角膜塑形镜对近视儿童脉络膜厚度和脉络膜轮廓的长期影响  

Long-term effect of orthokeratology on choroidal thickness and choroidal contour in myopic children

作　　者：许晟嵩 王梦怡 林思嘉 蒋金芸 余孟婷 唐湘华 谢丹茜 路明欣 李周越 杨晓[1] 《眼科学报》出版团队(翻译) XU Shengsong;WANG Mengyi;LIN Sijia;JIANG Jinyun;YU Mengting;TANG Xianghua;XIE Danxi;LU Mingxin;LI Zhouyue;YANG Xiao;Eye Science Publishing Team(State Key Laboratory of Ophthalmology,Zhongshan Ophthalmic Center,Sun Yat-sen University,Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science,Guangzhou 510060,China)

机构地区：[1]中山大学中山眼科中心,眼病防治全国重点实验室,广东省眼科视觉科学重点实验室,广州510060

出　　处：《眼科学报》2024年第2期63-74,共12页Eye Science

基　　金：国家自然科学基金(82070994)。

摘　　要：目的:调查角膜塑形镜对近视儿童脉络膜厚度和脉络膜轮廓的长期影响。方法:受试者来自一项2年的随机对照试验。研究对象为年龄8~12岁、等效球镜在−1.00~−6.00 D的儿童(n=80),这些研究对象被随机分配到对照组(n=40)和角膜塑形镜组(n=40)。本研究在基线和1、6、12、18、24个月的随访中收集光学相干断层扫描图像(optical coherence tomography,OCT),然后基于OCT图像计算脉络膜厚度和脉络膜轮廓。在这些随访点也同时测量了眼轴长度(axial length,AL)和其他眼生物学参数。结果:在2年内,对照组的脉络膜厚度随时间变薄,脉络膜轮廓变得更加后凸(均P<0.001)。角膜塑形镜可以改善脉络膜厚度(均P<0.001),并在所有随访中维持脉络膜轮廓不后凸(均P<0.05)。在角膜塑形镜组中,脉络膜轮廓在颞侧的变化小于鼻侧(P=0.008),而脉络膜厚度在颞侧以黄斑中心凹为中心、直径3 mm线性扫描区域的增厚更明显(P<0.001)。2年内脉络膜厚度的变化与对照组中2年内AL变化呈负相关(r=−0.52,P<0.001),然而,这一规律被角膜塑形镜打破(r=−0.05,P=0.342)。在多变量回归模型中校正其他变量后,角膜塑形镜对脉络膜厚度的影响是稳定的。结论:角膜塑形镜可以改善脉络膜厚度并维持脉络膜轮廓,但这种效果在长期内趋于减弱。Objective:To investigate the long-term effect of orthokeratology on the choroidal thickness and choroidal contour in myopic children.Methods:Subjects were from a conducted 2-year Randomized Clinical Trial.Children(n=80)aged 8-12 years with spherical equivalent refraction of-1.00 to-6.00 D were randomly assigned to the control group(n=40)and ortho-k group(n=40).OCT images were collected at the baseline,1-,6-,12-,18-,and 24-month visits,then the choroidal thickness and choroid contour were calculated.Axial length(AL)and other ocular biometrics were also measured.Results:During two years,in the control group,the choroidal thickness became thinning and the choroidal contour became prolate with time at all visits(all P<0.001).Ortho-k can improve the choroidal thickness(all P<0.001)and maintain the choroidal contour at all visits(all P<0.05).In the ortho-k group,the choroidal contour was less changed in the temporal than nasal(P=0.008),and the choroidal thickness was more thickening in the temporal 3 mm(P<0.001).Two-year change in choroidal thickness was significantly associated with the two-year AL change in the control group(r=−0.52,P<0.001),however,this trend was broken by ortho-k(r=−0.05,P=0.342).After being adjusted by other variables in the multivariable regression model,the effect of ortho-k on choroidal thickness was stable.Conclusions:In a short term,ortho-k can improve the choroidal thickness and maintain the choroidal contour,but this effect diminished in a long term.Further study with larger sample size and longer follow-up is warranted to refine this issue.

关 键 词：角膜塑形镜 近视 脉络膜 儿童 

分 类 号：R778.11[医药卫生—眼科]