5～12岁高度近视患儿5a近视进展情况分析

目的 探讨5 ～12岁高度近视患儿5 a的近视进展情况和视力预后.方法 对我院就诊的5 ～12岁高度近视患儿每6个月～1 a随访一次,每例入选患儿在初次检查及每次随访中均行详细的眼科检查,包括最佳矫正视力(best corrected visual acuity,BCVA)和睫状肌麻痹验光检查、眼底检查及眼轴测量等.结果 52例患儿每年近视进展(-0.66±0.43)D,其中双眼近视进展者32例(61.5％),单眼近视进展者4例(7.7％),双眼近视平稳者16例(30.8％).初始近视度数-6.0～-9.0D组、-9.0～-12.0D组和＞-12.0 D组患儿近视进展比例分别为86.4％、68.8％和42.9％,三者差异有统计学意义(P＜0.05);有高度近视家族史组和无高度近视家族史组近视进展比例分别为88.2％和60.0％,两者差异有统计学意义(P＜0.05).不同年龄组和性别组间近视进展比例差异均无统计学意义(均为P＞0.05).41例(78.8％)患儿随访终末双眼BCVA≥0.5,34例(65.4％)≥0.8.初始近视度数-6.0～-9.0D组、-9.0～-12.0 D组和＞-12.0 D组患儿随访终末双眼BCVA≥0.5的比例分别为95.5％、75.0％和57.1％,三者差异有统计学意义(P＜0.05).结论 5～12岁高度近视患儿每年有较快的度数增长,初始近视度数和高度近视家族史是其危险因素,多数高度近视患儿能保持较理想的BCVA.

Five years progression of high myopia in 5-12 years old children

Objective To investigate the changes of refractive status in 5-12 years old high mypoic children,and determine their visual prognosis after 5 years.Methods A total of 52 high myopic patients treated in our hospital,aged 5 years to 12 years,were enrolled in the study.Every enrolled patient underwent complete ophthalmological examinations every 6 months to 1 year,including best corrected visual acuity (BCVA),cycloplegic refraction,fundus examination and axial length measurement.Resuits The mean myopia progression of the 52 patients was (-0.66 ± 0.43) D per year.32 patients(61.5％)showed binocular progression,4 patients(7.7％)showed monocular progression,and 16 patients (30.8％) showed binocular stability.The myopic progression rate of the patients whose initial refraction from-6.0 D to-9.0 D was 86.4％,from-9.0 D to-12.0 D was 68.8％,and ＞-12.0 D was 42.9％,respectively,there were obvious differences (P ＜ 0.05).The myopic progression rate of the patients who had family history of high myopia was 88.2％,and no family history was 60.0％,there was obvious difference (P ＜ 0.05).The myopic progression rates were not significant different between different age level and different sex (all P ＞ 0.05).41 patients (78.8％) of high myopes demonstrated a final BCVA ≥ 0.5 in both eyes,and 34 patients(65.4％) ≥0.8.The rates of patients whose fmal BCVA ≥0.5 in both eyes were 95.5％,75.0％ and 57.1％ for whose initial refraction were from-6.0 D to-9.0 D,from-9.0 D to-12.0 D and ＞-12.0 D,respectively,there was obvious difference (P ＜ 0.05).Conclusion The 5-12 years old high myopic children will progress in a relatively quick level every year.The initial refraction level and family history of high myopia are risk factors associated with myopia progression.Most of high myopic children will have a relatively good vision.