Tay Su Ann, Farzavandi Sonal, Tan Donald
a Singapore National Eye Centre , Singapore.
b Singapore Eye Research Institute , Singapore.
Strabismus. 2017 Mar;25(1):23-32. doi: 10.1080/09273972.2016.1276940. Epub 2017 Feb 6.
Efforts to reduce the progression of myopia in childhood are on the rise, due to an increasing incidence of myopia worldwide and its associated sight-threatening complications. Interventions are aimed at reducing myopia in childhood and include environmental considerations, spectacles, contact lenses, and pharmacological agents. We reviewed recent literature with interventions aimed at reducing myopia progression in children and found that a number of interventions were significant in reducing the progression of myopia. Of these interventions, atropine showed the largest dose-related effect on myopia progression control. Although higher doses are associated with side effects of pupil dilatation, loss of accommodation, near vision blur, and rebound phenomenon, low-dose atropine has also been shown to provide effective myopia control with minimal side effects and rebound. To a lesser degree, bifocal soft contact lenses have also been shown to be effective in reducing the progression of myopia, though compliance is an issue. Similarly, orthokeratology lenses have also been shown to be effective in reducing axial length elongation and myopia progression, though long-term data on its rebound effects are unavailable.
由于全球近视发病率不断上升及其相关的致盲性并发症,降低儿童近视进展的努力正在增加。干预措施旨在减少儿童近视,包括环境因素、眼镜、隐形眼镜和药物制剂。我们回顾了近期旨在减少儿童近视进展的干预措施的文献,发现一些干预措施在减少近视进展方面具有显著效果。在这些干预措施中,阿托品对近视进展控制显示出最大的剂量相关效应。虽然高剂量与瞳孔散大、调节丧失、近视力模糊和反弹现象等副作用有关,但低剂量阿托品也已被证明能以最小的副作用和反弹提供有效的近视控制。在较小程度上,双焦点软性隐形眼镜也已被证明能有效减少近视进展,尽管依从性是一个问题。同样,角膜塑形镜也已被证明能有效减少眼轴长度延长和近视进展,尽管其反弹效应的长期数据尚不可用。