一款新型主客观验光一体化设备的临床评估

doi:10.3760/cma.j.issn.1674-845X.2019.12.002

摘要
图/表
参考文献(19)
相关文章 (15)

全文: PDF 2118KB HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要

拟对新型验光设备自适应光学视觉模拟器（VAO）的主观与客观验光的可靠性以及检查效率进行评估。方法：系列病例研究。收集2017年10─11月长沙爱尔眼科医院视光门诊患者。先由资深验光师采用传统方法为受检者分别进行双眼客观验光和主觉验光，其中客观验光采用尼德克电脑验光仪（ARK-1）、主觉验光采用综合验光仪；然后再由一名技术员利用VAO设备对所有受检者再次进行客观和主觉验光。最后用组内相关系数（ICC）和配对t检验比较2种检查方式结果的一致性以及检查耗时。结果：受检者共计70例（140眼），年龄（13.2±2.2）岁，其中男38例（54%）。2种检查方式在客观验光球镜度、J0、J45的ICC分别为0.897、0.907、0.732；在主觉验光球镜度、J0、J45的ICC分别为 0.937，0.891，0.543。2种检查方式客观验光的平均球镜度差异为0.46[95%可信区间（CI）：0.36， 0.55]D （t=9.663，P<0.001），主觉验光的平均球镜度差异为0.32（95%CI：0.25，0.39）D （t=9.087， P<0.001），均随着近视度数的增加而下降（r=-0.261，P<0.001），当受检者为中高度近视时（球镜度<-3.00 D），球镜度差异[95%CI]则降低为0.22（95%CI：0.14，0.32）D （t=4.987，P<0.001）； 2 种检查方式主觉验光的柱镜度差异无统计学意义。就检查耗时而言，VAO方式优于传统方法 [（5.9±1.9）min vs. （7.2±0.7）min，t=6.100，P<0.001]。结论：作为一个集合了客观验光与主觉验光功能的新仪器，VAO与传统验光方法的临床差异不大，而且差异随着被检者的近视度数增加而减少，其检查效率高于传统验光方法。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章

关键词 ：自适应光学, 近视, 验光

Abstract：

This study aimed to evaluate the accuracy and efficiency of the Visual Adaptive Optics Simulator (VAO, Spain) which is able to measure objective and subjective refraction. Methods: Therefractor VAO was an instrument based on the principle of adaptive optics. This was a series case study that included patients in Changsha Aier Eye Hospital from October to November 2017. Subjects with myopia were first measured by experienced optometrists for objective and subjective refraction using an autorefractor (Nidek ARK-1) and phoropter, respectively (designated as the "traditional approach"). Then, these subjects were again measured by a fresh technician with the VAO-based approach. The agreement of the results by these two approaches was compared with an intraclass correlation coefficient (ICC) and a paired-t test analysis. The efficiency of the VAO-based approach was also compared to the traditional approach with a paired-t test. Results: Seventy subjects (140 eyes, 38 males) with a mean age of 13.2±2.2 years participated in the study. The ICC of the objective refraction between the two approaches was 0.897, 0.907, 0.732 for spherical power, J0 and J45, respectively. The ICC of subjective refraction between the two approaches was 0.937, 0.891, 0.543, respectively. Specifically, the mean difference in objective and subjective refraction for spherical power with the two approaches was 0.46 D (95%CI: 0.36, 0.55 D) (t=9.663, P<0.001), and 0.32 D (95%CI: 0.25, 0.39 D) (t=9.087, P<0.001). However, the difference was found to diminish with an increase in the degree of myopia (r=-0.261, P<0.001) and the difference inspherical power dropped by 0.22 D [0.14 D, 0.32 D] for moderate-high myopia (spherical power <-3.00 D; t=4.987, P<0.001). For cylindrical power, there was no significant difference between the two approaches. Never the less, the average measurement time for the VAO-based approach was found to be significantly shorter than the traditional approach (5.9±1.9 min vs. 7.2±0.7 min, t=6.100, P<0.001). Conclusions: VAO produces clinically similar results compared to the traditional approach and the difference between the two approaches tends to be reduced with a greater degree of myopia. In addition, the efficiency of VAO is significantly better than the traditional approach.

Key words： adaptive optics myopia refraction

收稿日期: 2019-03-27

基金资助:

湖南省卫生计生委指导性科研项目（2013221）；爱尔眼科医院集团科研项目（AF2013001）；湖南省自然科学基金杰出青年科学基金项目（2019JJ20034）

通讯作者: 蓝卫忠（ORCID：0000-0002-3829-7415），Email：lanweizhong@aierchina.com

引用本文:

林政桦1 陈兆1，2 高文钰2 陈灿1，2 蓝卫忠1，2 杨智宽1，2. 一款新型主客观验光一体化设备的临床评估[J]. 中华眼视光学与视觉科学杂志, 2019, 21(12): 888-894. Zhenghua Lin1,Zhao Chen1, 2, Wenyu Gao2,Can Chen1, 2, Weizhong Lan1, 2, Zhikuang Yang1, 2. Accuracy and Efficiency of Refraction for Myopes Based on the Visual Adaptive Optics Simulator. Chinese Journal of Optometry Ophthalmology and Visual science, 2019, 21(12): 888-894. DOI: 10.3760/cma.j.issn.1674-845X.2019.12.002

