Liu Mengqi, Huang Jing, Xie Zhu, Wang Yuanyuan, Wang Pengqi, Xia Ruijing, Liu Xinting, Su Binbin, Qu Jia, Zhou Xiangtian, Mao Xinjie, Wu Hao
National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325027, China; State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325027, China.
State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325027, China; Oujiang Laboratory (Zhejiang Lab for Regenerative Medicine, Vision, and Brain Health), Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325027, China; Research Unit of Myopia Basic Research and Clinical Prevention and Control, Chinese Academy of Medical Sciences (2019RU025), Wenzhou, Zhejiang 325027, China.
Cont Lens Anterior Eye. 2025 Feb;48(1):102314. doi: 10.1016/j.clae.2024.102314. Epub 2024 Sep 29.
To investigate the dynamic changes of choroidal vasculature and its association in mediating ocular elongation over 1 year of orthokeratology (ortho-k) treatment.
This observational study included 8-14 year old myopic children who were willing to receive ortho-k treatment or wear single vision spectacle lenses (SVL). Axial length (AL) and choroidal characteristics, including submacular luminal area (LA), stromal area (SA), total choroidal area (TCA), choroidal vascularity index (CVI), subfoveal choroidal thickness (SFCT) and choriocapillaris flow deficits (CcFD) from OCT/OCTA images, were evaluated at baseline, 3, 6 and 12 months.
After 1 year, AL elongation was significantly less in 25 children treated with ortho-k than in 29 children wearing SVL (0.17 ± 0.14 v.s. 0.28 ± 0.16 mm, P<0.01). In the ortho-k group, LA, SA, TCA and SFCT were significantly increased by 0.033 ± 0.059 mm, 0.024 ± 0.035 mm, 0.058 ± 0.087 mm, 8.9 ± 17.4 μm, respectively, at 3 months (all P<0.05). These parameters returned to near baseline levels over the following 9 months. Meanwhile, CcFD decreased by 0.83 ± 1.09 % over 12 months, but CVI remained steady during this period. No significant changes in these choroidal parameters (except for CcFD, decreased by -0.56 ± 1.23 %) were observed in the SVL group over 12 months. Increases in SFCT, LA, SA and TCA over 12 months were significantly greater in the ortho-k group than in the SVL group. Mediation analyses showed that 44.8 % of effect on inhibiting AL elongation through ortho-k was mediated via TCA (in particular LA).
The decelerated ocular elongation during ortho-k treatment is accompanied by increases in content of choroidal vascular lumen and stromal component. Dynamic changes of choroidal vasculature provide a possible mechanism underlying myopia control efficacy via ortho-k.
研究角膜塑形术（ortho-k）治疗1年期间脉络膜血管系统的动态变化及其在介导眼轴延长中的关联。
这项观察性研究纳入了8至14岁愿意接受角膜塑形术治疗或佩戴单焦点眼镜（SVL）的近视儿童。在基线、3个月、6个月和12个月时评估眼轴长度（AL）和脉络膜特征，包括黄斑下管腔面积（LA）、基质面积（SA）、脉络膜总面积（TCA）、脉络膜血管指数（CVI）、黄斑中心凹下脉络膜厚度（SFCT）以及光学相干断层扫描/光学相干断层扫描血管造影（OCT/OCTA）图像中的脉络膜毛细血管血流缺损（CcFD）。
1年后，25例接受角膜塑形术治疗的儿童的眼轴延长明显少于29例佩戴单焦点眼镜的儿童（0.17±0.14对0.28±0.16mm，P<0.01）。在角膜塑形术组中，3个月时LA、SA、TCA和SFCT分别显著增加0.033±0.059mm、0.024±0.035mm、0.058±0.087mm、8.9±17.4μm（均P<0.05）。在接下来的9个月里，这些参数恢复到接近基线水平。同时，12个月内CcFD下降了0.83±1.09%，但在此期间CVI保持稳定。在单焦点眼镜组中，12个月内这些脉络膜参数（除CcFD下降了-0.56±1.23%外）无显著变化。角膜塑形术组12个月内SFCT、LA、SA和TCA的增加显著大于单焦点眼镜组。中介分析表明，通过角膜塑形术抑制眼轴延长的效应中有44.8%是通过TCA（特别是LA）介导的。
角膜塑形术治疗期间眼轴延长减速伴随着脉络膜血管腔和基质成分含量的增加。脉络膜血管系统的动态变化为角膜塑形术控制近视疗效提供了一种可能的机制。
