일산 거주 초등학생 및 중학생의 굴절이상도 변화에 따른 비구면계수와 각막 형상

국문 초록 (Abstract)

안질환이 없는 일산 거주 학생 163명 325안(초등학생 90명, 중학생 73명, 10.99± 2.08세, 2004년 기준)을 대상으로 조절마비하 자동굴절검사와 각막지형도 검사를 실시하여, 1년 동안의 변화도를 연령별(초등학생군과 중학생군) 및 굴절이상도별(근시군과 비근시군)로 분석하여 한국인에 적합한 콘택트렌즈의 설계와 제조 및 임상에서 콘택트렌즈를 피팅하는데 참고할만한 자료를 얻고자 하였다. 1년 동안 등가구면 굴절이상도는 -0.368±0.413D 근시 쪽으로 변화하였고(t=16.068, p=0.000), 1차 및 2차 측정에서 초등학생군과 중학생군의 평균 차이는 모두 유의하였으며(1차 측정: t=-3.696, p=0.000, 2차 측정: t=-3.016, p=0.003), 평균 변화도는 초등학생군에서 더 컸다(t=2.698, p=0.007). 근시군과 비근시군의 평균 변화도는 근시군에서 더 컸고(t=2.703, p=0.007), 초등학생군에서도 근시군에서 더 변화하였으며(t=3.002, p=0.003), 중학생군에서는 근시군의 변화도가 더 컸으나 유의성이 없었다(t=1.586, p=0.115). 30°반경의 비구면계수는 1차 및 2차 측정 모두 초등학생군과 중학생군 사이에 유의한 차이가 없었다. 평균 변화도는 중학생군에서 음(-)의 방향으로 좀 더 컸지만 유의성은 없었다(t=-1.711, p=0.088). 전체 대상에서 근시군의 변화도가 비근시군보다 더 컸고(t=1.873, p=0.062), 초등학생군에서도 근시군의 변화도가 더 컸으며(t=2.273, p=0.024), 중학생군에서는 비근시군에서 좀 더 변화하였지만 유의성은 없었다(t=-0.508, p=0.613). 전체 대상자의 각막 형상은 대부분 prolate 형상이었고, 비구면계수(Q)가 -0.4≤Q <-0.2의 범위에 해당하는 대상자의 분포가 가장 많았고, 중학생의 근시군에서 분포가 더 많은 것으로 조사되었다. 비구면계수는 근시군보다 비근시군에서 좀 더 양(+)의 방향인 값을 가졌으며, 비구면계수와 등가구면 굴절이상도의 변화는 상관성이 없었다(r=-0.035, p= 0.526).

다국어 초록 (Multilingual Abstract)

The present study conducted cycloplegic auto-refraction and corneal topography (Oculus Co., Keratograph V 1.65, Germany) for 325 eyes of 163 students living in Ilsan and analyzed changes for a year by age and refractive error in order to obtain reference data for contact lens fitting in clinics and for the design and manufacturing of contact lens fit for Koreans. For a year, the spherical equivalent of refractive error changed significantly (-0.368±0.413D) toward myopia(t=16.068, p=0.000), and the mean difference in the 1st and 2nd measurements was significantly in both elementary school students and middle school students(1st measurement: t=-3.696, p=0.000, 2nd measurement : t=-3.016, p=0.003), but the mean change was higher in elementary school students than in middle school ones and the difference was significant(t=2.698, p =0.007). In addition, the mean change was higher in the myopic group than in the non-myopic group(t=2.703, p=0.007). In the elementary school students the myopic group showed a larger change(t=3.002, p=0.003), and in the middle school students the myopic group showed a larger change but the difference was not significant(t=1.586, p=0.115). As to 30° radius asphericity, no significant difference was observed between elementary school students and middle school students in the 1st measurement(t=1.117, p=0.265) and in the 2nd measurement(t=0.084, p=0.933). The mean change was slightly higher toward the negative (-) in middle school students but not significant(t=-1.711, p=0.088). The mean change was slightly higher in the myopic group than in the non-myopic group(t=1.873, p=0.062). In elementary school students as well, the myopic group showed a larger change(t=2.273, p= 0.024), and in middle school students the non-myopic group showed a larger change but not significant(t=-0.508, p=0.613). The corneal shape was mostly that of a prolate ellipse, flattening from corneal apex to periphery. When asphericity(Q) range of -0.4≤Q<-0.2, and concentration in the range was particularly high in the myopic group of middle school students. Asphericity was slightly more positive (+) in the non-myopic group than in the myopic group, and no correlation was observed between the change of asphericity and the change of the spherical equivalent of refractive error(r=-0.035, p=0.526).