兒童近視防控效果的臨床比較分析

Effects of different intervention methods on myopia progression in children

目的分别評估低濃度阿托品、光學離焦眼鏡及兩者聯合使用對兒童近視控制的效果。方法選取2019年4月~2022年4月在鏡湖醫院眼科中心就診的近視兒童,共166眼。低濃度阿托品54眼,光學離焦眼鏡56眼,兩者聯合使用56眼,隨訪1年,比較分析等效球鏡和眼軸。結果治療前,三組性别、年齡、眼軸差異均無統計學意義,等效球鏡度差異有統計學意義(F=7.268,P<0.001),其中聯合組為(-3.9±1.61)D,高於其他兩組。隨訪1年後,三組的等效球鏡度均有增加,低濃度阿托品、光學離焦眼鏡、聯合組分别增加了(-0.41±0.47)D、(-0.39±0.44)D、(-0.38±0.44)D,差異無統計學意義(P>0.05)。每組近視干預後的眼軸均有增長,低濃度阿托品、光學離焦眼鏡、聯合組分别增加了(0.24±0.19)mm、(0.21±0.29)mm、(0.17±0.16)mm,差異無統計學意義(P>0.05)。結論低濃度阿托品、光學離焦眼鏡、兩者聯合使用三種方法對兒童近視控制效果差異無統計學意義;與其他近視眼流行病調查和臨床研究比較,配戴傳統的近視眼鏡,每年等效球鏡度增加值和眼軸增長值比較,本研究三種方法均有延緩近視加深的效果。

Objective To compare the efficacy of low-concentration atropine,defocus-incorporated multiple segment spectacle lenses(DIMS)and low-concentration atropine combined with DIMS in the treatment of myopia in children.Methods A total of 85 children(166 eyes)with myopia aged 5-12 years old who were treated in Kiang Wu Hospital from April 2019 to April 2022 were included.The eyes were allocated into three groups:low-concentration atropine(54 eyes),DIMS(56 eyes),and the combined group(56 eyes).The spherical equivalent power(SE)and axial length were followed up for 1 year.Results At baseline,there were no significant differences in sex,age,or axial length,but there were significant differences in equivalent spherical power(F=7.268,P<0.001).The combined treatment group(-3.9±1.61 D)was more myopic than the other groups.SE increased significantly over 1 year in the atropine group(-0.41±0.47 D),DIMS group(-0.39±0.44 D),and combined treatment group(-0.38±0.44 D);however,there were no significant differences(P>0.05).Axial length increased significantly over 1 year in the atropine group(0.24±0.19 mm),DIMS group(0.21±0.29 mm),and combined treatment group(0.17±0.16 mm);there were no significant differences between the groups(P>0.05).Conclusion There was no significant difference between low-concentration atropine,DIMS and low-concentration atropine combined with DIMS in the treatment of myopia in children.Compared with wearing single-vision glasses which was investigated in other epidemiological investigations,the three myopia treatment methods examined herein can control the progression of myopia..