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ENGLISH ABSTRACT
离焦环大小及其与瞳孔直径的关系对近视患者配戴角膜塑形镜后眼轴增长的影响
于嘉
张晶
周跃华
袁晓辉
周其亮
李辰
作者及单位信息
·
DOI： 10.3760/cma.j.cn115989-20211214-00686
Effect of peripheral plus ring diameter and its relationship with pupil diameter on axial elongation in myopic patients after wearing orthokeratology lenses
Yu Jia
Zhang Jing
Zhou Yuehua
Yuan Xiaohui
Zhou Qiliang
Li Chen
Authors Info & Affiliations
Yu Jia
Eye School, Chengdu University of Traditional Chinese Medicine, Ineye Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
Zhang Jing
Eye School, Chengdu University of Traditional Chinese Medicine, Ineye Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
Beijing Ming Vision and Ophthalmology, Beijing 100062, China
Zhou Yuehua
Eye School, Chengdu University of Traditional Chinese Medicine, Ineye Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
Beijing Ming Vision and Ophthalmology, Beijing 100062, China
Yuan Xiaohui
Eye School, Chengdu University of Traditional Chinese Medicine, Ineye Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
Zhou Qiliang
Eye School, Chengdu University of Traditional Chinese Medicine, Ineye Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
Li Chen
Eye School, Chengdu University of Traditional Chinese Medicine, Ineye Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China
·
DOI： 10.3760/cma.j.cn115989-20211214-00686
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摘要

目的探讨近视患者配戴角膜塑形镜后离焦环大小及其与瞳孔直径(PD)的关系是否会影响眼轴长度(AL)增长速度。

方法采用病例对照研究方法，纳入2020年1—6月在北京茗视光眼科配戴角膜塑形镜的近视患者100例100眼，分别于戴镜前及戴镜后3、6、9和12个月采用光学生物测量仪测量眼轴长度(AL)和中央角膜厚度(CCT)，采用角膜地形图仪测量角膜陡峭曲率(Ks)和角膜平坦曲率(Kf)。根据配戴角膜塑形镜后1年角膜地形图差异图模式上离焦环直径(PPRD)与PD关系，将研究对象分为较大PPRD(LPPRD)组(PD<PPRD－0.9 mm)55眼和较小PPRD(SPPRD)组(PPRD－0.9 mm<PD<PPRD+0.9 mm)45眼。比较2个组患者配戴角膜塑形镜前后不同时间点各参数差异。

结果配戴角膜塑形镜后12个月，LPPRD组受检眼PPRD为(5.15±0.37)mm，明显大于SPPRD组的(4.75±0.32)mm，差异有统计学意义(t＝0.214，P<0.01)。LPPRD组戴镜后3、6、9和12个月AL增长量分别为(0.13±0.07)、(0.23±0.11)、(0.31±0.13)和(0.36±0.41)mm，SPPRD组分别为(0.06±0.05)、(0.11±0.06)、(0.14±0.07)、(0.17±0.08)mm，2个组受检眼配戴角膜塑形镜后不同时间点AL增长量总体比较，差异均有统计学意义(F分组＝30.527，P<0.01；F时间＝16.528，P<0.01)，其中SPPRD组戴镜后不同时间点AL增长量均小于LPPRD组，差异均有统计学意义(均P<0.01)。戴镜后3、6、9和12个月2个组受检眼Ks和Kf均较戴镜前明显降低，CCT均较戴镜前变薄，差异均有统计学意义(均P<0.01)。2个组间Ks、Kf、CCT总体比较，差异均无统计学意义(均P>0.05)。2个组患者戴镜前后不同时间点PD总体比较，差异均无统计学意义(F分组＝1.133，P＝0.293；F时间＝231.427，P＝0.112)。

结论离焦环大小及其与PD的关系是影响角膜塑形镜配戴后近视患者AL增长速度的主要原因之一，PPRD更小者AL增长更缓慢，近视控制效果更好。

近视;治疗;角膜塑形术;离焦环;眼轴长度;近视性离焦
ABSTRACT

ObjectiveTo investigate the effect of peripheral plus ring size and its potential associations with pupil diameter (PD) on axial length (AL) elongation in myopic patients after wearing orthokeratology lenses.

