Axial length/corneal radius of curvature ratio and refractive development evaluation in 3-to 4-year-old children: the Shanghai Pudong Eye Study
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摘要
AIM: To measure and analysis axial length(AL)/corneal radius of curvature(CRC) ratio and other refractive parameters, provide a medical reference range for refractive development evaluation and earlier visual impairment screening of 3 to 4 y kindergarten students.METHODS: Between April and June 2017, a total of 4350 participants aged 3-to 4-year-old(8700 eyes) from 10 cluster random sampling kindergartens in Shanghai, Pudong District were involved. According to the measurement and analysis of the unaided visual acuity(VA), AL, CRC, AL/CRC ratio, astigmatism and other refractive parameters, the data distribution and reference range were obtained.RESULTS: Uncorrected VA of examined children was 0.23±0.08(logMAR, mean±SD) [95% confidence interval(CI) range ≤0.36]; AL was 22.10±0.79 mm(95%CI 20.55-23.65); CRC was 7.86±0.26 mm(95%CI, 7.35-8.37); AL/CRC ratio was 2.81±0.12(95%CI, 2.57-3.05). The median of astigmatism was-0.5 D, a total of 56.3% had astigmatism <-0.50 D, 85.3%<-1.00 D, 6.7%>-1.50 D; 71% were astigmatism with the rule. Eye-specific analyses were conducted. Statistical difference of VA was in right and left eyes. There were no significant differences between two eyes of AL, CRC, AL/CRC ratio and astigmatism(P>0.05).CONCLUSION: VA and AL/CRC ratio reference could be used to assess refractive development in children and screening uncorrected refractive errors or amblyopia. Astigmatism needs to be considered in the diagnosis.
AIM: To measure and analysis axial length(AL)/corneal radius of curvature(CRC) ratio and other refractive parameters, provide a medical reference range for refractive development evaluation and earlier visual impairment screening of 3 to 4 y kindergarten students.METHODS: Between April and June 2017, a total of 4350 participants aged 3-to 4-year-old(8700 eyes) from 10 cluster random sampling kindergartens in Shanghai, Pudong District were involved. According to the measurement and analysis of the unaided visual acuity(VA), AL, CRC, AL/CRC ratio, astigmatism and other refractive parameters, the data distribution and reference range were obtained.RESULTS: Uncorrected VA of examined children was 0.23±0.08(logMAR, mean±SD) [95% confidence interval(CI) range ≤0.36]; AL was 22.10±0.79 mm(95%CI 20.55-23.65); CRC was 7.86±0.26 mm(95%CI, 7.35-8.37); AL/CRC ratio was 2.81±0.12(95%CI, 2.57-3.05). The median of astigmatism was-0.5 D, a total of 56.3% had astigmatism <-0.50 D, 85.3%<-1.00 D, 6.7%>-1.50 D; 71% were astigmatism with the rule. Eye-specific analyses were conducted. Statistical difference of VA was in right and left eyes. There were no significant differences between two eyes of AL, CRC, AL/CRC ratio and astigmatism(P>0.05).CONCLUSION: VA and AL/CRC ratio reference could be used to assess refractive development in children and screening uncorrected refractive errors or amblyopia. Astigmatism needs to be considered in the diagnosis.
AIM: To measure and analysis axial length(AL)/corneal radius of curvature(CRC) ratio and other refractive parameters, provide a medical reference range for refractive development evaluation and earlier visual impairment screening of 3 to 4 y kindergarten students.METHODS: Between April and June 2017, a total of 4350 participants aged 3-to 4-year-old(8700 eyes) from 10 cluster random sampling kindergartens in Shanghai, Pudong District were involved. According to the measurement and analysis of the unaided visual acuity(VA), AL, CRC, AL/CRC ratio, astigmatism and other refractive parameters, the data distribution and reference range were obtained.RESULTS: Uncorrected VA of examined children was 0.23±0.08(logMAR, mean±SD) [95% confidence interval(CI) range ≤0.36]; AL was 22.10±0.79 mm(95%CI 20.55-23.65); CRC was 7.86±0.26 mm(95%CI, 7.35-8.37); AL/CRC ratio was 2.81±0.12(95%CI, 2.57-3.05). The median of astigmatism was-0.5 D, a total of 56.3% had astigmatism <-0.50 D, 85.3%<-1.00 D, 6.7%>-1.50 D; 71% were astigmatism with the rule. Eye-specific analyses were conducted. Statistical difference of VA was in right and left eyes. There were no significant differences between two eyes of AL, CRC, AL/CRC ratio and astigmatism(P>0.05).CONCLUSION: VA and AL/CRC ratio reference could be used to assess refractive development in children and screening uncorrected refractive errors or amblyopia. Astigmatism needs to be considered in the diagnosis.
