0.5%复方托品酰胺对近视儿童屈光度及前房深度的影响  

Effect of 0.5%compound tropicamide on ocular refraction and anterior chamber depth in myopic children

作　　者：郁昕[1] 刘媛媛 刘汉 冯雪亮[1] Yu Xin;Liu Yuanyuan;Liu Han;Feng Xueliang(Department of Strabismus and Pediatric Ophthalmology,Shanxi Eye Hospital Affiliated Shanxi Medical University,Taiyuan 030002,China;Department of Strabismus and Pediatric Ophthalmology,Shanxi Aier Ophthalmology Hospital,Taiyuan 030001,China;Shanxi Zhiyuan Huitu Techonlogy Co.,Ltd,Taiyuan 030006,China)

机构地区：[1]山西医科大学附属山西省眼科医院斜视与小儿眼科,太原030002 [2]山西爱尔眼科医院小儿眼科,太原030001 [3]山西致远慧图科技有限公司,太原030006

出　　处：《中华眼外伤职业眼病杂志》2024年第12期881-886,共6页Chinese Journal of Ocular Trauma and Occupational Eye Disease

基　　金：中央引导地方科技发展资金项目(YDZJSX2022B015)。

摘　　要：目的评价0.5%复方托品酰胺滴眼液对不同程度近视儿童屈光度及前房深度(ACD)的影响。方法前瞻性病例系列研究。纳入就诊于山西省眼科医院斜视与小儿眼科门诊2021年7月至2023年6月7~13岁近视儿童172例(172只眼),其中双眼近视151例,单眼近视21例,双眼近视者取右眼数据。采用0.5%复方托品酰胺滴眼液对近视儿童滴眼3次每次间隔5 min。收集睫状肌麻痹前后的电脑验光数据及ACD。根据睫状肌麻痹后眼的屈光状态(以等效球镜度数(SE)绝对值(|SE|)表示,分为轻度近视组(0.50 D≤|SE|<3.00 D)118只眼和中高度近视组54只眼(|SE|≥3.00 D)。观察睫状肌麻痹后屈光度和ACD变化,采用Spearman相关检验分析睫状肌麻痹前后SE变化值绝对值(|ΔSE|)与ACD变化值(ΔACD)及年龄之间的关系。结果172例近视儿童年龄(9.08±1.66)岁,男96例、女76例。睫状肌麻痹前后球镜[-2.00(1.75)、-1.75(1.75)D]、柱镜[-0.50(0.50)、-0.50(0.75)D]及SE[-2.38(1.75)、-2.06(1.87)D]比较,差异均有统计学意义(Z=-9.90、-2.13、-9.04;P<0.001、P=0.033、P<0.001),睫状肌麻痹后球镜及SE均减小,柱镜增大。睫状肌麻痹前后ACD[(3.15±0.23)、(3.22±0.21)mm]差异有统计学意义(t=12.24;P<0.001),睫状肌麻痹后ACD增加。低度近视组和中高度近视组睫状肌麻痹前后|ΔSE|[0.25(0.37)、0.19(0.39)D]及ΔACD[0.06(0.06)、0.04(0.06)mm]相比差异有统计学意义(Z=-1.98、-2.15;P=0.047、P=0.034)。睫状肌麻痹前后|ΔSE|与年龄呈负相关(r=-0.19,P=0.015),与ΔACD呈正相关(r=0.19,P=0.012)。结论近视儿童复方托品酰胺睫状肌麻痹后ACD增大;SE减少越多,ACD变化越大;随年龄、近视的程度增加,睫状肌麻痹前后SE及ACD差值减少。Objective To evaluate the effect of 0.5%compound tropicamide eye drops on ocular refraction and anterior chamber depth(ACD)in children with varying degrees of myopia.Methods This was a prospective case-control study.The myopia big data collection platform of Shanxi Eye Hospital was utilized to collect data from 172 myopic children,aged between 7 to 13 years,who visited the Strabismus and Pediatric Ophthalmology Clinic at Shanxi Eye Hospital from July 2021 to June 2023.Among them,there were 151 cases of binocular myopia and 21 cases of monocular myopia.For the binocular myopia cases,data from the right eye was used.The 0.5%compound tropicamid eye drops were administered to myopia children 3 times,with a 5-minute interval between each administration.Computer optometry data and ACD of compound tropicamide before and after cycloplegic administration were collected,and the refractive state of the eye after cycloplegia were expressed as spherical equivalent(SE).There were 118 eyes in the low myopia group(0.50 D≤|SE|<3.00 D)and 54 eyes in the moderate to high myopia group(|SE|≥3.00 D).The changes in SE(|ΔSE|)andΔACD after cycloplegia were observed,and the relationship between|ΔSE|,ΔACD and age were analyzed by Spearman correlation test.Results The average age of these children was(9.08±1.66)years,with 96 males and 76 females.The values of spherical diopter[-2.00(1.75),-1.75(1.75)D],cylindrical diopter[-0.50(0.50),-0.50(0.75)D]and SE[-2.38(1.75),-2.06(1.87)D]before and after cycloplegia were significantly different(Z=-9.90,-2.13,-9.04;P<0.001,P=0.033,P<0.001),and the values of spherical diopter and SE after cycloplegia reduced,and cylindrical diopter value increased;The differences between ACD[(3.15±0.23),(3.22±0.21)mm]before and after mydriasis were statistically significant(t=12.24,P<0.001),with an increase;There were significant differences in|ΔSE|[0.25(0.37),0.19(0.39)D]andΔACD[0.06(0.06),0.04(0.06)mm]between the low myopia group and the moderate to high myopia group(Z=-1.98,-2.15;P=0.047,0.034);The|ΔSE

关 键 词：近视 儿童 屈光度 前房深度 

分 类 号：S85[农业科学—兽医学]