the screening sensitivity was 77.3% and 72.7% respectively,the screening specificity was 99% and 98.8%respectively,the screening accuracy was 93.4% and 93.3% respectively,and the Kappa value was larger than 0.4.Conclusion The domestic handheld autorefractor HAR-800 may offer a novel useful tool to screen amblyopia in preschool children.
出处
《中华眼科医学杂志（电子版）》
2014年第2期26-29,共4页
Chinese Journal of Ophthalmologic Medicine(Electronic Edition)
基金
上海市卫生局青年科研基金(2008161)
上海市静安区十百千学科带头人基金项目(2010020103)
关键词
手持式视力筛查仪
学龄前儿童
弱视
HAR-800 hand-held autorefractor
Preschool children
Amblyopia
