l Introduction
Myopia is now recognized as a common condition with prevalence levels in young adolescents.
近視在現代被認為是種常見的流行疾病，在西方和東亞的工業化社會中以青少年近視率來說就分別占10%~25%及60%~80%。
Recent studies have reported orthokeratology contact lens wear to significantly reduce axial length growth by 30% to 50% in comparison to spectacle and soft contact lens wear.
最近有研究指出用角膜塑型片控制近視比起用眼鏡或隱形眼鏡可以顯著的減少30%~50%的眼軸長增加
l Purpose.
To examine which baseline measurements constitute predictive factors for axial length growth over 2 years in children wearing orthokeratology contact lenses (OK) and single-vision spectacles (SV).
檢驗配戴兩年OK及單光眼鏡的兒童身上於參與研究前有哪些因素會影響眼軸的增長。
l Methods.
This study was part of the MCOS study designed to assess the safety, efficacy and subjective acceptance of OK versus SV in White European children with myopia over a 2-year period.
這項研究是西班牙(MSCO)中的一項研究，MSCO是設計來評估有近視兩年以上的歐洲白人兒童配戴角膜塑型片和單光眼鏡的安全性、有效性及主觀的接受程度
In brief, normal, healthy white European subjects 6 to 12 years of age with moderate levels of myopia (-0.75 to -4.00D) and astigmatism (≦1.00D) and free of systemic or ocular disease were recruited for the study and prospectively assigned to wear OK or SV.
受試者的條件為正常、健康的、年齡為6~12歲的歐洲白人兒童、中度近視(度數約為-0.75D~-4.00D)和散光度數小於-1.00D、沒有任何全身性或眼睛疾病
SV group: Subjects were prescribed for constant wear distance single-vision spectacles having the highest positive/least negative power consistent with optimum visual acuity.
在SV組的受試者都必須持續配戴以最少近視度數矯正到最好視力的單光眼鏡
OK group:Subjects were fitted with Menicon Z Night contact lenses using Easy Fit Software.
OK配戴隱形眼鏡都是用Easy fit 軟體驗配Menicon Z的夜戴型鏡片
After initial enrolment, subjects were followed at 1, 6, 12, 18, and 24month intervals. Follow-up visits were scheduled to fall within 2 hours of awakening.
開始配戴後的第 1、6、12、18、24個月的時候起床後的兩小時內定期回診
A decrease in one line of visual acuity accompanied by a change in subjective refraction at any of the follow-up visits was considered clinically significant and was remedied by supplying contact lenses or spectacles made to the new prescription.
之後經過驗光檢查假如受試者視力下降≧一行，研究人員會再另外給予受試者正確的處方及符合規定鏡片
l Conclusions
利用角膜塑型片來控制眼軸變長在這些次變量中相較於配戴眼鏡是一個成功的治療選項
尤其是在
1. 年紀較大的兒童(Figure.1 十歲以上的兒童)
2. 較早被診斷有近視的兒童
3. 女生
4. 近視度數加深得較慢的兒童
5. 近視度數較淺的兒童
6. 前房較深的兒童
7.角膜屈光度較大且角膜形狀較橢圓的兒童
8.虹膜與瞳孔大小較大的兒童
9.父母近視度數少的兒童。
Orthokeratology is a successful treatment option in controlling axial elongation compared to SV in children of older age, had earlier onset of myopia, were female, had lower rate of myopia progression before baseline, had lower myopia at baseline, had longer anterior chamber depth, had greater corneal power, had more prolate corneal shape, had larger iris and pupil diameters, and had lower levels of parental myopia.
l 心得
這篇研究讓我知道原來眼軸長的變化與那麼多影響因子有關，也讓我知道尤其是在年紀較大的兒童(Figure.1 十歲以上的兒童) 、女生、較早被診斷有近視的兒童、近視度數較淺、前房較深、角膜屈光度較大且角膜形狀較橢圓、虹膜與瞳孔大小較大、父母近視度數少的群組中利用角膜塑型片來控制眼軸變長在這些次變量中相較於配戴眼鏡的比較成功的。
雖然說這篇研究並沒有一個很好的結論，因為變因多，且data蒐集的數量少，但卻提供了我一個往後想做的研究的方向。
From Joyce
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