不同年龄近视儿童使用0.01%阿托品滴眼液的有效性观察

目的:评价0.01%阿托品滴眼液控制不同年龄儿童近视进展的有效性。方法:随机、双盲、安慰剂平行对照、单中心临床研究。纳入2019-05/2020-05就诊于本院的年龄6～13周岁,近视球镜度数-0.5～-6.00D,散光度数≤2.0D的近视儿童295例,以2∶1的比例随机分配到试验组(197例)和对照组(98例),试验组和对照组按年龄又分为6～8岁(40例/26例)、9～10岁(84例/34例)及11～13岁(73例/38例)三个亚组,试验组每晚睡前点0.01%阿托品滴眼液,对照组每晚睡前点安慰剂。比较两组患者治疗前、治疗2wk, 3、6、9及12mo各指标变化情况。治疗2wk仅行眼压、调节幅度、最佳矫正远/近视力、瞳孔直径及泪膜检查;治疗前,治疗6及12mo行睫状肌麻痹验光。结果:治疗12mo后,试验组等效屈光度及眼轴变化分别为-0.37±0.69D及0.29±0.24mm,对照组为-0.59±0.65D及0.37±0.23mm(P=0.008、0.006)。两组间等效屈光度和眼轴变化比较6～8岁无差异(t=0.054,P=0.957;t=-0.623,P=0.536);9～10岁有...     

0.005%阿托品滴眼液联合角膜塑形镜控制青少年低度近视的可行性和民族差异性

目的:观察0.005%阿托品滴眼液联合角膜塑形镜控制不同民族青少年低度近视的有效性、安全性及民族差异性。方法:选取2021-01/10就诊于我院的汉族、哈尼族低度近视患者246例246眼,其中试验组患者120例120眼采用0.005%阿托品滴眼液联合角膜塑形镜治疗;对照组患者126例126眼采用角膜塑形镜治疗。观察两组患者戴镜前、戴镜1 a的裸眼视力、等效球镜度(SE)、眼轴长度(AL)、眼压、泪膜破裂时间(BUT)、角膜曲率、角膜厚度,记录两组患者并发症发生情况。结果:戴镜1 a,试验组患者AL和SE变化量(0.16±0.35 mm、-0.39±0.47 D)低于对照组(0.22±0.89 mm、-0.48±0.54 D),裸眼视力(LogMAR)优于对照组(0.11±0.25 vs 0.14±0.19)(P<0.05),BUT、前房深度、角膜曲率及角膜厚度均有差异(P<0.05),但两组患者眼压无差异(P>0.05),且两组中汉族和哈尼族患者裸眼视力、AL及SE变化量比较均无差异(P>0.05)。随访期间,两组患者均未出现明显的局部及全身不良反应,两组患者眼...     

0.01%阿托品滴眼液在不同年龄段青少年近视防控疗效分析

目的 分析应用0.01%阿托品滴眼液对青少年近视防控疗效观察。方法 选取本院眼科门诊进行治疗的青少年近视患者（2020年1月至2022年7月）74例作为观察对象,分别是初中组39例（平均年龄13.6岁）,高中组35例（平均年龄16.3岁）,每组随机分配法对患者进行分组,组别名称为框架镜组及观察组,观察组给予0.01%阿托品滴眼液治疗,框架镜组实施玻璃酸钠滴眼液点滴,都是每天一次睡前点滴。将治疗前后眼轴长度、轴差,治疗前后屈光度及屈光差作为观察指标结合进行治疗效果判定。结果 初中组的框架镜和阿托品治疗一年后轴长分别增加0.91±0.23(mm)、0.38±0.21(mm),(t=1.8612,P<0.05),高中组的框架镜和阿托品治疗一年后轴长分别增加0.68±0.22(mm)、0.25±0.26(mm),(t=1.5612,P<0.05),两组中患者治疗前眼轴长度差异明显,有统计学意义（P<0.05）,初中、高中两组患者眼轴长度均有所增加,初中组眼轴长增长相比高中组大,但在使用0.01%阿托品滴眼液干预后,初中生组眼轴长度增长速度的下降幅度显著大于高中生组。结论 应用...     

