Zhao Yuxuan, Yang Bi, Li Xiaoying, Ma Wei, Liu Longqian, Yan Naihong
( 610041) Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu 610041, China.
( 610041) Laboratory of Optometry and Vision Sciences, West China Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2024 Sep 20;55(5):1280-1287. doi: 10.12182/20240960109.
To explore the difference in myopia control efficacy between spectacle lenses with highly aspherical lenslets (HAL) combined with 0.01% atropine eye drops and spectacle lenses with HAL alone or single vision spectacle lenses (SVL) in children and adolescents.
A retrospective cohort study was conducted with a total of 105 myopic children aged 6-15 years. According to the specific myopia correction and control methods of each subject, they were evenly divided into the HAL+0.01% atropine (HAL+AT) group, the HAL group, and the SVL group, with 35 subjects in each group. Relevant data, such as cycloplegic refraction and axial length (AL) at baseline and 12 months after wearing spectacles, were retrieved. One-way analysis of variance, or the Kruskal-Wallis test, was used to analyze the changes in AL and spherical equivalent refraction (SER) after wearing spectacles for 12 months in comparison to those at baseline in the three groups.
There was no statistically significant difference in the baseline parameters and duration of wearing spectacles among the three groups (>0.05). After wearing spectacles for 12 months, the changes in SER were -0.13 (-0.25, 0.00) D, -0.25 (-0.63, -0.25) D, and -0.63 (-1.00, -0.25) D in the HAL+AT group, HAL group, and SVL group, respectively; AL elongation in the three groups was (0.09±0.11) mm, (0.19±0.16) mm, and (0.34±0.16) mm, respectively. The HAL+AT group exhibited slower SER changes ( =0.001, =0.002) and AL elongation ( =0.009, =0.001) than those of the HAL and the SVL groups. Compared with those of the SVL group, myopia progression was reduced by 79.4% and AL elongation was slowed down by 73.5% in the HAL+AT group, while in the HAL group, myopia progression and AL elongation were reduced by 60.3% and 44.1%, respectively. According to stratified analysis based on age and myopia progression rate, among younger children aged 6 to 8 years and older children aged 9 to 15 years, the HAL+AT group had a significantly lower proportion of subjects experiencing fast AL elongation (AL>0.36 mm/year) and a significantly higher proportion of subjects experiencing slow AL elongation (AL≤0.18 mm/year) compared to the SVL group (<0.017).
The combination intervention of spectacle lenses with HAL and 0.01% atropine eye drops is effective in controlling myopia progression in children and adolescents, with better myopia control effect achieved using this combination intervention in myopic children of all ages.
探讨含高非球面微透镜(HAL)的框架眼镜联合0.01%阿托品滴眼液与单纯HAL框架眼镜或单光框架眼镜(SVL)在儿童和青少年近视控制效果上的差异。
进行一项回顾性队列研究,共纳入105名6至15岁的近视儿童。根据各受试者具体的近视矫正和控制方法,将他们平均分为HAL + 0.01%阿托品(HAL + AT)组、HAL组和SVL组,每组35名受试者。收集基线时及佩戴眼镜12个月后的相关数据,如睫状肌麻痹验光和眼轴长度(AL)。采用单因素方差分析或Kruskal - Wallis检验,分析三组佩戴眼镜12个月后AL和等效球镜度(SER)相较于基线时的变化情况。
三组在基线参数和佩戴眼镜时长方面无统计学显著差异(>0.05)。佩戴眼镜12个月后,HAL + AT组、HAL组和SVL组的SER变化分别为-0.13(-0.25,0.00)D、-0.25(-0.63,-0.25)D和-0.63(-1.00,-0.25)D;三组的AL伸长分别为(0.09±0.11)mm、(0.19±0.16)mm和(0.34±0.16)mm。HAL + AT组的SER变化( =0.001, =0.002)和AL伸长( =0.009, =0.001)比HAL组和SVL组更慢。与SVL组相比,HAL + AT组的近视进展降低了79.4%,AL伸长减缓了73.5%,而HAL组的近视进展和AL伸长分别降低了60.3%和44.1%。根据年龄和近视进展率进行分层分析,在6至8岁的年幼儿童和9至15岁的年长儿童中,与SVL组相比,HAL + AT组中眼轴快速伸长(AL>0.36 mm/年)的受试者比例显著更低,眼轴缓慢伸长(AL≤0.18 mm/年)的受试者比例显著更高(<0.017)。
HAL框架眼镜与0.01%阿托品滴眼液联合干预对控制儿童和青少年近视进展有效,该联合干预在各年龄段近视儿童中均能取得更好的近视控制效果。