College of Optometry, The University of Houston, Houston, Texas, United States.
College of Optometry, The Ohio State University, Columbus, Ohio, United States.
Invest Ophthalmol Vis Sci. 2023 Nov 1;64(14):3. doi: 10.1167/iovs.64.14.3.
The purpose of this study was to evaluate the relationship between peripheral defocus and pupil size on axial growth in children randomly assigned to wear either single vision contact lenses, +1.50 diopter (D), or +2.50 D addition multifocal contact lenses (MFCLs).
Children 7 to 11 years old with myopia (-0.75 to -5.00 D; spherical component) and ≤1.00 D astigmatism were enrolled. Autorefraction (horizontal meridian; right eye) was measured annually wearing contact lenses centrally and ±20 degrees, ±30 degrees, and ±40 degrees from the line of sight at near and distance. Photopic and mesopic pupil size were measured. The effects of peripheral defocus, treatment group, and pupil size on the 3-year change in axial length were modeled using multiple variables that evaluated defocus across the retina.
Although several peripheral defocus variables were associated with slower axial growth with MFCLs, they were either no longer significant or not meaningfully associated with eye growth after the treatment group was included in the model. The treatment group assignment better explained the slower eye growth with +2.50 MFCLs than peripheral defocus. Photopic and mesopic pupil size did not modify eye growth with the +2.50 MFCL (all P ≥ 0.37).
The optical signal causing slower axial elongation with +2.50 MFCLs is better explained by the lens type worn than by peripheral defocus. The signal might be something other than peripheral defocus, or there is not a linear dose-response relationship within treatment groups. We found no evidence to support pupil size as a criterion when deciding which myopic children to treat with MFCLs.
本研究旨在评估随机分配佩戴单焦接触镜（+1.50 屈光度[D]）或+2.50 D 附加多焦点接触镜（MFCL）的儿童，周边离焦与瞳孔大小对眼轴增长的关系。
招募近视（球镜成分-0.75 至-5.00 D）且≤1.00 D 散光的 7 至 11 岁儿童。每年使用接触镜在中央和视线 ±20°、±30°和±40°处，在近距和远距时，对（右眼）自动折射（水平子午线）进行测量。测量明视和中间光瞳孔大小。使用评估视网膜上全焦点离焦的多变量模型，对 3 年眼轴长度变化的周边离焦、治疗组和瞳孔大小的影响进行建模。
虽然在使用 MFCL 时，几个周边离焦变量与眼轴增长较慢相关，但在将治疗组纳入模型后，它们要么不再显著，要么与眼轴增长无明显关联。治疗组的分配比周边离焦更好地解释了 +2.50 MFCL 眼轴增长较慢的原因。明视和中间光瞳孔大小均未改变 +2.50 MFCL 眼轴生长（所有 P ≥ 0.37）。
引起 +2.50 MFCL 眼轴伸长较慢的光学信号，更好地由所佩戴的镜片类型解释，而不是由周边离焦解释。该信号可能不是周边离焦，或者在治疗组内没有线性剂量-反应关系。我们没有发现证据支持瞳孔大小作为决定使用 MFCL 治疗哪些近视儿童的标准。
