中国人4～10歳児の屈折時における点眼の必要性の評価

Evaluation of the Necessity for Cycloplegia During Refraction of Chinese Children Between 4 and 10 Years Old.

• Xinting Liu
• Liang Ye
• Chong Chen
• Minfeng Chen
• Shuyun Wen
• Xinjie Mao

抄録

目的:

4歳から10歳までの小児の屈折状態に対するアトロピンシクロプレジアの効果を調べ、屈折矯正中の屈折状態や年齢の違いによるシクロプレジアの必要性を評価すること。

PURPOSE: To determine the effect of atropine cycloplegia on the refractive status of children aged 4 to 10 years and to evaluate the necessity of cycloplegia for different refractive states and ages during refractive correction.

方法:

このレトロスペクティブ研究では，低，中，高の近視および遠視の患者を対象に，年齢別に 4～6 歳（n = 5,320）と 7～10 歳（n = 6,475）の 2 つのグループに分けた．すべての患者にアトロピン硫酸塩によるシクロプレジアを施行した。屈折異常はレチノスコピーで測定した。

METHODS: This retrospective study included patients with low, moderate, and high myopia and hyperopia who were divided into two groups by age: 4 to 6 years (n = 5,320) and 7 to 10 years (n = 6,475). Every patient underwent cycloplegia with atropine sulphate. Refractive errors were measured by retinoscopy.

結果:

各群内では，シクロプレグと非シクロプレグの屈折異常（DIFF）の差は有意であった．DIFFは年齢と負の相関があった（r = -0.356、P < 0.001）。処方された眼鏡と非cycloplegic refraction（DIFF）の屈折異常の差は、近視が高い群で最も大きかった（4～6歳群では0.83±1.15ジオプター[D]、7～10歳群では0.60±1.47ジオプター[D]）。サイクロプレグ投与後，4～6年群では軽度の近視患者の62.5％が遠視または遠視になり，7～10年群では軽度の近視患者の11.3％が遠視または遠視になった．

RESULTS: Within each group, the differences between cycloplegic and non-cycloplegic refractive errors (DIFF) were significant. DIFF was negatively correlated with age (r = -0.356, P < .001). The differences in refractive error between prescribed glasses and non-cycloplegic refraction (DIFF) were largest in the groups with high myopia (0.83 ± 1.15 diopters [D] in the 4 to 6 years group and 0.60 ± 1.47 D in the 7 to 10 years group). After cycloplegia, 62.5% of the patients with mild myopia became emmetropic or hyperopic in the 4 to 6 years group, and 11.3% of the patients with mild myopia became emmetropic or hyperopic in the 7 to 10 years group.

結論:

サイクロプレジアを使用しないと、近視の子供の屈折異常を過大評価する傾向があります。正確な眼鏡処方のためには、4歳から10歳までの子供、特に近視が強い子供にはサイクロプレジアを使用すべきである。J Pediatr Ophthalmol Strabismus.2020;57(4):257-263.

CONCLUSIONS: Without cycloplegia, autorefraction tends to overestimate refractive error in children with myopia. For accurate glasses prescriptions, cycloplegia should be used for children between 4 and 10 years, especially for children with high myopia. [J Pediatr Ophthalmol Strabismus. 2020;57(4):257-263.].

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