链接本文:

https://www.cjoovs.com/CN/ 10.3760/cma.j.issn.1674-845X.2019.12.002 或 https://www.cjoovs.com/CN/Y2019/V21/I12/888

[1]	Hastings GD, Marsack JD, Nguyen LC, et al. Is an objective refraction optimised using the visual Strehl ratio better than a subjective refraction? Ophthalmic Physiol Opt, 2017, 37(3): 317-325. DOI: 10.1111/opo.12363.
[2]	Cathy. History of phoropters [EB/OL]. https://theopticalvisionsite. com/history-of-phoropters/, 2012-02-09/2018-04-28.
[3]	Pesudovs K, Parker KE, Cheng H, et al. The precision of wavefront refraction compared to subjective refraction and autorefraction. Optom Vis Sci, 2007, 84(5): 387-392. DOI: 10.1097/OPX. 0b013e31804f81a9.
[4]	Bullimore MA, Fusaro RE, Adams CW. The repeatability of automated and clinician refraction. Optom Vis Sci, 1998, 75(8): 617-622.
[5]	Holden BA, Fricke TR, Wilson DA, et al. Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology, 2016, 123(5): 1036-1042. DOI: 10.1016/j.ophtha.2016.01.006.
[6]	Otero C, Vilaseca M, Arjona M, et al. Comparison of the Adaptive Optics Vision Analyzer and the KR-1 W for measuring ocular wave aberrations. Clin Exp Optom, 2017, 100(1): 26-32. DOI: 10.1111/cxo.12413.
[7]	Porter J, Queener HM, Lin JE, et al. Adaptive optics for vision science. Hoboken: Wiley-Interscience, 2006, 3-11.
[8]	Fernández EJ1, Manzanera S, Piers P, et al. Adaptive Optics Visual Simulator. J Refract Surg, 2002, 18(5): S634-S638.
[9]	Prieto P, Fernández E, Manzanera S, et al. Adaptive optics with a programmable phase modulator: Applications in the human eye. Opt Express, 2004, 12(17): 4059-4071. DOI: 10.1364/opex. 12.004059.
[10]	Atchison DA. Recent advances in representation of monochromatic aberrations of human eyes. Clin Exp Optom, 2004, 87(3): 138- 148. DOI: 10.1111/j.1444-0938.2004.tb03166.x. [11] Thibos LN, Wheeler W, Horner D. Power vectors: An application of Fourier analysis to the description and statistical analysis of refractive error. Optom Vis Sci, 1997, 74(6): 367-375.
[12]	Kim A, Chuck RS. Wavefront-guided customized corneal ablation. Curr Opin Ophthalmol, 2008, 19(4): 314-320. DOI: 10.1097/ICU. 0b013e328302ccae.
[13]	Shetty R, Kochar S, Grover T, et al. Repeatability of a commercially available adaptive optics visual simulator and aberrometer in normal and keratoconic eyes. J Refract Surg, 2017, 33(11): 769-772. DOI: 10.3928/1081597X-20170718-02.
[14]	Marsack JD, Parker KE, Applegate RA. Performance of wavefront-guided soft lenses in three keratoconus subjects. Optom Vis Sci, 2008, 85(12): E1172-1178. DOI: 10.1097/ OPX.0b013e31818e8eaa.
[15]	Nochez Y, Majzoub S, Pisella PJ. Corneal aberration integrity after microincision cataract surgery: Prerequisite condition for prediction of total ocular aberrations. Br J Ophthalmol, 2010, 94(5): 661-663. DOI: 10.1136/bjo.2009.165498.
[16]	江洋琳, 王雁, 陈晓琴, 等. 自适应光学矫正高阶像差结合视知觉学习对难治性弱视的治疗效果. 中华眼视光学与视觉科学杂志, 2016, 18(10): 597-602. DOI: 10.3760/cma.j.issn.1674- 845X.2016.10.005.
[17]	López-Miguel A, Martínez-Almeida L, González-García MJ, et al. Precision of higher-order aberration measurements with a new Placido-disk topographer and Hartmann-Shack wavefront sensor. J Cataract Refract Surg, 2013, 39(2): 242-249. DOI: 10.1016/j.jcrs.2012.08.061.
[18]	余利华, 吕帆. 两种视力表检查89位学龄前儿童视力的对比研究. 眼视光学杂志, 2008, 10(2): 139-143. DOI: 10.3760/cma. j.issn.1674-845X.2008.02.015.
[19]	Visser N, Berendschot TT, Verbakel F, et al. Evaluation of the comparability and repeatability of four wavefront aberrometers. Invest Ophthalmol Vis Sci, 2011, 52(3): 1302-1311. DOI: 10.1167/iovs.10-5841.