[1]李秀红,符爱存,姫娜,等.多区正向设计离焦框架镜对儿童青少年近视进展的延缓效果[J].眼科新进展,2023,43(1):035-39.[doi:10.13389/j.cnki.rao.2023.0007]
　LI Xiuhong,FU Aicun,JI Na,et al.Control effect of defocus incorporated multiple segments spectacle lenses in children and adolescents’ myopia[J].Recent Advances in Ophthalmology,2023,43(1):035-39.[doi:10.13389/j.cnki.rao.2023.0007]
点击复制

多区正向设计离焦框架镜对儿童青少年近视进展的延缓效果/HTML
分享到：

《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
43卷
期数:
2023年1期
页码:
035-39
栏目:
应用研究
出版日期:
2023-01-05

文章信息/Info

Title:
Control effect of defocus incorporated multiple segments spectacle lenses in children and adolescents’ myopia
作者:
李秀红; 符爱存; 姫娜; 周路坦; 李光光; 张凤妍; 吕勇; 王卫群
450052　河南省郑州市，郑州大学第一附属医院眼科(李秀红，符爱存，李光光，张凤妍，吕勇，王卫群)；215000　江苏省苏州市，苏州卫生职业技术学院附属眼视光医院（姫娜）；450052　河南省郑州市，郑州铁路职业技术学院医学技术与工程学院（周路坦）
Author(s):
LI Xiuhong1; FU Aicun1; JI Na2; ZHOU Lutan3; LI Guangguang1; ZHANG Fengyan1; L? Yong1; WANG Weiqun1
1.Department of Ophthalmology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China
2.The Affiliated Eye Hospital of Suzhou Vocational Health College,Suzhou 215000,Jiangsu Province,China
3.Medical Technology and Engineering Institute,Zhengzhou Railway Vocational and Technical College,Zhengzhou 450000,Henan Pro-vince,China
关键词:
多区正向设计离焦框架镜; 等效球镜度; 眼轴长度; 近视; 儿童青少年
Keywords:
defocus incorporated multiple segments spectacle lenses;  spherical equivalent;  axial length;  myopia;  children and adolescents
分类号:
R778
DOI:
10.13389/j.cnki.rao.2023.0007
文献标志码:
A
摘要:
目的　研究多区正向设计离焦（DIMS）框架镜对儿童青少年近视进展的延缓效果。
方法　前瞻性临床对照研究。纳入2019年1月至2020年12月在郑州大学第一附属医院视光诊疗部就诊的近视［等效球镜度（SE）为-0.50～-6.00 D］儿童青少年276例（276眼），其中验配DIMS框架镜（DIMS组）和普通单光（SV）框架镜（SV组）者各138例，随访1年，比较两组患者的SE及眼轴长度（AL）的变化量，并使用Pearson相关分析对AL、SE变化量的影响因素进行分析。所有患者只取右眼数据纳入统计分析。
结果　完成6个月随访者共259例，DIMS组131例，SV组128例。戴镜6个月后DIMS组和SV组患者AL变化量分别为（0.10±0.13）mm和（0.18±0.11）mm，SE变化量分别为(-0.25±0.17）D和(-0.46±0.33）D，两组患者间AL和SE变化量相比差异均有统计学意义（均为P<0.001）。完成1年随访者共238例，DIMS组120例，SV组118例，两组中完成1年随访患者的主要基线资料差异均无统计学意义（均为P>0.05）。戴镜1年后DIMS组和SV组患者AL变化量分别为（0.22±0.16）mm和（0.38±0.21）mm，SE变化量分别为(-0.52±0.35）D和(-0.95±0.32）D，两组患者间AL和SE变化量相比差异均有统计学意义（均为P<0.001），相较于SV框架镜，DIMS框架镜延缓AL增长42.1%，延缓SE增长45.2%。Pearson相关分析结果显示，DIMS组患者戴镜1年后AL的变化量与年龄呈负相关（r=-0.252，P=0.006）。
结论　与SV框架镜相比，DIMS框架镜能有效延缓儿童青少年近视的进展及AL增长。
Abstract:
Objective　To study the myopia control effect of defocus incorporated multiple segments (DIMS) spectacle lenses in children and adolescents.
Methods　Totally 276 nearsighted children and adolescents ［spherical equivalent (SE): -0.50 to -6.00 D］ who were admitted to the Department of Ophthalmology, First Affiliated Hospital of Zhengzhou University from January 2019 to December 2020 were included in this prospective clinical control study, with 138 patients given DIMS spectacle lenses (DIMS group) and the other 138 patients given ordinary single vision (SV) spectacle lenses (SV group). After 1 year of follow-up, the SE and the axial length (AL) changes were compared. Pearson correlation analysis was used to analyze the influencing factors of SE and AL changes. Only the right eyes of the patients were included in the statistics.
Results　A total of 259 patients, 131 patients in the DIMS group and 128 patients in the SV group, completed 6 months of follow-up. After 6 months, the changes in AL were (0.10±0.13) mm for the DIMS group and (0.18±0.11) mm for the SV group, respectively, and the changes in SE were (-0.25±0.17) D and (-0.46±0.33) D, respectively, and the differences in the changes of AL and SE between the two groups were statistically significant (both P<0.001). A total of 238 patients completed the 1-year follow-up, with 120 people in the DIMS group and 118 people in the SV group. There was no significant difference in the primary baseline data of the patients who completed 1-year follow-up in the two groups (all P>0.05). One year later, the changes in AL were (0.22±0.16) mm for the DIMS group and (0.38±0.21) mm for the SV group, and the changes in SE were (-0.52±0.35) D and (-0.95±0.32) D in the DIMS group and SV group, respectively, with statistically significant differences between the two groups (both P<0.001). Compared with the SV spectacle lenses, the DIMS spectacle lenses restrained the AL growth by 42.1%and controlled the SE increase by 45.2%. The Pearson correlation analysis showed that the AL change of patients in the DIMS group was negatively correlated with age (r=-0.252, P=0.006).
Conclusion　Compared with the SV spectacle lenses, wearing DIMS spectacle lenses can effectively slow down the progression of myopia and AL growth in children.

