[1]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):946-951.[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(10):946-951.[doi:10.13389/j.cnki.rao.2020.0213]
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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/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
40卷
期数:
2020年10期
页码:
946-951
栏目:
应用研究
出版日期:
2020-10-05

文章信息/Info

Title:
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
作者:
金成成; 裴茹霞; 杜蓓; 王希莲; 刘桂华; 金楠; 韩丁; 刘琳; 魏瑞华
300384　天津市，天津医科大学眼科医院、眼视光学院、眼科研究所，天津市眼科学与视觉科学国际联合研究中心（金成成，裴茹霞，杜蓓，刘桂华，金楠，韩丁，刘琳，魏瑞华）；300400　天津市，天津市北辰医院眼科（王希莲）
Author(s):
JIN Chengcheng1; PEI Ruxia1; DU Bei1; WANG Xilian2; LIU Guihua1; JIN Nan1; HAN Ding1; LIU Lin1; WEI Ruihua1
1.Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science，Eye Institute and School of Optometry，Tianjin Medical University Eye Hospital，Tianjin 300384，China
2.Department of Ophthalmology，Tianjin Beichen Hospita
关键词:
盐酸环喷托酯; 等效球镜度; 瞳孔直径; 相关影响因素; 儿童
Keywords:
cyclopentolate hydrochloride;  spherical equivalents;  pupil diameters;  related factors; children
分类号:
R778.2
DOI:
10.13389/j.cnki.rao.2020.0213
文献标志码:
A
摘要:
目的　探讨不同屈光状态儿童应用盐酸环喷托酯（cyclopentolate hydrochloride，CH）滴眼后1 h内等效球镜度（spherical equivalent，SE）与瞳孔直径（pupil diameter，PD）达到稳定所需时间及变化幅度的相关影响因素。方法　选取2019年9月首次于天津医科大学眼科医院视光门诊就诊，拟诊断为屈光不正，需要进行睫状肌麻痹验光的患儿56例100眼。根据末次测量的SE将患儿分为3组：（1）近视组（40眼）：SE <-0.50 D；（2）正视组（29眼）：-0.50 D ≤ SE ≤ +0.50 D；（3）远视组（31眼）：SE > +0.50 D。在第一滴CH滴眼前和滴眼后1 h内，由同一名研究人员分别应用自动电脑验光仪（精度0.13 D）和红外瞳孔计（精度0.01 mm）监测SE和PD的动态变化，每5 min监测1次，共计13次。通过重复测量方差分析确定不同屈光状态组SE与PD达到稳定所需时间；通过方差分析比较不同屈光状态组SE和PD变化幅度差异；通过Pearson双变量相关分析寻找SE及PD变化幅度的相关影响因素。结果　近视组在第一滴CH滴眼30 min之后（包括30 min），SE峰值与各观察时间点SE测量值之间的差异均无统计学意义（均为P>0.05），差值均不超过0.04 D；正视组在第一滴CH滴眼30 min之后（包括30 min），SE峰值与各观察时间点SE测量值之间的差异均无统计学意义（均为P>0.05），差值均不超过0.13 D；远视组在第一滴CH滴眼35 min之后（包括35 min），SE峰值与各观察时间点SE测量值之间的差异均无统计学意义（均为P>0.05），差值均不超过0.07 D。总体上，95眼（95%）在第一滴CH滴眼后1 h内SE峰值与SE在第一滴CH滴眼后35 min时的测量值之间差异不超过0.25 D。近视组在第一滴CH滴眼后55 min内（包括55 min），PD峰值与各观察时间点PD测量值之间的差异均有统计学意义（均为P<0.05），但在55 min时差异（0.07 mm）无临床意义；正视组在第一滴CH滴眼后55 min内（包括55 min），PD峰值与各观察时间点PD测量值差异均有统计学意义（均为P<0.05），但在55 min时差异（0.05 mm）无临床意义；远视组在第一滴CH滴眼后55 min内（包括55 min），PD峰值与各观察时间点PD测量值差异均有统计学意义（均为P<0.05），但在55 min时差异（0.06 mm）无临床意义。总体上，86眼（86%）在第一滴CH滴眼后1 h内PD峰值与PD在第一滴CH滴眼后55 min时的测量值之间差异不超过0.10 mm。Pearson双变量线性相关分析显示，SE变化幅度与眼轴长度（r=-0.445，P<0.001）、年龄（r=-0.225,P=0.024）均呈显著负相关，与末次SE（r=0.543，P<0.001）、初始SE（r=0.297，P=0.003）均呈显著正相关，与性别（r=0.113，P=0.262）、眼压（r=-0.142，P=0.158）均无相关性。PD变化幅度与初始PD（r=-0.583，P<0.001）呈显著负相关，与年龄（r=-0.008，P=0.933）、性别（r=0.005，P=0.957）、眼压（r=-0.139，P=0.167）、眼轴长度（r=-0.020，P=0.843）、末次PD（r=-0.003，P=0.979）均无相关性。本研究全程未观察到严重不良反应。结论　CH用于6~15岁儿童时，SE早于PD达到稳定。睫状肌麻痹验光无需等到瞳孔充分散大，可在第一滴CH滴眼35 min后进行。CH对于年龄小和远视的儿童睫状肌麻痹作用更强，对于初始瞳孔越小的儿童瞳孔散大作用越明显。
Abstract:
Objective　To determine the time for spherical equivalents (SE) and pupil diameters (PD) to become stable and related factors of the changing amplitude at 1 hour after application of cyclopentolate hydrochloride (CH) to children in different refractive status.Methods　A total of 56 patients (100 eyes) with ametropia were selected who were first treated in Optometry Clinic of Tianjin Medical University Eye Hospital in September 2019. According to the final SE, subjects were divided into three groups: (1)myopia group (40 eyes): SE<-0.50 D; (2) emmetropia group (29 eyes): -0.50 