Turnbull Philip Raey Kidd, Munro Oliver James, Phillips John Robert
*PhD†BScSchool of Optometry and Vision Science, The University of Auckland, Auckland, New Zealand (all authors).
Optom Vis Sci. 2016 Sep;93(9):1120-6. doi: 10.1097/OPX.0000000000000957.
A number of optical methods for slowing myopia progression have been tested and are now available. However, data on real-world use in clinical use is scarce. Here, we present a review of the clinical outcomes for patients attending a specialist myopia control clinic at The University of Auckland Optometry School, NZ.
We report a comparative case series of 110 patients (aged 4-33 years, mean: 12.13 ± 4.58 years, 62% female) who attended the clinic between 2010 and 2014. Fifty-six were prescribed orthokeratology, 32 dual focus soft contact lenses, and 22 received advice only. Initial myopia, vitreous and axial eye length, previous myopia progression, age, number of myopic parents, and gender were not significantly different between orthokeratology and dual focus soft contact lens groups. Mean follow-up time for the orthokeratology and dual focus lens groups was the same (orthokeratology: 1.30 ± 0.88 years; dual focus lens: 1.33 ± 0.80 years (p = 0.989)). There was a significant reduction in the annualized myopia progression in both groups (orthokeratology: -1.17 ± 0.55 to -0.09 ± 017 D/yr, p < 0.001; dual focus soft contact lens: -1.15 ± 0.46 to -0.10 ± 0.23 D/yr, p < 0.001). There was no difference between orthokeratology and dual focus lens treatment efficacy (p = 0.763), nor in axial or vitreous chamber length changes after treatment (p = 0.184). One adverse event was reported over the 4-year period.
Both orthokeratology and dual focus soft contact lenses are effective strategies for targeting myopia progression in the clinic. We saw no significant difference in the efficacy of the two methods in this regard, and so we believe there are very few barriers for any contact lens practitioner to be actively promoting myopia control treatment to at-risk patients.
已经测试了多种减缓近视进展的光学方法，并且这些方法现在已经可用。然而，关于其在临床实际应用中的数据却很稀少。在此，我们对新西兰奥克兰大学视光学院专科近视控制诊所的患者临床结果进行了综述。
我们报告了一个比较病例系列，包含110例患者（年龄4 - 33岁，平均：12.13±4.58岁，62%为女性），他们在2010年至2014年间就诊于该诊所。56例患者被处方角膜塑形术，32例使用双焦点软性接触镜，22例仅接受建议。角膜塑形术组和双焦点软性接触镜组在初始近视、玻璃体和眼轴长度、既往近视进展、年龄、近视父母数量以及性别方面无显著差异。角膜塑形术组和双焦点镜片组的平均随访时间相同（角膜塑形术：1.30±0.88年；双焦点镜片：1.33±0.80年（p = 0.989））。两组的年化近视进展均显著降低（角膜塑形术：从 - 1.17±0.55降至 - 0.09±0.17 D/年，p < 0.001；双焦点软性接触镜：从 - 1.15±0.46降至 - 0.10±0.23 D/年，p < 0.001）。角膜塑形术和双焦点镜片的治疗效果无差异（p = 0.763），治疗后眼轴或玻璃体腔长度变化也无差异（p = 0.184）。在这4年期间报告了1例不良事件。
角膜塑形术和双焦点软性接触镜都是临床上针对近视进展的有效策略。我们发现这两种方法在这方面的效果没有显著差异，因此我们认为对于任何接触镜从业者而言，积极向高危患者推广近视控制治疗几乎没有障碍。
