Yam Jason C, Zhang Xiu Juan, Kam Ka Wai, Chen Li Jia, Tham Clement C, Pang Chi Pui
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.
Hong Kong Eye Hospital, Hong Kong, China.
Ophthalmic Physiol Opt. 2023 May;43(3):299-310. doi: 10.1111/opo.13118. Epub 2023 Mar 1.
The purpose of this study was to explore the findings from the Hong Kong Children Eye Study and the Low Concentration Atropine for Myopia Progression (LAMP-1) Study. The incidence of myopia among schoolchildren in Hong Kong more than doubled during the COVID-19 pandemic, with outdoor time decreased significantly and screen time increased. The change in lifestyle during the COVID-19 pandemic aggravated myopia development. Low-concentration atropine (0.05%, 0.025% and 0.01%) is effective in reducing myopia progression with a concentration-related response. This concentration-dependent response was maintained throughout a 3-year follow-up period, and all low concentrations were well tolerated. An age-dependent effect was observed in each treatment group with 0.05%, 0.025% and 0.01% atropine. Younger age was associated with a poor treatment response to low-concentration atropine. Additionally, low-concentration atropine induced choroidal thickening along a concentration-dependent response throughout the treatment period. During the third year, continued atropine treatment achieved a better effect across all concentrations compared with the washout regimen. Stopping treatment at an older age and receiving lower concentration were associated with a smaller rebound effect. However, differences in the rebound effect were clinically small across all the three concentrations studied.
本研究的目的是探讨香港儿童眼研究和低浓度阿托品延缓近视进展研究（LAMP-1）的结果。在新冠疫情期间，香港学童近视发病率增加了一倍多，户外活动时间显著减少，屏幕使用时间增加。新冠疫情期间生活方式的改变加剧了近视的发展。低浓度阿托品（0.05%、0.025%和0.01%）能有效延缓近视进展，且存在浓度相关反应。这种浓度依赖性反应在3年的随访期内持续存在，所有低浓度阿托品的耐受性都良好。在使用0.05%、0.025%和0.01%阿托品的各治疗组中均观察到年龄依赖性效应。年龄较小与低浓度阿托品治疗反应较差有关。此外，在整个治疗期间，低浓度阿托品可引起脉络膜增厚，且呈浓度依赖性反应。在第三年，与停药方案相比，持续使用阿托品治疗在所有浓度下均取得了更好的效果。年龄较大时停药且使用较低浓度与较小的反弹效应相关。然而，在所研究的所有三种浓度中，反弹效应的差异在临床上较小。
