消旋山莨菪碱滴眼液治疗儿童近视

Raceanisodamine eye drops for the treatment of childhood myopia

目的对0.5%消旋山莨菪碱滴眼液治疗儿童近视进行临床观察,探讨其有效性和安全性。方法随机选取2005～2007年在我院斜弱视专科就诊的近视患儿30例,5～12岁,既往戴框架眼镜半年以上,排除存在眼部器质性病变及曾接受其他减缓近视发展治疗的患者。患者双眼点用0.5%消旋山莨菪碱滴眼液,早晚各一次,每次1～2滴,用药时间不少于半年;用药期间每半年复查一次,包括主观症状及常规眼科检查、瞳孔大小及对光反射检查、眼压检查、静态检影和眼轴。采用用药前后自身对照,对用药前后的年近视发展度、眼轴、眼压和视力进行配对t检验。结果22例患儿最终完成研究,8例因移居外地、未能坚持戴镜等原因退出研究,平均年龄为(7.6±1.8)岁,接受治疗时间0.7～2.7年。用药前后年近视发展分别为(-1.02±0.48)D/年和(-0.54±0.43)D/年,用药后年近视发展明显少于用药前(P<0.01)。用药前及用药后末次随诊矫正视力分别为4.92±0.11和4.98±0.07,用药后末次随诊矫正视力优于用药前(P<0.01)。用药前后眼轴分别为(24.75±1.65)mm和(25.27±1.76)mm,用药后眼轴较用药前增长(P<0.01)。患者无诉畏光、视近物不清,眼压、裂隙灯及眼底检查均无异常。结论0.5%消旋山莨菪碱滴眼液具有减缓儿童近视发展的作用,并有较好的安全性和耐受性。

Objective To evaluate the efficacy and safety of 0.5% raceanisodamine eye drops for the treatment of childhood myopia.Methods Thirty cases of myopic children aged 5 to 12 years with a history of wearing glasses for more than half a year were randomly selected.Myopic children with structural ophthalmic diseases or those who had undergone other treatments for reducing the progression of myopia were excluded.Both eyes were treated with 0.5% raceanisodamine eye drops twice daily for more than half a year.Symptoms,routine ophthalmic tests,pupil size and reflex,intraocular pressure,cycloplegic refraction and axial length were collected at the first visit and follow-up visits.The patients were followed up every half year during the treatment period.A paired-sample t-test was used to compare the yearly progression of myopia, axial length, intraocular pressure and visual acuity before and after treatment. Results Twenty-two ehihhen completed the trial. The yearly progression of myopia before and after treatment was -1.02±0.48 diopters per year and -0.54±0.43 diopters per year, respectively, and after treatment progression was significantly slower than before treatment （P〈0.01）. The corrected visual acuilies before treatment and at the last visit were 4.92±0.11 and 4.98±0.07, respectively, and the corrected visual acuity at the last visit was significantly better than before treatment （P〈0.01）. The axial lengths before and after treatment were （24.75±1.65）mm and （25.27±1.76） mm, respectively, and axial length after treatment was significantly longer （P〈0.01）. There were no complaints of photophobia ur reduction in near vision, and there were no significant findings with tonometry, slit-lamp biomicroseopy or ophthalmoscopy. Conclusion 0.5% raceanisodamine eye drops were effective in slwing the progression of myopia. The drops are relatively safe and well tolerated.