基于个体眼睛参数预测角膜塑形镜使用时控制近视的有效性

P. Bezdetko, R. Parkhomets
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The average age was 11 [10; 13], from 7 to 14 years, of which 37 were females (61.7%), 23 males (38.3%). Ophthalmological examination consisted of visometry without correction and with optical correction, autorefractometry on the narrow pupil and in the state of drug cycloplegia, biomicroscopy, biometry, ophthalmoscopy of the central and peripheral fundus, keratotopography of the horns, pupilometry.\n\nThe results of the research: Among the studied people, the average refractive index at the beginning of the study was -2.25 [-3; -1.5] diopters. The initial diameter of the pupils was determined from 2.78 to 6.30 mm according to the pupilometry performed on the topograph. The average values of eccentricity (Ex) studied in the flat meridian averaged 0.51 [0.47; 0.58], in the steep - 0.53 [0.43; 0.59] at the beginning of the study. 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引用次数: 0

摘要

介绍。近视的发病率和进展过程是全世界最重要的医学和社会问题之一。近年来,国内外近视发病率呈上升趋势,在一些国家已成为一种流行病。近年来,最常见的有效控制近视的方法是角膜塑形镜片屈光治疗方法。目的:建立基于个体眼参数的角膜塑形镜控制近视效果的预测标准。研究对象和方法。临床研究共纳入60名儿童(117只眼),由加拿大KATT设计集团授权的联合设计公司SkyOptix选择。平均年龄11岁[10岁;[13], 7 ~ 14岁,其中女性37例(61.7%),男性23例(38.3%)。眼科检查包括无矫正和有矫正的粘度计、窄瞳及药物睫状体麻痹状态下的自折射、生物显微镜、生物测量、眼底中央和周围镜、角角膜地形图、瞳孔测量。研究结果:在研究对象中,研究开始时的平均折射率为-2.25 [-3;-1.5度。根据在地形仪上进行的瞳孔测量,确定瞳孔的初始直径从2.78到6.30 mm。在平子午线上研究的偏心率平均值为0.51 [0.47];0.58],在陡峭- 0.53 [0.43;0.59]在研究开始时。在我们的研究中,在研究开始时,角膜的角膜度数平均为43.5 [42.7;44.4]。根据概率分析结果(两年内APS增加),采用logistic回归模型构建方法。我们选择了五个因素特征(X):初始屈光度、瞳孔直径(X2)、角膜测量(X3)、角膜周围反区环受力(X4和X5)、角膜直径和治疗时眼轴长(APS)(初始)。在使用OKL的背景下,预测近视进展概率模型的逻辑回归方程为:模型的分类能力根据训练样本确定,为79.5%。使用该模型时,真阳性结果(APS增加小于0.3)的概率为91.9%,真阴性结果的概率为- 38.5%。roc曲线下面积(AUC) = 0.86 (p <0.001),表明性状分类质量较好。该模型的敏感性为82.6%,特异性为- 73.1%。作为研究和数学计算的一部分,还开发了一个交互式WEB应用程序,可以从连接到万维网的各种类型的设备访问它。IT(信息技术)中使用的现代解决方案和方法用于发展。因此,在检查进行性近视儿童时,在照相条件下注意瞳孔直径是很重要的,因为它可以预测近视的进展,并单独影响矫正的选择。预约屈光治疗前的角膜测量值越小,APS的大小值越大,因此该因素可作为预后指标。角膜沿与晶状体反向区相对应的外周环的不同地形力是一个预后的实际因素。考虑到眼睛的主要参数,您可以为每个近视儿童定制方法,改进角膜塑形镜片的个性化设计。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
PREDICTING THE EFFECTIVENESS OF MYOPIA CONTROL WHEN USING ORTHOKERATOLOGICAL LENSES BASED ON INDIVIDUAL EYE PARAMETERS
Introduction. The prevalence and progressive course of myopia is one of the most important medical and social problems worldwide. In recent years, in our country and abroad there is a tendency to increase the incidence of myopia, becoming in some countries an epidemic. In recent years, the most common method of effective control of myopia is the method of refractive therapy with orthokeratological lenses. Objective: To develop criteria for predicting the effectiveness of myopia control using orthokeratological lenses based on individual eye parameters. Object and methods of research. A total of 60 children (117 eyes) were included in the clinical study, who were selected by OKL of combined design, SkyOptix, licensed by KATT Design Group (Canada). The average age was 11 [10; 13], from 7 to 14 years, of which 37 were females (61.7%), 23 males (38.3%). Ophthalmological examination consisted of visometry without correction and with optical correction, autorefractometry on the narrow pupil and in the state of drug cycloplegia, biomicroscopy, biometry, ophthalmoscopy of the central and peripheral fundus, keratotopography of the horns, pupilometry. The results of the research: Among the studied people, the average refractive index at the beginning of the study was -2.25 [-3; -1.5] diopters. The initial diameter of the pupils was determined from 2.78 to 6.30 mm according to the pupilometry performed on the topograph. The average values of eccentricity (Ex) studied in the flat meridian averaged 0.51 [0.47; 0.58], in the steep - 0.53 [0.43; 0.59] at the beginning of the study. In our study, the keratometry of the cornea averaged 43.5 at the beginning of the study [42.7; 44.4]. As a result of probability analysis (increase in APS for two years), the method of construction of logistic regression models was used. We selected five factor features (X): Initial refraction, Pupil diameter (X2), Keratometry (X3), Peripheral corneal force on the reverse zone ring (X4 and X5), Corneal diameter, and Axial length of the eye (APS) at the time of treatment (initial). The equation of logistic regression of the model for predicting the probability of progression of myopia on the background of the use of OKL had the form: The classification ability of the model was determined according to the training sample and amounted to 79.5%. The probability of a true positive result (increase in APS less than 0.3) when using this model was 91.9%, and the probability of a true negative result - 38.5%. Evaluation of the quality of the model using ROC-analysis showed the following: the area under the ROC-curve (AUC) was equal to 0.86 (p <0.001), which characterizes the good quality of the classification of traits. The sensitivity of the model was 82.6%, specificity - 73.1%. As part of the research and mathematical calculations, an interactive WEB application was also developed, which can be accessed from various types of devices connected to the World Wide Web. Modern solutions and approaches used in IT (Information Technology) were used for development. Conclusions. It is determined that when examining a child with progressive myopia, it is important to pay attention to the diameter of the pupil in photographic conditions, because it can be a predictor of progression and influence the choice of correction individually. The smaller the value of keratometry before the appointment of refractive therapy, the greater the value of the size of the APS, so this factor can be indicated as prognostic. The differential topographic force of the cornea along the peripheral ring corresponding to the reverse zone of the lens is a prognostic practical factor. Taking into account the primary parameters of the eye allows you to customize the approach to each child with myopia, improving the individual design of orthokeratological lenses.
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