反复低强度红光治疗后近视前期儿童脉络膜厚度的变化及其在预测近视预防和控制近视进展中的作用

Changes in choroidal thickness in pre-myopic children after repeated low-level red-light therapy and their role in predicting myopia prevention and controlling myopic shift.

作者信息

Xiang Kaidi, Wang Jingjing, Zhu Zhuoting, Zhang Xinzi, Zhang Bo, Chen Jun, Yang Jinliuxing, Du Linlin, Ai Zhijian, He Xiangui, Xu Xun

机构信息

Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University, Shanghai, China; National Clinical Research Center for Eye Diseases, Shanghai, China; Shanghai Clinical Research Center for Eye Diseases, Shanghai, China; Shanghai Key Clinical Specialty, Shanghai, China; Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China; Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China; Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China; Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China.

Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China.

出版信息

Asia Pac J Ophthalmol (Phila). 2025 Mar-Apr;14(2):100115. doi: 10.1016/j.apjo.2024.100115. Epub 2024 Dec 1.

DOI:10.1016/j.apjo.2024.100115

PMID:39626798

Abstract

PURPOSE

To investigate longitudinal changes in choroidal thickness (ChT) after 1-year treatment of repeated low-level red-light (RLRL) and their predictive value in efficacy on myopia prevention and myopic shift among pre-myopic children.

METHODS

278 pre-myopic (-0.50 D < spherical equivalent refraction, SER ≤ 0.50 D) participants were assigned to the RLRL group and control group randomly and evenly. The OCT, visual acuity, AL, SER and other parameters were measured before enrollment and every 3 months after intervention. The data from both eyes of the included participants were analyzed.

RESULTS

A total of 463 eyes were analyzed. Due to the COVID-19 pandemic, 176 participants in the RLRL group had treatment interrupted. The continued RLRL group, interrupted RLRL group and control group were well balanced in baseline characteristics. In the continued and interrupted RLRL group, the average ChT increased significantly at 3-month visit (all P < 0.001) and the subfoveal ChT thickened evidently. The area under the curve (AUC) for the models including gender and 3-month change in ChT to predict satisfactory myopia prevention at 12 months was 0.983. The efficacy of the models that also used the combined indicators of baseline age, gender and the 3-month change in ChT to predict AL progression control over 12 months reached 0.944.

CONCLUSIONS

Continued RLRL intervention induced notable thickening of ChT in premyopic population, especially at the subfoveal sector. For participants received RLRL treatment, the 3-month change in ChT combined with other baseline factors have acceptable predictive discrimination of myopia prevention efficacy.

摘要

目的

探讨重复低强度红光（RLRL）治疗1年后脉络膜厚度（ChT）的纵向变化及其对近视前期儿童预防近视和近视进展的预测价值。

方法

278名近视前期儿童（等效球镜度数，SER：-0.50 D＜SER≤0.50 D）被随机平均分为RLRL组和对照组。在入组前及干预后每3个月测量OCT、视力、眼轴长度（AL）、SER等参数。对纳入研究对象的双眼数据进行分析。

结果

共分析463只眼。由于新冠疫情，RLRL组有176名参与者的治疗中断。继续治疗的RLRL组、治疗中断的RLRL组和对照组在基线特征上具有良好的均衡性。在继续治疗的RLRL组和治疗中断的RLRL组中，3个月随访时平均ChT显著增加（均P＜0.001），黄斑中心凹下ChT明显增厚。包含性别和ChT 3个月变化量来预测12个月时近视预防效果满意的模型的曲线下面积（AUC）为0.983。同时使用基线年龄、性别和ChT 3个月变化量的综合指标来预测12个月内AL进展控制情况的模型的效能达到0.944。