Sun Yun-Yun, Li Shi-Ming, Li Si-Yuan, Kang Meng-Tian, Liu Luo-Ru, Meng Bo, Zhang Feng-Ju, Millodot Michel, Wang Ningli
Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University, Beijing, China, 100730.
Department of Ophthalmology, Beijing Children's Hospital, Capital Medical University, Beijing, China.
Graefes Arch Clin Exp Ophthalmol. 2017 Jan;255(1):189-195. doi: 10.1007/s00417-016-3529-1. Epub 2016 Oct 29.
To investigate the effects of no correction versus full correction on myopia progression in Chinese children over a period of 2 years.
Myopia was defined as cycloplegic spherical equivalent (SE) of ≤ -0.50 D. Uncorrection was defined as no spectacles worn, and full correction was defined as when the value of SE subtracted from the dioptric power of the child's current spectacles was less than 0.5 D. Ocular examinations included visual acuity, cycloplegic autorefraction, axial length and vertometer measurements. Questionnaires were completed by parents on behalf of the children.
A total of 121 myopic children, with a median age of 12.7 years, were screened from the Anyang Childhood Eye Study, with 65 in the uncorrected group and 56 in the full correction group. At 2-year follow-up, children with no correction had slower myopia progression (-0.75 ± 0.49 D vs. -1.04 ± 0.49 D, P < 0.01) and less axial elongation (0.45 ± 0.18 mm vs. 0.53 ± 0.17 mm, P = 0.02) than children with full correction. In multivariate modeling, adjusting for baseline SE or axial length, age, gender, height, number of myopic parents, age at myopia onset, and time spent in near work and outdoors, children with no correction still had slower myopia progression (-0.76 ± 0.07 vs. -1.03 ± 0.08 D, P < 0.01) and less axial elongation (0.47 ± 0.03 mm vs. 0.51 ± 0.03 mm, P < 0.01). Myopia progression decreased significantly with an increasing amount of undercorrection in all children (r = 0.22, b = 0.16, P = 0.01).
Our findings suggest that myopic defocus slows the progression of myopia in already myopic children, supporting previous findings from animal studies.
研究2年内不矫正与完全矫正对中国儿童近视进展的影响。
近视定义为睫状肌麻痹后等效球镜度(SE)≤-0.50D。不矫正定义为不佩戴眼镜,完全矫正定义为儿童当前眼镜的屈光度减去SE值小于0.5D。眼部检查包括视力、睫状肌麻痹验光、眼轴长度和眼压计测量。问卷由家长代孩子填写。
从安阳儿童眼病研究中筛选出121名近视儿童,中位年龄为12.7岁,其中未矫正组65名,完全矫正组56名。在2年随访时,未矫正儿童的近视进展较慢(-0.75±0.49D vs -1.04±0.49D,P<0.01),眼轴伸长较少(0.45±0.18mm vs 0.53±0.17mm,P=0.02)。在多变量模型中,校正基线SE或眼轴长度、年龄、性别、身高、近视父母数量、近视发病年龄以及近距离工作和户外活动时间后,未矫正儿童的近视进展仍然较慢(-0.76±0.07 vs -1.03±0.08D,P<0.01),眼轴伸长较少(0.47±0.03mm vs 0.51±0.03mm,P<0.01)。在所有儿童中,近视进展随着欠矫量的增加而显著降低(r=0.22,b=0.16,P=0.01)。
我们的研究结果表明,近视性离焦可减缓已近视儿童的近视进展,支持先前动物研究的结果。