An Wenzai, Wei Shifei, Li Shi-Ming, Cao Kai, Hu Jianping, Lin Caixia, Bai Weiling, Fu Jing, Sun Yunyun, Wang Ningli
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China.
Beijing Institute of Ophthalmology, Beijing Key Laboratory of Intelligent Diagnosis Technology and Equipment for Optic Nerve-Related Eye Diseases, Beijing, China.
Transl Vis Sci Technol. 2025 May 1;14(5):26. doi: 10.1167/tvst.14.5.26.
To investigate the coordination among astigmatism components, including refractive astigmatism (RA), corneal astigmatism (CA), and internal astigmatism (IA), across refractive statuses in a large cycloplegic sample of Chinese young adults.
This cross-sectional study included 7971 undergraduate students in China. Cycloplegic refraction and ocular biometric were measured using an autorefractor and optical biometry. IA was calculated as the vector difference between RA and CA. Relationships among astigmatism components, refractive errors, and ocular parameters were analyzed using generalized additive models, smoothed curve fitting, and threshold effect analysis.
A total of 7315 young adults (mean age = 20.2 ± 1.5 years; 37.0% male) were included. The prevalence rates of RA, CA, and IA (≥1.0 D) were 16.4%, 36.7%, and 12.2%, respectively. RA and CA were significantly higher in the high myopia, moderate myopia, and moderate hyperopia groups compared to the emmetropia group, while IA was significantly smaller only in the high myopia group (P < 0.001). Piecewise relationships among RA, CA, and IA with refractive errors were identified. RA and CA showed a significant increase, whereas IA decreased in moderate and high myopia. Furthermore, the compensatory effect of IA was significantly reduced in the high myopia group.
The components of astigmatism demonstrated coordination from low myopia to low hyperopia, but this coordination was reduced in high myopia.
Greater attention should be paid to changes in astigmatism components and their coordination in high myopia.
在一大组中国年轻成年人的睫状肌麻痹样本中，研究散光成分（包括屈光性散光（RA）、角膜散光（CA）和内部散光（IA））在不同屈光状态下的协调性。
这项横断面研究纳入了7971名中国本科生。使用自动验光仪和光学生物测量法测量睫状肌麻痹验光和眼部生物特征。IA通过RA与CA之间的矢量差计算得出。使用广义相加模型、平滑曲线拟合和阈值效应分析来分析散光成分、屈光不正和眼部参数之间的关系。
共纳入7315名年轻成年人（平均年龄 = 20.2 ± 1.5岁；男性占37.0%）。RA、CA和IA（≥1.0 D）的患病率分别为16.4%、36.7%和12.2%。与正视组相比，高度近视、中度近视和中度远视组的RA和CA显著更高，而仅高度近视组的IA显著更小（P < 0.001）。确定了RA、CA和IA与屈光不正之间的分段关系。在中度和高度近视中，RA和CA显著增加，而IA减少。此外，高度近视组中IA的代偿作用显著降低。
散光成分在低度近视到低度远视之间表现出协调性，但在高度近视中这种协调性降低。
应更加关注高度近视中散光成分的变化及其协调性。
