0.01%阿托品延缓儿童近视进展的临床疗效。
Clinical efficacy of 0.01% atropine in retarding the progression of myopia in children.
机构信息
Department of Ophthalmology, The Second Hospital of Dalian Medical University, 467 Zhongshan Road, Shahekou District, Dalian, People's Republic of China.
出版信息
Int Ophthalmol. 2021 Mar;41(3):1011-1017. doi: 10.1007/s10792-020-01658-0. Epub 2020 Nov 17.
PURPOSE
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.
METHODS
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.
RESULTS
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).
CONCLUSIONS
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.
目的
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。
方法
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。
结果
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）。
结论
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。
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