Shen Yang, Zhao Jing, Sun Ling, Zeng Li, Chen Zhi, Tian Mi, Zhou Xingtao
Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.
NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.
Transl Pediatr. 2021 Apr;10(4):860-869. doi: 10.21037/tp-20-452.
The syndrome of monocular myelinated retinal nerve fibers (MRNF), myopia and amblyopia threatens visual development of infants and young children. The efficacy of part-time occlusion therapy remains controversial, and the long-term prognosis of the syndrome remains unclear.
Ten children (4.40±2.22 years, 4 boys and 6 girls) with monocular MRNF, myopia and amblyopia were recruited. Both the affected eyes (treatment group) and the fellow eyes (control group) underwent routine ophthalmic examinations, including AL, cycloplegic refraction, best-spectacles-corrected distance visual acuity (BSCDVA), cover test, simultaneous perception, corneal curvature, anterior segment and fundus examinations. Refractive error was corrected by either spectacles or rigid gas permeable (RGP) contact lenses. Part-time occlusion therapy was employed for amblyopia treatment. The retinal characteristics were examined only on the final visit with a Fourier-domain optical coherence tomography (FD-OCT). The speed of myopia progression and axial elongation were calculated. Statistical analysis was performed using SPSS 20 software. Cut-off P values were 0.05.
On the final visit, six children had normal simultaneous perception but three had strabismus. The mean AL and spherical equivalent (SE) values of the affected eyes were 28.05±1.59 mm and -12.60±4.20 D, respectively, while those of the fellow eyes were 23.67±1.13 mm and -0.66±1.99 D, respectively. AL and SE were significantly different over time and between groups (P<0.0001), but no time*group interaction effect (P>0.05) was observed. The differences in the corneal curvature, mean speed of myopia progression, axial elongation, foveal thickness and parafoveal thickness between the two groups were not significant (P>0.05). However, the perifoveal thickness in the affected eyes was significantly higher than that of the control eyes (P=0.047). In the treatment group, the occlusion dosage positively correlated with the final BSCDVA (R=0.764, P=0.016) but did not correlate with the speed of myopia progression or axial elongation (both P values >0.05).
The affected eyes have longer AL, severer myopia and thicker perifoveal retina when compared with the fellow eyes. Both the affected and the fellow eyes have similar speed of myopia progression as well as that of axial elongation.
单眼有髓鞘视网膜神经纤维（MRNF）、近视和弱视综合征威胁婴幼儿的视觉发育。部分遮盖疗法的疗效仍存在争议，该综合征的长期预后尚不清楚。
招募了10名患有单眼MRNF、近视和弱视的儿童（4.40±2.22岁，4名男孩和6名女孩）。患眼（治疗组）和对侧眼（对照组）均接受常规眼科检查，包括眼轴长度（AL）、散瞳验光、最佳矫正视力（BSCDVA）、遮盖试验、同时视、角膜曲率、眼前节和眼底检查。屈光不正通过眼镜或硬性透气性（RGP）隐形眼镜矫正。采用部分遮盖疗法治疗弱视。仅在最后一次就诊时使用傅里叶域光学相干断层扫描（FD-OCT）检查视网膜特征。计算近视进展速度和眼轴伸长率。使用SPSS 20软件进行统计分析。截断P值为0.05。
在最后一次就诊时，6名儿童同时视正常，但3名儿童有斜视。患眼的平均AL和等效球镜（SE）值分别为28.05±1.59mm和-12.60±4.20D，而对侧眼分别为23.67±1.13mm和-0.66±1.99D。AL和SE随时间和组间差异有统计学意义（P<0.0001），但未观察到时间*组交互作用（P>0.05）。两组之间的角膜曲率、近视进展平均速度、眼轴伸长、黄斑中心凹厚度和黄斑旁厚度差异无统计学意义（P>0.05）。然而，患眼的黄斑旁厚度显著高于对照眼（P=0.047）。在治疗组中，遮盖剂量与最终的BSCDVA呈正相关（R=0.764，P=0.016），但与近视进展速度或眼轴伸长率均无相关性（P值均>0.05）。
与对侧眼相比，患眼的AL更长，近视更严重，黄斑旁视网膜更厚。患眼和对侧眼的近视进展速度以及眼轴伸长率相似。
