1Department of Ophthalmology, Children's Hospital of Nanjing Medical University, Nanjing 210029,China;
2Department of Quality Management, Children's Hospital of Nanjing Medical University, Nanjing 210029, China
Abstract：Objective: To investigate the influence of different cycloplegic agents on astigmatism in school-age children by comparing the vector changes of astigmatism before and after optometry in children aged 6-12 years with atropine and compound tropicamide. Methods: We conducted a retrospective cohort study of 1 262 outpatients (1 262 eyes), aged from 6 to 12 years, who underwent ciliary palsy optometry from January 2019 to September 2020. The patients were divided into two groups according to different cycloplegic agents, the atropine group (530 eyes) and the compound tropicamide group (732 eyes). Data of right eye of each patient was selected. The refractive measurements before and after cycloplegia were measured using an autorefractor (TOPCON KR 800) for all children, and the spherical, cylindrical and axial powers were recorded. The Thibos vector analysis method was used to decompose the astigmatism into J0 and J45. Before and after cycloplegia, data were analyzed by using t-test for the changes in astigmatism; the correlations of J0 and J45 were analyzed by Spearman's correlation coefficient, and the consistencies were described by the Bland-Altman diagram. Results: The J0 values of compound tropicamide group after cycloplegia increased by 0.04卤0.13 (t=8.34, P<0.001). Further grouped according to astigmatism and spherical equivalent, there was no significant difference between the J0 and J45 values between the noncycloplegia and cycloplegia in the atropine group while in the compound tropicamide group, a statistically significant difference in J0 values between noncycloplegica and cycloplegica (all P<0.001), J45 was only significant in the highly astigmatic eyes and myopic eyes (t=-2.18, P=0.031; t=-2.67, P=0.008). Spearman correlation analysis showed that high correlations of J0 and J45 values between noncycloplegia and cycloplegia in both groups. Bland-Altman analysis comparing the two methods showed a good agreement. Conclusions: Compared with atropine, there were significantly changes in astigmatism after cycloplegia refraction with compound tropicamide, especially in school-age children with myopia or high astigmatism.
贾桂祯1,顾伟2,朱娜1, 等. 比较阿托品和复方托吡卡胺对学龄期儿童散光的影响[J]. 中华眼视光学与视觉科学杂志, 2022, 24(9): 689-697.
Guizhen Jia1,Wei Gu2,Na Zhu1,et al. A Comparative Study of the Influence of Atropine and Compound Tropicamide on Astigmatism in School-Age Children. Chinese Journal of Optometry Ophthalmology and Visual science, 2022, 24(9): 689-697. DOI: 10.3760/cma.j.cn115909-20220130-00046
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