Xu Shengsong, Wang Yanbin, Ruan Zhenbang, Wang Shuhang, Yin Runzhuo, Tang Xianghua, Lu Mingxin, Chen Weiyin, Li Zhouyue, Yang Xiao
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China.
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China.
Cont Lens Anterior Eye. 2025 Apr;48(2):102342. doi: 10.1016/j.clae.2024.102342. Epub 2024 Dec 7.
To explore the longitudinal changes in choroidal features in myopic children with low to moderate myopia under orthokeratology (ortho-k) treatment.
Children (n = 80) aged 8-12 years with spherical equivalent refraction of -1.00 to -6.00D were randomly assigned to the control (single vision spectacles) (n = 40) and ortho-k (n = 40) groups. OCT images were collected at the baseline, 1-, 6-, 12-, 18-, and 24-month visits. Choroidal structure parameters, including choroidal total area (TA), luminal area (LA), stromal area (SA), and choroidal vascularity index (CVI) were calculated. Axial length (AL) was measured as the primary indicator for myopic progression. The analysis followed the intention-to-treat criteria.
Compared to the control, ortho-k significantly improved the choroidal structures in choroidal TA and LA at all follow-up points (all P < 0.05). Choroidal LA was the primary contributor to TA changes (85.8 %[control], 91.4 %[ortho-k]), with the most significant improvement within the first 6 months. While, the changes in SA and CVI over time were not significantly different between the two groups (all P > 0.05). Correlation matrices identified several noteworthy correlations between AL change and choroidal structure features. Further analysis showed a significant interaction effect between baseline choroidal LA and intervention type on subsequent AL change (P for interaction = 0.005), suggesting that ortho-k might be more effective in children with larger baseline choroidal LA.
This 2-year prospective study demonstrated that ortho-k can improve the choroidal structures, primarily manifested in choroidal LA, although this positive effect diminishes over time. Myopic children with larger baseline choroidal LA might benefit more from ortho-k.
探讨低至中度近视儿童在角膜塑形术（ortho-k）治疗下脉络膜特征的纵向变化。
将8至12岁、等效球镜度为-1.00至-6.00D的儿童（n = 80）随机分为对照组（单光眼镜）（n = 40）和角膜塑形术组（n = 40）。在基线、1个月、6个月、12个月、18个月和24个月随访时收集OCT图像。计算脉络膜结构参数，包括脉络膜总面积（TA）、管腔面积（LA）、基质面积（SA）和脉络膜血管指数（CVI）。测量眼轴长度（AL）作为近视进展的主要指标。分析遵循意向性治疗标准。
与对照组相比，角膜塑形术在所有随访点均显著改善了脉络膜TA和LA的结构（所有P < 0.05）。脉络膜LA是TA变化的主要贡献者（对照组为85.8%，角膜塑形术组为91.4%），在最初6个月内改善最为显著。同时，两组间SA和CVI随时间的变化无显著差异（所有P > 0.05）。相关矩阵确定了AL变化与脉络膜结构特征之间的几个值得注意的相关性。进一步分析显示，基线脉络膜LA与干预类型对后续AL变化有显著的交互作用（交互作用P = 0.005），表明角膜塑形术对基线脉络膜LA较大的儿童可能更有效。
这项为期2年的前瞻性研究表明，角膜塑形术可改善脉络膜结构，主要表现在脉络膜LA上，尽管这种积极作用会随着时间减弱。基线脉络膜LA较大的近视儿童可能从角膜塑形术中获益更多。