角膜塑形镜联合0.01%阿托品滴眼液治疗青少年近视

目的:探讨分析角膜塑形镜联合0.01%阿托品滴眼液在控制青少年近视过程中的疗效和安全性。方法:收集2019-01/2022-01在衡水市人民医院眼科诊治的100例100眼(均取右眼数据)青少年近视患者,根据患者意愿采用随机对照原则将患者分为试验组和对照组,每组各50例50眼。对照组患者采用单一角膜塑形镜治疗,试验组患者采用角膜塑形镜联合0.01%阿托品滴眼液治疗。记录两组患者持续治疗1、3、6、9、12mo后的治疗数据,对比两组患者在治疗前后的屈光度、角膜曲率、眼轴长度(AL)、中央角膜厚度(CCT)、瞳孔直径(PD)、泪膜脂质层厚度(LLT)和泪膜破裂时间(BUT)、角膜总高阶像差(RMSh)、黄斑中心凹下脉络膜厚度(SFCT)、角膜内皮细胞密度(CD)和六边形细胞比例(HEX)等参数。随访期间观察患者不良反应发生情况。结果:治疗后12mo,试验组患者屈光度、角膜曲率、AL分别为-2.42±0.17D、38.89±1.18D、25.44±0.23mm,均显著优于对照组(-2.56±0.19D、40.12±1.65D、25.54±0.19mm,均P<0.05);试验组患者CCT(...     

不同浓度阿托品滴眼液控制儿童青少年近视进展的Meta分析

目的:评估已发表的关于不同浓度的阿托品滴眼液延缓儿童青少年近视进展的有效性。方法:搜集PubMed、the Cochrane Library、Embase、中国知网、维普和万方数据库内建库至2022-05阿托品滴眼液治疗儿童青少年近视的随机对照试验(RCT)。对纳入文献采用《Cochrane干预措施系统评价手册》中偏倚风险评价工具进行质量评价;采用Review Manager 5.4软件进行Meta分析。结果:共纳入14项RCT研究,包含3 946例儿童青少年受试者。Meta分析结果显示：与对照组相比,不同浓度阿托品滴眼液均可延缓儿童青少年近视进展。1%、0.5%、0.05%、0.02%、0.01%阿托品滴眼液组的眼轴增长量均低于对照组,差异均有统计学意义(MD=-0.34,95%CI:-0.39～-0.29,P<0.00001;MD=-0.51,95%CI:-0.79～-0.24,P=0.0003;MD=-0.17,95%CI:-0.30～-0.04,P=0.01;MD=-0.21,95%CI:-0.30～-0.11,P<0.0001;MD=-0.09,95%CI:-0....     

不同浓度和给药频次的低浓度阿托品滴眼液控制儿童近视进展疗效比较

目的:比较质量分数0.02%阿托品滴眼液隔日点眼1次与0.01%阿托品滴眼液每日点眼1次控制儿童近视进展疗效及不良反应的差异。方法:采用随机对照研究,纳入2016年6月至2017年6月于郑州大学第一附属医院和河南省立眼科医院就诊的汉族近视性屈光不正儿童231例,采用随机数表法分为0.02%阿托品组110例和0.01%阿...     

低浓度阿托品控制近视的临床研究进展

随着近视患病率的不断攀升,近视相关视力损害及其防控日益成为社会关注的焦点。目前主要的近视控制方法包括阿托品、角膜塑形镜、双焦角膜接触镜、多焦角膜接触镜和功能框架眼镜等。近年来,低浓度阿托品(0.01%、0.05%)成为有效控制近视发生和进展的一线用药。同时低浓度阿托品比高浓度阿托品疗效更加持久,副作用更少见,患者的接受度更高。现本文对低浓度阿托品延缓近视进展的临床研究作一综述,从有效性、安全性、使用时机、联合控制效果等方面进行归纳总结,以期为临床使用低浓度阿托品控制近视提供依据。     

