Additive Effect of Highly Aspherical Lenslet Target Spectacles to Children Inadequately Controlled by Atropine Monotherapy

IF 3.2 Q1 OPHTHALMOLOGY

Ophthalmology science Pub Date : 2025-02-26 DOI:10.1016/j.xops.2025.100753

Bryan Xiangrong Sim MMed, FRCOphth , Kai Lyn Loh MMed, FAMS , Hla Myint Htoon PhD , Yudah Sri , Maithily Balakrishnan , Pauline Chan Poh Lin , Ralene Zi Hui Sim MMed, FRCOphth , Crystal Shue Wen Lam BSc , Audrey Wei Lin Chia PhD, FRANZCO

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引用次数: 0

Abstract

Purpose

Myopia progression in children, especially in East Asia, is a significant public health concern. This study evaluated the efficacy of combining myopia control spectacle lenses with Highly Aspherical Lenslet Target (HALT) technology and atropine in children who continued to progress on low-dose atropine (LDA).

Design

Prospective cohort.

Subjects

Children aged 6–11 years with ≥0.5 diopters (D) myopia progression over 6 months on LDA (0.01% or 0.025%) were recruited.

Methods

All participants used HALT (Essilor Stellest) spectacle lenses while maintaining their LDA dose. The changes in spherical equivalent (SE) and axial length (AL) were tracked for 6 months before and 6–12 months after starting combination treatment.

Main Outcome Measures

Progression of SE and AL.

Results

Fifty children (mean age 8.9 ± 1.1 years) were separated into group A (on 0.01% atropine daily, n20) and group B (on 0.01% atropine twice daily, n5 and 0.025% atropine nightly, n25). Most (86%) were ethnic Chinese. The baseline SE and AL showed no significant intergroup differences, with prior myopia progression (0.60D/0.24 mm) over 6 months. After adding HALT lenses, progression slowed to −0.06D/0.06 mm at 6 months and −0.15D/0.14 mm at 12 months. A hyperopic shift in AL was seen in 11 children (24%). However, the progression of >0.5D was noted in 20%, with 18% and 40% progressing by >0.3 mm and >0.15 mm, respectively. Univariate analysis suggested that children who progressed >0.10 mm over 6 months were more likely to be younger, whereas multivariate analysis suggested that change in AL was associated with smaller pupil size (possibly from poor compliance or absorption of atropine) at 6 months and younger age at 12 months, after controlling for sex, race, and baseline SE and AL. There were no complaints of glare, near, or peripheral blur in children after starting combination treatment.

Conclusions

The addition of HALT spectacle lenses significantly reduced myopia progression in children, aged 6–11 years, who were poorly controlled on LDA alone demonstrating a potential synergistic effect with LDA. These findings supported combination therapy for managing challenging myopia cases.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

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目的儿童近视的发展是一个重大的公共卫生问题，尤其是在东亚地区。本研究评估了在使用低剂量阿托品（LDA）后近视度数继续加深的儿童中，将高非球面小镜靶点（HALT）技术的近视控制眼镜片与阿托品相结合的疗效。方法所有参与者在保持 LDA 剂量不变的情况下使用 HALT（依视路 Stellest）眼镜片。结果50名儿童（平均年龄8.9 ± 1.1岁）被分为A组（每天服用0.01%阿托品，20人）和B组（每天两次服用0.01%阿托品，5人；每晚服用0.025%阿托品，25人）。大多数（86%）为华裔。基线SE和AL在组间无明显差异，6个月内近视度数有所加深（0.60D/0.24 mm）。添加 HALT 镜片后，近视度数在 6 个月和 12 个月分别减缓至-0.06D/0.06 mm 和-0.15D/0.14 mm。11名儿童（24%）出现了AL远视偏移。然而，有20%的儿童视力下降了0.5D，分别有18%和40%的儿童视力下降了0.3毫米和0.15毫米。单变量分析表明，6个月内瞳距增加0.10毫米的儿童年龄更小，而多变量分析表明，在控制了性别、种族、基线SE和瞳距后，6个月时瞳距的变化与瞳孔变小（可能是由于顺应性差或阿托品的吸收）和12个月时年龄更小有关。结论对于单用 LDA 控制不佳的 6-11 岁儿童，添加 HALT 镜片可显著降低近视度数的加深，这表明 HALT 镜片与 LDA 有潜在的协同作用。这些发现支持将联合疗法用于管理具有挑战性的近视病例。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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