Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Sci Rep. 2020 Sep 8;10(1):14789. doi: 10.1038/s41598-020-71710-7.
In Taiwan, the prevalence of myopia in children between 6 and 18 years old is over 80%, and high myopia accounts for over 20%, which turned out to be in the leading place worldwide. Orthokeratology and low-dose atropine are proven treatments to reduce myopia progression, though the potential corneal disturbances remain an issue in young populations. The alteration of the tear film is widely discussed but there is no consensus to date, so we aim to investigate the tear film spatial instability in children with myopia control using atropine or orthokeratology. Thirty-eight treatment-naïve participants and 126 myopic children under treatments were enrolled. The ocular surface homeostasis, spatial distribution of tear break-up, and high-order aberrations (HOAs) of the corneal surface were assessed. We found out that myopic children treated with either atropine or orthokeratology showed ocular surface homeostasis similar to that in treatment-naïve children. Nevertheless, children treated with orthokeratology presented higher HOAs (p < 0.00001) and a tendency of the first tear break-up zone at the inner half of the cornea (p = 0.04). This unique spatial instability of the tear film associated with myopia treatment might provide a more focused way of monitoring the pediatric tear film instability.
在台湾，6 至 18 岁儿童的近视患病率超过 80%，高度近视占比超过 20%，这一数据在全球范围内处于领先地位。角膜塑形术和低浓度阿托品已被证实可减缓近视进展，但在年轻人群中，其潜在的角膜干扰仍是一个问题。泪膜的改变被广泛讨论，但目前尚无定论，因此我们旨在研究使用阿托品或角膜塑形术控制近视的儿童的泪膜空间不稳定性。我们招募了 38 名未经治疗的参与者和 126 名正在接受治疗的近视儿童。评估了眼表面稳态、泪膜破裂的空间分布和角膜表面的高阶像差（HOAs）。我们发现，接受阿托品或角膜塑形术治疗的近视儿童的眼表面稳态与未经治疗的儿童相似。然而，接受角膜塑形术治疗的儿童表现出更高的高阶像差（p<0.00001）和泪膜第一次破裂区在内眼角的趋势（p=0.04）。这种与近视治疗相关的独特的泪膜空间不稳定性可能为监测儿童泪膜不稳定性提供一种更集中的方法。
