周边离焦设计框架眼镜对学龄儿童近视进展的影响:四年回顾分析  

Myopia Progression in Children Wearing Peripheral Defocus Modifying Lenses:Four Years of Retrospective Analysis

作　　者：郭寅[1] 田飞飞 吴敏[1] 冯祎[1] 唐萍[1] 吕燕云[1] Yin Guo;Feifei Tian;Min Wu;Yi Feng;Ping Tang;Yanyun Lu(Tongren Eye Care Center,Beijing Tongren Hospital,Capital Medical University,Beijing 100015,China;School of Public Health,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京同仁医院验光配镜中心,100015 [2]首都医科大学公共卫生学院,100069

出　　处：《中华眼视光学与视觉科学杂志》2021年第4期267-271,共5页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的:观察8~14岁儿童连续4年配戴周边离焦设计框架眼镜后的近视进展情况,评价其近视控制效果。方法:回顾性病例对照研究。对北京同仁医院验光配镜中心电子病历系统中2011─2014年连续4年配戴周边离焦设计框架眼镜(PDMLs)、单焦点框架眼镜(SVLs)的217例儿童就诊资料进行回顾分析,提取包括年龄、性别、屈光度、镜片类型等相关信息。使用的周边离焦镜片为非球面设计,采用“周边视力控制”技术达到延缓近视发展的目的。通过倾向性评分匹配,PDMLs、SVLs组各44例,取右眼数据纳入统计分析。2组儿童近视进展情况的比较采用独立样本t检验、卡方检验和广义估计方程等方法。结果:PDMLs组2011─2014年期间每年屈光度进展分别为(-0.85±0.43)D、(-0.60±0.35)D、(-0.64±0.26)D和(-0.53±0.28)D,SVLs组分别为(-0.82±0.42)D、(-0.79±0.44)D、(-0.61±0.40)D和(-0.58±0.33)D。PDMLs组中约59%(26/44)的儿童屈光度进展未超过2.00 D,略高于SVLs组(50%,22/44),但差异无统计学意义(χ^(2)=2.06,P=0.12)。对基线屈光度、年龄分组后,2组儿童屈光度进展差异均无统计学意义。通过广义估计方程分析,每年屈光度进展与年龄(β=0.06;标准误:0.01;95%CI:0.03,0.09;P<0.001)、镜片类型(β=-0.09;标准误:0.05;95%CI:-0.19,-0.01;P=0.04)相关。结论:与单焦点镜片相比,该设计类型的周边离焦镜片可以一定程度上延缓儿童近视进展速度,但临床效果不明显。Objective:To review myopia progression over 4 years in children who wore peripheral defocus modifying lenses(PDMLs),and assess its efficacy of myopia control.Methods:This was a retrospective,nonrandomized controlled trial at a tertiary referral center(Tongren Eye Care Center,Beijing Tongren Hospital).Data from 217 children aged 8-14 years who wore PDMLs or single vision lenses(SVLs)consecutively for 4 years(from 2011 to 2014)were collected from electronic medical records.Information such as age,gender,refraction,and type of spectacle lenses were included.PDML is an asymmetric design in which myopia progression was slowed using peripheral vision control technology.Final subjects were 88 children who were included after propensity score matching,with 44 children in each group.Only data of right eyes were included using a generalized estimation equation(GEE)model.Independent t tests and Chi-square tests were used to determine whether myopia progression differed between the two groups.Results:Annual myopia progression was-0.85±0.43 D,-0.60±0.35 D,-0.64±0.26 D and-0.53±0.28 D in the PDML group,and was-0.82±0.42 D,-0.79±0.44 D,-0.61±0.40 D and-0.58±0.33 D in the SVL group,respectively.59%(26/44)in the PDML group progressed lower than 2.00 D,slightly higher than that of 50.0%(22/44)in the SVL group(χ2=2.06,P=0.12).After stratification by age and baseline refraction,there was also no significant difference in myopia progression between the two groups.In the GEE model,annual myopia progression was associated with age(β=0.06;standard error:0.01;95%CI:0.03,0.09;P<0.001)and treatment(β=-0.09;standard error:0.05;95%CI:-0.19,-0.01;P=0.04).Conclusions:Compared to single vision lenses,peripheral defocus modifying lenses can moderately slow myopia progression.However,the effect is not remarkable in clinical practice.

关 键 词：周边离焦 近视控制 真实世界研究 

分 类 号：R778.11[医药卫生—眼科]