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评估离焦多焦点设计(DIMS)镜片和阿波罗渐进多焦点眼镜(PALs)控制 6 至 12 岁儿童近视进展的疗效:一项前瞻性、多中心、随机对照试验的研究方案。

Evaluating the myopia progression control efficacy of defocus incorporated multiple segments (DIMS) lenses and Apollo progressive addition spectacle lenses (PALs) in 6- to 12-year-old children: study protocol for a prospective, multicenter, randomized controlled trial.

机构信息

Department of Ophthalmology, Peking University People's Hospital, Beijing, China.

Eye Diseases and Optometry Medical Research Institute, Peking University People's Hospital, Beijing, China.

出版信息

Trials. 2020 Mar 19;21(1):279. doi: 10.1186/s13063-020-4095-8.

Abstract

BACKGROUND

Myopia is increasing in prevalence and is currently recognized as a significant public health issue worldwide, particularly in China. Once myopia develops, appropriate clinical interventions need to be prescribed to slow its progression. Currently, several publications indicate that myopic defocus (MD) retards eye growth and myopia progression. However, no clinical trials have compared the outcomes of different MD spectacle lenses in the same observational group, especially in mainland China. The aim of the present study is to compare the myopia control efficiency of two different MD spectacle lenses: defocus incorporated multiple segments (DIMS) lenses and Apollo progressive addition lenses (PALs).

METHODS

The trial is designed as a 3-year, prospective, randomized, multicenter clinical trial of schoolchildren treated with DIMS lenses and PALs. A total of 600 Chinese primary school children aged 6-12 years will be recruited, and each group is intended to include 300 subjects. The inclusion criteria are myopia between - 1.00 and - 5.00 diopters and astigmatism ≤ 1.50 diopters. The follow-up time points will be 1 month (m), 3 m, 6 m, 12 m, 18 m, 24 m, 30 m, and 36 m. The primary outcome will be determined by the difference between the two groups in cycloplegic spherical equivalent refraction between baseline and the last follow-up visit. The secondary outcome is the axial length, and the exploratory outcomes include ocular biometric measures, peripheral refraction, binocular vision, accommodation, compliance, and the results of questionnaires related to wearing experiences.

DISCUSSION

The present study will be the first randomized controlled trial in myopic primary school children treated with DIMS lenses and PALs in China. The results will indicate whether and how much different MD mechanisms retard myopia progression and axial elongation. In addition, the comparison will provide information on the clinical efficacy and safety of DIMS lenses and PALs, including information related to wearing experiences and visual function.

TRIAL REGISTRATION

Chinese Clinical Trial Registry (ChiCTR), ChiCTR1900025645. Registered on 3 September 2019. http://www.chictr.org.cn/showproj.aspx?proj=42927.

摘要

背景

近视的发病率正在上升,目前已被认为是全球范围内的一个重大公共卫生问题,尤其在中国。近视一旦发生,就需要采取适当的临床干预措施来减缓其进展。目前,有几项研究表明近视离焦(MD)可以抑制眼轴增长和近视进展。然而,尚未有临床试验比较同一观察组中不同 MD 框架镜的效果,特别是在中国内地。本研究旨在比较两种不同 MD 框架镜的近视控制效果:离焦多焦点(DIMS)镜片和阿波罗渐进多焦点(PAL)镜片。

方法

本试验是一项为期 3 年、前瞻性、随机、多中心的小学生 DIMS 镜片和 PAL 治疗临床试验。共招募 600 名 6-12 岁的中国小学生,每组 300 人。纳入标准为近视屈光度在-1.00 至-5.00 屈光度之间,散光≤1.50 屈光度。随访时间点为 1 个月(m)、3 个月(m)、6 个月(m)、12 个月(m)、18 个月(m)、24 个月(m)、30 个月(m)和 36 个月(m)。主要结局指标为两组在基线至最后随访时的睫状肌麻痹球镜等效屈光度之间的差异。次要结局是眼轴长度,探索性结局包括眼生物学测量、周边屈光度、双眼视觉、调节、顺应性以及与佩戴体验相关的问卷结果。

讨论

本研究将是中国首次在近视小学生中开展的 DIMS 镜片和 PAL 治疗的随机对照试验。研究结果将表明不同的 MD 机制是否以及在多大程度上可以减缓近视进展和眼轴增长。此外,比较还将提供关于 DIMS 镜片和 PALs 的临床疗效和安全性的信息,包括与佩戴体验和视觉功能相关的信息。

试验注册

中国临床试验注册中心(ChiCTR),ChiCTR1900025645。注册于 2019 年 9 月 3 日。http://www.chictr.org.cn/showproj.aspx?proj=42927.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fadc/7081604/0aed1461d392/13063_2020_4095_Fig1_HTML.jpg

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