摘要目的:评估3种电脑自动验光仪检测儿童青少年屈光不正的差异性、一致性和准确性,为临床使用提供依据.方法:前瞻性研究.选择2019年5—6月温州医科大学附属眼视光医院视光门诊9～18岁儿童青少年屈光不正患者449例(449眼).先由3名护士按照随机图表顺序分别应用国眼RM-9000、尼德克AR-1、拓普康RM-800这3种自动验光仪对入选的儿童青少年进行电脑验光,再由专业眼视光医师对入选的儿童青少年进行综合验光仪主觉验光.采用Wilcoxon符号秩检验对3种自动验光仪测得的结果与综合验光仪主觉验光测得的结果进行比较.3种自动验光仪测得的结果之间的比较采用Friedman检验.结果:国眼RM-9000、尼德克AR-1、拓普康RM-800和主觉验光测得的等效球镜度(SE)中位数(四分位数间距)分别为-2.38(2.63)D、-2.63(2.44)D、-2.75(2.56)D和-2.38(2.50)D,3种自动验光仪测得的SE差异有统计学意义(χ2=384.893,P<0.001).3种自动验光仪测得的SE分别与主觉验光结果进行比较,国眼RM-9000测得的SE与主觉验光结果比较差异无统计学意义(Z=-0.199,P=0.842),而尼德克AR-1和拓普康RM-800测得的SE分别与主觉验光结果比较均差异有统计学意义(Z=-11.758,P<0.001;Z=-15.733,P<0.001).结论:国眼RM-9000和尼德克AR-1在自然瞳孔状态下检测儿童青少年屈光不正具有较好的准确性,而拓普康RM-800的准确性欠佳.3种仪器检测儿童青少年屈光不正的测量结果存在差异.

abstractsObjective: To assess the validity, differences and agreements among measurements of refractive status in school-aged children and adolescents using Goaleye RM-9000, Nidek AR-1 and Topcon RM-800. Methods: In this prospective study, 449 individuals (449 right eyes) aged from 9 to 18 from Eye Hospital, Wenzhou Medical University were measured in turns by the three autorefractors for their refractive status in random sequence from May to June, 2019. Then a professional optometrist conducted a subjective refraction for them by phoropter. All measurements by the three autorefractors were compared using a Friedman test, and measurements by the three autorefractors were compared with the subjective refraction respectively using Wilcoxon signed ranks test. Results: The median of spherical equivalent (SE) from Goaleye RM-9000, Nidek AR-1, Topcon RM-800 and the subjective refraction were -2.38(2.63)D, -2.63(2.44)D, -2.75(2.56)D and -2.38(2.50)D, respectively. There were significant differences among the SE of the three autorefractors in the refraction measurement of school-aged children and adolescents (χ2=384.893, P<0.001). There were no significant differences between the SE of Goaleye RM-9000 and subjective refraction (Z=-0.199, P=0.842), There were significant differences between the SE of Nidek AR-1 and subjective refraction (Z=-11.753, P<0.001), There were significant differences between the SE of Topcon RM-800 and subjective refraction (Z=-15.733, P<0.001). Conclusion: The measurements conducted by Goaleye RM-9000 and Nidek AR-1 were more accurate than by Topcon RM-800. There were significant differences among the results of the three autorefractors in the refraction measurement of school-aged children and adolescents.