眼科

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1%阿托品眼膏控制近视性散光青少年近视进展的一年疗效

沈降 吴晓兰 周磊 郁琪华 张晓瑾   

  1. 315040浙江省宁波市眼科医院
  • 收稿日期:2015-11-24 出版日期:2016-09-25 发布日期:2016-09-26
  • 通讯作者: 沈降, Email:nbykyyshen@163.com
  • 基金资助:

    宁波市社会发展科技项目(2012C50024)

Effect of 1% topical atropine on the progression of myopia in the myopic astigmatism children

SHEN Jiang, WU Xiao-lan, ZHOU Lei, YU Qi-hua, ZHANG Xiao-jin   

  1. Ningbo Eye Hospital, Ningbo Zhejiang 315040, China
  • Received:2015-11-24 Online:2016-09-25 Published:2016-09-26
  • Contact: SHEN Jiang,Email:nbykyyshen@163.com

摘要:

目的 研究1%阿托品眼膏控制近视性散光青少年近视进展的一年疗效。设计 病例对照研究。研究对象 选择2013年2-9月在宁波市眼科医院视光门诊诊治的120例(240眼)6~9岁近视性散光患者(近视性散光≥-1.50 D,等效球镜在-1.00~ -4.00 D,弱视已治愈)。方法 采用随机数字表法将患者分为A、B、C三组,每组均为40例80眼,A组戴框架眼镜,B组戴框架眼镜联合0.5%复方托吡卡胺滴眼液1次/晚,C组戴框架眼镜联合1%阿托品眼膏1次/周五晚。随访12个月,每个月复查最佳矫正视力、屈光状态、眼压及眼轴变化。主要指标 视力、屈光度及眼轴。结果 随访12个月时,A组、B组和C组患者近视屈光度进展分别为(-1.22±0.38)D、(-1.07±0.31)D和(-0.38±0.25)D,各组之间比较差异有统计学意义(F=58.031, P<0.001);眼轴增长分别为(0.48±0.21)mm、(0.39±0.15)mm和(0.15±0.09)mm,各组之间比较差异有统计学意义(F=24.612, P<0.001);散光屈光度变化分别为(+0.33±0.12)D、(+0.21±0.18)D和(+0.26±0.13)D,各组之间比较差异无统计学意义(F=0.253, P=0.901);各组患者均无明显不适主诉及高眼压等眼部并发症。结论 随访一年的结果表明,戴框架眼镜联合1%阿托品眼膏每周五晚1次能安全、有效地控制近视性散光青少年近视的进展,适宜基层医院推广。(眼科, 2016, 25: 298-301)

关键词: 散光, 近视, 屈光, 阿托品, 青少年

Abstract:

Objective To study the effect of 1% topical atropine on the progression of myopia in the myopic astigmatism children. Design Case control study. Participants 120 cases (240 eyes) of highly myopic astigmatism (≥-1.50 diopter) children from 6 to 9 year old without amblyopia. Methods 120 (240 eyes) myopic astigmatism children were enrolled for the study, who were randomly divided into 3 groups, 40 cases (80 eyes) in each group. Group A was treated with glasses, group B was treated with glasses with compound tropicamide eye drops nightly, and group C was treated with 1% topical atropine gel every Friday evening combined with astigmatic glasses. The visual acuity, the status of refraction, the intraocular pressure and the axial length were examined monthly for 12 months. Main Outcome Measures Progression of myopic diopters and axial length. Results After 12 months, the progression of myopia in group C treated by 1% topical atropine gel every Friday evening combined with astigmatic glasses was significantly lower than group A and group B (F=58.031, P<0.001), and the increase of the axial length in group C was also significantly less than group A and group B (F=24.612, P<0.001). There was no significant reduction of astigmatic diopters among all groups (F=0.253, P=0.901). And there were no other complaints and complications such as high intraocular pressure and photophobia in children treated with 1% atropine gel. Conclusions It was a safe, effective resolution for most of high myopic astigmatism children treated with 1% topical atropine gel every Friday evening combined with astigmatic glasses for one year to slowdown the progression of myopia. (Ophthalmol CHN, 2016, 25: 298-301)

Key words: astigmatism, myopia, refraction, atropine, children