1%阿托品不同用药方式对控制青少年低度近视进展的远期效果

 目的 探讨1%阿托品凝胶的不同用药方式对控制青少年低度近视发展的影响。设计 前瞻性比较性病例系列。研究对象 2011年1-4月就诊的9~12岁之间,屈光度数在-0.50~-1.50 DS之间的青少年150例（300眼）。方法 根据随机数字表法将患者随机分为3组,每组50例。A组为对照组：每晚使用1次1%阿托品凝胶。B组：每周使用2次。C组：每周使用1次。观察2年,每3个月复查。主要指标 视力、屈光度、眼压、眼轴长度。结果 133例完成了2年的观察。其中A组38例,B组47例,C组48例。失访率11.3%。3组经治疗后近视屈光度进展分别为（-0.33±0.11）D、（-0.36±0.13）D和（-0.62±0.30）D;眼轴增长分别为（0.32±0.08）mm、（0.33±0.10）mm和（0.48±0.17）mm。A组与B组球镜屈光度、眼轴长度变化较少,差异均无统计学意义（P均>0.05）。C组患者视力下降,屈光度增加,眼轴变长,与A、B组比较差异均有统计学意义（P 均<0.05）。结论 1%阿托品凝胶长期滴眼能有效控制青少年低度数近视进展,每天用药与每周2次用药效果无显著性差异。每周2次用药患者耐受程度高,是比较适宜的给药方式。（眼科, 2014, 23： 111-114）     

角膜塑形镜联合0.1 g·L-1阿托品延缓儿童近视进展分析

目的 探讨角膜塑形镜联合0.1 g·L^-1阿托品(AOK)控制儿童近视进展效果,并分析影响控制近视进展疗效的因素。方法 回顾性研究。选取2020年10月至2022年11月在西安市第一医院激光近视治疗中心就诊的近视儿童60例(112眼)作为研究对象,根据治疗方法不同分为仅接受OK镜治疗的OK镜组31例(55眼)和同时接受OK镜和0.1 g·L^-1阿托品治疗的AOK组29例(57眼)。根据基线年龄[年龄较小组(8～<10岁)和年龄较大组(10～14岁)]和基线眼轴长度(AL)[AL较短组(22.00～24.50 mm)与AL较长组(>24.50～27.00 mm)]对患儿进行分层比较。分析治疗后3个月、6个月、12个月两组患儿AL变化,采用混合线性模型分析两组患儿治疗前后数据,采用多因素线性回归分析比较影响控制近视进展疗效的因素。结果 AOK组患儿在治疗后12个月累积AL增长(0.14±0.20)mm,显著小于OK镜组的(0.20±0.20)mm(P=0.01),AOK组比OK镜组患儿AL增长减少约30%。根据基线年龄和基线AL分层比...     

Atropine 0.01% eye drops slow myopia progression: a systematic review and Meta-analysis

AIM: To evaluate the effects of atropine 0.01% on slowing myopia progression. METHODS: We searched for relevant studies in the Cochrane Library, PubMed, Embase, Ovid, CBM, CNKI, VIP and Wan Fang Data in Chinese. A supplementary search was conducted in OpenGrey (System for Information on Grey Literature in Europe), the ISRCTN registry, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform (ICTRP) from the dates of inception to June 30, 2018. RESULTS: Seven randomized controlled trials (RCTs) with a total of 1079 subjects were included (505 in the atropine 0.01% group and 574 in the control group). The results showed that the atropine 0.01% group exhibited significantly greater control of axial growth than the control group [MD=-0.12, 95%CI (-0.19, -0.06)]. There was also a statistically significant difference between the atropine 0.01% and control groups in the changes in axial length [MD=-0.14, 95%CI (-0.25, -0.03)], but the quality of evidence was low. There were no significant differences between the atropine 0.01% and control groups in the overall effect with respect to diopter value, change in diopter, distance vision and intraocular pressure [MD=0.08, 95%CI (-0.27, 0.42); MD=0.09, 95%CI (-0.17, 0.36); MD= -0.01, 95%CI (-0.02, 0.00); MD=0.08, 95%CI (-0.56,0.40)]. The sensitivity analysis showed that the conclusion of the Meta-analysis is relatively stable. With respect to adverse events, there were significant differences between the atropine 0.01% and control groups [OR=0.26, 95%CI (0.11, 0.61)]. CONCLUSION: Based on the available evidence, atropine 0.01% eye drops offer benefits in controlling axial growth and safety without causing significant differences in diopter values, distance vision and intraocular pressure.     

