State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, VIC, Australia.
Acta Ophthalmol. 2019 May;97(3):e454-e459. doi: 10.1111/aos.13866. Epub 2018 Oct 4.
To investigate changes in subfoveal choroidal thickness (SFChT) during orthokeratology (Ortho-K) lens wear and after its cessation and the association of short-term change in SFChT with the long-term eye elongation in Ortho-K subjects.
A prospective clinical trial.
Fifty myopic children aged between 9 and 14 years were enrolled. Twenty-nine subjects continuously wore Ortho-K lens for 12 months and discontinued for 1 month. Twenty-one subjects wearing single vision distance spectacles for 12 months were included as the control group. SFChT was assessed using optical coherence tomography. Ocular parameters, including axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT) and apical corneal power (ACP), were also measured.
After 12 months of follow-up, AL elongation was larger and SFChT change was smaller in the control group compared to the Ortho-K group (both p < 0.001). In the Ortho-K group, SFChT increased by 16 μm from baseline at the 1-month visit (p < 0.001), and the magnitude of choroidal thickening remained unchanged at the 6- and 12-month visit (p = 0.289). One month after discontinuation of Ortho-K lens, SFChT and ocular parameters of the anterior segment, including ACP, CCT and ACD recovered to baseline level (All p > 0.05), and AL increased by 0.23 ± 0.18 mm compared to baseline (p = 0.018). SFChT change at 1-month was negatively associated with AL change at 13-month (standard β, -0.581, p = 0.001) after adjusting for other influencing factors, including baseline age and the ocular parameters.
Subfoveal ChT (SFChT) significantly increased after short-term Ortho-K lens treatment and the increase maintained throughout the period of treatment. One month after Ortho-K lens cessation, SFChT, ACP, CCT and ACD returned to baseline. Short-term response in SFChT is associated with long-term change in AL in children undergoing Ortho-K lens and may be a predictor for the effectiveness of the treatment.
研究角膜塑形术（Ortho-K）镜片佩戴期间及停戴后，黄斑下脉络膜厚度（SFChT）的变化，以及短期 SFChT 变化与 Ortho-K 受试者眼轴长期伸长的关系。
前瞻性临床试验。
共纳入 50 名年龄在 9 至 14 岁之间的近视儿童。其中 29 名患者连续佩戴 Ortho-K 镜片 12 个月，停戴 1 个月。21 名连续佩戴单光远距视力眼镜 12 个月的患者作为对照组。采用光学相干断层扫描评估 SFChT。还测量了眼轴长度（AL）、中央角膜厚度（CCT）、前房深度（ACD）、晶状体厚度（LT）和顶点角膜曲率（ACP）等眼部参数。
12 个月随访后，对照组的 AL 伸长量大于 Ortho-K 组，SFChT 变化量小于 Ortho-K 组（均 p<0.001）。在 Ortho-K 组中，SFChT 在 1 个月时较基线增加了 16μm（p<0.001），6 个月和 12 个月时脉络膜增厚的幅度保持不变（p=0.289）。停戴 Ortho-K 镜片 1 个月后，SFChT 和前节的眼部参数，包括 ACP、CCT 和 ACD 恢复到基线水平（所有 p>0.05），与基线相比，AL 增加了 0.23±0.18mm（p=0.018）。调整其他影响因素，包括基线年龄和眼部参数后，1 个月时 SFChT 的变化与 13 个月时 AL 的变化呈负相关（标准β，-0.581，p=0.001）。
短期 Ortho-K 镜片治疗后黄斑下脉络膜厚度（SFChT）显著增加，并且在治疗期间保持不变。停戴 Ortho-K 镜片 1 个月后，SFChT、ACP、CCT 和 ACD 恢复至基线。在接受 Ortho-K 镜片治疗的儿童中，SFChT 的短期反应与 AL 的长期变化相关，这可能是治疗效果的预测因素。
