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目的探讨学龄儿童眼球生物参数变化与近视发展特点。设计回顾性队列研究。研究对象6~7岁学龄儿童167例(167眼)。方法 167例儿童3年2次(2011年、2014年)行眼球生物参数与屈光度检查。根据检查结果(取右眼数据),分为非近视组(2011年与2014年检查均未确定为近视),新增近视组(2011年检查未近视,2014年检查确定近视),近视组(2011年与2014年检查均确定为近视)。采用配对样本t检验比较各组参数变化,组间比较采用方差分析。主要指标等效球镜(SE)、眼轴长度(AL)、角膜曲率半径(CR)、中央角膜厚度(CCT)、前房深度(ACD)、晶状体厚度(LT)、轴率比(AL/CR)等。结果非近视组105眼2011到2014年SE、CR变化差异无统计学意义(t=0.86、-1.75,P=0.36、0.084),AL、CCT、ACD、LT、AL/CR变化差异有统计学意义(t=-19.84、-2.28、-13.94、9.81、-8.18,P=0.000、0.025、0.000、0.000、0.000)。新增近视组45眼2011到2014年CR变化差异无统计学意义(t=-1.68,P=0.099),SE、AL、CCT、ACD、LT、AL/CR变化差异有统计学意义(t=13.09、-15.54、3.37、-15.30、11.16、-61.90,P=0.000、0.000、0.002、0.000、0.000)。近视组17眼2011到2014年CR变化差异无统计学意义(t=-0.35,P=0.733),SE、AL、CCT、ACD、LT、AL/CR变化差异有统计学意义(t=4.30、-10.70、-2.43、-3.746、4.439、-7.95,P=0.01、0.000、0.027、0.002、0.000、0.000)。3组间2011年SE、AL、ACD、LT、AL/CR比较差异均有统计学意义(F=46.14、8.89、9.29、4.47、11.76,P=0.000、0.000、0.000、0.013、0.000),非近视组与新增近视组两两比较LT有显著差异;2014年SE、AL、ACD、LT、AL/CR组间比较差异均有统计学意义(F=134.85、24.77、11.17、6.63、41.08,P=0.000、0.000、0.000、0.002、0.000)。结论三年随访观察显示,此年龄段儿童眼球生物参数变化显示SE降低、AL增长、CCT变厚、ACD加深、LT变薄、AL/CR增大等特点,而CR无明显变化。LT可能是近视发生的预警信号之一。
Objective To investigate the changes of eyeball biological parameters and the development of myopia in school-age children. Design retrospective cohort study. The study included 167 school-aged children aged 6-7 years (167 eyes). Methods One hundred and sixty-seven children underwent biopsy and refraction examination twice a year (2011 and 2014). According to the examination results (taking the right eye data), the patients were divided into non-myopia group (2011 and 2014 were not identified as myopia), new myopia group (non-myopia in 2011, myopia in 2014), myopia 2011 and 2014 were identified as myopia examination). Paired sample t-test was used to compare the changes of parameters in each group, the analysis of variance was used to compare between groups. The main indexes were spherical equivalent (SE), axial length (AL), corneal curvature radius (CR), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT) CR) and so on. Results There was no significant difference in the changes of SE and CR between 105 eyes of non-myopia group from 2011 to 2014 (t = 0.86, -1.75, P = 0.36,0.084). The differences of AL, CCT, ACD, Significance (t = -19.84, -2.28, -13.94, 9.81, -8.18, P = 0.000,0.025,0.000,0.000,0.000). There were no significant differences in CR between 2011 and 2014 in 45 eyes of new myopia group (t = -1.68, P = 0.099). There were significant differences in SE, AL, CCT, ACD, 13.09, -15.54, 3.37, -15.30, 11.16, -61.90, P = 0.000,0.000,0.002,0.000,0.000). There was no significant difference in CR between 17 and 20 eyes in myopia between 2011 and 2014 (t = -0.35, P = 0.733). There were significant differences in SE, AL, CCT, ACD, -10.70, -2.43, -3.746, 4.439, -7.95, P = 0.01, 0.000, 0.027, 0.002, 0.000, 0.000). The differences of SE, AL, ACD, LT and AL / CR between the three groups were statistically significant (F = 46.14,8.89,9.29,4.47,11.76, P = 0.000,0.000,0.000,0.013,0.000) There were significant differences in LT between myopic group and newly added myopia group. There was significant difference between SE, AL, ACD, LT and AL / CR in 2014 (F = 134.85,24.77,11.17,6.63,41.08, P = 0.000, 0.000, 0.000, 0.002, 0.000). Conclusions The three-year follow-up observation showed that the change of ocular biological parameters in children of this age showed the characteristics of reduced SE, increased AL, thickening of CCT, deepening of ACD, thinning of LT, increasing of AL / CR, and no significant change of CR. LT may be one of the early warning signals of myopia.