引文
1 Holmes JM,Clarke MP.Amblyopia.Lancet 2006;367(9519):1343-1351.
2 Li SM,Liu LR,Li SY,et al.Design,methodology and baseline data of a school-based cohort study in Central China:the Anyang Childhood Eye Study.Ophthalmic Epidemiol 2013;20(6):348-359.
3 Xu L,Wang Y,Li Y,Wang Y,Cui T,Li J,Jonas JB.Causes of blindness and visual impairment in urban and rural areas in Beijing:the Beijing Eye Study.Ophthalmology 2006;113(7):1134.e1-1134.11.
4 Hsu WM,Cheng CY,Liu JH,Tsai SY,Chou P.Prevalence and causes of visual impairment in an elderly Chinese population in Taiwan:the Shihpai Eye Study.Ophthalmology 2004;111(1):62-69.
5 Liang YB,Friedman DS,Wong TY,et al.Prevalence and causes of low vision and blindness in a rural Chinese adult population:the Handan Eye Study.Ophthalmology 2008;115(11):1965-1972.
6 Huang S,Zheng Y,Foster PJ,Huang W,He M;Liwan Eye Study.Prevalence and Causes of Visual Impairment in Chinese Adults in Urban Southern China.Arch Ophthalmol 2009;127(10):1362-1367.
7 US Preventive Services Task Force.Vision screening for children 1to 5 years of age:US Preventive Services Task Force Recommendation statement.Pediatrics 2011;127(2):340-346.
8 Hendler K,Mehravaran S,Lu X,Brown SI,Mondino BJ,Coleman AL.Refractive errors and amblyopia in the UCLA preschool vision program;first year results.Am J Ophthalmol 2016;172:80-86.
9 Stewart CE,Fielder AR,Stephens DA,Moseley MJ.Treatment of unilateral amblyopia:factors influencing visual outcome.Invest Ophthalmol Vis Sci 2005;46(9):3152-3160.
10 Williams C,Northstone K,Harrad RA,Sparrow JM,Harvey I;ALSPAC Study Team.Amblyopia treatment outcomes after preschool screening v school entry screening:observational data from a prospective cohort study.Br J Ophthalmol 2003;87(8):988-993.
11 Liu JC,Green W,Van Stavern GP,Culican SM.Assessing the utility of2.5%phenylephrine for diagnostic pupillary dilation.Can J Ophthalmol2017;52(4):349-354.
12 Silbert DI,Matta NS,Andersen K.Plusoptix photoscreening may replace cycloplegic examination in select pediatric ophthalmology patients.J AAPOS 2013;17(2):163-165.
13 Foo VHX,Verkicharla PK,Ikram MK,et al.Axial length/corneal radius of curvature ratio and myopia in 3-year-old children.Trans Vis Sci Tech 2016;5(1):5.
14 Shanghai Statistical Yearbook.Available at:http://www.stats-sh.gov.cn/html/sjfb/201701/1000339.html.
15 Tabulation on the 2010 Population Census of the People’s Republic of China.Available at:http://www.stats.gov.cn/tjsj/pcsj/rkpc/6rp/indexch.htm.
16 Shanghai Pudong New District Educational Website.Available at:http://www.pudong-edu.sh.cn/web/PDJY/jyzc_xxlb.aspx.
17 Pan CW,Ramamurthy D,Saw SM.Worldwide prevalence and risk factors for myopia.Ophthalmic Physiol Opt 2012;32(1):3-16.
18 Schneider J,Leeder SR,Gopinath B,Wang JJ,Mitchell P.Frequency,course,and impact of correctable visual impairment(uncorrected refractive error).Surv Ophthalmol 2010;55(6):539-560.
19 US Preventive Services Task Force,Grossman DC,Curry SJ,et al.Vision screening in children aged 6 months to 5 years:US preventive services task force recommendation statement.JAMA 2017;318(9):836-844.
20 Hashemi H,Khabazkhoob M,Miraftab M,Emamian MH,Shariati M,Abdolahi-Nia T,Fotouhi A.Axial length to corneal radius of curvature ratio and refractive errors.J Ophthalmic Vis Res 2013;8(3):220-226.
21 Scheiman M,Gwiazda J,Zhang Q,Deng L,Fern K,Manny RE,Weissberg E,Hyman L;COMET Group.Longitudinal changes in corneal curvature and its relationship to axial length in the Correction of Myopia Evaluation Trial(COMET)cohort.J Optom 2016;9(1):13-21.
22 He X,Zou H,Lu L,Zhao R,Zhao H,Li Q,Zhu J.Axial length/corneal radius ratio:association with refractive state and role on myopia detection combined with visual acuity in Chinese schoolchildren.PLoS One2015;10(2):e0111766.
23 Wang H,Zhao KK,Qu JF,Song L.The accuracy of the axial length/corneal radius ratio in the diagnosis of myopia in adolescents and children.Chin J Optom Ophthalmol Vis Sci 2016;18(2):108-110.
