周边离焦设计框架眼镜对学龄儿童近视进展的影响：四年回顾分析

doi:10.3760/cma.j.cn115909-20201122-00451

摘要
图/表
参考文献(20)
相关文章 (15)

全文: PDF 737KB HTML (1 KB)
输出: BibTeX | EndNote (RIS) 背景资料

文章导读

摘要目的：观察8～14岁儿童连续4年配戴周边离焦设计框架眼镜后的近视进展情况，评价其近视控制效果。方法：回顾性病例对照研究。对北京同仁医院验光配镜中心电子病历系统中2011─2014年连续4年配戴周边离焦设计框架眼镜（PDMLs）、单焦点框架眼镜（SVLs）的217例儿童就诊资料进行回顾分析，提取包括年龄、性别、屈光度、镜片类型等相关信息。使用的周边离焦镜片为非球面设计，采用“周边视力控制”技术达到延缓近视发展的目的。通过倾向性评分匹配，PDMLs、SVLs组各44例，取右眼数据纳入统计分析。2组儿童近视进展情况的比较采用独立样本t检验、卡方检验和广义估计方程等方法。结果：PDMLs组2011─2014年期间每年屈光度进展分别为（-0.85±0.43）D、（-0.60±0.35）D、（-0.64±0.26）D和（-0.53±0.28）D，SVLs组分别为（-0.82±0.42）D、（-0.79±0.44）D、（-0.61±0.40）D和（-0.58±0.33）D。PDMLs组中约59%（26/44）的儿童屈光度进展未超过2.00 D，略高于SVLs组（50%，22/44），但差异无统计学意义（χ2 =2.06，P=0.12）。对基线屈光度、年龄分组后， 2组儿童屈光度进展差异均无统计学意义。通过广义估计方程分析，每年屈光度进展与年龄（β=0.06；标准误：0.01；95%CI：0.03，0.09；P<0.001）、镜片类型（β=-0.09；标准误：0.05；95%CI：-0.19，-0.01； P=0.04）相关。结论：与单焦点镜片相比，该设计类型的周边离焦镜片可以一定程度上延缓儿童近视进展速度，但临床效果不明显。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章

关键词 ： , 周边离焦, 近视控制, 真实世界研究

Abstract： Objective: To review myopia progression over 4 years in children who wore peripheral defocus modifying lenses (PDMLs), and assess its efficacy of myopia control. Methods: This was a retrospective, nonrandomized controlled trial at a tertiary referral center (Tongren Eye Care Center, Beijing Tongren Hospital). Data from 217 children aged 8-14 years who wore PDMLs or single vision lenses (SVLs) consecutively for 4 years (from 2011 to 2014) were collected from electronic medical records. Information such as age, gender, refraction, and type of spectacle lenses were included. PDML is an asymmetric design in which myopia progression was slowed using peripheral vision control technology. Final subjects were 88 children who were included after propensity score matching, with 44 children in each group. Only data of right eyes were included using a generalized estimation equation (GEE) model. Independent t tests and Chi-square tests were used to determine whether myopia progression differed between the two groups. Results: Annual myopia progression was -0.85±0.43 D, -0.60±0.35 D, -0.64±0.26 D and -0.53±0.28 D in the PDML group, and was -0.82±0.42 D, -0.79±0.44 D, -0.61±0.40 D and -0.58±0.33 D in the SVL group, respectively. 59%(26/44) in the PDML group progressed lower than 2.00 D, slightly higher than that of 50.0%(22/44) in the SVL group (χ2 =2.06, P=0.12). After stratification by age and baseline refraction, there was also no significant difference in myopia progression between the two groups. In the GEE model, annual myopia progression was associated with age (β=0.06; standard error: 0.01; 95%CI: 0.03, 0.09; P<0.001) and treatment (β=-0.09; standard error: 0.05; 95%CI: -0.19, -0.01; P=0.04). Conclusions: Compared to single vision lenses, peripheral defocus modifying lenses can moderately slow myopia progression. However, the effect is not remarkable in clinical practice.

Key words： peripheral defocus myopia control real world study

收稿日期: 2020-11-22

PACS:

基金资助:

通讯作者: 吕燕云（ORCID：0000-0002-3948-1652），Email：1489043665@qq.com

引用本文:

郭寅1 田飞飞2 吴敏1 冯祎1 唐萍1 吕燕云1. 周边离焦设计框架眼镜对学龄儿童近视进展的影响：四年回顾分析[J]. 中华眼视光学与视觉科学杂志, 2021, 23(4): 267-271. Yin Guo1,Feifei Tian2,Min Wu1,Yi Feng1,Ping Tang1,Yanyun Lu1. Myopia Progression in Children Wearing Peripheral Defocus Modifying Lenses: Four Years of Retrospective Analysis. Chinese Journal of Optometry Ophthalmology and Visual science, 2021, 23(4): 267-271. DOI: 10.3760/cma.j.cn115909-20201122-00451

链接本文:

https://www.cjoovs.com/CN/10.3760/cma.j.cn115909-20201122-00451 或 https://www.cjoovs.com/CN/Y2021/V23/I4/267

