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中华眼科医学杂志(电子版) ›› 2019, Vol. 09 ›› Issue (02) : 71 -76. doi: 10.3877/cma.j.issn.2095-2007.2019.02.002

论著

481例6周龄婴儿屈光状态的筛查及其检测结果的临床研究
马燕1, 邓光达1, 麻婧1, 刘敬花1, 李松峰1, 卢海1,†()   
  1. 1. 100730　北京，首都医科大学附属北京同仁医院眼科　北京同仁眼科中心　北京市眼科学与视觉科学重点实验室
  • 收稿日期:2018-11-12 出版日期:2019-04-28
  • 通信作者: 卢海
  • 基金资助:
    首都临床特色应用研究(Z141107002514029); 首都医科大学附属北京同仁医院扬帆计划(TRZDYXZY201703)

Clinical research of screening and analysis of refractive status in 481 infants at the age of 6 weeks

Yan Ma1, Guangda Deng1, Jing Ma1, Jinghua Liu1, Songfeng Li1, Hai Lu1,†()   

  1. 1. Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
  • Received:2018-11-12 Published:2019-04-28
  • Corresponding author: Hai Lu
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引用本文：

马燕, 邓光达, 麻婧, 刘敬花, 李松峰, 卢海. 481例6周龄婴儿屈光状态的筛查及其检测结果的临床研究[J/OL]. 中华眼科医学杂志(电子版), 2019, 09(02): 71-76.

Yan Ma, Guangda Deng, Jing Ma, Jinghua Liu, Songfeng Li, Hai Lu. Clinical research of screening and analysis of refractive status in 481 infants at the age of 6 weeks[J/OL]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2019, 09(02): 71-76.

目的

探讨6周龄婴儿的屈光状态及影响因素，评价使用SureSight视力筛查仪对低龄婴儿进行屈光筛查的可行性和有效性。

方法

本研究为回顾性研究。收集2015年4月至2016年8月在首都医科大学附属北京同仁医院出生的481例(962只眼)婴儿的病例资料。所有婴儿均于出生后6周龄左右时使用SureSight视力筛查仪进行屈光检查，其中对超出视力筛查仪测量范围的婴儿采用视网膜检影法检查。同时收集婴儿出生时的基本情况，包括出生体重、出生身长、性别、眼别、分娩方式、是否早产以及父母是否有高度近视眼。采用Pearson相关系数分析出生体重、出生身长和屈光状态之间的关系，采用独立样本t检验比较眼别、性别、分娩方式、足月儿和早产儿之间等效球镜度的差异。

结果

481例(962只眼)婴儿中，共有16例(32只眼)，占3.3%，超出SureSight视力筛查仪检测范围。除1例(1只眼)因玻璃体积血使用视网膜检影法亦无法测出结果外，其余480例(961只眼)眼等效球镜度为(+3.632±1.272) D，最大值为+8.00 D，最小值为-3.25 D。其中，有9例(11只眼)小于0 D，5例(10只眼)大于+6.00 D。出生体重和出生身长与等效球镜度之间均无相关性(r＝-0.017, -0.003; P>0.05)。男婴和女婴等效球镜度分别为(+3.568±1.334) D和(+3.704±1.196) D；右眼和左眼等效球镜度分别为(+3.631±1.273) D和(+3.634±1.272) D；剖宫产和顺产等效球镜度分别为(+3.711±1.194) D和(+3.574±1.325) D；足月儿和早产儿等效球镜度分别为(+3.634±1.276) D和(+3.599±1.255) D；眼别、性别、分娩方式、足月儿和早产儿之间等效球镜度的差异无统计学意义(t＝-1.656, 0.038, -1.662, 0.348; P>0.05)。有高度近视眼家族史和无高度近视眼家族史的婴儿眼等效球镜度分别为(+3.346±1.214) D和(+3.689±1.276) D。有高度近视眼家族史的婴儿眼等效球镜度低于无高度近视眼家族史的婴儿，差异有统计学意义(t＝-3.112, P<0.05)。

结论

6周龄婴儿屈光状态以远视为主，屈光状态与父母是否有高度近视眼有关，与出生体重、出生身长、性别、眼别、分娩方式及是否早产无关。使用SureSight视力筛查仪对婴儿进行屈光筛查方便有效，有助于早期监测和干预婴儿的视力发育。

关键词: 婴儿, 屈光状态, 筛查, 危险因素
Objective

The aim of this study was to investigate refractive status of infants at 6-week-old and evaluate feasibility and effectiveness of using SureSight vision screener to screen infants′ refractive status.

Methods

A retrospective research involved 481 infants (962 eyes) who were born in Beijing Tongren Hospital from Apr. 2015 to Aug. 2016. Infants aged 6 weeks around were underwent refractive screening using SureSight vision screener. Retinoscopy optometry were applied when refractive value were exceeded the measurement range of the equipment. Basic information of newborns was collected, including birth weight, birth length, gender, laterality, delivery methods, pre-term or not, and family history of high myopia.

Results

Among of 481 infants (962 eyes), refractive power cannot be measured in 16 infants (32 eyes, 3.3%) using SureSight vision screener. One infant (1 eye) with vitreous hemorrhage cannot be detected either by SureSight vision screener or by retinoscopy optometry. The rest of 480 infants (961 eyes) were included. Spherical equivalent power was (+ 3.632±1.272) D. The maximum power was + 8.00 D and the minimal power was -3.25 D. Nine infants (11 eyes) were under 0 D and 5 infants (10 eyes) were more than + 6.00 D. Spherical equivalent power did not related to birth weight or birth length (r=-0.017, -0.003; P>0.05). Spherical equivalent power of male and female infants were (+ 3.568±1.334) D and (+ 3.704±1.196) D; spherical equivalent power of right and left eyes of infants were (+ 3.631±1.273) D and (+ 3.634±1.272) D; spherical equivalent power of spontaneous labor and cesarean section infants were (+ 3.711±1.194) D and (+ 3.574±1.325) D ; spherical equivalent power of premature and mature infants were (+ 3.634±1.276) D and (+ 3.599±1.255) D. There were no statistically differences in spherical equivalent between right and left eyes, male and female, spontaneous labor and cesarean section, premature and mature infants (t=-1.656, 0.038, -1.662, 0.348; P>0.05). Spherical equivalent powers of family high myopia history and without family history infants were (+ 3.346±1.214) D and (+ 3.689±1.276) D. Spherical equivalent powers were lower in infants with family high myopia history than those without family history (t=-3.112, P<0.05).

Conclusions

Most infants at 6-week-old were hyperopia. Refractive status was related to family history of high myopia, and was not related to birth weight, birth length, gender, laterality, delivery mode, or premature. Using SureSight vision screener for infants refraction screening is convenient and effective, which can help to monitor and intervene vision development at an early age.

Key words: Infants, Refractive status, Screening, Risk factor
图1 婴儿屈光状态检查体位示意图　图A示检查者通过窥视孔，将十字靶对准婴儿的瞳孔中心，仪器会发出声音及灯光闪烁吸引婴儿注意。图B~D示检查时使仪器与婴儿视线保持一致，检查者和婴儿距离35 cm左右，被检查的婴儿可以取平卧位，或趴于家长肩上，或坐靠于家长怀中
图2 等效球镜度频率直方图　图示等效球镜度的分布符合正态分布，偏向于远视，峰值在+4.00 D
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