低浓度阿托品对近视进展、瞳孔直径和调节幅度的影响：低浓度阿托品与近视进展。
Effect of low-dose atropine on myopia progression, pupil diameter and accommodative amplitude: low-dose atropine and myopia progression.
机构信息
Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Optometry, UNSW, Sydney, New South Wales, Australia.
出版信息
Br J Ophthalmol. 2020 Nov;104(11):1535-1541. doi: 10.1136/bjophthalmol-2019-315440. Epub 2020 Feb 21.
PURPOSE
To evaluate the effects of 0.01% and 0.02% atropine eye drops on myopia progression, pupil diameter and accommodative amplitude in myopic children.
METHODS
A cohort study assessed 400 myopic children divided into three groups: 138 and 142 children were randomised to use either 0.02% or 0.01% atropine eye drops, respectively. They wore single-vision (SV) spectacles, with one drop of atropine eye drop applied to both eyes once nightly. Control children (n=120) only wore SV spectacles. Repeated measurements of spherical equivalent refractive errors (SERs), axial length (AL), pupil diameter and accommodative amplitude were performed at baseline, and 4, 8 and 12 months after treatment.
RESULTS
After 12 months, the SER change was -0.38±0.35D, -0.47±0.45D, -0.70±0.60D and AL change was 0.30±0.21 mm, 0.37±0.22 mm, 0.46±0.35 mm in the 0.02%, 0.01% atropine and control groups, respectively. There were significant differences in the change in AL and SER between three groups (all p<0.001). Between baseline and the 12-month visit, the overall change in accommodative amplitude was 1.50±0.25D, 1.61±0.31D and change in pupil diameter was 0.78±0.42 mm, 0.69±0.39 mm, with 0.02% and 0.01% atropine, respectively. Accommodative amplitude significantly decreased and pupil diameter significantly increased in two atropine groups (all p<0.001). Moreover, there was no statistical difference in the change difference in accommodative amplitude and pupil diameter between two atropine groups (p=0.24, p=0.38), whereas the accommodative amplitude (p=0.45) and pupil diameter (p=0.39) in the control group remained stable.
CONCLUSIONS
0.02% atropine eye drops had a better effect on myopia progression than 0.01% atropine, but 0.02% and 0.01% atropine showed similar effects on pupil diameter and accommodative amplitude after 12 months of treatment.
TRIAL REGISTRATION NUMBER
ChiCTR-IPD-16008844.
目的
评估 0.01%和 0.02%阿托品滴眼液对近视儿童近视进展、瞳孔直径和调节幅度的影响。
方法
一项队列研究评估了 400 名近视儿童，分为三组：138 名和 142 名儿童分别随机使用 0.02%或 0.01%阿托品滴眼液，每晚每只眼滴一滴。对照组儿童（n=120）仅佩戴单视（SV）眼镜。在基线时以及治疗后 4、8 和 12 个月，重复测量等效球镜（SER）、眼轴（AL）、瞳孔直径和调节幅度。
结果
治疗 12 个月后，0.02%、0.01%阿托品组和对照组的 SER 变化分别为-0.38±0.35D、-0.47±0.45D、-0.70±0.60D，AL 变化分别为 0.30±0.21 mm、0.37±0.22 mm、0.46±0.35 mm。三组间 AL 和 SER 的变化差异均有统计学意义（均 P<0.001）。与基线相比，12 个月时调节幅度的总体变化分别为 1.50±0.25D、1.61±0.31D，瞳孔直径的变化分别为 0.78±0.42 mm、0.69±0.39 mm，分别为 0.02%和 0.01%阿托品组。两组阿托品组的调节幅度均显著下降，瞳孔直径均显著增大（均 P<0.001）。此外，两组阿托品组调节幅度和瞳孔直径的变化差异无统计学意义（P=0.24，P=0.38），而对照组的调节幅度（P=0.45）和瞳孔直径（P=0.39）保持稳定。
结论
0.02%阿托品滴眼液对近视进展的疗效优于 0.01%阿托品滴眼液，但治疗 12 个月后，0.02%和 0.01%阿托品滴眼液对瞳孔直径和调节幅度的影响相似。
试验注册号
ChiCTR-IPD-16008844。
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