Chiesi Carlo, Chiesi Laura, Cavallini Gian Maria
Department of Ophthalmology, Modena & Reggio Emilia University, Modena, Italy.
J Pediatr Ophthalmol Strabismus. 2009 Sep-Oct;46(5):266-72. doi: 10.3928/01913913-20090903-04. Epub 2009 Sep 22.
To assess possible refractive changes according to age and strabismus in a statistically significant cohort.
A population-based sample of 12,534 subjects 0.5 to 20 years old, examined between 2004 and 2006, was tested. Each subject received a complete orthoptic examination, including spherocylindrical streak retinoscopy in cycloplegia. Patients were divided into those with orthophoria (7,784) and those with strabismus (4,750), and the latter group was further divided into those with esodeviation (3,026) and those with exodeviation (1,724). A statistical analysis of the spherical equivalent, astigmatism, and anisometropia was performed with an independent samples t test or one-way analysis of variance.
The percentage of patients with a mean spherical equivalent within +/- 1 and +/- 2 standard deviations was greater than 68% and 95%, respectively. The mean spherical equivalent of the total sample was 1.62 diopters (D) (+/- 2.88). The mean spherical equivalent was 1.10 +/- 2.94 D in the orthophoria group, 3.22 +/- 2.29 D in the esodeviation group, and 1.13 +/- 2.50 D in the exodeviation group (one-way analysis of variance; P = .000). Age-related changes in the mean spherical equivalent showed a clear and steady myopic shift, reaching mean myopic refraction at 12 to 14 years in both the total sample and the orthophoria and exodeviation groups. It assumed a more constant trend, with no myopic swing, in the esodeviation group (P = .000). Mean astigmatism was less in patients with less than 1.00 D anisometropia (0.83 +/- 0.92 D) than in those with 1.00 D or greater anisometropia (1.42 +/- 1.18 D) (t test; P = .0001).
Both the age-related trend in the spherical equivalent and the high hyperopic values of the distribution peak in patients with esodeviation confirm the importance of the hypermetropic refractive component. The statistically significantly higher incidence of astigmatism in patients with 1.00 D or greater ametropia highlights its incidence in amblyopia.
在一个具有统计学意义的队列中评估根据年龄和斜视可能出现的屈光变化。
对2004年至2006年间检查的12534名年龄在0.5至20岁的基于人群的样本进行测试。每位受试者接受了完整的视光学检查，包括在睫状肌麻痹下的球柱面带状检影验光。患者被分为正位视组（7784例）和斜视组（4750例），后者进一步分为内斜视组（3026例）和外斜视组（1724例）。采用独立样本t检验或单因素方差分析对等效球镜度、散光和屈光参差进行统计分析。
等效球镜度均值在±1和±2标准差范围内的患者百分比分别大于68%和95%。总样本的等效球镜度均值为1.62屈光度（D）（±2.88）。正位视组的等效球镜度均值为1.10±2.94 D，内斜视组为3.22±2.29 D，外斜视组为1.13±2.50 D（单因素方差分析；P = 0.000）。等效球镜度的年龄相关变化显示出明显且稳定的近视偏移，在总样本以及正位视组和外斜视组中，12至14岁时达到平均近视屈光状态。在内斜视组中呈现出更稳定的趋势，没有近视波动（P = 0.000）。等效球镜度小于1.00 D的屈光参差患者的平均散光（0.83±0.92 D）低于等效球镜度为1.00 D或更高的屈光参差患者（1.42±1.18 D）（t检验；P = 0.0001）。
等效球镜度的年龄相关趋势以及内斜视患者分布峰值处的高远视值均证实了远视屈光成分的重要性。等效球镜度为1.00 D或更高的屈光不正患者散光的统计学显著更高发生率突出了其在弱视中的发生率。