Short-term effect of 0.01% atropine sulphate eye gel on myopia progression in children

AIM: To investigate the effect of 0.01% atropine sulphate eye gel on myopia progression and axial elongation in a 6-month treatment in children. METHODS: Totally 185 children aged 6-12y with binocular myopia of 3.0 D or less in both eyes were enrolled in this prospective cohort study. The atropine group (n=125) received one drop of 0.01% atropine sulphate eye gel in each eye before bedtime daily. The control group included 60 matched children without drug intervention during the same period. The spherical equivalent and axial length was recorded at baseline and the sixth month of treatment. The efficacy was evaluated by the change of the spherical equivalent and axial length. Adverse events were also recorded. RESULTS: The average spherical equivalent and axial length at baseline were not statistically significant between the atropine group (-1.64±0.80 D, 24.13±0.76 mm) and the control group (-1.59±0.94 D, 24.06±0.77 mm, P>0.05). After 6mo, there was significantly difference in the spherical equivalent progression between the atropine and the control group (-0.27±0.33 vs -0.60±0.35 D, P<0.001), with a relative reduction of 55.0% in myopia progression. The increase in axial elongation in the atropine group was significantly less than control group (0.19±0.14 vs 0.26±0.14 mm, P<0.001), with a relative reduction of 26.9% in axial length. The 84.4% and 38.4% of the eyes progressed by less than 0.50 D and remained stable in the atropine group, compared with 51.7% and 4.2% in the control group. No adverse events were observed. CONCLUSION: Atropine sulphate eye gel 0.01% can slow down myopia progression and axial elongation in children with a 6-month treatment.     

Effect of atropine 0.01% on progression of myopia

Purpose:Myopia is the most common type of refractive error and the leading cause of functional visual loss. Increased risk of myopic maculopathy, retinal detachment, glaucoma and cataract has been seen with a myopia of as low as −1D. This study was done to determine the effect of atropine 0.01% eye drops on the progression of myopia in children >5 years.Methods:This was a single-blind, prospective, randomized case–control study which included children of 5–15 years with myopia of >2D and were divided into treatment group (group 1) and placebo group (group 2). Children under treatment group were treated with application of 0.01% atropine at night. Children with history of any ocular surgery, chronic ophthalmic illness, squint and amblyopia were excluded from the study. The follow-up for myopia progression was done for two years.Results:This study showed a significant difference in increase of spherical equivalent and axial length among treatment and placebo groups after a duration of two years. Total duration of follow up was twenty-four months. Mean increase in axial length of group 1 and 2 was 0.115 mm and 0.32 mm, respectively. Mean increase in refraction of groups 1 and 2 was −0.30 D and −0.88 D, respectively, showing significant change in axial length and refraction (P < 0.0001).Conclusion:This study supports the use of atropine 0.01% eye drops in reducing the progression of myopia.     

消旋山莨菪碱滴眼液治疗儿童近视

目的对0.5%消旋山莨菪碱滴眼液治疗儿童近视进行临床观察,探讨其有效性和安全性。方法随机选取2005～2007年在我院斜弱视专科就诊的近视患儿30例,5～12岁,既往戴框架眼镜半年以上,排除存在眼部器质性病变及曾接受其他减缓近视发展治疗的患者。患者双眼点用0.5%消旋山莨菪碱滴眼液,早晚各一次,每次1～2滴,用药时间不少于半年;用药期间每半年复查一次,包括主观症状及常规眼科检查、瞳孔大小及对光反射检查、眼压检查、静态检影和眼轴。采用用药前后自身对照,对用药前后的年近视发展度、眼轴、眼压和视力进行配对t检验。结果22例患儿最终完成研究,8例因移居外地、未能坚持戴镜等原因退出研究,平均年龄为（7.6±1.8）岁,接受治疗时间0.7～2.7年。用药前后年近视发展分别为（-1.02±0.48）D/年和（-0.54±0.43）D/年,用药后年近视发展明显少于用药前（P〈0.01）。用药前及用药后末次随诊矫正视力分别为4.92±0.11和4.98±0.07,用药后末次随诊矫正视力优于用药前（P〈0.01）。用药前后眼轴分别为（24.75±1.65）mm和（25.27±1.76）mm,用药后眼轴较用药前增长（P〈0.01）。患者无诉畏光、视近物不清,眼压、裂隙灯及眼底检查均无异常。结论0.5%消旋山莨菪碱滴眼液具有减缓儿童近视发展的作用,并有较好的安全性和耐受性。     

Effects of endogenous dopamine induced by low concentration atropine eye drops on choroidal neovascularization in high myopia mice

