0.005%阿托品滴眼液控制低度近视儿童近视进展的安全性及有效性  

Safety and efficacy of 0.005%Atropine eye drops on myopia progression in children with low myopia

作　　者：赵兵新 张傲帆 崔璨[1] 魏丽 李彬彬[1] 庞雪娜 吕勇[1] 王卫群[1] 张俊杰[3] 符爱存[1] Bing-Xin Zhao;Ao-Fan Zhang;Can Cui;Li Wei;Bin-Bin Li;Xue-Na Pang;Yong Lyu;Wei-Qun Wang;Jun-Jie Zhang;Ai-Cun Fu(Department of Ophthalmology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan Province,China;Academy of Medical Sciences,Zhengzhou University,Zhengzhou 450001,Henan Province,China;Henan Provincial People's Hospital,Henan Eye Hospital,Henan Eye Institute,Zhengzhou 450003,Henan Province,China)

机构地区：[1]郑州大学第一附属医院眼科,中国河南省郑州市450000 [2]郑州大学医学科学院,中国河南省郑州市450001 [3]河南省人民医院河南省立眼科医院河南省眼科研究所,中国河南省郑州市450003

出　　处：《国际眼科杂志》2022年第3期388-393,共6页International Eye Science

基　　金：河南省卫计委医学科技攻关项目(No.201602073);河南省科技厅重点研发与推广专项项目(No.201801591);河南省卫生计生科技英才海外研修工程(No.2018038);河南省教育厅高等学校重点科研项目(No.19A320066)。

摘　　要：目的:观察低度近视儿童应用质量分数0.005%阿托品滴眼液控制近视进展的安全性及有效性。方法:前瞻性对照研究。116例116眼低度近视儿童根据受试者和监护人意愿分为两组。阿托品(试验)组:58例58眼近视儿童配戴全矫单焦框架眼镜,同时睡前双眼各点1滴质量分数0.005%的阿托品滴眼液。框架镜(对照)组:58例58眼近视儿童仅配戴全矫单焦框架眼镜。用药前及用药后每4mo复查一次,共随访12mo,观察两组近视等效球镜度、眼轴长度、瞳孔直径和调节幅度的变化情况及试验组的不适症状。结果:随访1a后,两组的近视等效球镜度和眼轴长度治疗前后均有差异(P<0.05);两组间近视等效球镜屈光度增加量无差异(P>0.05);两组间眼轴长度增加量有微小差异,但差异无统计学意义(P>0.05);两组的瞳孔直径增加量有差异(P<0.05);两组的调节幅度下降量有差异(P<0.01)。试验组不适症状:用药初期6眼(10.3%)出现畏光,其中4眼用药2wk后畏光消失,余2眼4wk后消失。无视近模糊、过敏等其它不适症状。结论:低度近视儿童规律应用质量分数0.005%阿托品滴眼液1a,与单纯配戴框架镜相比,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。AIM:To evaluate the safety and efficacy of 0.005%atropine eye drops on myopia control in children with low myopia.METHODS:Prospective one-year controlled study.One hundred and sixteen children with low myopia were divided into two groups(0.005%atropine group and control group)according to the requirements of children and their guardians.The children(n=58)in the 0.005%atropine group wore single-vision(SV)spectacles,with one drop of 0.005%atropine eye drop applied to both eyes once nightly.The children(n=58)in the control group only wore SV spectacles.Repeated measurements of spherical equivalent refractive errors(SERs),axial length(AL),pupil diameter and accommodative amplitude were performed at baseline,and 4,8 and 12mo after treatment.The discomfort symptoms were also observed.RESULTS:There were no significant increase shown in change in SERs and AL from baseline to 12mo in the 0.005%atropine group and control group(P<0.05).There were differences in the change in SERs and AL between two groups,but either the change in SERs or change in AL failed to reach statistical significance(P>0.05).Statistically significant differences were all found in pupil diameter increase and accommodative amplitude decrease between two groups(P<0.01).Six eyes(10.3%)were mild photophobic in the early stage in the 0.005%atropine group.Photophobia disappeared in 4 and 2 eyes after using 0.005%eye drops 2 and 4wk,respectively.No children showed any other discomfort symptoms such as blurred vision or allergy in the two groups.CONCLUSION:Compared to wear SV spectacles alone,regular application of 0.005%atropine could somewhat control the progression of myopia in children with low myopia.However,its clinical effect was not obvious.

关 键 词：低度近视 近视进展 0.005%阿托品滴眼液 眼轴长度 

分 类 号：R59[医药卫生—内科学]