眼颜色和皮肤色素沉着作为远视儿童屈光结果和剩余调节的重要因素：使用 1%环戊通和 1%托吡卡胺的随机临床试验

Eye colour and skin pigmentation as significant factors for refractive outcome and residual accommodation in hypermetropic children: a randomized clinical trial using cyclopentolate 1% and tropicamide 1.

机构信息

Department of Ophthalmology, Haaglanden Medical Centre, The Hague, The Netherlands.

Department of Ophthalmology, Pediatric Ophthalmology, Leiden University Medical Centre, Leiden, The Netherlands.

出版信息

Acta Ophthalmol. 2022 Jun;100(4):454-461. doi: 10.1111/aos.15016. Epub 2021 Oct 20.

DOI:10.1111/aos.15016

PMID:34672100

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9298034/

Abstract

PURPOSE

To compare the refractive outcome and residual accommodation with respect to various degrees of iris and skin pigmentation in hypermetropic children using 2 drops of cyclopentolate 1% (C + C) or 1 drop of cyclopentolate 1% and 1 drop of tropicamide 1% (C + T).

METHODS

Two hundred fifty-one hypermetropic children were classified according to iris and skin pigmentation (light, medium, dark) and received randomized and double-blind C + C or C + T. Refractive error (spherical equivalent, SEQ) was determined using the Retinomax-K + 3. In 204 subjects, residual accommodation (RA) was determined using the PlusoptiX PowerRefractor.

RESULTS

A linear mixed model with a light-irided and light skin-pigmented reference group receiving C + T (mean SEQ +3.10 ± 1.87D) indicated significant less hypermetropia in subjects with a dark iris having a medium- and dark-pigmented skin in C + T, -1.02 ± 0.29 (-1.59/-0.45) and -1.53 ± 0.30 (-2.10/-0.95); and in subjects having a light-, medium- and dark-pigmented skin in C + C, -0.74 ± 0.34 (-1.41/-0.06), -1.26 ± 0.30 (-1.85/-0.66) and -1.84 ± 0.30 (-2.42/-1.26). Similar findings were present for RA. Our model with a light-irided and light skin-pigmented reference group receiving C + T (mean RA +0.84 ± 0.61D) indicated significantly higher RA in dark-irided subjects with medium- and dark-pigmented skin in C + T, +1.05 ± 0.19 (+0.67/+1.43) and +1.35 ± 0.20 (+0.9/+1.74), and in C + C, +1.13 ± 0.21 (+0.71/+1.55) and +1.90 ± 0.19 (+1.51/+2.28).

CONCLUSIONS

We found solid evidence that skin pigmentation rather than iris pigmentation is the decisive factor for effectiveness of cycloplegics. Awareness of the limitations of cycloplegic regimens in dark-irided/pigmented children is needed. Our study showed that cyclopentolate 1% combined with tropicamide 1% provides more accurate refractive outcomes both statistically and clinically integrating the factor skin pigmentation for dark-irided subjects.

摘要

目的

比较使用 2 滴环戊通 1%（C+C）或 1 滴环戊通 1%加 1 滴托吡卡胺 1%（C+T）时，不同程度虹膜和皮肤色素沉着对远视儿童的屈光结果和剩余调节的影响。

方法

251 名远视儿童根据虹膜和皮肤色素沉着（浅色、中等、深色）进行分类，并接受随机和双盲 C+C 或 C+T 治疗。使用 Retinomax-K+3 测量屈光不正（等效球镜，SEQ）。在 204 名受试者中，使用 PlusoptiX PowerRefractor 测量剩余调节（RA）。

结果

采用以接受 C+T 的浅色虹膜和浅色皮肤为参考组的线性混合模型（平均 SEQ+3.10±1.87D）表明，在接受 C+T 的深色虹膜和中-深色皮肤的受试者中，远视程度显著降低，分别为-1.02±0.29（-1.59/-0.45）和-1.53±0.30（-2.10/-0.95）；在接受 C+C 的浅色、中等和深色皮肤的受试者中，远视程度分别降低-0.74±0.34（-1.41/-0.06）、-1.26±0.30（-1.85/-0.66）和-1.84±0.30（-2.42/-1.26）。RA 也存在类似的发现。我们的模型以接受 C+T 的浅色虹膜和浅色皮肤为参考组（平均 RA+0.84±0.61D）表明，在接受 C+T 的深色虹膜和中-深色皮肤的受试者中，RA 显著增加，分别为+1.05±0.19（+0.67/+1.43）和+1.35±0.20（+0.9/+1.74），在 C+C 中，分别为+1.13±0.21（+0.71/+1.55）和+1.90±0.19（+1.51/+2.28）。