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目的探讨便携式电脑验光仪的准确性及用其筛查屈光不正的可行性。设计诊断试验。研究对象2008年6月至9月南通大学附属医院眼科就诊的屈光不正患者65例(130眼)。方法对所有病例分别行SHIN-NIPPON SRH-2000便携式电脑验光仪验光及视网膜检影。主要指标屈光值(球镜度数、柱镜度数及轴向)的差异性检验、相关分析及受试者工作特征(ROC)曲线分析。结果以视网膜检影为金标准,电脑验光的球镜度数轻度偏正,其中睫状肌麻痹后电脑验光与检影的差值为(+0.33±0.56)D,呈高度正相关(r=0.98,P<0.01),差异有统计学意义(t=6.87,P<0.01);电脑验光的柱镜度数轻度偏负,其中睫状肌麻痹后电脑验光与检影的差值为(-0.23±0.45)D,呈中度正相关(r=0.81,P<0.01),差异有统计学意义(t=-5.85,P<0.01)。电脑验光在睫状肌麻痹前后比较无统计学差异(球镜度数t=1.31,P=0.26;柱镜度数t=-0.28,P=0.78)。电脑验光对散光的检出率高,但主要是≤0.75D的低度散光,且与视网膜检影的轴向差值多数≤150。以视网膜检影的等效球镜为参考指标,电脑验光的ROC曲线下面积>0.95(睫状肌麻痹后为0.984,睫状肌麻痹前为0.979)。结论便携式电脑验光仪筛查屈光不正的准确性与视网膜检影一致,可用在群体眼病流行病学调查中筛查屈光不正。
Objective To investigate the accuracy of portable refractor and its feasibility of screening for refractive error. Design diagnostic test. Participants 65 patients (130 eyes) with refractive errors in ophthalmology department of Nantong University Affiliated Hospital from June to September in 2008. Methods All cases were performed SHIN-NIPPON SRH-2000 portable computer refractor optometry and retinoscopy. The main indexes of refraction (spherical power, cylinder power and axial) differences in the test, correlation analysis and receiver operating characteristics (ROC) curve analysis. Results The retinoscopy was the gold standard. The degree of spherical optometry was mildly positive. The difference between computer optometry and retinoscopy after cycloplegia was (+0.33 ± 0.56) D, which was highly positive (r = 0.98, P <0.01), the difference was statistically significant (t = 6.87, P <0.01); the degree of computerized retroreflectometry was mildly negative, and the difference between computerized optometry and retinoscopy after cycloplegia was (- 0.23 ± 0.45) D, there was a moderate positive correlation (r = 0.81, P <0.01), the difference was statistically significant (t = -5.85, P <0.01). Computer optometry in cycloplegia before and after no significant difference (spherical degree t = 1.31, P = 0.26; cylinder degree t = -0.28, P = 0.78). Computer optometry on the detection rate of astigmatism, but mainly ≤0.75D of low astigmatism, and axial retinal retinoscopy most of the difference ≤ 150. Using the equivalent spherical retinoscopy as a reference index, the area under the ROC curve of computerized optometry was> 0.95 (0.984 after cycloplegia and 0.979 before cycloplegia). Conclusions The accuracy of the portable computer refractometer screening for refractive errors is consistent with retinoscopy and can be used to screen for refractive errors in epidemiological investigations of group ophthalmology.