[1]刘锦卉,解瑞,袁自由,等.角膜塑形镜对不同类型近视性屈光参差儿童控制效果[J].眼科新进展,2024,44(4):297-301.[doi:10.13389/j.cnki.rao.2024.0058]
　LIU Jinhui,XIE Rui,YUAN Ziyou,et al.Study on the control effect of orthokeratology lenses on children with different types of myopic anisometropia[J].Recent Advances in Ophthalmology,2024,44(4):297-301.[doi:10.13389/j.cnki.rao.2024.0058]
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角膜塑形镜对不同类型近视性屈光参差儿童控制效果/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
44卷
期数:
2024年4期
页码:
297-301
栏目:
应用研究
出版日期:
2024-04-05

文章信息/Info

Title:
Study on the control effect of orthokeratology lenses on children with different types of myopic anisometropia
作者:
刘锦卉; 解瑞; 袁自由; 王莉
030001　山西省太原市，山西医科大学公共卫生学院儿少卫生学教研室（刘锦卉，王莉）；046000　山西省长治市，长治医学院附属和平医院眼科（解瑞）；046000　山西省长治市，长治医学院附属和济医院眼科（袁自由）
Author(s):
LIU Jinhui1; XIE Rui2; YUAN Ziyou3; WANG Li1
1.Department of Child Health,School of Public Health,Shanxi Medical University,Taiyuan 030001,Shanxi Province,China
2.Department of Ophthalmology,Heping Hospital Affiliated to Changzhi Medical College,Changzhi 046000,Shanxi Province,China
3.Department of Ophthalmology,Heji Hospital Affiliated to Changzhi Medical College,Changzhi 046000,Shanxi Province,China
关键词:
角膜塑形镜; 屈光参差; 近视; 眼轴长度
Keywords:
orthokeratology lenses;  anisometropia;  myopia;  axial length
分类号:
R778.1
DOI:
10.13389/j.cnki.rao.2024.0058
文献标志码:
A
摘要:
目的　探究角膜塑形镜对不同类型近视性患儿屈光参差的控制效果。
方法　纳入2020年9月至2022年11月于长治医学院附属和平医院眼科验配角膜塑形镜并且资料完整的8～16岁近视患儿99例。分为单纯近视性屈光参差组（单眼近视，双眼屈光度差值≥1.00 D）39例和复合近视性屈光参差组（双眼近视，双眼屈光度差值≥1.00D）60例。将两组中双眼间屈光参差量较高（双眼屈光度差值≥2.50 D）的患儿设为高屈光参差亚组（分别为18例和29例），较低（1.00 D≤双眼屈光度差值<2.50 D）的设为低屈光参差亚组（分别为21例和31例）。各组内将屈光度数较高眼设为高度数眼，对侧屈光度数较低眼设为低度数眼。检查并记录两组患儿屈光度、角膜地形图、眼压、角膜内皮、眼轴长度等。比较两组患儿在配戴角膜塑形镜前及戴镜1年后双眼眼轴长度的变化，分析屈光参差程度与双眼眼轴长度变化的相关关系。
结果　配戴角膜塑形镜1年后，两组患儿双眼眼轴长度均增长，且均表现为高度数眼的眼轴长度增长量低于低度数眼；在戴镜前及戴镜1年后，两组患儿高度数眼眼轴长度均大于低度数眼，差异均有统计学意义（均为P<0.05）。两组患儿均表现为戴镜1年后双眼间眼轴长度差值缩小；在戴镜前及戴镜1年后，单纯近视性屈光参差组患儿双眼间眼轴长度差值较复合近视性屈光参差组均更大，差异均有统计学意义（t=4.903、2.670，均为P<0.05）。单纯近视性高屈光参差亚组患儿与单纯近视性低屈光参差亚组患儿戴镜前后双眼眼轴长度差值变化量均分别大于复合近视性高屈光参差亚组与复合近视性低屈光参差亚组，差异均有统计学意义（均为P<0.05）。单纯近视性屈光参差组与复合近视性屈光参差组中，屈光参差程度与戴镜前后1年双眼间眼轴长度变化量均呈正相关（r=0.423、0.510，均为P<0.05）。
结论　角膜塑形镜可有效减少近视性屈光参差患儿双眼眼轴长度的差异，且对于单纯近视性患儿屈光参差的控制效果优于复合近视性屈光参差患儿。
Abstract:
Objective　To explore the effect of the orthokeratology lenses on the control of different types of anisometropia in myopic children.
Methods　A total of 99 myopic children aged 8 to 16 years who got the orthokeratology lenses at the Department of Ophthalmology, Heping Hospital Affiliated to Changzhi Medical College from September 2020 to November 2022 with complete data were included. These children were divided into the simple myopic anisometropia group (monocular myopia, binocular diopter difference≥1.00 D, n=39) and the compound myopic