D≤SE≤+0.50 D; (3) hyperopia group (31 eyes): SE>+0.50 D. The dynamic changes of SE and PD were monitored 13 times by the same researcher through the autorefractor (with an accuracy of 0.13 D) and infrared pupillometer (with an accuracy of 0.01 mm) every 5 minutes in 1 hour after and before the first drop of CH. Repeated-measure analyses of variance were used to determine the time required for SE and PD to reach stability in different refractive groups. Analyses of variance were conducted to compare the changing amplitude of SE and PD among different refractive groups. Pearson bivariate correlation analyses were utilized to find related factors with the changing amplitude of SE and PD.Results　No significant difference was found between the peak value of SE and the value measured 30 minutes after (including 30 minutes) the first drop of CH in myopia group (all P> 0.05), with the difference not more than 0.04 D. No significant difference was found between the peak value of SE and the value measured 30 minutes after (including 30 minutes) the first drop of CH in emmetropia group (all P> 0.05), with the difference not more than 0.13 D. No significant difference was found between the peak value of SE and the value measured 35 minutes after (including 35 minutes) the first drop of CH in hyperopia group (all P> 0.05), with the difference not more than 0.07 D. Totally, the difference between the peak value of SE within 1 hour after the first CH and the SE measured at 35 minutes after the first CH was not more than 0.25 D in 95 eyes (95%). Significant difference was found between the peak value of PD and the value measured within 55 minutes after (including 55 minutes) the first drop of CH in myopia group (all P< 0.05), with no clinical difference (0.07 mm) at 55 minutes. Significant difference was found between the peak value of PD and the value measured within 55 minutes after (including 55 minutes) the first drop of CH in emmetropia group (all P< 0.05), with no clinical difference (0.05 mm) at 55 minutes. Significant difference was found between the peak value of PD and the value measured within 55 minutes after (including 55 minutes) the first drop of CH in hyperopia group (all P< 0.05), with no clinical difference (0.06 mm) at 55 minutes. Totally, the difference between the peak value of PD within 1 hour after the first CH and the PD measured at 55 minutes after the first CH was not more than 0.10 mm in 86 eyes (86%). Pearson bivariate linear correlation analysis showed that the change of SE was negatively correlated with axial length (r=-0.445, P<0.001) and age (r=-0.225, P=0.024), and positively correlated with the final SE (r=0.543, P< 0.001) and initial SE (r=0.297, P=0.003), but not significantly correlated with gender (r=0.113, P=0.262) or intraocular pressure (r=-0.142, P=0.158). The change of PD was negatively correlated with the initial PD (r=-0.583, P<0.001), but not significantly correlated with age (r=-0.008, P=0.933), gender (r=0.005, P=0.957), intraocular pressure (r=-0.139, P=0.167), axial length (r=-0.020, P=0.843) or the final PD (r=-0.003, P=0.979). No serious side effects were observed throughout the study.

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备注/Memo

备注/Memo:
天津市科技计划项目基金资助（编号：17ZXHLSY00070）；天津医科大学眼科医院临床重点学科（专科）建设项目（编号：TJLCZDXKM007）
更新日期/Last Update: 2020-10-05