MethodsA case-control study was conducted.One hundred eyes from 100 myopic patients who underwent orthokeratolokgy lenses fitting were enrolled at Beijing Ming Vision and Ophthalmology from January to June 2020.AL and central corneal thickness (CCT) measurements were obtained using Lenstar LS900 ocular biometry, and steep keratometry (Ks), flat keratometry (Kf) were assessed using the TMS-4 corneal topographer.The patients were divided into larger peripheral plus ring diameter (LPPRD) group consisting of 55 eyes with PD<PPRD-0.9 mm and smaller PPRD (SPPRD) group consisting of 45 eyes with PPRD-0.9 mm <PD<PPRD+ 0.9 mm based on PPRD and PD sizes in the tangential difference map.Differences in the above parameters before and after wearing orthokeratology lenses were compared between the two groups.The study followed the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Ineye Hospital of Chengdu University of Traditional Chinese Medicine (No.2021yh-008). All the subjects and their guardians understood the purpose and method of the study and signed the informed consent voluntarily.

ResultsThe PPRD of LPPRD group was (5.15±0.37)mm 12 months after wearing orthokeratology lenses, which was significantly higher than (4.75±0.32)mm of SPPRD group (t=0.214, P<0.01). The elongation of AL at 3, 6, 9 and 12 months after wearing orthokeratology lenses were (0.13±0.07), (0.23±0.11), (0.31±0.13) and (0.36±0.41)mm in LPPRD group, and (0.06±0.05), (0.11±0.06), (0.14±0.07) and (0.17±0.08)mm in SPPRD group, respectively.There were significant differences in AL elongation at different time points after wearing orthokeratology lenses between the two groups (Fgroup=30.527, P<0.01; Ftime=16.528, P<0.01), and the AL elongation at different time points was smaller in SPPRD group than in LPPRD group, showing statistically significant differences (all at P<0.01). Compared to before wearing orthokeratology lenses, Ks and Kf were significantly smaller and CCT was thinner 3, 6, 9, and 12 months after wearing orthokeratology lenses in both groups (all at P<0.01). There was no significant difference in Ks, Kf, and CCT between the two groups (all at P>0.05). There was no significant difference in PD at different time points before and after wearing orthokeratology lenses between the two groups (Fgroup=1.133, P=0.293; Ftime=231.427, P=0.112).

ConclusionsThe size of peripheral plus ring and its relationship with PD are key factors influencing the AL elongation rate in myopic patients after wearing orthokeratology lenses.With smaller PPRD, patients have slower AL elongation and better myopia control.

Myopia;Therapy;Orthokeratologic procedures;Peripheral plus ring;Axial length;Myopia defocus
Zhou Yuehua, Email: mocdef.3ab6177663260HY
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引用本文

于嘉,张晶,周跃华,等. 离焦环大小及其与瞳孔直径的关系对近视患者配戴角膜塑形镜后眼轴增长的影响[J]. 中华实验眼科杂志,2023,41(08)：776-781.

