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重复低强度红光治疗近视控制后脉络膜结构的纵向变化:一项随机对照试验的二次分析

Longitudinal Changes in Choroidal Structure Following Repeated Low-Level Red-Light Therapy for Myopia Control: Secondary Analysis of a Randomized Controlled Trial.

作者信息

Xuan Meng, Zhu Zhuoting, Jiang Yu, Wang Wei, Zhang Jian, Xiong Ruilin, Shi Danli, Bulloch Gabriella, Zeng Junwen, He Mingguang

机构信息

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong Province, China.

Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia.

出版信息

Asia Pac J Ophthalmol (Phila). 2023;12(4):377-383. doi: 10.1097/APO.0000000000000618. Epub 2023 Jun 27.

Abstract

PURPOSE

Repeated low-level red-light (RLRL) therapy has been confirmed as a novel intervention for myopia control in children. This study aims to investigate longitudinal changes in choroidal structure in myopic children following 12-month RLRL treatment.

MATERIALS AND METHODS

The current study is a secondary analysis from a multicenter, randomized controlled trial (NCT04073238). Choroidal parameters were derived from baseline and follow-up swept-source optical coherence tomography scans taken at 1, 3, 6, and 12 months. These parameters included the luminal area (LA), stromal area (SA), total choroidal area (TCA; a combination of LA and SA), and choroidal vascularity index (CVI; ratio of LA to TCA), which were automatically measured by a validated custom choroidal structure assessment tool.

RESULTS

A total of 143 children (88.3% of all participants) with sufficient image quality were included in the analysis (n=67 in the RLRL and n=76 in the control groups). At the 12-month visit, all choroidal parameters increased in the RLRL group, with changes from baseline of 11.70×10 3  μm 2 (95% CI: 4.14-19.26×10 3  μm 2 ), 3.92×10 3  μm 2 (95% CI: 0.56-7.27×10 3  μm 2 ), 15.61×10 3  μm 2 (95% CI: 5.02-26.20×10 3  μm 2 ), and 0.21% (95% CI: -0.09% to 0.51%) for LA, SA, TCA, and CVI, respectively, whereas these parameters reduced in the control group.

CONCLUSIONS

Following RLRL therapy, the choroidal thickening was found to be accompanied by increases in both the vessel LA and SA, with the increase in LA being greater than that of SA. In the control group, with myopia progression, both the LA and SA decreased over time.

摘要

目的

重复低强度红光(RLRL)疗法已被确认为一种控制儿童近视的新型干预措施。本研究旨在调查近视儿童接受12个月RLRL治疗后脉络膜结构的纵向变化。

材料与方法

本研究是一项来自多中心随机对照试验(NCT04073238)的二次分析。脉络膜参数来自于在第1、3、6和12个月进行的基线和随访扫频光学相干断层扫描。这些参数包括管腔面积(LA)、基质面积(SA)、脉络膜总面积(TCA;LA和SA之和)以及脉络膜血管指数(CVI;LA与TCA之比),这些参数由经过验证的定制脉络膜结构评估工具自动测量。

结果

共有143名图像质量足够的儿童(占所有参与者的88.3%)纳入分析(RLRL组67名,对照组76名)。在12个月的随访中,RLRL组所有脉络膜参数均增加,LA、SA、TCA和CVI相对于基线的变化分别为11.70×10³μm²(95%CI:4.14 - 19.26×10³μm²)、3.92×10³μm²(95%CI:0.56 - 7.27×10³μm²)、15.61×10³μm²(95%CI:5.02 - 26.20×10³μm²)和0.21%(95%CI:-0.09%至0.51%),而对照组这些参数则降低。

结论

RLRL治疗后,发现脉络膜增厚伴随着血管LA和SA的增加,且LA的增加大于SA。在对照组中,随着近视进展,LA和SA均随时间下降。

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