摘要
目的:观察多元透镜分区优化框架眼镜(DSDO)与多区正向光学离焦框架眼镜(DIMS)在儿童青少年近视管理中的临床效果。方法:前瞻性临床研究。连续选取2022年7月1日至2023年12月31日在北京大学人民医院就诊的6~14岁且诊断为近视前期和近视患者1951例,按照自愿原则分为DSDO组(配戴DSDO)1376例和DIMS组(配戴DIMS)575例。观察2组患者戴镜后3、6、9、12个月4个随访时间点的眼轴长度(AL)和等效球镜度(SE)较基线的变化及眼部并发症情况,分析同时完成6个月和12个月访视患者近视控制情况。分析不同SE组的AL控制情况。分析2组患者戴镜前后对比敏感度和视觉舒适度变化。比较2组患者入组时基线屈光度和初始配戴框架眼镜的季节对AL控制的影响。采用卡方检验、独立样本t检验进行数据分析。结果:完成3、6、9、12个月随访患者分别为1520、765、341、232例,同时完成6个月和12个月随访近视患者总计141例,2组基线数据差异均无统计学意义(P>0.05)。2组患者在戴镜后不同时间点AL及SE均有不同程度增长,且DSDO组AL增长量低于DIMS组(P<0.05),2组AL均值差异在戴镜后3、6、9、12个月分别为0.01、0.04、0.05、0.07 mm。在同时完成6个月和12个月随访的近视患者中,DSDO组56例,DIMS组85例;2组戴镜6个月和12个月后AL的组间差异分别为(0.04±0.02)mm和(0.08±0.03)mm,差异有统计学意义(t=2.26,P=0.026;t=2.65,P=0.009)。DSDO组的近视患者中的-2.00 D<SE≤-0.50 D组和SE≤-4.00 D组中AL增长较DIMS组中变缓,差异有统计学意义(t=2.03,P=0.049;t=2.75,P=0.015)。10—12月初始戴镜儿童AL增长较4—6月戴镜儿童AL增长更快。2组受检者配戴后的舒适度及眼部并发症差异无统计学意义(P>0.05)。结论:光学近视离焦框架眼镜是一种有效延缓近视进展的治疗手段。与DIMS相比,DSDO能进一步延缓儿童青少年AL增长。
Objective:To investigate the clinical effect of diverse segments defocus optimization(DSDO)and defocus incorporated multiple segments(DIMS)spectacles lenses in myopia management of children and adolescents.Methods:This was a prospective clinical study.A total of 1951 patients aged 6 to 14 years,diagnosed with pre-myopia and myopia,and consecutively attending Peking University People's Hospital from July 1,2022,to December 31,2023,were enrolled in this study.Based on their voluntary participation,all participants were divided into groups wearing DSDO(1376 cases)and DIMS lenses(575 cases).The changes in axial length(AL)and spherical equivalent(SE)from baseline were observed at 3,6,9 and 12 months after wearing the lenses at 4 follow-up time points,along with ocular complications.The myopia control effect was analyzed for participants who completed 6 and 12 months of follow-up.The control of AL among different SE groups were analyzed.The changes of contrast sensitivity and visual comfort before and after wearing the lenses were also analyzed.The impact of baseline refraction and the season of initial frame glasses fitting on axial length control was compared between the two groups.Chi-square test and independent sample t-test were used in this study.Results:The follow-up was completed by 1520 participants at 3 months,765 participants at 6 months,341 participants at 9 months,and 232 participants at 12 months,with a total of 141 myopic participants completing both 6 and 12 months of follow-up.There were no statistically significant differences in baseline data between the two groups(P>0.05).Both groups showed varying degrees of increase in AL and SE at different time,with the DSDO group exhibiting a lower AL increase compared to the DIMS group(all P<0.05).The mean differences in AL between the two groups at 3,6,9 and 12 months were 0.01,0.04,0.05,and 0.07 mm,respectively.Among the myopic patients who completed both 6 and 12 months of follow-up,there were 56 patients in the DSDO group and 85 patients in the DIMS group.The intergroup differences in AL at 6 and 12 months were 0.04±0.02 mm and 0.08±0.03 mm,respectively,which were statistically significant(t=2.26,P=0.026;t=2.65,P=0.009).In the DSDO group,AL growth slowed significantly compared to the DIMS group in both the-2.00 D<SE≤-0.50 D subgroup and the SE≤-4.00 D subgroup(t=2.03,P=0.049;t=2.75,P=0.015).The AL of children initially wearing glasses from October to December increased more faster compared with those wearing glasses from April to June.There were no statistically significant differences in comfort and ocular complications between the two groups after wearing the lenses(P>0.05).Conclusions:Optical myopia defocus spectacle glasses represent an effective method to delaying the progression of myopia.Compared to DIMS,DSDO can further retard the axial growth of the eyes in children and adolescents.
作者
彭子苏
黄丽莎
唐辛
邓秋林
刘志明
陈思童
赵明威
王凯
李岩
Zisu Peng;Lisha Huang;Xin Tang;Qiulin Deng;Zhiming Liu;Sitong Chen;Mingwei Zhao;KaiWang;Yan Li(Department of Ophthalmology,Peking University People's Hospital,Center of Optometry,Institute of Ophthalmology and Optometry,Beijing Key Laboratory of Retino-Choroidal Diagnosis and Treatment,College of Optometry,Peking University Health Science Center,Beijing 100044,China;Peking University International Hospital,Beijing 102206,China)
出处
《中华眼视光学与视觉科学杂志》
CSCD
北大核心
2024年第11期808-815,共8页
Chinese Journal Of Optometry Ophthalmology And Visual Science
基金
国家自然科学基金项目(82171092)
关键词
近视
近视离焦眼镜
近视控制
近视管理
眼轴
屈光度
myopia
myopia defocus spectacles
myopia control
myopia management
axial length
refraction