DOI:10.3760/cma.j.cn115989-20211214-00686

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角膜塑形镜是一种利用反向几何学原理设计的特殊硬性透气性角膜接触镜，是目前临床上用于矫正近视性屈光不正的常用手段之一，可重塑角膜形态进而控制眼轴增长，达到近视防控的目的[ 1 , 2 ]。临床实践表明，配戴角膜塑形镜在延缓眼轴增长方面效果良好[ 3 , 4 , 5 ]，但控制效果存在个体差异，有研究者认为患者瞳孔直径(pupil diameter，PD)和戴镜后形成的离焦环大小是造成这种差异的重要因素之一[ 6 , 7 ]。角膜塑形镜偏心配戴对近视控制效果影响的研究证实，戴镜后治疗区偏心改变离焦环与瞳孔的相对位置关系，影响了进入眼内的有效离焦光线在视网膜周边形成近视离焦量的大小，从而对角膜塑形镜控制近视增长的效果产生影响，即通过影响离焦环在视网膜周边形成的近视离焦量大小从而影响角膜塑形镜对近视控制的效果[ 8 , 9 ]。最新研究表明，角膜塑形镜参数设计、近视程度可能会影响戴镜后形成离焦环的大小[ 10 ]。因此，根据患者戴镜后形成离焦环的大小和角膜生物力学特性调整角膜塑形镜参数对提高近视防控效果具有重要的临床意义。本研究拟分析自然光线下离焦环大小及其与瞳孔的不同位置关系对近视患者配戴角膜塑形镜后眼轴增长速度的影响，为临床上角膜塑形镜个性化验配提供参考依据。
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参考文献
[1]
Li X , Friedman IB , Medow NB ，et al. Update on orthokeratology in managing progressive myopia in children：efficacy，mechanisms，and concerns[J]．J Pediatr Ophthalmol Strabismus， 2017,54(3):142-148. DOI： 10.3928/01913913-20170106-01 .
返回引文位置Google Scholar
百度学术
万方数据
[2]
Villa-Collar C , Carracedo G , Chen Z ，et al. Overnight orthokeratology：technology，efficiency，safety，and myopia control[J/OL]．J Ophthalmol， 2019,2019:2607429[2022-12-05]．https://pubmed.ncbi.nlm.nih.gov/31089424/. DOI： 10.1155/2019/2607429 .
返回引文位置Google Scholar
百度学术
万方数据
[3]
Swarbrick HA . Orthokeratology (corneal refractive therapy)∶what is it and how does it work？[J]．Eye Contact Lens， 2004,30(4):181-185; 10.1097/01.icl.0000140221.41806.6e . DOI：.
返回引文位置Google Scholar
百度学术
万方数据
[4]
Charm J ．Orthokeratology：clinical utility and patient perspectives[J]．Clin Optom (Auckl)， 2017,9:33-40. DOI： 10.2147/OPTO.S104507 .
返回引文位置Google Scholar
百度学术
万方数据
[5]
Singh K , Bhattacharyya M , Goel A ，et al. Orthokeratology in moderate myopia：a study of predictability and safety[J]．J Ophthalmic Vis Res， 2020,15(2):210-217. DOI： 10.18502/jovr.v15i2.6739 .
返回引文位置Google Scholar
百度学术
万方数据
[6]
Zhu MJ , Ding L , Du LL ，et al. Photopic pupil size change in myopic orthokeratology and its influence on axial length elongation[J]．Int J Ophthalmol， 2022,15(8):1322-1330. DOI： 10.18240/ijo.2022.08.15 .
返回引文位置Google Scholar
百度学术
万方数据
[7]
Santodomingo-Rubido J , Villa-Collar C , Gilmartin B ，et al. Factors preventing myopia progression with orthokeratology correction[J]．Optom Vis Sci， 2013,90(11):1225-1236. DOI： 10.1097/OPX.0000000000000034 .
返回引文位置Google Scholar
百度学术
万方数据
[8]
Chu M , Zhao Y , Hu P ，et al. Is orthokeratology treatment zone decentration effective and safe in controlling myopic progression？[J]．Eye Contact Lens， 2023,49(4):147-151. DOI： 10.1097/ICL.0000000000000981 .
返回引文位置Google Scholar
百度学术
万方数据
[9]
Lin W , Li N , Gu T ，et al. The treatment zone size and its decentration influence axial elongation in children with orthokeratology treatment[J/OL]．BMC Ophthalmol， 2021,21(1):362[2022-12-06]．https://pubmed.ncbi.nlm.nih.gov/34641799/. DOI： 10.1186/s12886-021-02123-x .
返回引文位置Google Scholar
百度学术
万方数据
[10]
Gruhl J , Widmer F , Nagl A ，et al. Factors influencing treatment zone size in orthokeratology[J/OL]．Cont Lens Anterior Eye， 2023:101848[2023-06-05]．https://pubmed.ncbi.nlm.nih.gov/37137758/. DOI： 10.1016/j.clae.2023.101848 .
