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| 阿托品滴眼液不同浓度与给药频率对儿童近视患者瞳孔直径、调节幅度及泪膜功能的影响 |
| 胡泊,肖婷,廖梦霏,陈西嘉,曾晓黎,易姝* |
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(重庆市人民医院眼科, 重庆 400016
*通信作者) |
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| 摘要: |
| 目的 探讨不同浓度与给药频率的阿托品滴眼液对儿童近视患者瞳孔直径、调节幅度及泪膜功能的影响。方法 选择 2018 年 1 月至 2021 年 1 月我院接诊的 280 例近视儿童的左眼数据进行研究。采用随机信封法将患儿分为 4 组(A、B、C、D 组),每组 70 例(70 眼)。A 组患儿给予 0.01 % 阿托品滴眼液每晚睡前滴眼 1 次(双眼),B 组给予 0.01 % 阿托品滴眼液隔天晚上睡前滴眼 1 次(双眼), C 组给予 0.02 % 阿托品滴眼液每晚睡前滴眼 1 次(双眼), D 组给予 0.02 % 阿托品滴眼液隔天晚上睡前滴眼 1 次(双眼),每次 1 滴。比较 4 组患儿用药前及用药后 4、8、12个月的瞳孔直径、调节幅度、等效球镜度、眼轴长度、前房深度、泪膜功能及不良反应发生情况。结果 用药前,4 组患儿的瞳孔直径、调节幅度、等效球镜度、眼轴长度、前房深度、泪膜脂质层厚度差异均无统计学意义(均 P>0.05)。4 组患儿用药前后瞳孔直径、调节幅度、等效球镜度、眼轴长度、前房深度、泪膜脂质层厚度比较差异均无统计学意义(均 P组间>0.05),各组用药前后不同时间点瞳孔直径、调节幅度、等效球镜度、眼轴长度、前房深度、泪膜脂质层厚度的变化趋势相同(均 P时间>0.05)。4 组患儿在用药后各时间点瞳孔直径、等效球镜度均大于用药前,调节幅度均小于用药前(均 P<0.01);在用药后 4、8 个月时各组眼轴长度与用药前相比差异均无统计学意义(均 P>0.05),用药后 12 个月时各组眼轴长度均大于用药前(均 P<0.05);各组前房深度、泪膜脂质层厚度用药前后比较差异均无统计学意义(均 P>0.05)。各时间点瞳孔直径、调节幅度、等效球镜度、眼轴长度、前房深度、泪膜脂质层厚度组间比较差异均无统计学意义(均 P>0.05),且不同疗法与用药时间无交互作用(均 P 交互>0.05)。用药后 1 个月内, 4 组均有部分患儿出现畏强光症状,按意向性分析(ITT)统计分别为 A 组 12 例(17.14 %)、B 组11 例(15.71 %)、C 组 16 例(22.86 %)和 D 组 13 例(18.57 %),组间比较差异无统计学意义(P>0.05);按符合方案分析(PP)统计分别为 A 组 12 例(18.18 %)、B 组 10 例(15.62 %)、C 组 14 例(20.90 %)和 D 组 11 例(16.42 %),组间比较差异无统计学意义(P>0.05)。还有部分患儿在用药 1 个月内出现近视阅读模糊症状,按 ITT 统计分别为A 组 7 例(10.00 %)、B 组 4 例(5.71 %)、C 组 6 例(8.57 %)和 D 组 8 例(11.43 %),组间比较差异无统计学意义(P>0.05);按 PP 统计分别为 A 组 5 例(7.58 %)、B 组 3 例(4.69 %)、C 组 6 例(8.96 %)和 D 组 5 例(7.46 %),组间比较差异无统计学意义(P>0.05)。结论 质量分数为 0.01 %、0.02 % 的阿托品滴眼液每日点眼与隔日点眼对近视儿童的瞳孔直径、调节幅度、等效球镜度的影响趋势一致,且用药后不良反应发生情况无明显差异。 |
| 关键词: 阿托品 浓度 给药频率 儿童 近视 |
| DOI：10.16781/j.CN31-2187/R.20230291 |
| 投稿时间：2023-05-25修订日期：2023-10-09 |
| 基金项目:重庆市卫生和计划生育委员会科研计划项目(2016MSXM070). |
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| Effects of atropine eye drops of different concentrations and administration frequencies on pupil diameter, accommodative amplitude, and tear film function in myopic children |
| HU Bo,XIAO Ting,LIAO Mengfei,CHEN Xijia,ZENG Xiaoli,YI Shu* |
(Department of Ophthalmology, Chongqing General Hospital, Chongqing 400016, China
*Corresponding author) |
| Abstract: |
| Objective To investigate the effects of atropine eye drops of different concentrations and administration frequencies on pupil diameter, accommodative amplitude, and tear film function in myopic children. Methods The left eye data of 280 myopic children who were treated in our hospital from Jan. 2018 to Jan. 2021 were selected. The randomized envelope method was used to divide the patients into 4 groups (groups A, B, C, and D), with 70 cases (70 eyes) in each group. Patients in the group A were given 0.01 % atropine eye drops every night at bedtime (both eyes); patients in the group B were given 0.01 % atropine eye drops every other night at bedtime (both eyes); patients in the group C were given 0.02 % atropine eye drops every night at bedtime (both eyes); patients in the group D were given 0.02 % atropine eye drops every other night at bedtime (both eyes); and all of them were given 1 drop each time per eye. The pupil diameter, accommodative amplitude, equivalent spherical diopter, axial length, anterior chamber depth, tear film function, and adverse reactions of the 