类太阳光谱LED照明对儿童青少年视网膜血流灌注影响的随机对照临床试验

Effects of sunlike spectrum LED illumination on retinal blood perfusion in children and adolescents:a randomized controlled trial

目的分析类太阳光谱发光二极管(LED)照明对视网膜血流灌注影响,探索类太阳光谱LED照明与儿童青少年眼健康指标的相关性。方法在上海市眼病防治中心和线上平台发放研究招募贴,招募适龄学生。采取随机对照双盲设计,对照组(11人)为普通LED台灯、试验组(12人)为类太阳光谱LED台灯,与太阳光谱拟合度分别为87%和95%。采用两独立样本t检验和多元线性回归模型比较两组试验前后视网膜血流灌注改变量。结果近距离阅读1 h后,普通LED台灯组受试者视网膜浅层和深层毛细血管密度均有下降(浅层:-3.05±2.04,P<0.01;深层:-4.03±4.94,P=0.02),类太阳光谱LED台灯组视网膜浅层毛细血管密度未见明显降低(浅层:-0.59±1.44,P=0.18;深层:-0.49±4.27,P=0.70)。多元回归分析发现,类太阳光谱LED照明相比普通LED照明可明显缓解视网膜浅层和深层毛细血管密度下降(β=2.83,95%CI=1.54~4.12,P<0.01;β=4.21,95%CI=0.58~7.84,P=0.02)。结论类太阳光谱LED照明可缓解儿童青少年近距离用眼时引起的视网膜血流灌注降低,可能延缓近视发生发展,未来近视防控工作需要关注人工照明的光谱功率分布。

Objective To analyze the effect of sunlike spectrum LED illumination on retinal blood flow perfusion,and to explore the the correlation between sunlike spectrum LED illumination and eye health indicators in children and adolescents.Methods A randomized control double-blind trial was conducted.The ordinary LED table lamp in the control group(11)and the sunlike spectrum LED table lamp in the experimental group(12)had a fitting degree of 87%and 95%with the daylighting spectrum,respectively.Two-sample independent t test and multivariable linear regression model were applied to compare the changes of retinal blood perfusion before and after the trial.Results After near reading for 1 hour,the retinal capillary density in the superficial and deep layers of the subjects in the ordinary LED illumination group decreased(superficial layer:-3.05±2.04,P<0.01;deep layer:-4.03±4.94,P=0.02),no significant decrease was found in the sunlike spectrum LED illumination group(superficial layer:-0.59±1.44,P=0.18;deep layer:-0.49±4.27,P=0.70).Multivariable regression analysis found that compared with ordinary LED illumination,sunlike spectrum LED illumination could significantly alleviate the decrease in capillary density in the superficial and deep retinal layers,respectively(β=2.83,95%CI=1.54-4.12,P<0.01;β=4.21,95%CI=0.58-7.84,P=0.02).Conclusion Sunlike spectrum LED illumination can alleviate the decrease in retinal blood perfusion caused by near work among children and adolescents,suggesting that it may delay the onset and development of myopia.Prevention and control of myopia needs to pay attention to the spectral power distribution of artificial illumination.