返回引文位置Google Scholar
百度学术
万方数据
[11]
Carracedo G , Espinosa-Vidal TM , Martínez-Alberquilla I ，et al. The topographical effect of optical zone diameter in orthokeratology contact lenses in high myopes[J/OL]．J Ophthalmol， 2019,2019:1082472[2022-12-07]．https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334375/. DOI： 10.1155/2019/1082472 .
返回引文位置Google Scholar
百度学术
万方数据
[12]
Pauné J , Fonts S , Rodríguez L ，et al. The role of back optic zone diameter in myopia control with orthokeratology lenses[J/OL]．J Clin Med， 2021,10(2):336[2022-12-06]．https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7831104/. DOI： 10.3390/jcm10020336 .
返回引文位置Google Scholar
百度学术
万方数据
[13]
Shin YI , Won YK , Shin KS ，et al. Effect of serous retinal detachment on the measurement of axial length in central serous chorioretinopathy[J]．Korean J Ophthalmol， 2019,33(1):63-69. DOI： 10.3341/kjo.2018.0032 .
返回引文位置Google Scholar
百度学术
万方数据
[14]
Hashimoto S , Yasuda M , Fujiwara K ，et al. Association between axial length and myopic maculopathy：the Hisayama study[J]．Ophthalmol Retina， 2019,3(10):867-873. DOI： 10.1016/j.oret.2019.04.023 .
返回引文位置Google Scholar
百度学术
万方数据
[15]
Wong TY , Ferreira A , Hughes R ，et al. Epidemiology and disease burden of pathologic myopia and myopic choroidal neovascularization：an evidence-based systematic review[J]．Am J Ophthalmol， 2014,157(1):9-25. DOI： 10.1016/j.ajo.2013.08.010 .
返回引文位置Google Scholar
百度学术
万方数据
[16]
Chan NS , Teo K , Cheung CM . Epidemiology and diagnosis of myopic choroidal neovascularization in Asia[J]．Eye Contact Lens， 2016,42(1):48-55. DOI： 10.1097/ICL.0000000000000201 .
返回引文位置Google Scholar
百度学术
万方数据
[17]
Cho P , Cheung SW , Edwards M ．The longitudinal orthokeratology research in children (LORIC) in Hong Kong：a pilot study on refractive changes and myopic control[J]．Curr Eye Res， 2005,30(1):71-80. DOI： 10.1080/02713680590907256 .
返回引文位置Google Scholar
百度学术
万方数据
[18]
Chen C , Cheung SW , Cho P ．Myopia control using toric orthokeratology (TO-SEE study)[J]．Invest Ophthalmol Vis Sci， 2013,54(10):6510-6517. DOI： 10.1167/iovs.13-12527 .
返回引文位置Google Scholar
百度学术
万方数据
[19]
Walline JJ , Jones LA , Sinnott LT . Corneal reshaping and myopia progression[J]．Br J Ophthalmol， 2009,93(9):1181-1185. DOI： 10.1136/bjo.2008.151365 .
返回引文位置Google Scholar
百度学术
万方数据
[20]
Kakita T , Hiraoka T , Oshika T ．Influence of overnight orthokeratology on axial elongation in childhood myopia[J]．Invest Ophthalmol Vis Sci， 2011,52(5):2170-2174. DOI： 10.1167/iovs.10-5485 .
返回引文位置Google Scholar
百度学术
万方数据
[21]
Hiraoka T , Kakita T , Okamoto F ，et al. Long-term effect of overnight orthokeratology on axial length elongation in childhood myopia：a 5-year follow-up study[J]．Invest Ophthalmol Vis Sci， 2012,53(7):3913-3919. DOI： 10.1167/iovs.11-8453 .
返回引文位置Google Scholar
百度学术
万方数据
[22]
Pauné J , Morales H , Armengol J ，et al. Myopia control with a novel peripheral gradient soft lens and orthokeratology：a 2-year clinical trial[J/OL]．Biomed Res Int， 2015,2015:507572[2022-12-08]．https://pubmed.ncbi.nlm.nih.gov/26605331/. DOI： 10.1155/2015/507572 .