2 Li SM,Liu LR,Li SY,et al.Design,methodology and baseline data of a school-based cohort study in Central China:the Anyang Childhood Eye Study.Ophthalmic Epidemiol 2013;20(6):348-359.
3 Xu L,Wang Y,Li Y,Wang Y,Cui T,Li J,Jonas JB.Causes of blindness and visual impairment in urban and rural areas in Beijing:the Beijing Eye Study.Ophthalmology 2006;113(7):1134.e1-1134.11.
4 Hsu WM,Cheng CY,Liu JH,Tsai SY,Chou P.Prevalence and causes of visual impairment in an elderly Chinese population in Taiwan:the Shihpai Eye Study.Ophthalmology 2004;111(1):62-69.
5 Liang YB,Friedman DS,Wong TY,et al.Prevalence and causes of low vision and blindness in a rural Chinese adult population:the Handan Eye Study.Ophthalmology 2008;115(11):1965-1972.
6 Huang S,Zheng Y,Foster PJ,Huang W,He M;Liwan Eye Study.Prevalence and Causes of Visual Impairment in Chinese Adults in Urban Southern China.Arch Ophthalmol 2009;127(10):1362-1367.
7 US Preventive Services Task Force.Vision screening for children 1to 5 years of age:US Preventive Services Task Force Recommendation statement.Pediatrics 2011;127(2):340-346.
8 Hendler K,Mehravaran S,Lu X,Brown SI,Mondino BJ,Coleman AL.Refractive errors and amblyopia in the UCLA preschool vision program;first year results.Am J Ophthalmol 2016;172:80-86.
9 Stewart CE,Fielder AR,Stephens DA,Moseley MJ.Treatment of unilateral amblyopia:factors influencing visual outcome.Invest Ophthalmol Vis Sci 2005;46(9):3152-3160.
10 Williams C,Northstone K,Harrad RA,Sparrow JM,Harvey I;ALSPAC Study Team.Amblyopia treatment outcomes after preschool screening v school entry screening:observational data from a prospective cohort study.Br J Ophthalmol 2003;87(8):988-993.
11 Liu JC,Green W,Van Stavern GP,Culican SM.Assessing the utility of2.5%phenylephrine for diagnostic pupillary dilation.Can J Ophthalmol2017;52(4):349-354.
12 Silbert DI,Matta NS,Andersen K.Plusoptix photoscreening may replace cycloplegic examination in select pediatric ophthalmology patients.J AAPOS 2013;17(2):163-165.
13 Foo VHX,Verkicharla PK,Ikram MK,et al.Axial length/corneal radius of curvature ratio and myopia in 3-year-old children.Trans Vis Sci Tech 2016;5(1):5.
14 Shanghai Statistical Yearbook.Available at:http://www.stats-sh.gov.cn/html/sjfb/201701/1000339.html.
15 Tabulation on the 2010 Population Census of the People’s Republic of China.Available at:http://www.stats.gov.cn/tjsj/pcsj/rkpc/6rp/indexch.htm.
16 Shanghai Pudong New District Educational Website.Available at:http://www.pudong-edu.sh.cn/web/PDJY/jyzc_xxlb.aspx.
17 Pan CW,Ramamurthy D,Saw SM.Worldwide prevalence and risk factors for myopia.Ophthalmic Physiol Opt 2012;32(1):3-16.
18 Schneider J,Leeder SR,Gopinath B,Wang JJ,Mitchell P.Frequency,course,and impact of correctable visual impairment(uncorrected refractive error).Surv Ophthalmol 2010;55(6):539-560.
19 US Preventive Services Task Force,Grossman DC,Curry SJ,et al.Vision screening in children aged 6 months to 5 years:US preventive services task force recommendation statement.JAMA 2017;318(9):836-844.
20 Hashemi H,Khabazkhoob M,Miraftab M,Emamian MH,Shariati M,Abdolahi-Nia T,Fotouhi A.Axial length to corneal radius of curvature ratio and refractive errors.J Ophthalmic Vis Res 2013;8(3):220-226.
21 Scheiman M,Gwiazda J,Zhang Q,Deng L,Fern K,Manny RE,Weissberg E,Hyman L;COMET Group.Longitudinal changes in corneal curvature and its relationship to axial length in the Correction of Myopia Evaluation Trial(COMET)cohort.J Optom 2016;9(1):13-21.
22 He X,Zou H,Lu L,Zhao R,Zhao H,Li Q,Zhu J.Axial length/corneal radius ratio:association with refractive state and role on myopia detection combined with visual acuity in Chinese schoolchildren.PLoS One2015;10(2):e0111766.
23 Wang H,Zhao KK,Qu JF,Song L.The accuracy of the axial length/corneal radius ratio in the diagnosis of myopia in adolescents and children.Chin J Optom Ophthalmol Vis Sci 2016;18(2):108-110.