anisometropia group (binocular myopia, binocular diopter difference≥1.00 D, n=60). The children with higher anisometropia (binocular diopter difference≥2.50 D) in the two groups were set as the high anisometropia subgroup (n=18 and 29, respectively), and children with lower anisometropia (1.00 D≤binocular diopter difference<2.50 D) were set as the low anisometropia subgroup (n=21 and 31, respectively). In each group, eyes with a higher diopter were set as the high diopter eyes, and the contralateral eyes with a lower diopter were set as the low diopter eyes. Diopter, corneal topography, intraocular pressure, corneal endothelium and axial length of children in the two groups were examined and recorded. The changes in axial length before and after wearing orthokeratology lenses for 1 year were compared between the two groups, analyzing the correlation between the degree of anisometropia and changes in the binocular axial length.
Results　After wearing orthokeratology lenses for 1 year, children in both groups had an increase in the axial length with a lower increase in the axial length of the high diopter eyes compared to the low diopter eyes; before and 1 year after wearing orthokeratology lenses, the axial length of high diopter eyes was greater than that of the low diopter eyes in both groups, and the differences were statistically significant (all P<0.05). Both groups of children showed a decrease in the binocular axial length difference after wearing the orthokeratology lenses for 1 year; before and 1 year after wearing orthokeratology lenses, the binocular axial length difference of children in the simple myopic anisometropia group was greater than that in the compound myopic anisometropia group, and the differences were statistically significant (t=4.903 and 2.670; both P<0.05). The changes in binocular axial length difference before and after wearing the orthokeratology lenses of children in the high anisometropia subgroup and low anisometropia subgroup of the simple myopic anisometropia group were greater than those in the high anisometropia subgroup and low anisometropia subgroup of the compound myopic anisometropia group, respectively, and the differences were statistically significant (both P<0.05). In the simple myopic anisometropia and compound myopic anisometropia groups, the degree of anisometropia was positively correlated with the binocular axial length changes before and 1 year after wearing the orthokeratology lenses (r=0.423 and 0.510, both P<0.05).
Conclusion　Orthokeratology lenses can effectively reduce the difference in binocular axial length of children with myopic anisometropia, and their control effect on simple myopic anisometropia is better than that of compound myopic anisometropia.

