Department of Ophthalmology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Kyoto, 602-8566, Japan.
Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Jpn J Ophthalmol. 2023 Sep;67(5):602-611. doi: 10.1007/s10384-023-01012-8. Epub 2023 Aug 7.
Having previously demonstrated the efficacy of 0.01% atropine eye drops for inhibiting progression of childhood myopia, we conducted additional analyses to assess post-treatment changes in myopia progression.
Analysis of follow-up data from a previously reported randomized controlled trial METHODS: A mixed-effects model was used to compare intergroup changes in spherical equivalent (SE) and axial length (AL) at 1 month and 12 months after discontinuation of 2-year treatment with atropine or placebo in 167 school-age children.
Follow-up measurements were available for 149 participants at 1 month after discontinuation of treatment and for 51 participants at 12 months after discontinuation. At 1 month post-treatment, differences between the atropine and placebo groups in least squares (LS) mean changes in SE and AL, respectively, from 24 months were -0.06 diopters (D) (95% CI: -0.21, 0.08; P = .39) and 0.02 mm (95% CI: -0.05, 0.08; P = .60). At 12 months post-treatment, intergroup differences (atropine vs placebo) in LS mean changes in SE and AL, respectively, were -0.13 D (95% CI: -0.35, 0.10; P = .26) and -0.02 mm (95% CI: -0.12, 0.09; P = .75). LS mean changes in SE and AL from treatment discontinuation did not differ between the groups at 1 or 12 months post-treatment.
Axial elongation was significantly less in the atropine group than in the placebo group. The suppression effect obtained at 2 years was maintained after 12 months. The absence of intergroup differences in myopia progression since treatment cessation suggests that myopic rebound did not occur.
我们之前已经证明了 0.01%阿托品滴眼液抑制儿童近视进展的疗效，在此基础上，我们进行了进一步的分析，以评估治疗停止后的近视进展变化。
对之前报道的一项随机对照试验的随访数据进行分析
采用混合效应模型比较 167 名学龄儿童在停止为期 2 年的阿托品或安慰剂治疗后 1 个月和 12 个月时，两组间球镜等效（SE）和眼轴（AL）的变化。
149 名参与者在治疗停止后 1 个月时可进行随访测量，51 名参与者在治疗停止后 12 个月时可进行随访测量。治疗停止后 1 个月时，与安慰剂组相比，阿托品组 SE 和 AL 的最小二乘均数（LS）变化差异分别为-0.06 屈光度（D）（95%可信区间：-0.21，0.08；P=0.39）和 0.02 毫米（95%可信区间：-0.05，0.08；P=0.60）。治疗停止后 12 个月时，SE 和 AL 的 LS 平均变化差异分别为-0.13 D（95%可信区间：-0.35，0.10；P=0.26）和-0.02 毫米（95%可信区间：-0.12，0.09；P=0.75）。治疗停止后 1 个月和 12 个月时，两组 SE 和 AL 的 LS 平均变化无差异。
与安慰剂组相比，阿托品组眼轴伸长明显减少。治疗 2 年后获得的抑制效果在 12 个月后仍能维持。治疗停止后近视进展无组间差异表明近视反弹并未发生。
