Deuchert Mona, Frings Andreas, Druchkiv Vasyl, Schweighofer Jakob, Muhammad Sajjad, Linke Stephan, Katz Toam
Department of Ophthalmology, Medical Faculty and University Hospital Duesseldorf, Heinrich Heine University, Duesseldorf, Germany.
Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
PLoS One. 2025 Jan 3;20(1):e0315080. doi: 10.1371/journal.pone.0315080. eCollection 2025.
To examine the prevalence and associations of anisometropia with spherical ametropia, cylindrical power, age, and sex.
Anisometropia was analyzed for subjective refraction. In total, 134,603 refractive surgery candidates were included in the period from 2010 to 2020 at the CARE Vision Refractive Centers in Germany. Our study was approved by the local ethics committee at the University in Duesseldorf (approval date: February 9, 2021) and conducted according to the tenets of the Declaration of Helsinki and Good Clinical Practices Guidelines. The treatment contract included explicit patient consent to use medical data for scientific purposes. Correlations between anisometropia and explanatory variables were analyzed using the chi-squared test (χ2 test), nonparametric Kruskal-Wallis or Mann-Whitney U-tests, and binomial logistic regression. Power vector analysis was applied for further analysis of cylindrical power.
The median level of anisometropia (Asubj) in the whole population was 0.38 D. The prevalence of Asubj was 17.9%. In hyperopes, all explanatory variables (spherical ametropia, cylindrical power, age, sex) were independently associated with anisometropia. Asubj decreased with increasing cylindrical ametropia: an increase in cylindrical power by 7.8 D reduced the chance of observing anisometropia by half. It was also associated with male sex. Asubj decreased by half with a 16.7 D increase in spherical power and an increase in age by 22.7 years. In myopes, cylindrical power was most strongly associated with anisometropia: an increase in (negative) cylindrical power by 2.15 D doubled the chances of observing anisometropia in myopes. In addition, advancing age (double chance with an increase of 38.3 years), increasing spherical power (double chance with an increase of 8.15 D), and female sex correlated positively with increasing anisometropia in myopes.
This retrospective analysis gives evidence for the independent association between anisometropia and spherical power, cylindrical power, age, and sex in myopic refractive surgery candidates. The relation of anisometropia with age was positive in myopes but negative in hyperopes. The analysis of sex revealed a positive relation of female sex and anisometropia in myopes and furthermore revealed a positive relation of male sex and anisometropia in hyperopes. Further clinical research into the underlying mechanisms behind our findings is indicated.
研究屈光参差与球镜屈光不正、柱镜度数、年龄及性别的患病率和相关性。
对主观验光中的屈光参差进行分析。2010年至2020年期间，德国CARE视力屈光中心共纳入134,603例屈光手术候选者。我们的研究得到了杜塞尔多夫大学当地伦理委员会的批准（批准日期：2021年2月9日），并按照《赫尔辛基宣言》和《良好临床实践指南》的原则进行。治疗合同包括患者明确同意将医疗数据用于科学目的。使用卡方检验（χ2检验）、非参数Kruskal-Wallis检验或Mann-Whitney U检验以及二项逻辑回归分析屈光参差与解释变量之间的相关性。应用屈光力矢量分析进一步分析柱镜度数。
整个人群中屈光参差（Asubj）的中位数为0.38 D。Asubj的患病率为17.9%。在远视眼中，所有解释变量（球镜屈光不正、柱镜度数、年龄、性别）均与屈光参差独立相关。Asubj随柱镜屈光不正的增加而降低：柱镜度数增加7.8 D可使观察到屈光参差的几率减半。它也与男性性别有关。球镜度数增加16.7 D和年龄增加22.7岁时，Asubj减半。在近视眼中，柱镜度数与屈光参差的相关性最强：（负）柱镜度数增加2.15 D可使近视眼中观察到屈光参差的几率加倍。此外，年龄增长（增加38.3岁时几率加倍）、球镜度数增加（增加8.15 D时几率加倍）以及女性性别与近视眼中屈光参差增加呈正相关。
这项回顾性分析为近视屈光手术候选者中屈光参差与球镜度数、柱镜度数、年龄和性别的独立关联提供了证据。屈光参差与年龄在近视眼中呈正相关，在远视眼中呈负相关。性别分析显示女性性别与近视眼中的屈光参差呈正相关，此外还显示男性性别与远视眼中的屈光参差呈正相关。需要对我们研究结果背后的潜在机制进行进一步的临床研究。
