降低框架眼镜球镜度数间隔有可能延缓青少年近视进展

Decreasing the spherical lens adjustment interval maybe delay the progression of children's myopia

目的观察近视儿童配戴以0.05 D、0.25 D球镜间隔制作的框架眼镜后的近视进展情况。设计回顾性病例系列。研究对象收集2019-2021年北京同仁医院配戴采用0.05 D球镜间隔(53例,其中男性25例)和0.25 D球镜间隔(73例,其中男性38例)设计单焦点框架眼镜的连续病例126例。方法对北京市眼科研究所电子病历系统中上述儿童的配镜资料进行回顾分析。收集年龄、性别、屈光度、前后两次验光的间隔时间、镜片类型等相关信息。两组验光的方法与环境、镜片的材质、制造工艺、生产厂家均一致,差别仅为获取验光处方时球镜的调整间隔分别为0.05 D和0.25 D。取右眼数据统计分析。两组儿童近视进展情况的比较,采用独立样本t检验、广义估计方程等方法。主要指标月均等效球镜变化。结果0.05 D、0.25 D球镜间隔组平均年龄分别为(8.2±2.3)岁和(8.7±2.4)岁(t=-1.276,P=0.204)。两组相邻两次配镜间隔时间分别为(9.5±5.6)个月和(11.2±5.6)个月(t=-1.692,P=0.093)。第一次配镜时两组等效球镜分别为(-2.24±1.49)D和(-2.46±2.42)D(t=0.587,P=0.558);第二次配镜时两组等效球镜分别为(-2.76±1.65)D和(-3.36±2.62)D(t=1.457,P=0.148)。0.05 D组前后两次配镜间等效球镜变化(-0.52±0.60)D,明显低于0.25 D球镜间隔组的(-0.89±0.79)D(t=2.887,P=0.005);0.05 D组月均等效球镜变化(-0.05±0.05)D明显低于0.25 D组的(-0.09±0.05)D(t=4.582,P<0.001)。通过广义估计方程分析,月均等效球镜变化与年龄不相关(χ^(2)=11.241,P=0.260);与验光处方球镜间隔(χ^(2)=32.826,P<0.001)和前后相邻两次配镜的间隔时间(χ^(2)=198.715,P<0.001)相关。结论与以0.25 D为间隔调整球镜相比,以0.05 D间隔调整球镜制作出的框架眼镜显示出可延缓儿童近视进展的趋势。

Objective To observe the progress of myopia in children with myopia after wearing frame glasses with 0.05 D and 0.25 D spherical lens interval.Design Retrospective case series.Participants 126 consecutive myopia children wore spectacles with 0.05 D spherical interval(53 cases,25 males)and 0.25 D spherical interval(73 cases,38 males)design from 2019 to 2021 in Beijing Tongren Hospital.Methods The data of 126 children in electronic medical record system of Beijing Institute of Ophthalmology was retrospectively analyzed.Extract relevant information including age,gender,diopter,time between before and after optometry,lens type,etc.The method and environment of optometry,material,manufacturing process and manufacturer of the two sets of lenses were the same,and the only difference was that the adjustment interval of the spherical lens when obtaining the prescription was 0.05 D and 0.25 D respectively.The data of the right eye was taken into the statistical analysis.The progression of myopia in the two groups was compared using independent sample t test and generalized estimating equation.Main Outcome Measures The monthly average changes of spherical equivalents.Results In 0.05 D spherical interval group and 0.25 D spherical interval group,the mean ages was 8.2±2.3 and 8.7±2.4 years,respectively(t=-1.276,P=0.204).The interval time between two adjacent prescriptions was 9.5±5.6 and 11.2±5.6 months respectively(t=-1.692,P=0.093).The equivalent spherical lenses was-2.24±1.49 D and-2.46±2.42 D respectively at the first prescription(t=0.587,P=0.558).The equivalent spherical lenses was-2.76±1.65 D and-3.36±2.62 D respectively in the second prescription(t=1.457,P=0.148).The equivalent spherical lens changes between the two prescriptions was-0.52±0.60 D and-0.89±0.79 D respectively(t=2.887,P=0.005).The monthly average changes of spherical equivalents was-0.05±0.05 D and-0.09±0.05 D,respectively(t=4.582,P<0.001).Through generalized estimating equation analysis,the average monthly equivalent spherical lens change was not correlated with age(χ^(2)=11.241,P=0.260),but was correlated with the interval between prescription spherical lenses(χ^(2)=32.826,P<0.001)and the time interval between two prescriptions(χ^(2)=198.715,P<0.001).Conclusion Compared with adjusting the spherical lens at 0.25 D interval,the frame glasses made by adjusting the spherical lens at 0.05 D interval shows a tendency to delay the progression of children's myopia,which is worth verifying by further randomized controlled experiments.