The Effect of Different Concentrations of Atropine on Myopia Prevention and Control in Adolescents
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摘要:
目的 探讨阿托品在不同浓度下应用于青少年近视防控中的效果。 方法 采用前瞻性双盲随机对照研究方法，选取2021年10月至2022年10月玉溪市人民医院眼科收治的青少年近视患者86例，采用数字随机表法分为3组。对照组（n = 26例）仅配戴全矫单焦框架镜，研究1组（n = 30例）和研究2组（n = 30例）在配戴全矫单焦框架镜同时分别应用0.01%和0.05%阿托品滴眼液。记录3组治疗前后眼轴长度（axial length，AL）、裸眼视力（uncorrected visual acuity，UCVA）及屈光度，并记录研究1组和研究2组的临床治疗有效率及不良反应发生率。 结果 治疗前，3组眼轴长度、裸眼视力、屈光度指标比较，差异无统计学意义（P > 0.05）；治疗后，研究1组和研究2组眼轴长度均短于对照组，裸眼视力高于对照组，屈光度低于对照组，差异有统计学意义（P < 0.05）；研究2组眼轴长度短于研究1组，裸眼视力高于研究1组，屈光度低于研究1组，差异具有统计学意义（P < 0.05）；研究2组治疗有效率96.67%（29/30）高于研究1组的73.33%（22/30），差异有统计学意义（P < 0.05）；不良反应发生率方面，研究1组为13.33%（4/30），研究2组为6.67%（2/30），差异无统计学意义（P > 0.05）。 结论 与仅配戴全矫单焦框架镜相比，应用0.01%和0.05%阿托品滴眼液在防控青少年近视方面均具有一定的治疗效果，其中，0.05%阿托品应用效果更显著，可以有效缩短眼轴长度、提高裸眼视力、降低屈光度和不良反应发生率，提高临床治疗有效率。 Abstract:Objective To investigate the effect of different concentrations of atropine on myopia prevention and control in adolescents. Methods A prospective double-blind randomized controlled trial was conducted. A total of 86 adolescent myopia patients admitted to the Department of Ophthalmology, Yuxi People’s Hospital from October 2021 to October 2022 were selected and divided into three groups by random number table method. Among them, 26 cases only wore the proper framework of single focal lens. Study group 1 （n = 30） and study group 2 （n = 30） were treated with 0.01% and 0.05% atropine eye drops while wearing fully corrected monocular frames, respectively. The axial length （AL）, uncorrected visual acuity （UCVA）, and refractive index of three groups before and after the treatment, and the clinical treatment effectiveness and adverse reaction rates of study 1 and study 2 groups were recorded respectively. Results Before the treatment, there were no statistically significant differences in ocular axial length, naked eye sight, diopter index comparison among the three groups（P > 0.05）; After the treatment, the axial length of study group 1 and study group 2 was shorter than that of the control group, the uncorrected visual acuity was higher than that of the control group, and the diopter was lower than that of the control group. There were statistically significant differences （P < 0.05）. The axial length of study group 1 and study group 2 was shorter than that of the control group, and the naked eye vision was higher than that of the control group. The diopter was lower than that of the control group, and there was a statistically significant difference （P < 0.05）; The treatment effectiveness rate of 96.67% （29/30） in study group 2 was higher than that of 73.33% （22/30） in study group 1, with a statistically significant difference （P < 0.05）; In terms of the incidence of adverse reactions, study group 1 was 13.33% （4/30）, and study group 2 was 6.67% （2/30）, with no statistically significant difference （P > 0.05）. Conclusion Compared with those only wearing the whole framework of single focal lens correction, the application of 0.01% and 0.05% atropine eye drops in juvenile myopia prevention and control of all have a certain therapeutic effect. Among them, 0.05% atropine application is more effective and it can effectively shorten the ocular axial length and improve the naked eye sight so as to reduce the diopter and incidence of adverse reactions and effectively improve the clinical treatment. -
Key words:
- Juvenile myopia /
- Atropine /
- Axial length /
- Uncorrected visual acuity /
- Diopter /
- Response rate of treatment
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表 1 3组一般资料对比（
$\bar x \pm s $ ）Table 1. Comparison of of general data among three groups （
$\bar x \pm s $ ）组别 n 性别（n） 年龄（岁） 平均年龄（岁） 男 女 对照组 26 14 12 12～18 15.15 ± 1.75 研究1组 30 17 13 12～17.5 15.00 ± 1.91 研究2组 30 16 14 12.5～18 15.25 ± 1.72 F/χ2 - 0.597 0.649 0.134 P - 0.752 0.088 0.999 
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表 2 3组眼轴长度、裸眼视力、屈光度变化情况对比（
$ \bar x \pm s$ ）Table 2. Comparison of axial length，uncorrected visual acuity and diopter changes among three groups （
$ \bar x \pm s$ ）组别 n 眼轴长度（mm） 裸眼视力（D） 屈光度（D） 治疗前 治疗后 治疗前 治疗后 治疗前 治疗后 对照组 26 24.43 ± 0.58 25.32 ± 0.6 0.38 ± 0.07 0.39 ± 0.06 −1.66 ± 0.69 −3.02 ± 0.83 研究1组 30 24.49 ± 0.61 25.21 ± 0.64* 0.37 ± 0.07 0.43 ± 0.08* −1.71 ± 0.88 −2.61 ± 1.00* 研究2组 30 24.50 ± 0.58 25.12 ± 0.63*# 0.38 ± 0.06 0.48 ± 0.09*# −1.65 ± 0.67 −2.37 ± 0.71*# F − 0.020 5.410 0.209 5.210 1.511 1.770 P − 0.996 0.006 0.811 0.046 0.240 0.047 与对照组比较，*P < 0.05；与研究1组比较，#P < 0.05。
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表 3 2组临床有效率对比[n（%）]
Table 3. Study 1 and study 2 group of clinical efficient contrast [n（%）]
组别 n 显效 有效 无效 有效率 研究1组 30 10（33.33） 9（30.00） 11（36.67） 19（63.33） 研究2组 30 15（50.00） 14（46.67） 1（3.33） 29（96.67）* χ2 − − − − 4.849 P − − − − <0.027 与研究1组比较，*P < 0.05。
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表 4 2组不良反应发生率对比[n（%）]
Table 4. Comparison of the incidence of adverse reactions between study group 1 and study group 2 [n（%）]
组别 n 头晕 眼部不适 畏光 视物模糊 不良反应发生率 研究1组 30 0（0.00） 1（3.33） 1（3.33） 2（6.67） 4（13.33） 研究2组 30 0（0.00） 0（0.00） 1（3.33） 1（3.33） 2（6.67） χ2 − − − − − 0.267 P − − − − − >0.605
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