脉络膜厚度、近视及儿童近视控制干预措施：一项Meta分析与系统评价
Choroidal thickness, myopia, and myopia control interventions in children: a Meta-analysis and systemic review.
作者信息
Meng Qing-Yu, Miao Ze-Qun, Liang Shu-Ting, Wu Xi, Wang Le-Jin, Zhao Ming-Wei, Guo Li-Li
机构信息
Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing 100044, China.
Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing 100044, China.
出版信息
Int J Ophthalmol. 2023 Mar 18;16(3):453-464. doi: 10.18240/ijo.2023.03.17. eCollection 2023.
AIM
To investigate changes of choroidal thickness (ChT) in children with myopia and the effect of current myopia control interventions on ChT.
METHODS
Major literature databases were searched for studies relevant to myopia in children. All studies used swept-source optical coherence tomography (SS-OCT) or enhanced depth imaging optical coherence tomography (EDI-OCT) to measure the ChT value. The weighted mean difference (WMD) and 95% confidence interval (CI) were pooled to evaluate ChT in myopia children.
RESULTS
A total of 11 eligible articles, including 1693 myopic and 1132 non-myopic eyes, were included in the first Meta-analysis. The sub-foveal choroidal thickness (SFCT; WMD=-40.06, 95%CI, -59.36 to -20.75, <0.001) and ChT at other sectors were significantly thinner in myopic eyes compared with the non-myopic eyes. The Meta-analysis revealed that the ChT decreased horizontally from the temporal sector toward the nasal sector in the pediatric myopia population. Another 11 studies reporting the effect of myopia control interventions were included in the second Meta-analysis for the relationship between myopia control treatments and ChT. SFCT significantly increased after orthokeratology (OK) treatment and OK combined with 0.01% atropine (OKA) treatment (WMD=19.47, 95%CI, 15.96 to 22.98, <0.001; WMD=21.81, 95%CI, 12.92 to 29.70, <0.001, respectively). The forest plots showed that SFCT changed little in myopic children receiving 0.01% atropine (=0.30). Furthermore, the Meta-analysis showed that OK treatment had a stronger effect on the value of SFCT in myopic children as compared with 0.01% atropine (WMD=9.86; 95%CI, -0.21 to 19.93, =0.05). There is no difference between the treatment with OK and OKA treatment in ChT in myopic children (=0.37).
CONCLUSION
The ChT in myopic eyes is thinner than that in non-myopic eyes in pediatric population. Myopia control interventions including OK and OKA lead to ChT thickening, but other treatments such as 0.01% atropine did not show an increase in ChT.
目的
探讨近视儿童脉络膜厚度（ChT）的变化以及当前近视控制干预措施对ChT的影响。
方法
检索主要文献数据库中与儿童近视相关的研究。所有研究均使用扫频光学相干断层扫描（SS-OCT）或增强深度成像光学相干断层扫描（EDI-OCT）测量ChT值。汇总加权平均差（WMD）和95%置信区间（CI）以评估近视儿童的ChT。
结果
首次Meta分析共纳入11篇符合条件的文章，包括1693只近视眼和1132只非近视眼。与非近视眼相比，近视眼角膜下脉络膜厚度（SFCT；WMD=-40.06，95%CI，-59.36至-20.75，<0.001）及其他区域的ChT明显更薄。Meta分析显示，在儿童近视人群中，ChT从颞侧区域向鼻侧区域呈水平下降。第二次Meta分析纳入另外11项报告近视控制干预措施效果的研究，以探讨近视控制治疗与ChT之间的关系。角膜塑形术（OK）治疗以及OK联合0.01%阿托品（OKA）治疗后，SFCT显著增加（WMD分别为19.47，95%CI，15.96至22.98，<0.001；WMD为21.81，95%CI，12.92至29.70，<0.001）。森林图显示，接受0.01%阿托品治疗的近视儿童的SFCT变化不大（P=0.30）。此外，Meta分析显示，与0.01%阿托品相比，OK治疗对近视儿童SFCT值的影响更强（WMD=9.86；95%CI，-0.21至19.93，P=0.05）。近视儿童中，OK治疗与OKA治疗在ChT方面无差异（P=0.37）。
结论
儿童人群中，近视眼的ChT比非近视眼薄。包括OK和OKA在内的近视控制干预措施可导致ChT增厚，但其他治疗方法如0.01%阿托品并未显示ChT增加。
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