山东大学耳鼻喉眼学报 ›› 2025, Vol. 39 ›› Issue (6): 118-125.doi: 10.6040/j.issn.1673-3770.0.2024.229

• 论著 • 上一篇    

影响婴幼儿定量视力评估检出的相关因素

陈婷毅1,2,龚慧2,陈亮2,梁平2,王鲜3,刘亚玲2,胡亚柔2,张国明1,2   

  1. 1.贵州医科大学 临床医学院, 贵州 贵阳 550004;
    2.深圳市眼科医院/深圳市眼病防治研究所, 广东 深圳 518040;
    3.贵州医科大学附属医院 眼科, 贵州 贵阳 550004
  • 发布日期:2025-11-19
  • 通讯作者: 张国明. E-mail:zhangguoming@sz-eyes.com

Analysis of factors affecting detection in quantitative visual assessment of infants

CHEN Tingyi1,2, GONG Hui2, CHEN Liang2, LIANG Ping2, WANG Xian3, LIU Yaling2, HU Yarou2,ZHANG Guoming1,2   

  1. 1. Clinical Medical College, Guizhou Medical University, Guiyang 550004, Guizhou, China 2. Shenzhen Eye Hospital, Shenzhen Eye Institute, Shenzhen 518040, Guangdong, China3. Department of Ophthalmology, Affiliated Hospital of Guizhou Medical University, Guiyang 550004, Guizhou, China
  • Published:2025-11-19

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摘要： 目的 探讨婴幼儿定量视力评估检出的相关因素,提升婴幼儿定量视力评估检出率。 方法 采取前瞻性观察性研究方法,选取就诊于深圳市眼科医院小儿眼底病门诊的0~36月龄的240例婴幼儿作为研究对象,由两名不同经验的检查者进行定量视力评估,记录婴幼儿的基本情况、起始视标选择、配合度以及检查前准备程度等。使用Logistic回归模型筛选婴幼儿定量视力评估检出的影响因素。基于影响因素采用受试者工作特征曲线(receiver operating characteristic, ROC)构建婴幼儿定量视力评估检出的列线图预测模型,并用Hosmer-Lemeshow(H-L)检验和Calibration校准曲线评估预测模型的校准度。 结果 本研究共纳入婴幼儿240例。以婴幼儿定量视力是否检出为因变量,性别、有无早产、有无眼病、年龄、起始试标的选择、配合度、检查前准备程度为自变量,单因素Logistic回归分析显示其中有效起始视标(OR=119.182, 95%CI:45.904~309.435)、配合度高(OR=14.806, 95%CI:7.014~31.256)以及检查前准备程度高(OR=182.668, 95%CI:25.166~1 325.898)为正向影响因素,其检出率更高;有眼病(OR=0.178, 95%CI:0.093~0.338)、早产(OR=0. 329, 95%CI:0.184~0.586)为负向影响因素,检出率更低,差异有统计学意义。将有统计意义的相关因素纳入多因素模型,并进行逐步回归,有效起始试标(OR=23.340, 95%CI:2.973~183.243)、配合度(OR=20.380, 95%CI:2.859~145.278)以及检查前准备(OR=1 380.262,95%CI:I30.876~61 702.162)为影响婴幼儿定量视力评估检出的关键因素。ROC曲线分析结果显示,预测模型预测婴幼儿定量视力评估检出的的曲线下面积(area under the curve, AUC)为 0.995(95%CI:0.991~1.000),灵敏度、特异度、准确率分别为95.00%、100%、96.60%。 结论 婴幼儿的定量视力评估检出率受多种因素影响,检测者需要做好检查前准备工作、选择有效的起始视标,提高婴幼儿配合度,最终提升实际临床工作中婴幼儿定量视力评估的检率。

关键词: 婴幼儿, 定量视力评估, 定性视力评估, 受试者工作特征曲线, 视力评估检出率

Abstract: Objective To analyze the factors affecting the detection of quantitative visual assessment in infants, extract clinical experience, and improve detection rates. Methods This prospective observational study included 240 infants(0-36 months)who visited the pediatric fundus clinic at Shenzhen Eye Hospital between November 2022 and February 2024. Two examiners with different levels of experience conducted quantitative visual assessments, recording the basic characteristics, initial visual target selection, cooperation level, and preparation status of each child. A logistic regression model was used to identify factors influencing the detection of quantitative visual assessment. Based on these factors, a receiver operating characteristic(ROC)curve was used to develop a nomogram prediction model, with calibration evaluated using the Hosmer-Lemeshow(H-L)test and calibration curves. Results This study included 240 infants. Univariate logistic regression analysis identified effective initial visual targets(OR=119.182, 95%CI:45.904-309.435), high level of cooperation(OR=14.806, 95%CI:7.014-31.256)and thorough preparation(OR=182.668, 95%CI:25.166-1 325.898)as positive influencing factors for higher detection rates. In contrast, the presence of eye disease(OR=0.178, 95%CI:0.093-0.338)and premature birth(OR=0.329, 95%CI:0.184-0.586)were negative influencing factors, associated with lower detection rates. These differences were statistically significant. Multivariate regression analysis, including statistically significant factors, indicated that effective initial visual targets(OR=23.340, 95%CI:2.973-183.243), cooperation level(OR=20.380, 95%CI:2.859-145.278)and thorough preparation(OR=1 380.262, 95%CI:130.876-61 702.162)were key factors influencing the detection of quantitative visual assessment in infants. The analysis of the ROC curve revealed that the area under the curve(AUC)of the prediction model was 0.995(95%CI:0.991-1.000), with a sensitivity of 95.00%, specificity of 100% and precision of 96.60%. Conclusion The detection rate of quantitative visual assessment in infants is influenced by multiple factors. To improve detection rates in clinical practice, it is essential to ensure thorough preparation, select effective initial visual targets, and enhance the level of cooperation of infants.

Key words: Infants, Quantitative Visual Acuity Assessment, Qualitative Visual Acuity Assessment, Receiver operating characteristic, Detection Rate of Quantitative Visual Assessment

中图分类号: 

  • R779.7
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