Zhang Ju, Zhang Xiaoliang, Ding Ranyi, Ji Yanan, Zhu Zhe, Bao Qingdong, Wang Ting, Shi Weiyun
Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China.
Eye Hospital of Shandong, Eye Institute of Shandong First Medical University, First Medical University (Shandong Eye Hospital), 372 Jingsi Road, Jinan, 250021, China.
Sci Rep. 2025 Aug 23;15(1):31065. doi: 10.1038/s41598-025-17115-w.
This prospective study aimed to investigate changes in corneal higher-order aberrations (HOAs) in myopic children using orthokeratology (ortho-k) lenses and their relationship with myopia progression. A total of 112 children aged 8-13 years were divided into group A (axial elongation ≤ 0.1 mm/y with ortho-k) and group B (axial elongation > 0.1 mm/y with ortho-k). At baseline, 1, 6, and 12 months following the initiation of lens wear, HOAs and corneal peripheral defocus were evaluated. Ninety-three patients completed the 1-year follow-up. The mean axial elongation was - 0.07 ± 0.15 mm/y in group A, versus 0.32 ± 0.17 mm/y in group B. No statistical differences were observed in HOAs and corneal peripheral defocus at 1, 6, and 12 months (F = 0.653, 0.878; P > 0.05). Multivariate linear regression showed axial elongation was negatively correlated with ∆HOAs, peripheral defocus, and ∆horizontal coma (standardized beta=-0.331, -0.318, -0.209; P = 0.006, 0.001, 0.010, respectively) and positively correlated with the treatment zone diameter (standardized beta = 0.261, P = 0.003). Multivariate logistic regression identified ∆HOAs, peripheral defocus, ∆horizontal coma, and treatment zone as key factors distinguishing group A from group B (OR = 0.009, 0.455, 0.123, 12.172; P = 0.036, 0.003, 0.032, 0.019, respectively). The ROC curve for ∆HOAs had an area of 0.803 with a cut-off value of 0.834 μm. The ∆HOAs were more effective independent predictors of axial elongation than corneal peripheral defocus in children using ortho-k lenses. The ∆HOAs greater than 0.834 μm may lead to axial elongation ≤ 0.1 mm/y. These findings can be beneficial to fitting and optimizing ortho-k lenses.
这项前瞻性研究旨在调查使用角膜塑形术（ortho-k）镜片的近视儿童角膜高阶像差（HOAs）的变化及其与近视进展的关系。总共112名8至13岁的儿童被分为A组（使用ortho-k镜片时眼轴伸长≤0.1毫米/年）和B组（使用ortho-k镜片时眼轴伸长>0.1毫米/年）。在基线、开始佩戴镜片后的1个月、6个月和12个月，评估高阶像差和角膜周边离焦情况。93名患者完成了1年的随访。A组的平均眼轴伸长为-0.07±0.15毫米/年，而B组为0.32±0.17毫米/年。在1个月、6个月和12个月时，高阶像差和角膜周边离焦方面未观察到统计学差异（F = 0.653，0.878；P>0.05）。多元线性回归显示，眼轴伸长与高阶像差变化量（∆HOAs）、周边离焦和水平彗差变化量呈负相关（标准化β=-0.331，-0.318，-0.209；P分别为0.006、0.001、0.010），与治疗区直径呈正相关（标准化β = 0.261，P = 0.003）。多元逻辑回归确定高阶像差变化量、周边离焦、水平彗差变化量和治疗区是区分A组和B组的关键因素（OR分别为0.009、0.455、0.123、12.172；P分别为0.036、0.003、0.032、0.019）。高阶像差变化量的ROC曲线面积为0.803，截断值为0.834微米。在使用ortho-k镜片的儿童中，高阶像差变化量比角膜周边离焦更能有效独立预测眼轴伸长。高阶像差变化量大于0.834微米可能导致眼轴伸长≤0.1毫米/年。这些发现有助于角膜塑形术镜片的验配和优化。
