2022 年上海封控期间 0.01%阿托品滴眼液对 6-13 岁儿童近视控制的影响。
Effect of atropine 0.01% on myopia control in children aged 6-13 years during the 2022 lockdown in Shanghai.
机构信息
Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China.
Key Laboratory of Visual Impairment and Restoration of Shanghai, Fudan University, Shanghai, China.
出版信息
Front Public Health. 2023 Jan 26;11:1074272. doi: 10.3389/fpubh.2023.1074272. eCollection 2023.
PURPOSE
To compare the myopic progression in children treated with 0. 01% atropine and those who discontinued atropine during the 2022-home quarantine in Shanghai.
METHODS
In this retrospective study, children aged 6-13 years with follow-up visits before (between January 2022 and February 2022) and after the lockdown (between July 2022 and August 2022) were included. Cycloplegic refraction and axial length (AL) were measured at both visits. The atropine group had continuous medication during the lockdown while the control group discontinued. The 0.01% atropine eyedrops were administered daily before bedtime. The types of spectacle lens were recorded: single vision (SV) spectacles or defocus incorporated multiple segments lenses (DIMS).
RESULTS
In total, 41 children (81 eyes) in the atropine group and 32 children (64 eyes) in the control group were enrolled. No significant difference was found in the demographic characteristics, spherical diopter, spherical equivalent (SE), AL, and follow-up time between the two groups before the lockdown in 2022 (all > 0.1). After the home confinement, a greater myopia progression was observed in the control group (-0.46 ± 0.42 D) compared to atropine group (-0.26 ± 0.37 D; = 0.0023). Axial elongation was also longer in the control group than that in children sustained with atropine (0.21 ± 0.17 vs. 0.13 ± 0.15 mm, = 0.0035). Moreover, there was no significant change of spherical diopter and SE during lockdown in the atropine + DIMS combined subgroup (0.03 ± 0.033 D for spherical diopter, = 0.7261 and 0.08 ± 0.27 D for SE, = 0.2042, respectively). However, significant myopic shift was observed in the atropine + SV subgroup during the quarantine time (-0.31 ± 0.39 D for SE and 0.15 ± 0.16 mm for AL, both < 0.001).
CONCLUSION
Children treated with 0.01% atropine had slower myopia progression during the lockdown period in Shanghai compared with children discontinued. Moreover, the effect of atropine on myopic prevention can be strengthened with DIMS lenses.
目的
比较 2022 年上海居家隔离期间使用 0.01%阿托品和停止使用阿托品的儿童的近视进展情况。
方法
本回顾性研究纳入了随访时间分别在 2022 年 1 月至 2 月（隔离前）和 2022 年 7 月至 8 月（隔离后）的 6-13 岁儿童。在两次就诊时均进行睫状肌麻痹验光和眼轴（AL）测量。阿托品组在隔离期间持续用药，而对照组则停止用药。0.01%阿托品滴眼液在睡前每日滴眼。记录了眼镜类型：单光（SV）眼镜或离焦多焦点镜片（DIMS）。
结果
共纳入 41 名儿童（81 只眼）的阿托品组和 32 名儿童（64 只眼）的对照组。两组在 2022 年隔离前的人口统计学特征、球镜屈光度、等效球镜（SE）、AL 和随访时间方面均无显著差异（均 >0.1）。居家隔离后，对照组的近视进展较阿托品组更为明显（-0.46 ± 0.42 D 比 -0.26 ± 0.37 D； = 0.0023）。对照组眼轴伸长也比阿托品组长（0.21 ± 0.17 比 0.13 ± 0.15 mm， = 0.0035）。此外，在阿托品+DIMS 联合亚组中，隔离期间球镜屈光度和 SE 无明显变化（球镜屈光度为 0.03 ± 0.033 D， = 0.7261，SE 为 0.08 ± 0.27 D， = 0.2042）。然而，在隔离期间，阿托品+SV 亚组的近视变化明显（SE 为-0.31 ± 0.39 D，AL 为 0.15 ± 0.16 mm，均 <0.001）。
结论
与停药的儿童相比，2022 年上海居家隔离期间使用 0.01%阿托品的儿童近视进展较慢。此外，DIMS 镜片可增强阿托品对近视的预防作用。
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