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

10.12408/J.issn2223-4462.2024.01.014

袁淑敏(UN Sok Man)；賴一凡(LAI Iat Fan)

近視 ； 阿托品 ； 眼軸 ； 多區正向離焦 ； 等效球鏡度 ； Myopia ； Atropinel ； Axial length ； Defocus-incorporated multiple segment spectacle lenses

鏡湖醫學

24卷1期（2024 / 06 / 01）

42 - 44

繁體中文;英文

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.