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低剂量(0.01%)阿托品滴眼液治疗近视儿童的疗效分析。

Analysis of treatment response about low-dose (0.01%) atropine eye-drops in myopic children.

作者信息

Jeon Gang Seok, Hong In Hwan, Lee Jang Hun, Song Tae Geun, Lee Tae Yeem, Han Jae Ryong

机构信息

Department of Ophthalmology, Dasan Samsung Bright Eye Clinic, Gyeonggi-do, Korea.

Department of Ophthalmology, Dongtan Sacred Heart Hospital, College of Medicine, Hallym University, Hwaseong, Gyeonggi, Korea.

出版信息

Eur J Ophthalmol. 2022 Jul;32(4):2011-2017. doi: 10.1177/11206721211038817. Epub 2021 Aug 16.

Abstract

INTRODUCTION

Myopia usually commences during primary school and progresses until the mean age of 16 years. Topical low-dose (0.01%) atropine eye-drop appears to be safe and efficacious for myopia control in children. However, in some cases, a higher concentration of atropine is required in some cases because low-dose atropine treatment is not effective.

METHODS

This is a retrospective study among young myopic children between 5 and 15 years with myopia progression > 0.50 D/year. We selected patients treated with low-dose atropine (0.01%) eye-drops for 12 months and conducted a comparative analysis of the group with good responder and poor responder. Patients were classified as good responders if spherical equivalent refractive error (SE) progression was ⩽ 0.50 D after 12 months of treatment and poor responders if SE progression > 0.50 D. The prognostic factors before and after treatment were analyzed in two groups.

RESULTS

A total of 68 eyes were included. Low-dose (0.01%) atropine eye-drops have a good treatment response in 54% of patients. In the good responder group ( = 37), the mean rate of myopia progression after 12 months of treatment (0.36 ± 0.17 D) was significantly slower compared with the baseline progression ( < 0.001). Good responders have smaller changes in axial length (AL) elongation and SE than poor responders ( < 0.001). The only adverse event was temporary near vision difficulty (10%), photophobia (10%), and mild pupil dilation (30%).

DISCUSSION

The AL elongation is an important indicator for monitoring the treatment response. Children with a family history of myopia at a young age may not respond well to low-dose (0.01%) atropine eye-drops. In these cases, increasing the concentration of atropine eye-drops should be considered.

摘要

引言

近视通常始于小学阶段,并持续发展至平均16岁。局部低剂量(0.01%)阿托品滴眼液似乎对儿童近视控制安全有效。然而,在某些情况下,由于低剂量阿托品治疗无效,需要更高浓度的阿托品。

方法

这是一项针对5至15岁近视进展>0.50 D/年的年轻近视儿童的回顾性研究。我们选择接受低剂量(0.01%)阿托品滴眼液治疗12个月的患者,并对反应良好组和反应不佳组进行比较分析。如果治疗12个月后球镜等效屈光不正(SE)进展≤0.50 D,则患者被分类为反应良好者;如果SE进展>0.50 D,则为反应不佳者。分析两组治疗前后的预后因素。

结果

共纳入68只眼。低剂量(0.01%)阿托品滴眼液在54%的患者中具有良好的治疗反应。在反应良好组(n = 37)中,治疗12个月后的平均近视进展率(0.36±0.17 D)与基线进展相比显著减慢(P<0.001)。反应良好者的眼轴长度(AL)伸长和SE变化比反应不佳者小(P<0.001)。唯一的不良事件是暂时性近视力困难(10%)、畏光(10%)和轻度瞳孔散大(30%)。

讨论

AL伸长是监测治疗反应的重要指标。年轻时有近视家族史的儿童可能对低剂量(0.01%)阿托品滴眼液反应不佳。在这些情况下,应考虑增加阿托品滴眼液的浓度。

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