返回引文位置Google Scholar
百度学术
万方数据
[23]
Huang Z , Zhao W , Mao YZ ，et al. Factors influencing axial elongation in myopic children using overnight orthokeratology[J/OL]．Sci Rep， 2023,13(1):7715[2023-06-05]．https://pubmed.ncbi.nlm.nih.gov/37173387/. DOI： 10.1038/s41598-023-34580-3 .
返回引文位置Google Scholar
百度学术
万方数据
[24]
Lam A , Hon Y , Leung S ，et al. Association between long-term orthokeratology responses and corneal biomechanics[J/OL]．Sci Rep， 2019,9(1):12566[2022-12-09]．https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6715748/. DOI： 10.1038/s41598-019-49041-z .
返回引文位置Google Scholar
百度学术
万方数据
[25]
Curatolo A , Birkenfeld JS , Martinez-Enriquez E ，et al. Multi-meridian corneal imaging of air-puff induced deformation for improved detection of biomechanical abnormalities[J]．Biomed Opt Express， 2020,11(11):6337-6355. DOI： 10.1364/BOE.402402 .
返回引文位置Google Scholar
百度学术
万方数据
[26]
Yu AY , Shao H , Pan A ，et al. Corneal biomechanical properties in myopic eyes evaluated via Scheimpflug imaging[J/OL]．BMC Ophthalmol， 2020,20(1):279[2022-12-09]．https://pubmed.ncbi.nlm.nih.gov/32652982/. DOI： 10.1186/s12886-020-01530-w .
返回引文位置Google Scholar
百度学术
万方数据
[27]
郭曦，谢培英．青少年近视眼患者配戴角膜塑形镜七年的角膜厚度和内皮观察[J]．中华眼科杂志， 2014,50(1):9-13. DOI： 10.3760/cma.j.issn.0412-4081.2014.01.004 .
返回引文位置Google Scholar
百度学术
万方数据
Guo X , Xie PY . Corneal thickness and endothelial observation for youth myopia patients fitted with ortho-k lens for seven years[J]．Chin J Ophthalmol， 2014,50(1):9-13. DOI： 10.3760/cma.j.issn.0412-4081.2014.01.004 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[28]
边思林，刘华，林江．近视儿童角膜塑形镜与框架眼镜配戴一年临床效果的随机对照研究[J]．中华实验眼科杂志， 2020,38(2):121-127. DOI： 10.3760/cma.j.issn.2095-0160.2020.02.008 .
返回引文位置Google Scholar
百度学术
万方数据
Bian SL , Liu H , Lin J ．A randomized-controlled clinical study of one-year outcome between orthokeratology contact lens wear and glasses wear in myopic children[J]．Chin J Exp Ophthalmol， 2020,38(2):121-127. DOI： 10.3760/cma.j.issn.2095-0160.2020.02.008 .
Goto CitationGoogle Scholar
Baidu Scholar
Wanfang Data
[29]
Queirós A , Lopes-Ferreira D , Yeoh B ，et al. Refractive，biometric and corneal topographic parameter changes during 12 months of orthokeratology[J]．Clin Exp Optom， 2020,103(4):454-462. DOI： 10.1111/cxo.12976 .
返回引文位置Google Scholar
百度学术
万方数据
[30]
Wan K , Yau HT , Cheung SW ，et al. Corneal thickness changes in myopic children during and after short-term orthokeratology lens wear[J]．Ophthalmic Physiol Opt， 2021,41(4):757-767. DOI： 10.1111/opo.12824 .
返回引文位置Google Scholar
百度学术
万方数据
[31]
Tan Q , Ng AL , Cheng GP ，et al. Repeatability of pupil size measurements with NIDEK OPD-Scan Ⅲ in myopic children[J]．Ophthalmic Physiol Opt， 2021,41(2):431-436. DOI： 10.1111/opo.12774 .
返回引文位置Google Scholar
百度学术
万方数据
备注信息
A
周跃华，Email：mocdef.3ab6177663260HY
B

于嘉：参与研究参数的测量、数据收集和分析、论文写作和修改；张晶、袁晓辉、周其亮、李辰：参与研究参数的测量、数据整理和论文修改；周跃华：参与选题、研究设计、研究实施、数据分析、论文智力性内容修改和定稿

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