参考文献/References:

［1］　MORGAN I G,OHNO-MATSUI K,SAW S M.Myopia［J］.Lancet,2012,379(9827):1739-1748.
［2］　HOLDEN B A,FRICKE T R,WILSON D A,JONG M,NAIDOO K S,SANKA-RIDURG P,et al.Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050［J］.Ophthalmology,2016,123(5):1036-1042.
［3］　CHARMAN W N,MOUNTFORD J,ATCHISON D A,MARKWELL E L.Peripheral refraction in orthokeratology patients［J］.Optom Vis Sci,2006,83(9):641-684.
［4］　QUEIRS A,GONZLEZ-MIJOME J M,JORGE J,VILLA-COLLAR C,GUTIRREZ A R.Peripheral refraction in myopia patient after orthokeratology［J］.Optom Vis Sci,2010,87(5):323-329.
［5］　CHEN Z,XUE F,ZHOU J,QU X,ZHOU X.Effects of orthokeratology on choroidal thickness and axial length［J］.Optom Vis Sci,2016,93(9):1064-1071.
［6］　ZHONG Y,CHEN Z,XUE F,ZHOU J,NIU L,ZHOU X.Central and peripheral corneal power change in myopic orthokeratology and its relationship with 2-year axial length change［J］.Invest Ophthalmol Vis Sci,2015,56(8):4514-4519.
［7］　谢培英.进一步提升长期角膜塑形术近视控制的疗效与安全［J］.中华眼科杂志,2014,50(1):3-5.
XIE P Y.Further enhance the long-term myopia control efficacy and safety of or thokeratology［J］.Chin J Ophthalmol,2014,50(1):3-5.
［8］　LAM C S,TANG W C,TSE D Y,TANG Y Y,TO C H.Defocus incorporated multiple segments (DIMS) spectacle lenses slow myopia progression:a 2-year randomised clinical trial［J］.Br J Ophthalmol,2020,104(3):363-368.
［9］　LAM C S,TANG W C,LEE P H,ZHANG H Y,QI H,HASEGAWA K,et al.Myopia control effect of defocus incorporated multiple segments (DIMS) spectacle lens in Chinese children:results of a 3-year follow-up study［J］.Br J Ophthalmol,2022,106(8):1110-1114 .
［10］　郝晶晶,唐琰,范春雷,张宗端.两种近视离焦设计框架镜片对儿童近视控制效果的临床研究［J］.中国临床医生杂志,2021,49(9)：1115-1117.
HAO J J,TANG Y,FAN C L,ZHANG Z R.The clinical studies of control effect of two myopia defocus spectacle lenses for children with myopia［J］.Chin J Clin Doc,2021,49(9):1115-1117.
［11］　LAM C S Y,LAM C H,CHENG S C K,CHAN L Y.Prevalence of myopia among Hong Kong Chinese school children:changes over two decades［J］.Ophthalmic Physiol Opt,2012,32(1):17-24.
［12］　FRICKE T R,HOLDEN B A,WILSON D A,SCHLENTHER G,NAIDOO K S,RESNIKOFF S,et al.Global cost of correcting vision impairment from uncorrected refractive error［J］.Bull World Health Organ,2012,90(2012):728-738.
［13］　HUANG J,WEN D,WANG Q,MCALINDEN C,FLITCROFT I,CHEN H,et al.Efficacy comparison of 16 interventions for myopia control in children:a network meta-analysis［J］.Ophthalmology,2016,123(4):697-708.
［14］　SMITH M J,WALLINE J J.Controlling myopia progression in children and adolescents［J］.Adolesc Health Med Ther,2015,6:133-140.
［15］　李秀红，钟梅，朱豫，王卫群，吕勇.角膜塑形术在儿童青少年近视控制中的作用［J］.中华眼外伤职业眼病杂志,2017,39(7):491-495.
LI X H,ZHONG M,ZHU Y,WANG W Q,L Y.The control effect of orthokeratology on adolescent myopia［J］.Chin J Ocul Traum Occupat Eye Dis,2017,39 (7):491-495.
［16］　李秀红,王敏,吕勇,符爱存,尚丽娜,朱豫.不同光学矫正方式对儿童青少年近视的控制效果研究［J］.眼科新进展,2017,37(7):636-639.
LI X H,WANG M,L Y,FU A C,SHANG L N,ZHU Y.Control effects of different optical correction methods on adolescent myopia［J］.Rec Adv Ophthalmol,2017,37(7):636-639.
［17］　YAM J C,JIANG Y,TANG S M,LAW A K P,CHAN J J,WONG E，et al.Low-concentration atropine for myopia progression (LAMP) study:a randomized,double-blinded,placebo-controlled trial of 0.05%,0.025%,and 0.01%atropine eye drops in myopia control［J］.Ophthalmology,2019,126(1):113-124.
［18］　TIAN J X,WEI S F,LI S M,AN W Z,BAI W L,LIANG X T，et al.The effect of atropine 0.01%eye drops relative peripheral refraction in myopic children［J］.Eye,2021,12:1-6.
［19］　LI S M,KANG M T,WU S S,LIU L R,LI H,CHEN Z，et al.Efficacy,safety and acceptability of orthokeratology on slowing axial elongation in myopic children by meta-analysis［J］.Curr Eye Res,2015,41(5):600.
［20］　TU E Y,JOSLIN C E.Recent outbreaks of atypical contact lens-related eratitis:what have we learned ［J］.Am J Ophthalmol,2010,150(5):602-608.
［21］　税丹,刘宗顺,胡卜丹,杨君,曾莉,郝更生.角膜塑形镜并发症的观察及相关因素分析［J］.临床眼科杂志,2017,25(5):462-464.
SHUI D,LIU Z S,HU B D,YANG J,ZENG L,HAO G S.Complications and analysis of associated factors for overnight orthokeratology［J］.J Clin Ophthalmol,2017,25(5):462-464.
［22］　TABERNERO J,VAZQUEZ D,SEIDEMANN A,UTTENWEILER D,SCHAEFFEL F.Effects of myopic spectacle correction and radial refractive gradient spectacles on peripheral refraction［J］.Vision Res,2009,49(17):2176-2186.
［23］　戴宇森，林丹丹，吕平，陈浩,姜珺.近视儿童配戴单光镜后的周边屈光研究［J］.国际眼科杂志,2013,13(2):339-342.
DAI Y S,LIN D D,L P,CHEN H,JIANG J.Study of peripheral refraction with single-vision spectacle lenses in myopic children［J］.Int Eye Sci,2013,13(2):339-342.
［24］　SANKARIDURG P,DONOVAN L,VARNAS S,HO A,CHEN X,MAR-TINEZ A,et al.Spectacle lenses designed to reduce progression of myopia:12-month results［J］.Optom Vis Sci,2010,87(9):631-641.
［25］　KANDA H,OSHIKA T,HIRAOKA T,HASEBE S,OHNO-MATSUI K,ISHIKO S,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［J］.Jpn J Ophthalmol,2018,62(5):537-543.
［26］　BAO J,YANG A,HUANG Y,LI X,PAN Y,DING C，et al.One-year myopia control efficacy of spectacle lenses with aspherical lenslets［J］ .Br J Ophthalmol,2022,106(8):1171-1176.

