波前像差在屈光参差性弱视光学质量评估中的应用

发布时间：2019-04-22 19:12

【摘要】：目的探讨屈光参差性弱视双眼间的波前像差差异以及临床特点。方法选取53例屈光参差性弱视患者,年龄9~40岁,其中男31例,女22例,纳入本横断面研究。所有患者均接受Wave Scan溲波前像差检查,弱视眼与对侧眼之间的波前像差差异采用配对t检验;波前像差参数值、等效离焦度、最佳矫正视力,以及年龄之间的关系采用相关分析。然后将中度弱视患者按照年龄分为成年弱视组和儿童弱视组,分析这两组的临床特点。结果经配对t检验显示,53例患者的弱视眼与对侧眼在最佳矫正视力、等效离焦度、总像差、总高阶像差、三叶草像差、三阶像差均方根值等指标上差异均有统计学意义(均为P0.05)。成年弱视组与儿童弱视组内均未发现年龄与高阶像差参数之间存在相关性。成年弱视组弱视眼与对侧眼之间在总像差(P=0.000)、三叶草像差(P=0.047)和三阶像差均方根值(P=0.032)上差异均有统计学意义(均为P0.05);儿童弱视组弱视眼与对侧眼之间在总像差(P=0.000)、球差(P=0.008)和四阶像差均方根值(P=0.032)上差异均有统计学意义(均为P0.05)。两个年龄组内的相关回归分析显示,在成年弱视组,等效离焦度与总像差有相关性(P0.01),最佳矫正视力与总像差、球差均有相关性(均为P0.05);且等效离焦度与总像差的回归方程为y=3.343+0.942x(F=40.830、P=0.000、R2=0.671),最佳矫正视力与总像差的回归方程为y=0.321+0.017x(F=5.058、P=0.036、R2=0.202)。在儿童弱视组,等效离焦度与总像差、总高阶像差均有相关性(均为P0.05),最佳矫正视力与五阶像差均方根值存在相关性(P0.01);等效离焦度与总像差的回归方程为y=1.529+1.176x(F=17.090、P=0.001、R2=0.501),最佳矫正视力与五阶像差均方根值的回归方程为y=0.006+0.143x(F=10.851、P=0.004、R2=0.390)。结论除最佳矫正视力、等效离焦度、总像差之外,屈光参差性弱视患者双眼间的高阶像差存在显著差异;对于中度弱视患者,双眼间高阶像差差异在成人与儿童表现不同。
[Abstract]:Objective to investigate the wavefront aberrations and clinical characteristics of anisometropic amblyopia. Methods 53 patients with anisometropic amblyopia, aged 9 to 40, including 31 males and 22 females, were included in this cross-sectional study. All patients were examined by Wave Scan wavefront aberration. The difference of wavefront aberration between amblyopia and contralateral eyes was tested by paired t-test. Correlation analysis was used for wavefront aberration parameters, equivalent defocus, best corrected visual acuity, and age. Then the patients with moderate amblyopia were divided into adult amblyopia group and children amblyopia group according to their age, and the clinical characteristics of the two groups were analyzed. Results the paired t test showed that the amblyopia and contralateral eyes of 53 patients had the best corrected visual acuity, the equivalent defocus, the total aberration, the total high order aberration, the clover aberration, the best corrected visual acuity, the equivalent defocus, the total aberration, the total high order aberration and the clover aberration. There were significant differences in root mean square values of third order aberrations (all P0.05). There was no correlation between age and high-order aberrations in adult amblyopia group and children amblyopia group. In adult amblyopia group, there were significant differences between amblyopia eyes and contralateral eyes in total aberrations (P < 0. 000), clover aberrations (P < 0. 047) and root mean square values of third-order aberrations (P < 0. 05). There were significant differences between amblyopia eyes and contralateral eyes in total aberration (P < 0. 000), spherical aberration (P < 0. 008) and root mean square value of fourth-order aberration (P < 0. 032) in children amblyopia group (P 0. 05). The correlation regression analysis between the two age groups showed that in adult amblyopia group, the equivalent defocus was correlated with the total aberration (P0.01), and the best corrected visual acuity was correlated with the total aberration and spherical aberration (all P0.05). The regression equation between the equivalent defocus and the total aberration was y = 3.343 0.942 x (F = 40.830, P = 0.000, R _ 2 = 0.671), and the regression equation between the best corrected visual acuity and the total aberration was y = 0.321 0.017 x (F = 5.058, P = 0.036, R _ 2 = 0.202). In the amblyopia group, the equivalent defocus was correlated with the total aberration and the total high-order aberration (all P0.05), and the best corrected visual acuity was correlated with the root mean square value of the fifth-order aberration (P0.01). The regression equation between the equivalent defocus and the total aberration was y = 1.529 1.176x (F = 17.090, P = 0.0001, R2 = 0.501). The regression equation between the best corrected visual acuity and the root mean square value of the fifth-order aberration was y = 0.006 0.143x (F = 10.851, P = 0.004, R _ 2 = 0.390). Conclusion there are significant differences in higher order aberrations between the eyes of anisometropic amblyopia patients except for the best corrected visual acuity, equivalent defocus and total aberrations, and for moderate amblyopic patients, the difference of higher order aberrations between the eyes of adults and children is different.
【作者单位】：广西壮族自治区人民医院视光科广西视光中心;
【基金】：广西壮族自治区卫生厅资助项目(编号:桂卫Z2013336) 广西壮族自治区人民医院青年基金项目~~
【分类号】：R777.44

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