Zhang Xiaoyu, Wang Yuliang, Zhou Xingtao, Qu Xiaomei
Key NHC Key Laboratory of Myopia (Fudan University), Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.
Department of Ophthalmology, The Eye and ENT Hospital of Fudan University, Shanghai, China.
Front Pharmacol. 2020 Sep 9;11:01081. doi: 10.3389/fphar.2020.01081. eCollection 2020.
Children respond differently to atropine treatment, and predicting patient factors associated with better myopia control is important. Therefore, we aimed to evaluate factors related to myopia progression in Chinese children treated with atropine 0.01%. This retrospective study included 133 children who were administered atropine 0.01% eyedrops every night for 1 year. Enrolled children were examined at follow-up visits at 3 and 6 months, and 1 year. The primary outcome was clinically significant myopia progression (over a -0.75 diopter (D) increase in spherical equivalent (SE)). Multivariate logistic analysis was used to identify predictive factors for myopia progression. The mean baseline SE was -3.92 ± 2.76D, and the average increase in SE and axial length at 1 year from baseline were -0.55 ± 0.57D and 0.43 ± 0.52 mm, respectively. The risk of myopia progression significantly increased in children whose mothers had moderate myopia of less than -6D compared to that in children whose mothers had no history of myopia (odd ratio [OR] = 2.76, 95% confidence interval [CI]: 1.06 to 7.19, P = 0.0382). Birth by cesarean section was also a risk factor for myopia progression (odd ratio [OR] = 2.35, 95% CI: 1.30 to 4.27, P = 0.0048). The correlation between SE and treatment efficiency was linear, and the risk of myopia progression significantly decreased with increasing SE. Atropine 0.01% controlled myopia more effectively in children with higher myopia, who were delivered naturally, and whose mothers had no genetic background of myopia.
儿童对阿托品治疗的反应各不相同，预测与更好地控制近视相关的患者因素很重要。因此，我们旨在评估接受0.01%阿托品治疗的中国儿童近视进展的相关因素。这项回顾性研究纳入了133名儿童，他们每晚使用0.01%阿托品滴眼液，持续1年。入选儿童在3个月、6个月和1年的随访中接受检查。主要结局是具有临床意义的近视进展（等效球镜度（SE）增加超过-0.75屈光度（D））。采用多因素逻辑分析来确定近视进展的预测因素。平均基线SE为-3.92±2.76D，1年时SE和眼轴长度相对于基线的平均增加分别为-0.55±0.57D和0.43±0.52mm。与母亲无近视病史的儿童相比，母亲患有中度近视且近视度数小于-6D的儿童近视进展风险显著增加（比值比[OR]=2.76，95%置信区间[CI]：1.06至7.19，P=0.0382）。剖宫产也是近视进展的一个危险因素（比值比[OR]=2.35，95%CI：1.30至4.27，P=0.0048）。SE与治疗效果之间的相关性呈线性，近视进展风险随SE增加而显著降低。0.01%阿托品对近视程度较高、顺产且母亲无近视遗传背景的儿童控制近视更有效。