[1]	Holden BA, Fricke TR, Wilson DA, et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology, 2016,123(5): 1036-1042. DOI: 10.1016/ j.ophtha.2016.01.006.
[2]	Guo Y, Duan JL, Liu LJ, et al. High myopia in greater Beijing school children in 2016. PLoS One, 2017, 12(11): e0187396. DOI: 10.1371/journal.pone.0187396.
[3]	郭寅, 唐萍, 吴敏, 等. 青少年高度近视患眼眼底特征及其与屈光状态的相关性. 中华眼底病杂志, 2016, 32(6): 628-632. DOI: 10.3760/cma.j.issn.1005-1015.2016.06.015.
[4]	Cho P, Tan Q. Myopia and orthokeratology for myopia control. Clin Exp Optom, 2019, 102(4): 364-377. DOI: 10.1111/ cxo.12839.
[5]	Wu PC, Chuang MN, Choi J, et al. Update in myopia and treatment strategy of atropine use in myopia control. Eye (Lond), 2019, 33(1): 3-13. DOI: 10.1038/s41433-018-0139-7.
[6]	Sankaridurg P. Contact lenses to slow progression of myopia. Clin Exp Optom, 2017, 100(5): 432-437. DOI: 10.1111/ cxo.12584.
[7]	Huang J, Wen D, Wang Q, et al. Efficacy comparison of 16 interventions for myopia control in children: A network metaanalysis. Ophthalmology, 2016, 123(4): 697-708. DOI: 10.1016/ j.ophtha.2015.11.010.
[8]	Sankaridurg P, Donovan L, Varnas S, et al. Spectacle lenses designed to reduce progression of myopia: 12-month results. Optom Vis Sci, 2010, 87(9): 631-641. DOI: 10.1097/ OPX.0b013e3181ea19c7.
[9]	Kanda H, Oshika T, Hiraoka T, et al. Effect of spectacle lenses designed to reduce relative peripheral hyperopia on myopia progression in Japanese children: A 2-year multicenter randomized controlled trial. Jpn J Ophthalmol, 2018, 62(5): 537-543. DOI: 10.1007/s10384-018-0616-3.
[10]	郭寅, 刘丽娟, 张嵘, 等. 角膜塑形镜、周边离焦眼镜、单光眼镜对儿童近视控制的一年效果. 眼科, 2016, 25(5): 302-306. DOI: 10.13281/j.cnki.issn.1004-4469.2016.05.004.
[11]	Smith EL 3rd, Huang J, Hung LF, et al. Hemiretinal form deprivation: Evidence for local control of eye growth and refractive development in infant monkeys. Invest Ophthalmol Vis Sci, 2009, 50(11): 5057-5069. DOI: 10.1167/iovs.08-3232.
[12]	Smith EL 3rd, Hung LF, Huang J, et al. Effects of optical defocus on refractive development in monkeys: Evidence for local, regionally selective mechanisms. Invest Ophthalmol Vis Sci, 2010, 51(8): 3864-3873. DOI: 10.1167/iovs.09-4969.
[13]	Faria-Ribeiro M, Queirós A, Lopes-Ferreira D, et al. Peripheral refraction and retinal contour in stable and progressive myopia. Optom Vis Sci, 2013, 90(1): 9-15. DOI: 10.1097/OPX. 0b013e318278153c.
[14]	Atchison DA, Rosén R. The possible role of peripheral refraction in development of myopia. Optom Vis Sci, 2016, 93(9): 1042- 1044. DOI: 10.1097/OPX.0000000000000979.
[15]	姜珺. 近视管理白皮书(2019). 中华眼视光学与视觉科学杂志, 2019, 21(3): 161-165. DOI: 10.3760/cma.j.issn.1674- 845X.2019.03.001.
[16]	Backhouse S, Fox S, Ibrahim B, et al. Peripheral refraction in myopia corrected with spectacles versus contact lenses. Ophthalmic Physiol Opt, 2012, 32(4): 294-303. DOI: 10.1111/ j.1475-1313.2012.00912.x.
[17]	Li SM, Li SY, Liu LR, et al. Peripheral refraction in 7- and 14-year-old children in central China: the Anyang Childhood Eye Study. Br J Ophthalmol, 2015, 99(5): 674-679. DOI: 10.1136/bjophthalmol-2014-305322.
[18]	张璐, 刘艳琳, 石晓庆, 等. 中国青少年近视患者水平视网膜相对周边屈光度和散光分量曲线类型研究. 中华实验眼科杂志, 2017, 35(6): 520-525. DOI: 10.3760/cma.j.issn.2095-0160. 2017.06.007.
[19]	Verkicharla PK, Mathur A, Mallen EA, et al. Eye shape and retinal shape, and their relation to peripheral refraction. Ophthalmic Physiol Opt, 2012, 32(3): 184-199. DOI: 10.1111/ j.1475-1313.2012.00906.x.
[20]	Faria-Ribeiro M, Navarro R, González-Méijome JM. Effect of pupil size on wavefrontrefraction during orthokeratology. Optom Vis Sci, 2016, 93(11): 1399-1408. DOI: 10.1097/OPX. 0000000000000989.