相似文献/References:

[1]李秀红,段素芳,吕勇,等.圆锥角膜患者验配RGP便捷方法探讨[J].眼科新进展,2016,36(9):853.[doi:10.13389/j.cnki.rao.2016.0228]
　LI Xiu-Hong,DUAN Su-Fang,LV Yong,et al.Investigating a converuent method of fitting keratoconus patients for RGP[J].Recent Advances in Ophthalmology,2016,36(1):853.[doi:10.13389/j.cnki.rao.2016.0228]
[2]金成成,裴茹霞,杜蓓,等.不同屈光状态儿童应用盐酸环喷托酯滴眼后1 h内等效球镜度与瞳孔直径达到稳定所需时间及变化幅度的相关影响因素[J].眼科新进展,2020,40(10):946.[doi:10.13389/j.cnki.rao.2020.0213]
　JIN Chengcheng,PEI Ruxia,DU Bei,et al.Time to reach stabilization and factors related with changing amplitude of spherical equivalents and pupil diameters during1hour after cycloplegia with cyclopentolate hydrochloride on children in different refractive status[J].Recent Advances in Ophthalmology,2020,40(1):946.[doi:10.13389/j.cnki.rao.2020.0213]
[3]周单,董如亚,郑青青,等.生长激素缺乏症患儿和正常儿童屈光状态的比较研究[J].眼科新进展,2022,42(3):218.[doi:10.13389/j.cnki.rao.2022.0044]
　ZHOU Dan,DONG Ruya,ZHENG Qingqing,et al.Comparison of refractive state between child patients with growth hormone deficiency and the controls[J].Recent Advances in Ophthalmology,2022,42(1):218.[doi:10.13389/j.cnki.rao.2022.0044]

备注/Memo

备注/Memo:
河南省教育厅高等学校重点科研项目(编号：23A320011)；河南省软科学项目（编号：222400410070）
更新日期/Last Update: 2023-01-05