Poels Mariëlle M F, de Wit Gerard C, Bijveld Mieke M C, van Genderen Maria M
Bartiméus Diagnostic Center for Complex Visual Disorders, Zeist, The Netherlands.
Department of Ophthalmology University Medical Center Utrecht, Utrecht, The Netherlands.
Invest Ophthalmol Vis Sci. 2024 Dec 2;65(14):9. doi: 10.1167/iovs.65.14.9.
A range of pharmacological and optical therapies are being studied and implemented in children with myopia to reduce the progression of myopia. At present, the efficacy of these myopia reduction treatments in children with underlying inherited retinal disorders (IRDs) is largely unknown. To evaluate this efficacy, it is essential to first understand the natural progression of myopia within each distinct underlying IRD. We investigated the natural course of refractive error throughout childhood in patients with congenital stationary night blindness (CSNB) of the Schubert-Bornschein type.
We retrospectively assessed a total of 295 refraction measurements in 127 patients with CSNB (48 with "complete" CSNB [CSNB1] and 79 with "incomplete" CSNB [CSNB2]) at different ages between 0 and 21 years old. None had a history of myopia control treatment. A linear mixed effects model was fitted on the data to analyze the natural course of refraction in these patients.
The fitted model showed that refractive error in patients with CSNB increases quickly toward myopia in the first years of life. After the age of 4 years, there was a minimal progression of only -0.12 diopters (D) per year up to 15 years, after which the refraction seemed stable. All (43/43) of the patients with CSNB1 aged > 4 years were myopic and 84% (62/74) of the patients with CSNB2 aged > 4 years were myopic at the last refraction measurement.
In general, the refractive error of children with CSNB changes minimally after the age of 4 years old. A critical approach to myopia control interventions in these children is warranted.
一系列药物和光学疗法正在儿童近视患者中进行研究和应用，以减缓近视进展。目前，这些近视减缓治疗方法在患有潜在遗传性视网膜疾病（IRD）的儿童中的疗效很大程度上尚不清楚。为了评估这种疗效，首先必须了解每种不同潜在IRD中近视的自然进展情况。我们研究了舒伯特 - 博恩施泰因型先天性静止性夜盲（CSNB）患者整个儿童期屈光不正的自然病程。
我们回顾性评估了127例CSNB患者（48例“完全性”CSNB [CSNB1]和79例“不完全性”CSNB [CSNB2]）在0至21岁不同年龄的总共295次验光测量结果。所有患者均无近视控制治疗史。对数据拟合线性混合效应模型，以分析这些患者屈光不正的自然病程。
拟合模型显示，CSNB患者的屈光不正在生命的最初几年迅速向近视发展。4岁以后，直到15岁，每年仅以-0.12屈光度（D）的最小速度进展，此后屈光似乎稳定。在最后一次验光测量时，所有年龄>4岁的CSNB1患者（43/43）均为近视，年龄>4岁的CSNB2患者中有84%（62/74）为近视。
一般来说，CSNB儿童4岁以后屈光不正变化极小。对这些儿童的近视控制干预措施需要采取审慎的方法。