AIM: To evaluate effects of endogenous dopamine induced by low concentration atropine eye drops on choroidal neovascularization (CNV) in high myopia mice. METHODS: The C57BL/6J mice were deprived of the right eye for 4wk, and the high myopia was diagnosed by optometry, the diopter was less than -6.00 D, and CNV was induced by 532 nm laser. The changes of dopamine D1 receptor (DRD1), dopamine D2 receptor (DRD2), and vascular endothelial growth factor A (VEGFA) were detected by Western blot technology at 0.5, 1, 2h, and 7d after 0.01%, 0.05%, and 0.1% atropine eye drops, respectively, the area of CNV was measured. RESULTS: Significant increases were observed on the expression of DRD2 in mouse high myopia model at 0.5, 1, 2h, 7d with 0.05% and 0.1% atropine eye drops (P<0.05). Significant decreases were observed on the expression of DRD1 and VEGFA in mouse high myopia model at 0.5, 1, 2h, 7d with 0.05% and 0.1% atropine eye drops (P<0.05). The area of CNV induced by laser in the drug-treated group was significantly smaller than that in the control group, and the higher the concentration, the more significant the inhibitory effect (P<0.05). CONCLUSION: The 0.01%, 0.05%, 0.1% atropine eye drops can decrease the level of VEGFA and inhibit high myopia CNV indirectly by up-regulating the level of DRD2 and down-regulating the level of DRD1, and the effect of 0.05% and 0.1% atropine eye drops is more significant.     

高非球微透镜对儿童青少年低度近视的控制效果

目的：探讨高非球微透镜对低度近视的控制效果。方法：前瞻性研究。收集2022-05-1/31在我院就诊的7-12岁低度近视患者100例。根据配镜意愿分为两组：配戴单光眼镜组50例、配戴高非球微透镜组50例，均取右眼参数分析。比较两组戴镜后6mo，1a近视增长量(绝对值)、眼轴(AL)增长量、低度近视进入中度近视率、AL负增长率的差异。结果：两组患者戴镜6 mo，1 a后配戴高非球微透镜组近视度数增长量低于配戴单光眼镜组，AL增长量小于配戴单光眼镜组(均P&#x003C;0.001)； 戴镜6 mo AL负增长率明显高于配戴单光眼镜组(P&#x003C;0.001)； 两组患者进入中度近视率无差异(P=0.62)； 但戴镜1a后配戴高非球微透镜组进入中度近视率明显低于配戴单光眼镜组(P&#x003C;0.001)，两组间AL负增长率差异无统计学意义(P=0.12)。对比配戴单光眼镜组患者，配戴高非球微透镜对低度近视患者6 mo近视度数增长控制率为88.2%，AL增长控制率为90.0%，低度近视进入中度近视控制率为66.7%； 戴镜1 a近视度数增长控制率为75.6%，AL增长控制率为69.2%，低度近视进入中度近视控制率为88.9%。结论：对于7-12岁的低度近视儿童青少年，高非微透镜在控制近视效果上远优于单光眼镜，是低度近视防控的优质手段之一。     

3%地夸磷索钠滴眼液治疗睑板腺功能障碍相关性干眼

目的：研究3%地夸磷索钠滴眼液治疗睑板腺功能障碍相关性干眼的疗效。

方法：选取2020-05/2021-05就诊于杭州市中医院眼科的睑板腺功能障碍相关性干眼患者280例,采用随机数字表法将患者分为治疗组(160例320眼)及对照组(120例240眼)。对照组予养血润目颗粒剂联合0.3%玻璃酸钠滴眼液,治疗组予养血润目颗粒剂联合3%地夸磷索钠滴眼液治疗。两组均连续用药4wk。分别于治疗前、治疗后2、4wk测定以下指标：眼表疾病评分指数(OSDI)评分,基础泪液分泌试验(SⅠt)、眼表综合分析测定泪河高度(TMH)、非侵入性泪膜破裂时间(NITBUT),睑板腺睑脂分泌通畅度评分,睑板腺管缺失评分,测定泪液中白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平,以评估两种治疗方法的疗效。

结果：治疗组及对照组总体有效率分别为95.6%、81.7%(P<0.05)。治疗2、4wk后两组OSDI评分、NITBUT、睑板腺管缺失评分、睑板腺睑脂分泌通畅度评分、泪液炎症因子TNF-α、IL-6水平较治疗前均有差异(P<0.05),且治疗组优于对照组; 两组治疗前后SⅠt与TMH组间均无差异(P>0.05)。

结论：3%地夸磷索钠滴眼液可通过延长泪膜的稳态促进睑板腺的正常分泌,还可抑制泪液中炎症因子的释放等作用治疗睑板腺功能障碍相关性干眼。