Abstract：【Objective】 To establish and validate the risk model of the failure of correction therapy in children with amblyopia. 【Methods】The clinical data of 129 children with amblyopia treated in our hospital from January 2020 to June 2023 were retrospectively analyzed and randomly divided into a training set (n=104) and a validation set (n=25) according to 8∶2. All the children were given routine corrective treatment. After 3 months of treatment, the refractive status was checked to evaluate the treatment effect. The effective and effective children were included in the effective group, and the ineffective children were included in the ineffective group. The factors influencing the effect of correction treatment in children with amblyopia were analyzed, and the prediction model of correction treatment ineffectiveness was established, and the model was validated and evaluated. 【Results】There were 23 cases (22.12%) in the training set and 7 cases (28.00%) in the verification set. Logistic regression analysis showed that the degree of disease, the difference of retinal nerve fiber layer (RNFL) and the difference of retinal thickness (MRT) in macular area were the factors affecting the effect of correction treatment in children with amblyopia (P<0.05). Using the above influencing factors as predictive variables, a nomogram prediction model was established. The C-index was 0.804 (95%CI:0.756-0.828), and the correction curve for predicting the failure of correction treatment in children with amblyopia with abnormal refractive error was close to the ideal curve (P>0.05). ROC curve analysis of the training set showed that the sensitivity, specificity and AUC of the nomogram model were 78.26%, 81.48% and 0.844 to predict the failure of corrective treatment in the children with amblyopia. ROC curve results of validation set showed that the sensitivity, specificity and AUC of the nomogram model to predict the failure of correction therapy in children with abnormal refractive amblyopia were 71.43%, 88.89% and 0.873. 【Conclusion】The degree of illness, RNFL difference and MRT difference are the factors that affect the therapeutic effect of correction in children with amblyopia. The nematic model based on this construction can predict the ineffective therapeutic effect of correction in children with amblyopia.
魏宁. 屈光异常弱视患儿矫正治疗无效的列线图风险模型建立及验证[J]. 医学临床研究, 2024, 41(12): 1874-1877.
WEI Ning. Establishment and Validation of A Nomogram Risk Model for the Failure of Corrective Treatment in Children with Amblyopia. JOURNAL OF CLINICAL RESEARCH, 2024, 41(12): 1874-1877.
[1] SEN S, SINGH P, SAXENA R. Management of amblyopia in pediatric patients: Current insights[J].Eye (Lond),2022, 36(1):44-56. [2] 中华医学会眼科学分会斜视与小儿眼科学组. 弱视诊断专家共识(2011年)[J].中华眼科杂志,2011,47(8):768. [3] AL-SALEM K M, SALEEM M S, EREIFEJ I, et al. Amblyopia screening for first and second-grade children in Jordan[J].Int J Ophthalmol,2022, 15(2):352-356. [4] 向剑波,郭燕,杨俊芳,等. 208例儿童屈光不正性弱视的治疗效果及其影响因素分析[J].医学临床研究,2023,40(1):21-23. [5] LIU X Y, GENG Z H, CHEN W F, et al. A prediction model and nomogram for technical difficulty of peroral endoscopic myotomy[J].Surg Endosc,2023, 37(4):2781-2788. [6] 中华医学会眼科学分会斜视与小儿眼科学组,中国医师协会眼科医师分会斜视与小儿眼科学组. 中国儿童弱视防治专家共识(2021年)[J].中华眼科杂志,2021,57(5):336-340. [7] 冯鑫媛,南莉,田璐. 传统弱视治疗联合调节训练对屈光异常弱视儿童的治疗效果评价[J].天津医药,2021,49(7):727-730. [8] BOKHARY K A, ALSABIH R I, EL-HITI G A. Binocular treatment for amblyopic children: a review[J].J Pak Med Assoc,2023, 73(3):627-634. [9] 熊燕,王玉梅,何光华,等. 屈光异常弱视矫正治疗预后不良患儿风险因素及RNFL表现特点分析[J].中国煤炭工业医学杂志,2023,26(2):194-199. [10] 巨朝娟,许寅聪,李康宁,等. 屈光异常弱视儿童RNFL和MRT的变化及预测疗效价值[J].国际眼科杂志,2023,23(11):1896-1901. [11] PARIKH R, SACHDEVA V, KEKUNNAYA R, et al. Retinal nerve fiber layer thickness in amblyopia[J].Indian J Ophthalmol,2022, 70(8):3065-3072. [12] ÇIÇEK N, DEMIRAYAK B, YIGIT F U. Evaluation of the macular sensitivity and retinal ganglion cell layer in unilateral amblyopia[J].Indian J Ophthalmol,2024 , 72(2):232.
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