Sun Yun-Yun, Wei Shi-Fei, Li Shi-Ming, Hu Jian-Ping, Yang Xiao-Hui, Cao Kai, Lin Cai-Xia, Du Jia-Ling, Guo Ji-Yuan, Li He, Liu Luo-Ru, Morgan Ian G, Wang Ning-Li
Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China.
Anyang Eye Hospital, Anyang, Henan Province, China.
Br J Ophthalmol. 2018 Jun 21. doi: 10.1136/bjophthalmol-2018-312199.
To document the difference between non-cycloplegic and cycloplegic refraction and explore its associated factors in Chinese young adults.
A school-based study including 7971 undergraduates was conducted in Anyang, Henan Province, China. Cycloplegia was achieved with two drops of 1% cyclopentolate and 1 drop of Mydrin P (Tropicamide 0.5%, phenylephrine HCl 0.5%) with a 5 min interval. Non-cycloplegic and cycloplegic refractions were measured by an autorefractor. A paired-sample t-test and Spearman correlation analysis were used for analysis with data from only the right eyes included. RESULTS: Of the 7971 students examined, 7793 (97.8%) with complete data were included, aging 20.2±1.5 years. Male students accounted for 36.8%. Overall, there was a significant difference between non-cycloplegic and cycloplegic SE (spherical equivalent) of 0.83±0.81D (p<0.01). The difference was 1.80±1.11D, 1.26±0.93D and 0.69±0.69D for those with cycloplegic hyperopia, emmetropia and myopia, respectively (p<0.01 for all). Those with a hyperopic shift less than 0.25D and 0.5D accounted for 11.1% and 34.1%, respectively. A significant relationship was found between difference in SE and cycloplegic refraction (r=0.33, b=0.11, p<0.01). Without cycloplegia, prevalence of hyperopia and emmetropia would be underestimated by 6.2% (1.0% vs 7.2%) and 5.7% (3.8% vs 9.5%), respectively, with prevalence of myopia and high myopia overestimated by 12.1% (95.3% vs 83.2%) and 6.1% (17.2% vs 11.1%). CONCLUSION: Lack of cycloplegia will lead to significant misclassification of myopia, emmetropia and hyperopia in Chinese young adults. Cycloplegia is therefore essential for this age-group in epidemiological studies.
记录中国年轻成年人非散瞳验光与散瞳验光的差异，并探讨其相关因素。
在中国河南省安阳市开展了一项基于学校的研究，纳入7971名本科生。使用两滴1%的环喷托酯和一滴美多丽P（托吡卡胺0.5%，盐酸去氧肾上腺素0.5%）进行散瞳，间隔5分钟。使用自动验光仪测量非散瞳验光和散瞳验光结果。仅纳入右眼数据，采用配对样本t检验和Spearman相关分析进行分析。结果：在检查的7971名学生中，纳入了7793名（97.8%）有完整数据的学生，年龄为20.2±1.5岁。男生占36.8%。总体而言，非散瞳验光和散瞳验光的球镜等效度（SE）存在显著差异，为0.83±0.81D（p<0.01）。散瞳远视、正视和近视者的差异分别为1.80±1.11D、1.26±0.93D和0.69±0.69D（均p<0.01）。远视偏移小于0.25D和0.5D者分别占11.1%和34.1%。发现SE差异与散瞳验光之间存在显著相关性（r=~0.33，b=0.11，p<0.01）。未散瞳时，远视和正视的患病率分别会被低估6.2%（1.0%对7.2%）和5.7%（3.8%对9.5%），近视和高度近视的患病率分别会被高估12.1%（95.3%对83.2%）和6.1%（17.2%对11.1%）。结论：未散瞳会导致中国年轻成年人近视、正视和远视的显著误诊。因此，散瞳在该年龄组的流行病学研究中至关重要。
