Cumberland P M, Peckham C S, Rahi J S
Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, London, UK.
Eye (Lond). 2008 Jul;22(7):939-43. doi: 10.1038/sj.eye.6702775. Epub 2007 Mar 9.
Understanding genetic and environmental factors that together contribute to the development of myopia is an international research priority. We have investigated the feasibility and accuracy of identifying and classifying refractive error, without formal refraction, as a means of easily identifying affected individuals in a large-scale, non-ophthalmological, and population-based survey.
At age 44/45 years, members of the 1958 British birth cohort underwent a biomedical, community survey. Refractive error (autorefraction) was measured and categorised by spherical equivalent (SE) measurement; myopia (SE of -1.00 or more extreme), hypermetropia (+1.00 or more extreme), or emmetropia (-0.99 to +0.99). Lenses of prescribed distance glasses, if worn, were assessed as minifying, magnifying, or making no difference to a standard viewed image and cohort members reported on 'short' or 'long' sightedness.
A total of 2499 cohort members, randomly selected, had formal refraction (autorefraction) and 917 (36.7%) of these individuals had their prescribed distance glasses examined. Sensitivities for myopia and hypermetropia using examination of glasses were over 80% and positive predictive values were 95 and 65% respectively whereas self-report of 'short-sightedness' or 'long-sightedness' had poor accuracy.
We suggest examination of prescribed distance glasses can be an effective method of 'screening' for refractive error in the field, especially where prevalence is high.
了解共同导致近视发展的遗传和环境因素是一项国际研究重点。我们研究了在大规模、非眼科的人群调查中，不进行正规验光而识别和分类屈光不正的可行性和准确性，以此作为轻松识别受影响个体的一种方法。
1958年英国出生队列的成员在44/45岁时接受了一次生物医学社区调查。通过等效球镜度（SE）测量来测量和分类屈光不正；近视（SE为-1.00或更低）、远视（+1.00或更高）或正视（-0.99至+0.99）。如果佩戴了处方远用眼镜，则评估其对标准视像的缩小、放大或无影响情况，队列成员报告自己是“近视”还是“远视”。
总共随机选择了2499名队列成员进行正规验光（自动验光），其中917人（36.7%）接受了处方远用眼镜检查。使用眼镜检查对近视和远视的敏感度超过80%，阳性预测值分别为95%和65%，而“近视”或“远视”的自我报告准确性较差。
我们认为检查处方远用眼镜可以成为现场“筛查”屈光不正的有效方法，尤其是在患病率较高的情况下。
