Department of Ophthalmology, The Second Hospital of Dalian Medical University, 467 Zhongshan Road, Shahekou District, Dalian, People's Republic of China.
Int Ophthalmol. 2021 Mar;41(3):1011-1017. doi: 10.1007/s10792-020-01658-0. Epub 2020 Nov 17.
To investigate the clinical efficacy of 0.01% atropine in slowing the progression of myopia in children and to evaluate the influence of 0.01% atropine on secretion of basal tear and stability of tear film.
Eighty children aged 5-14 years with myopia, 40 were randomly divided into two groups consisting of those who received spectacles in addition to 0.01% atropine (SA group) and those who received only spectacles (S group). The remaining 40 children who were wearing orthokeratology (OK) lenses for 3 months were randomly divided into two groups comprising those who received OK lenses in addition to 0.01% atropine (OKA group) and those who received only OK lenses (OK group). Comprehensive ophthalmologic examinations, including slit-lamp examination, visual acuity testing, autorefraction, intraocular pressure, axial length (AL), corneal topography, Schirmer's test, and tear film break-up time (TBuT), were performed before treatment and after every 3 months treatment.
During the follow-up visits, evidently better spherical equivalent (SE) control over 3, 6 and 12 months was observed in the SA and OKA groups compared with the S and OK groups. The AL over 3, 6, and 12 months was evidently inhibited in the SA and OKA groups compared with the S and OK groups. No statistically significant differences in Schirmer's test and TBuT results were observed between the S and SA groups and between the OK and OKA groups. However, statistically significant differences were found in TBuT results between before treatment and after 3 months treatment in the OK group (P < 0.05, paired t test) and the OKA group (P < 0.05, paired t test).
0.01% atropine can effectively control myopia progression and axial elongation regardless of combined treatment with spectacles or OK lenses. And 0.01% atropine has no evident effect on Schirmer's test and TBuT results; however, researchers also found that Schirmer's test and TBuT results showed a tendency to reduce after treatment with 0.01% atropine.
探讨 0.01%阿托品对儿童近视进展的临床疗效，并评估其对基础泪液分泌和泪膜稳定性的影响。
选择年龄为 5-14 岁的近视儿童 80 例，随机分为两组，分别为在配戴框架镜的基础上加用 0.01%阿托品（SA 组）和单纯配戴框架镜（S 组），各 40 例；另外 40 例曾佩戴角膜塑形镜（OK 镜）3 个月的儿童随机分为两组，分别为在配戴 OK 镜的基础上加用 0.01%阿托品（OKA 组）和单纯配戴 OK 镜（OK 组），各 20 例。所有患者均进行全面的眼科检查，包括裂隙灯检查、视力检查、自动验光、眼压、眼轴（AL）、角膜地形图、Schirmer 试验和泪膜破裂时间（TBuT），在治疗前和治疗后每 3 个月进行一次。
在随访过程中，SA 组和 OKA 组治疗 3、6 和 12 个月后的球镜等效（SE）控制明显优于 S 组和 OK 组。SA 组和 OKA 组治疗 3、6 和 12 个月后的 AL 明显抑制。S 组和 SA 组、OK 组和 OKA 组的 Schirmer 试验和 TBuT 结果无统计学差异。然而，OK 组治疗前后 TBuT 结果差异有统计学意义（P<0.05，配对 t 检验），OKA 组差异有统计学意义（P<0.05，配对 t 检验）。
0.01%阿托品无论联合配戴框架镜还是 OK 镜均可有效控制近视进展和眼轴伸长。0.01%阿托品对 Schirmer 试验和 TBuT 结果无明显影响，但研究人员还发现，使用 0.01%阿托品治疗后，Schirmer 试验和 TBuT 结果有降低的趋势。