参考文献/References:

［1］　GABAI A,ZEPPIERI M.Anisometropia［M］.StatPearls Publishing,2023.
［2］　HU Y Y,WU J F,LU T L,WU H,SUN W,GUO D D,et al.Prevalence and associations of an-isometropia in Children［J］.Invest Ophthalmol Vis Sci,2016,57(3):979-988.
［3］　NUNES A F,BATISTA M,MONTEIRO P.Prevalence of anisometropia in children and adolescents［J］.F1000Res,2021,10:1101.
［4］　TSAI H R,WANG J H,CHIU C J.Effect of orthokeratology on anisometropia control:a meta-analysis［J］.J Formos Med Assoc,2021,120(12):2120-2127.
［5］　孙笑笑,张钰,陈跃国.角膜塑形镜对近视性屈光参差儿童双眼视功能的影响［J］.眼科新进展,2021,41(11):1052-1056.
SUN X X,ZHANG Y,CHEN Y G.Effect of orthokeratology lens on binocular vision of children with myopic an-isometropia［J］.Rec Adv Ophthalmol,2021,41(11):1052-1056.
［6］　陈小虎,代艳.角膜塑形镜控制青少年单眼近视的临床观察［J］.国际眼科杂志,2019,19(3):517-519.
CHEN X H,DAI Y.Clinical observation of orthokeratology controlling monocular myopia in adolescents［J］.Int Eye Sci,2019,19(3):517-519.
［7］　TSAI W S,WANG J H,CHIU C J.A comparative study of orthokeratology and low-dose atropine for the treatment of anisomyopia in children［J］.Sci Rep,2020,10(1):14176.
［8］　WANG X,PAN J,ZHANG Y,LAN Y,ZUO J,JIANG Z.Prevalence and associations of myopic anisometropia in Chinese adults［J］.Eye Contact Lens,2020,46(3):147-153.
［9］　TEKIN K,CANKURTARAN V,INANC M,SEKEROGLU M A,YILMAZBAS P.Effect of myopic anisometropia on anterior and posterior ocular segment parameters［J］.Int Ophthalmol,2017,37(2):377-384.
［10］　VINCENT S J,COLLINS M J,READ S A,CARNEY L G.Myopic anisometropia:ocular char-acteristics and aetiological considerations［J］.Clin Exp Optom,2014,97(4):291-307.
［11］　CHEUNG S W,CHO P.Validity of axial length measurements for monitoring myopic prog-ression in orthokeratology［J］.Invest Ophthalmol Vis Sci,2013,54(3):1613-1615.
［12］　XU Z,WU Z,WEN Y,DING M,SUN W,WANG Y,et al.Prevalence of anisometropia and associated factors in Shandong school-aged children［J］.Front Public Health,2022,10:1072574.
［13］　PRSSINEN O,KAUPPINEN M.Anisometropia of spherical equivalent and astigmatism am-ong myopes:a 23-year follow-up study of prevalence and changes from childhood to adulthood［J］.Acta Ophthalmol,2017,95(5):518-524.
［14］　HIRAOKA T.Myopia control with orthokeratology:a review［J］.Eye Contact Lens,2022,48(3):100-104.
［15］　陈晓琴,刘金丽,张姝贤,李丽华.青少年近视患者配戴角膜塑形镜5年的有效性及安全性［J］.眼科新进展,2021,41(3):236-239.
CHEN X Q,LIU J L,ZHANG S X,LI L L.Efficacy and security of orthokeratology lens on my-opia progression in teen-agers for 5 years［J］.Rec Adv Ophthalmol,2021,41(3):236-239.
［16］　SUN L,LI Z X,WANG S P,SONG H X.The relationship between axis length difference and refractive error in unilateral myopic anisometropic children treated with orthokeratology［J］.J Ophthalmol,2023,2023:3110478.
［17］　CHEN Z,ZHOU J,QU X,ZHOU X,XUE F,SHANGHAI ORTHOKERATOLOGY STUDY (SOS) GROUP.Effects of orthokeratology on a-xial length growth in myopic anisometropes［J］.Cont Lens Anterior Eye,2018,41(3):263-266.
［18］　ZHONG Y,KE L,QIONG W,LIU F.Orthokeratology lens for management of myopia in aniso-metropic children:a contralateral study［J］.Cont Lens Anterior Eye,2020,43(1):40-43.
［19］　TSAI W S,WANG J H,LEE Y C,CHIU C J.Assessing the change of anisometropia in unilater-al myopic children receiving monocular orthokeratology treatment［J］.J Formos Med Assoc,2019,118(7):1122-1128.
［20］　李盼,张学辉,艾欣,王瑾,王若馨.不同程度屈光参差的单眼近视儿童配戴角膜塑形镜后近视进展对比［J］.国际眼科杂志,2022,22(9):1528-1532.
LI P,ZHANG X H,AI X,WANG J,WANG R X.Comparison of myopia progression in anisome-tropic children on the effect of orthokeratology with different degrees of unilateral myopia［J］.Int Eye Sci,2022,22(9):1528-1532.
［21］　FU A C,QIN J,RONG J B,JI N,WANG W Q,ZHAO B X,et al.Effects of orthokeratology len-s on axial length elongation in unilateral myopia and bilateral myopia with anisometropia children［J］.Cont Lens Anterior Eye,2020,43(1):73-77.

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备注/Memo:
山西省基础研究计划(自由探索类)项目（编号：202203021221302）
更新日期/Last Update: 2024-04-05