阿托品对近视儿童脉络膜厚度的影响：一项荟萃分析。
Effects of atropine on choroidal thickness in myopic children: a meta-analysis.
作者信息
Yang Yaqi, Wei Lijuan, Wang Bo, Zheng Wei
机构信息
Ophthalmology Department, Affiliated Hospital of Changchun University of Traditional Chinese Medicine, Changchun, China.
出版信息
Front Pharmacol. 2024 Oct 21;15:1440180. doi: 10.3389/fphar.2024.1440180. eCollection 2024.
BACKGROUND
Atropine is an effective medicine for myopia prevention and control. This meta-analysis was conducted to investigate the effects of atropine on choroidal thickness (ChT) in children with myopia.
METHODS
Between its inception and 1 June 2023, Medline, Embase, and Web of Science were all searched, and only English literature was included. The choroidal thickness was the primary study outcome. Axial length, standardized equivalent refraction were examined as secondary outcomes. STATA 12.0 was used for data extraction and analysis.
RESULTS
A total of 307 eyes were involved in this study to evaluate the effect of atropine on ChT, axial length (AL) and standardized equivalent refraction (SER) in myopic children. Choroidal thickening was significantly higher in the atropine group than in the control group at 1 month (WMD, 6.87 mm, 95% CI, 0.04 to 13.10, = 0.049), whereas it was significantly higher in the atropine group than in the control group at months 6 (WMD, 10.37 mm, 95% CI, -3.21 to 23.95, = 0.135), 12 (WMD, 15.10 mm, 95% CI, -5.08 to 35.27, = 0.143) and at final follow-up (WMD, 11.52 mm, 95% CI, -3.26 to 26.31, = 0.127), the differences were not statistically significant. At months 1 (WMD, -0.03 mm, 95% CI, -0.04 to -0.01, = 0.003), 6 (WMD, -0.07 mm, 95% CI, -0.01 to -0.03, = 0.000), 12 (WMD, -0.13mm, 95% CI, -0.15 to -0.11, = 0.843), and at final follow-up (WMD, -0.08 mm, 95% CI, -0.16 to -0.01, = 0.127), atropine treatment was able to delay the axial elongation. At 1-month follow-up, there was no significant difference in the effect of atropine on SER in myopic children compared with the control group (WMD, 0.01D, 95% CI, -0.07 to 26.31, = 0.127), whereas it was able to control the progression of refractive status at final follow-up (WMD, 11.52 mm, 95% CI, -3.26 to 26.31, = 0.127).
CONCLUSION
Limited evidence suggests that 0.01% atropine causes choroidal thickening in myopic children at 1 month of treatment. In the short term, choroidal thickness may be a predictor of the effectiveness of atropine in controlling myopia in children. 0.01% atropine is effective in controlling myopic progression in terms of SER and AL.
SYSTEMATIC REVIEW REGISTRATION
http://www.crd.york.ac.uk/prospero, identifier, CRD42022381195.
背景
阿托品是一种预防和控制近视的有效药物。本荟萃分析旨在研究阿托品对近视儿童脉络膜厚度（ChT）的影响。
方法
在其开始至2023年6月1日期间，检索了Medline、Embase和Web of Science，仅纳入英文文献。脉络膜厚度是主要研究结局。眼轴长度、标准化等效球镜度作为次要结局进行检查。使用STATA 12.0进行数据提取和分析。
结果
本研究共纳入307只眼，以评估阿托品对近视儿童脉络膜厚度、眼轴长度（AL）和标准化等效球镜度（SER）的影响。在1个月时，阿托品组脉络膜增厚显著高于对照组（加权均数差[WMD]，6.87mm，95%置信区间[CI]，0.04至13.10，P = 0.049），而在6个月（WMD，10.37mm，95% CI，-3.21至23.95，P = 0.135）、12个月（WMD，15.10mm，95% CI，-5.08至35.27，P = 0.143）及最终随访时（WMD，11.52mm，95% CI，-3.26至26.31，P = 0.127），阿托品组脉络膜增厚虽高于对照组，但差异无统计学意义。在1个月（WMD，-0.03mm，95% CI，-0.04至-0.01，P = 0.003）、6个月（WMD，-0.07mm，95% CI，-0.01至-0.03，P = 0.000）、12个月（WMD，-0.13mm，95% CI，-0.15至-0.11，P = 0.843）及最终随访时（WMD，-0.08mm，95% CI，-0.16至-0.01，P = 0.127），阿托品治疗能够延缓眼轴伸长。在1个月随访时，与对照组相比，阿托品对近视儿童等效球镜度的影响无显著差异（WMD，0.01D，95% CI，-0.07至26.31，P = 0.127），而在最终随访时能够控制屈光状态进展（WMD，11.52mm，95% CI，-3.26至26.31，P = 0.127）。
结论
有限的证据表明，0.01%阿托品在治疗1个月时可使近视儿童脉络膜增厚。短期内，脉络膜厚度可能是阿托品控制儿童近视有效性的一个预测指标。0.01%阿托品在等效球镜度和眼轴长度方面对控制近视进展有效。
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