0.01%阿托品联合角膜塑形镜对于延缓青少年近视进展的Meta分析

doi:10.3760/cma.j.cn115909-20210528-00222

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摘要目的：评估0.01%阿托品联合角膜塑形镜对于延缓青少年近视进展的疗效。方法：循证医学研究。检索2016年2月至2021年2月在中国期刊全文数据库、中国维普全文数据库、中国生物医学文献服务系统、万方数据库、PubMed、The Cochrane Library和EMbase等各大数据库中的相关文献。经过筛选、统计数据后，将数据导入RevMan 5.4数据库进行统计学分析，应用均值、标准差，计算各个研究数据的均值差和95%置信区间（95%CI），评估比较0.01%阿托品联合配戴角膜塑形镜和仅配戴角膜塑形镜干预前后眼轴长度、等效球镜度（SE）、瞳孔直径的变化。结果：检索得到144篇文献，经过筛选后纳入9篇随机对照文献，共858例，9篇文献均分为试验组和对照组，试验组为0.01%阿托品联合配戴角膜塑形镜，对照组为单独配戴角膜塑形镜。Meta分析结果显示，6篇文献记录干预 1年后眼轴长度的变化，经敏感性分析后剔除1篇文献，重新分析发现试验组干预前后眼轴长度变化量小于对照组，差异有统计学意义[均值差（MD）=-0.17，95%CI（-0.22，-0.17），P<0.001]；4篇文献记录了干预前后SE的变化，试验组SE变化量小于对照组，差异有统计学意义[MD=-0.16，95%CI （0.09，0.22），P<0.001]；3篇文献记录了瞳孔直径的变化，试验组瞳孔直径变化大于对照组，差异有统计学意义[MD=0.70，95%CI（0.41，0.98），P<0.001]。结论：相较于单独配戴角膜塑形镜，采用0.01% 阿托品联合角膜塑形镜的方法在控制青少年近视进展方面效果更佳。

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关键词 ： 0.01%阿托品, 角膜塑形镜, 近视, 青少年, Meta分析

Abstract：Objective: To use meta-analysis to assess the efficacy of using 0.01% atropine combined with orthokeratology in inhibiting myopia among adolescents. Methods: Relevant articles from February 2016 to February 2021 were searched in CNKI, VIP, SINOMED, WanFang, PubMed, Cochrane Library, and EMBASE, and the data were imported into the RevMan 5.4 database to conduct the statistical analysis. The mean difference and 95% confidence interval of each article were determined to assess and compare 0.01% atropine combined with ortho-keratoplasty before and after the intervention-induced variations in eye axial length, spherical equivalent power and pupil diameter. Results: On the whole, 144 articles were retrieved,9 RCTs were included, and 858 patients were involved. The experimental group was treated with the 0.01% atropine intervention combined with orthokeratology, and the control group underwent intervention with only wearing orthokeratology. As indicated from the meta-analysis results, 6 articles recorded the variations in axial length after one year of intervention. After the sensitivity analysis and one literature exclusion, the present meta-analysis revealed that the patients in the experimental group had a mean axial length of 0.17 mm less than those in the control group [mean difference (MD)=-0.17, 95%CI (-0.22, -0.17), P<0.001]. Overall, 4 articles recorded the variations in spherical equivalent power. The patients in the experimental group achieved the mean spherical equivalent power of 0.16 D less than those in the control group [MD=-0.16, 95%CI (0.09, 0.22), P<0.001]. In general, 3 articles recorded variations in pupil diameter. The mean pupil diameter of the patients in the experimental group was higher than that of patients in the control group [MD=0.70, 95%CI (0.41, 0.98), P<0.001]. Conclusions: Compared with only wearing orthokeratology lenses, 0.01% atropine combined with orthokeratology can control the progression of myopia in adolescents more effectively

Key words： 0.01% atropine orthokeratology myopia adolescent meta-analysisinal

收稿日期: 2021-04-23

PACS:

基金资助:天津市临床重点学科（专科）项目（TJLCZDXKM007）；天津市教委重大社科项目（2020JWZD20）

通讯作者: 魏瑞华（ORCID：0000-0002-9708-0355），Email：rwei@tmu.edu.cn

引用本文:

王静怡, 谷天瀑, 李双成, 等. 0.01%阿托品联合角膜塑形镜对于延缓青少年近视进展的Meta分析[J]. 中华眼视光学与视觉科学杂志, 2022, 24(1): 52-57. Jingyi Wang, Tianpu Gu, Shuangcheng Li, et al. The OCT Imaging Characteristics of Foldable Capsular Vitreous Body Implanted in Eyes with Severe Retinal Detachment. Chinese Journal of Optometry Ophthalmology and Visual science, 2022, 24(1): 52-57. DOI: 10.3760/cma.j.cn115909-20210528-00222

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https://www.cjoovs.com/CN/ 10.3760/cma.j.cn115909-20210528-00222 或 https://www.cjoovs.com/CN/Y2022/V24/I1/52

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