0.05%阿托品控制儿童近视眼进展的研究

The study of 0.05% atropine solution for controlling myopia progression in children

目的探讨0.05%阿托品控制儿童近视眼进展的效果。设计前瞻性病例系列。研究对象64例6～13岁患近视眼的学龄儿童。方法将64例临床诊断的近视眼学龄儿童按照随机数字表法随机分为两组:试验组30例,每晚睡前点用0.05%阿托品滴眼液;对照组34例,不做任何治疗。观察1年,每月1次,检查视力、屈光状态和眼轴,比较两组的差异。主要指标屈光度、眼轴。结果阿托品治疗组患者近视眼进展(-0.28±0.26)D/年,显著低于对照组(-0.75±0.35)D/年(P=0.008)。阿托品治疗组眼轴增长(0.30±0.28)mm也低于对照组(0.65±0.61)mm(P=0.004)。阿托品治疗组患者无畏光、视物不清,眼压、裂隙灯及眼底检查无异常。结论在至少1年规律应用的情况下,0.05%阿托品是控制多数学龄儿童近视眼进展的有效药物。

Objective To evaluate the efficacy of 0.05% atropine solution for controlling myopia progression in children. Design Prospective case series. Participants A group of 64 myopic school children. Methods This retrospective, case-control study enrolled 64 myopic school children from 2007 to 2008. The children （30 boys, 34 girls; 6-13 years of age） were divided into 2 groups. A subgroup of 30 children （14 boys, 16 girls） who received atropine eye drops （0.05%） every evening, and a subgroup of 34 children （16 boys, 18 girls）, who remained untreated, served as controls. The visual acuity, the status of refraction and the axial length were examined every month, and followed up for 1 year. Main Outcome Measures Myopic diopters and axial length. Results The myopia progression for the group of patients treated with 0.05% atropine eyedrop was -0.28± 0.26 D/year, significantly lower than that of the control group of -0.75 ±0.35 D/year （ P =0.008）. Axial length increase was also smaller in the atropine group （0.30±0.28 mm） than in the control group （0.65±0.61mm） （P=-0.004）. There were no complaints of photaphobia or reduce in near vision and there were no significant findings with tonometry, slit-lamp biomicroscopy or ophthalmoscopy in the treatment group. Conclusions The results of this study demonstrate that, with regular instillation for at least a period of 1 year, topical 0.05% atropine is an effective agent for controlling myopia progression in school children.