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近视控制光学干预停止后近视进展的系统评价

Systematic Review of Myopia Progression after Cessation of Optical Interventions for Myopia Control.

作者信息

Chiu Yu-Chieh, Tsai Ping-Chiao, Lee Ssu-Hsien, Wang Jen-Hung, Chiu Cheng-Jen

机构信息

School of Medicine, Tzu Chi University, Hualien 970, Taiwan.

Department of Medical Research, Buddhist Tzu Chi General Hospital, Hualien 970, Taiwan.

出版信息

J Clin Med. 2023 Dec 21;13(1):53. doi: 10.3390/jcm13010053.

Abstract

Despite high discontinuation rates for myopia optical interventions, limited attention has been given to the potential rebound effects post-discontinuation. This systematic review aims to assess the extent of the rebound effects following the cessation of common clinical optical myopia-control interventions in children. A comprehensive search of PubMed, Embase, Cochrane CENTRAL, and ClinicalTrials.gov was conducted from inception to October 2023. The rebound effects, defined as changes in the axial length or spherical equivalent during and after treatment cessation, were categorized into four levels. These studies encompassed 703 participants and spanned from 2019 to 2023, with durations of treatment and cessation ranging from 6 months to 3.5 years and from 2 weeks to 5 years, respectively. This review, encompassing 14 studies, revealed a predominant strong rebound effect in orthokeratology (8 studies), a weak rebound effect in multifocal soft contact lenses (4 studies), and a variable rebound effect in peripheral-plus spectacle lenses (2 studies). Notably, with the increasing cessation duration, the rebound effects diminished, potentially linked to the reversal of choroidal thickening and the disappearance of peripheral myopic defocus. In conclusion, a temporal trend of rebound effects exists in all three myopia optical interventions, possibly contributing to their myopia control mechanisms.

摘要

尽管近视光学干预的停用率很高,但对于停用后的潜在反弹效应关注有限。本系统评价旨在评估儿童常见临床光学近视控制干预措施停止后反弹效应的程度。对PubMed、Embase、Cochrane CENTRAL和ClinicalTrials.gov进行了从创建到2023年10月的全面检索。将反弹效应定义为治疗停止期间及之后眼轴长度或等效球镜度的变化,并分为四个级别。这些研究涵盖703名参与者,时间跨度从2019年到2023年,治疗和停止的持续时间分别为6个月至3.5年和2周至5年。本综述纳入14项研究,结果显示角膜塑形术有明显的强烈反弹效应(8项研究),多焦点软性接触镜有微弱反弹效应(4项研究),周边离焦加光眼镜有可变的反弹效应(2项研究)。值得注意的是,随着停止时间的增加,反弹效应减弱,这可能与脉络膜增厚的逆转和周边近视性离焦的消失有关。总之,所有三种近视光学干预措施均存在反弹效应的时间趋势,这可能有助于其近视控制机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b666/10779574/dedb80c70218/jcm-13-00053-g001.jpg

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