角膜塑形镜对近视青少年脉络膜厚度的影响研究

Effects of orthokeratology on choroidal thickness in adolescent myopia

目的随访观察配戴角膜塑形镜及框架眼镜1年的青少年低、中度近视患者,探讨戴镜前后及2组间脉络膜厚度的差异。方法选取-1.00~-6.00 D的252例青少年近视患者,随机分为试验组及对照组,试验组配戴角膜塑形镜,对照组配戴框架眼镜。应用重复测量方差分析、独立样本t检验分析患者治疗1年期间的眼轴,黄斑中心凹及鼻侧、颞侧脉络膜厚度(应用EDI-SD OCT)。结果治疗1年后,试验组患者的眼轴增加明显缓于对照组(低度近视组t=19.071,P<0.001;中度近视组t=19.457,P<0.001);试验组戴镜后各时间点的脉络膜厚度与戴镜前相比均有增厚(P<0.001),低度近视组在戴镜1个月内脉络膜增厚最为明显(P<0.05),1个月后基本趋于稳定(P>0.05),而中度近视组在戴镜3个月内脉络膜增厚最为明显(P<0.05),3个月后基本趋于稳定(P>0.05)。颞侧脉络膜厚度厚于鼻侧。1年后试验组与对照组脉络膜厚度比较差异均有统计学意义(P<0.001)。结论青少年近视患者配戴角膜塑形镜后,眼轴增长变慢,早期脉络膜厚度有不同程度增加,1~3个月后基本保持稳定。

Objective To observe the adolescents with low and moderate myopia who wore orthokeratology(OK)and frame glasses for 1 year,and to investigate the difference of choroidal thickness.Methods Two hundred and fifty-two cases of adolescent myopia(-1.00 D~-6.00 D)were selected.they were randomly divided into the experimental group and the control group.The experimental group wore orthokeratology lens,and the control group wore frame glasses.Their AL,subfoveal choroidal thickness(SFChT),nasal choroidal thickness and Temporal choroidal thickness(using EDI-SD OCT)were observed for 1 year,and the data was analyzed by repeated measurement analysis of variance and independent sample t-test.Results After 1 year of treatment,the increase of AL in the experimental group was significantly slower than that in the control group(low myopia group:t=19.071,P<0.001;moderate myopia group:t=19.457,P<0.001).In the experimental group,the choroidal thickness at each time point after wearing OK lens was thicker than before(P<0.001).The choroid thickening was most obvious in 1 month after wearing OK lens in low myopia group(P<0.05).After 1 month,the choroidal thickness of each point basically tended to be stable(P>0.05).The choroid thickening was most obvious in 3 months after wearing OK lens in moderate myopia group(P<0.05).After 3 months,the choroidal thickness of each point basically tended to be stable(P>0.05).The thickness of temporal choroid was thicker than that of nasal side.One year later,there were significant differences in choroidal thickness between the experimental group and the control group(P<0.001).Conclusion After wearing OK lenses,the AL growth slowed down,while the choroidal thickness increased in early stage and remained stable after 1 month to 3 months.