剑桥近视防控研究：与近视进展相关的变量

The Cambridge Anti-myopia Study: variables associated with myopia progression.

作者信息

Price Holly, Allen Peter M, Radhakrishnan Hema, Calver Richard, Rae Sheila, Theagarayan Baskar, Sailoganathan Ananth, O'Leary Daniel J

机构信息

*PhD Vision and Eye Research Unit (HP, PMA, RC, SR, BT), Postgraduate Medical Institute, Department of Vision and Hearing Sciences, Anglia Ruskin University, Cambridge, United Kingdom; Vision Cooperative Research Centre (HP, PMA, HR, RC, SR, BT, DJO), Sydney, Australia; Faculty of Life Sciences (HR), University of Manchester, Manchester, United Kingdom; School of Optometry (AS), National Institute of Ophthalmic Sciences, Academic arm of The Tun Hussein Onn National Eye Hospital, Malaysia; and Cardiff Metropolitan University, Cardiff (DJO), Wales, United Kingdom.

出版信息

Optom Vis Sci. 2013 Nov;90(11):1274-83. doi: 10.1097/OPX.0000000000000067.

DOI:10.1097/OPX.0000000000000067

PMID:24100478

Abstract

PURPOSE

To identify variables associated with myopia progression and to identify any interaction between accommodative function, myopia progression, age, and treatment effect in the Cambridge Anti-Myopia Study.

METHODS

Contact lenses were used to improve static accommodation by altering ocular spherical aberration, and vision training was performed to improve dynamic accommodation. One hundred forty-two subjects, aged 14-21 years, were recruited who had a minimum of -0.75D of myopia. Subjects were assigned to contact lens treatment only, vision training only, contact lens treatment and vision training, or control group. Spherical aberration, lag of accommodation, accommodative convergence/accommodation (AC/A) ratio, accommodative facility, ocular biometry, and refractive error were measured at regular intervals throughout the 2-year trial.

RESULTS

Ninety-five subjects completed the 24-month trial period. There was no significant difference in myopia progression between the four treatment groups at 24 months. Age, lag of accommodation, and AC/A ratio were significantly associated with myopia progression. There was a significant treatment effect at 12 months in the contact lens treatment group in younger subjects, based on a median split, aged under 16.9 years (p = 0.005). This treatment effect was not maintained over the second year of the trial. Younger subjects experienced a greater reduction in lag of accommodation with the treatment contact lens at 3 months (p = 0.03), compared to older contact lens treatment and control groups. There was no interaction between AC/A ratio and contact lens treatment effect.

CONCLUSIONS

Age, lag of accommodation, and AC/A ratio were significantly associated with myopia progression. Although there was no significant treatment effect at 24 months, an interaction between age and contact lens treatment suggests younger subjects may be more amenable, at least in the short term, to alteration of the visual system using optical treatments.

摘要

目的

在剑桥近视防控研究中，确定与近视进展相关的变量，并确定调节功能、近视进展、年龄和治疗效果之间的相互作用。

方法

通过改变眼的球差使用隐形眼镜来改善静态调节，并进行视觉训练以改善动态调节。招募了142名年龄在14至21岁之间、近视度数至少为-0.75D的受试者。受试者被分配到仅接受隐形眼镜治疗组、仅接受视觉训练组、隐形眼镜治疗加视觉训练组或对照组。在为期2年的试验中，定期测量球差、调节滞后、调节性集合/调节（AC/A）比值、调节灵活度、眼生物测量参数和屈光不正。

结果

95名受试者完成了24个月的试验期。24个月时，四个治疗组之间的近视进展没有显著差异。年龄、调节滞后和AC/A比值与近视进展显著相关。根据年龄中位数划分，16.9岁以下的年轻受试者在12个月时，隐形眼镜治疗组有显著的治疗效果（p = 0.005）。在试验的第二年，这种治疗效果没有持续。与年龄较大的隐形眼镜治疗组和对照组相比，年轻受试者在3个月时使用治疗性隐形眼镜后调节滞后的减少更为明显（p = 0.03）。AC/A比值与隐形眼镜治疗效果之间没有相互作用。