Photopic pupil size change in myopic orthokeratology and its influence on axial length elongation  

作　　者：Meng-Jun Zhu Li Ding Lin-Lin Du Jun Chen Xian-Gui He Shan-Shan Li Hai-Dong Zou 

机构地区：[1]Shanghai Eye Disease Prevention&Treatment Center/Shanghai Eye Hospital,Shanghai 200040,China [2]Shanghai General Hospital,National Clinical Research Center for Eye Diseases,Shanghai Key Laboratory of Ocular Fundus Diseases,Shanghai Engineering Center for Visual Science and Photomedicine,Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases,Shanghai 200080,China

出　　处：《International Journal of Ophthalmology(English edition)》2022年第8期1322-1330,共9页国际眼科杂志（英文版）

基　　金：Supported by the Natural Science Foundation of Shanghai(No.18ZR1435700);Clinical Research Project of Shanghai Health and Family Planning Committee(No.201840199)。

摘　　要：AIM:To explore the photopic pupil size behavior in myopic children undergoing overnight orthokeratology(ortho-k)over 1-year period and its effects on the axial elongation.METHODS:A total of 202 Chinese myopic children were enrolled in this prospective clinical trial.Ninetyfive subjects in ortho-k group and eighty-eight subjects in spectacle group completed the 1-year study.Axial length(AL)was measured before enrollment and every 6mo after the start of ortho-k.The photopic pupil diameter(PPD)was determined using the Pentacam AXL and measured in an examination room with lighting of 300-310 Lx.Stepwise multiple linear regression analysis was used to identify variables contribution to axial elongation.RESULTS:Compared with spectacle group,the average 1-year axial elongation was significantly slower in the ortho-k group(0.25±0.27 vs 0.44±0.23 mm,P<0.0001).In ortho-k group,PPDs significantly decreased from 4.21±0.62 mm to 3.94±0.53 mm after 1mo of lens wear(P=0.001,Bonferroni correction)and the change lasts for 3-month visit.No significantly change during the other follow-up visits was found(P>0.05,Bonferroni correction).The 4.81 mm PPD may be a possible cutoff point in the ortho-k group.Subjects with PPD below or equal to 4.81 mm tended to have smaller axial elongation compared to subjects with PPD above 4.81 mm after 1-year period(t=-3.09,P=0.003).In ortho-k group,univariate analyses indicated that those with older age,greater degree of myopia,longer AL,smaller baseline PPD(PPDbaseline)experienced a smaller change in AL.In multivariate analyses,older age,greater AL and smaller PPDbaseline were associated with smaller increases in AL.In spectacle group,PPD tended to be stable(P>0.05,Bonferroni correction)and did not affect axial growth.CONCLUSION:PPDs experience significantly decreases at 1-month and 3-month ortho-k treatment.Children with smaller PPD tend to experience slower axial elongation and may benefit more from ortho-k.

关 键 词：ORTHOKERATOLOGY MYOPIA axial length pupil diameter ACCOMMODATION 

分 类 号：R779.6[医药卫生—眼科]