0.01%阿托品对学龄期儿童近视防控作用研究

探讨0.01%阿托品对学龄期儿童近视防控的有效性和安全性,为改善儿童视力提供有效措施.方法 在2012-2016年期间收集来温州市人民医院眼科门诊进行视力检查的7~12岁近视临近期及近视眼儿童217例,随机分为2组:试验组110例,每晚睡前用0.01%阿托品滴眼液;对照组117例,不做任何处理.随访时间为1年.检查2组对象在干预前和干预后1年的屈光状态及度数、眼轴、眼压变化,记录近视度数快速增长率及有无发生不良反应,并进行比较.采用多元性线性回归分析影响近视度数变化的相关因素.结果 随访1年后,试验组屈光度数变化为(-0.20±0.84)D,低于对照组的(-0.63±0.88)D,差异有统计学意义(t=-3.734,P<0.01);试验组中近视度数快速增长率为10.91%,低于对照组的43.59%(x2=30.200,P<0.01);试验组眼轴变化为(0.11±0.62) mm,低于对照组的(0.37±0.65) mm(t=3.096,P=0.002);试验组眼压变化为(0.30± 3.81) mmHg(1 mmHg=0.133 kPa),与对照组的(-0.44±4.17)mmHg比较,差异无统计学意义(t=-1.386,P=0.167).多元线性回归分析显示,0.01%阿托品对抑制近视度数变化影响有统计学意义(B=0.238,95%CI=0.209~0.551,P<0.01).所有试验组对象自诉未出现畏光、视近模糊或其他不能耐受的副作用.结论 在1年规律地局部滴眼使用下,0.01%阿托品能安全有效防控学龄期儿童近视的发生及进展.

Prevention of myopia onset and progression with 0.01% atropine solution among school-age children

Objective To evaluate the efficacy and safety of 0.01% atropine solution for prevention of myopia onset and progression among school-age children.Methods From 2012 to 2016,217 premyopic and myopic children aged 7-12 years were randomly selected and divided into two groups:1 10 cases (110 cyes) in intervention group receiving 0.01% atropine eye drops every evening,and 117 cases (117 eyes) served as control group without any treatment.All participants were followed up for 1 year.The change of refraction and diopter,eye axis length and intraocular pressure (IOP) between the two groups were assessed before and after the intervention.Rapid growth rate in myopia and adverse reaction was compared between the two groups.Multivariate linear regression analysis was used to analyze the related factors of myopic degree changes.Results After 1-year follow-up,average spherical refraction myopic shift in intervention group was (-0.20±0.84) D,which was significantly lower than that of control group (-0.63±0.88) D (P<0.01).Incidence of myopia and myopia rapid growth rate in the intervention group was significantly lower than that of control group (7.2% vs.19.66%,P=0.007;10.91% vs.43.59%,P<0.01).Change of ocular axial length showed the same trend,with intervention group (0.11±0.62) mm significantly lower than that of control group (0.37±0.65) mm (P=0.002).No significant difference was found in change of IOP,(0.30±3.81) mmHg for intervention group and (-0.44±4.17) mmHg for control group.Multiple linear regression showed that 0.01% atropine had significant effects in preventing myopia progression(B =0.238,95%CI=0.209-0.551,P<0.01).All the two groups did not appear photophobia,near-blurred vision or the other intolerant side effects.Conclusion Regular topical instillation of 0.0t% atropine can safely prevent myopia onset and progression among schoolage children for at least a period of one year.