4 groups of patients were compared before and 4, 8, and 12 months after treatment. Results Before treatment, there were no significant differences in pupil diameter, accommodative amplitude, equivalent spherical diopter, axial length, anterior chamber depth, or tear film lipid layer thickness between the 4 groups (all P>0.05). There were no significant differences in pupil diameter, accommodative amplitude, equivalent spherical diopter, axial length, anterior chamber depth, or lipid layer thickness before and after treatment between the 4 groups (all Pgroup>0.05). The change trends of pupil diameter, accommodative amplitude, equivalent spherical diopter, axial length, anterior chamber depth and tear film lipid layer thickness at different time points before and after treatment were the same in each group (all Ptime>0.05). At each time point after administration, the pupil diameter and equivalent spherical diopter were significantly greater than those before administration, and the accommodative amplitude was significantly less than that before administration (all P<0.01). At 4 and 8 months after administration there was no significant difference in the axial length of each group compared with that before administration (all P>0.05), but at 12 months after administration the axial length of each group was significantly greater than that before administration (all P<0.05); and there were no significant differences in anterior chamber depth or tear film lipid layer thickness before and after administration in each group (all P>0.05). There were no significant differences in pupil diameter, accommodative amplitude, equivalent spherical diopter, axial length, anterior chamber depth, or tear film lipid layer thickness at each time point between the groups (all P>0.05), and there was no interaction between different treatments and administration time points (all Pinteraction>0.05). Within 1 month after treatment, some children were afraid of strong light; according to intention to treat analysis (ITT), there were 12 (17.14 %) cases in the group A, 11 (15.71 %) in the group B, 16 (22.86 %) in the group C, and 13 (18.57 %) in the group D, with no significant difference (P>0.05); according to per-protocol analysis (PP), there were 12 (18.18 %) cases in the group A, 10 (15.62 %) in the group B, 14 (20.90 %) in the group C, and 11 (16.42 %) in the group D, with no significant difference (P>0.05). There were also some myopic children with blur of close-up reading within 1 month after treatment; according to ITT, there were 7 (10.00 %) cases in the group A, 4 (5.71 %) in the group B, 6 (8.57 %) in the group C, and 8 (11.43 %) in the group D, with no significant difference (P>0.05); according to PP, there were 5 (7.58 %) cases in the group A, 3 (4.69 %) in the group B, 6 (8.96 %) in the group C, and 5 (7.46 %) in the group D, with no significant difference (P>0.05). Conclusion Daily or every other day eye drops of 0.01 % or 0.02 % atropine have the same effects on pupil diameter, accommodative amplitude and equivalent spherical diopter of myopic children, and there was no significant difference in adverse reactions. |
| Key words: atropine concentration administration frequency children myopia |
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