目的:观察和分析配戴角膜塑形镜后调节幅度、眼轴的改变,探讨配戴角膜塑形镜延缓近视进展的机制。方法:前瞻性研究。收集2018-05/2019-08至我院治疗的7~14岁中低度青少年近视患者215例。行全面眼科检查后,根据检查结果、患者及家长依从...目的:观察和分析配戴角膜塑形镜后调节幅度、眼轴的改变,探讨配戴角膜塑形镜延缓近视进展的机制。方法:前瞻性研究。收集2018-05/2019-08至我院治疗的7~14岁中低度青少年近视患者215例。行全面眼科检查后,根据检查结果、患者及家长依从性等综合评估,其中113例患者配戴角膜塑形镜,102例患者配戴框架眼镜。配戴期间规律复诊,测量角膜塑形镜组戴镜前,戴镜后1、3、6mo,1a时的调节幅度及1a后两组眼轴的改变。结果:随访1a后,角膜塑形镜组共100例100眼完成随访,13例13眼失访。框架眼镜组共77例77眼完成随访,25例25眼失访。配戴角膜塑形镜前,患者调节幅度为13.57±2.47D,戴镜后1、3、6mo,1a后调节幅度均较戴镜前显著提高(均P<0.005),调节幅度在戴镜6mo时达到峰值,戴镜1a(15.44±2.35D)较戴镜6mo(15.74±2.32D)略有下降。配戴角膜塑形镜1a后眼轴增长明显小于框架眼镜组(0.13±0.15 vs 0.50±0.28mm,P<0.001)。结论:中低度青少年近视患者在配戴角膜塑形镜后伴有调节幅度的提高。配戴角膜塑形镜能够控制眼轴的增长,是目前较为有效地延缓青少年近视进展的方法之一。展开更多
AIM:To explore the photopic pupil size behavior in myopic children undergoing overnight orthokeratology(ortho-k)over 1-year period and its effects on the axial elongation.METHODS:A total of 202 Chinese myopic children...AIM:To explore the photopic pupil size behavior in myopic children undergoing overnight orthokeratology(ortho-k)over 1-year period and its effects on the axial elongation.METHODS:A total of 202 Chinese myopic children were enrolled in this prospective clinical trial.Ninetyfive subjects in ortho-k group and eighty-eight subjects in spectacle group completed the 1-year study.Axial length(AL)was measured before enrollment and every 6mo after the start of ortho-k.The photopic pupil diameter(PPD)was determined using the Pentacam AXL and measured in an examination room with lighting of 300-310 Lx.Stepwise multiple linear regression analysis was used to identify variables contribution to axial elongation.RESULTS:Compared with spectacle group,the average 1-year axial elongation was significantly slower in the ortho-k group(0.25±0.27 vs 0.44±0.23 mm,P<0.0001).In ortho-k group,PPDs significantly decreased from 4.21±0.62 mm to 3.94±0.53 mm after 1mo of lens wear(P=0.001,Bonferroni correction)and the change lasts for 3-month visit.No significantly change during the other follow-up visits was found(P>0.05,Bonferroni correction).The 4.81 mm PPD may be a possible cutoff point in the ortho-k group.Subjects with PPD below or equal to 4.81 mm tended to have smaller axial elongation compared to subjects with PPD above 4.81 mm after 1-year period(t=-3.09,P=0.003).In ortho-k group,univariate analyses indicated that those with older age,greater degree of myopia,longer AL,smaller baseline PPD(PPDbaseline)experienced a smaller change in AL.In multivariate analyses,older age,greater AL and smaller PPDbaseline were associated with smaller increases in AL.In spectacle group,PPD tended to be stable(P>0.05,Bonferroni correction)and did not affect axial growth.CONCLUSION:PPDs experience significantly decreases at 1-month and 3-month ortho-k treatment.Children with smaller PPD tend to experience slower axial elongation and may benefit more from ortho-k.展开更多
文摘目的:观察和分析配戴角膜塑形镜后调节幅度、眼轴的改变,探讨配戴角膜塑形镜延缓近视进展的机制。方法:前瞻性研究。收集2018-05/2019-08至我院治疗的7~14岁中低度青少年近视患者215例。行全面眼科检查后,根据检查结果、患者及家长依从性等综合评估,其中113例患者配戴角膜塑形镜,102例患者配戴框架眼镜。配戴期间规律复诊,测量角膜塑形镜组戴镜前,戴镜后1、3、6mo,1a时的调节幅度及1a后两组眼轴的改变。结果:随访1a后,角膜塑形镜组共100例100眼完成随访,13例13眼失访。框架眼镜组共77例77眼完成随访,25例25眼失访。配戴角膜塑形镜前,患者调节幅度为13.57±2.47D,戴镜后1、3、6mo,1a后调节幅度均较戴镜前显著提高(均P<0.005),调节幅度在戴镜6mo时达到峰值,戴镜1a(15.44±2.35D)较戴镜6mo(15.74±2.32D)略有下降。配戴角膜塑形镜1a后眼轴增长明显小于框架眼镜组(0.13±0.15 vs 0.50±0.28mm,P<0.001)。结论:中低度青少年近视患者在配戴角膜塑形镜后伴有调节幅度的提高。配戴角膜塑形镜能够控制眼轴的增长,是目前较为有效地延缓青少年近视进展的方法之一。
基金Supported by the Natural Science Foundation of Shanghai(No.18ZR1435700)Clinical Research Project of Shanghai Health and Family Planning Committee(No.201840199)。
文摘AIM:To explore the photopic pupil size behavior in myopic children undergoing overnight orthokeratology(ortho-k)over 1-year period and its effects on the axial elongation.METHODS:A total of 202 Chinese myopic children were enrolled in this prospective clinical trial.Ninetyfive subjects in ortho-k group and eighty-eight subjects in spectacle group completed the 1-year study.Axial length(AL)was measured before enrollment and every 6mo after the start of ortho-k.The photopic pupil diameter(PPD)was determined using the Pentacam AXL and measured in an examination room with lighting of 300-310 Lx.Stepwise multiple linear regression analysis was used to identify variables contribution to axial elongation.RESULTS:Compared with spectacle group,the average 1-year axial elongation was significantly slower in the ortho-k group(0.25±0.27 vs 0.44±0.23 mm,P<0.0001).In ortho-k group,PPDs significantly decreased from 4.21±0.62 mm to 3.94±0.53 mm after 1mo of lens wear(P=0.001,Bonferroni correction)and the change lasts for 3-month visit.No significantly change during the other follow-up visits was found(P>0.05,Bonferroni correction).The 4.81 mm PPD may be a possible cutoff point in the ortho-k group.Subjects with PPD below or equal to 4.81 mm tended to have smaller axial elongation compared to subjects with PPD above 4.81 mm after 1-year period(t=-3.09,P=0.003).In ortho-k group,univariate analyses indicated that those with older age,greater degree of myopia,longer AL,smaller baseline PPD(PPDbaseline)experienced a smaller change in AL.In multivariate analyses,older age,greater AL and smaller PPDbaseline were associated with smaller increases in AL.In spectacle group,PPD tended to be stable(P>0.05,Bonferroni correction)and did not affect axial growth.CONCLUSION:PPDs experience significantly decreases at 1-month and 3-month ortho-k treatment.Children with smaller PPD tend to experience slower axial elongation and may benefit more from ortho-k.
