Value of adding 0.01% atropine with orthokeratology for myopia in children: an updated meta-analysis of randomized controlled trials.

IF 2.1 3区 医学 Q2 PEDIATRICS
Frontiers in Pediatrics Pub Date : 2025-06-03 eCollection Date: 2025-01-01 DOI:10.3389/fped.2025.1571790
Shudan Tu, Huangfang Ying, Liyang Ni, Zilong Zhang, Weiping Hu
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引用次数: 0

Abstract

Background: This systematic review and meta-analysis aimed to compare outcomes of 0.01% atropine with orthokeratology (AOK) vs. orthokeratology (OK) alone for slowing the progression of myopia in children.

Methods: MEDLINE via PubMed, Embase, Scopus, Web of Science, CENTRAL (Cochrane Central Register of Controlled Trials), Chinese electronic databases of VIP, and Wanfang were searched from inception until 19th August 2024 for randomized controlled trials (RCTs) about the review topic. The primary outcome was a change in axial length (AL) (mm). Secondary outcomes were spherical equivalent refraction (SER) (Diopter), pupil diameter (PD) (mm), amplitude of accommodation (AA) (Diopter), and intraocular pressure (IOP) (mmHg).

Results: 10 articles corresponding to eight RCTs were included. Meta-analysis found that change in AL was significantly reduced with AOK as compared to OK alone at 6 months (MD: -0.10 95% CI: -0.14, -0.06 I2 = 48%), 12 months (MD: -0.08 95% CI: -0.10, -0.07 I2 = 0%) and 24 months (MD: -0.14 95% CI: -0.19, -0.08 I2 = 0%). Pooled analysis found that AOK did not reduce the progression of SER (MD: 0.06 95% CI: -0.00, 0.12 I2 = 7%) and increased PD (MD: 0.63 95% CI: 0.40, 0.85 I2 = 86%) as compared to OK alone. Pooled analysis also found a tendency of reduced AA with AOK as compared to OK alone but without significant results (MD: -0.45 95% CI: -1.00, 0.10 I2 = 59%). Meta-analysis failed to show a statistically significant difference in change of IOP between AOK and OK (MD: -0.49 95% CI: -1.48, 0.50 I2 = 51%).

Conclusions: AOK seems to be more efficacious in slowing the progression of myopia in children as compared to OK alone.

0.01%阿托品加角膜塑形镜治疗儿童近视的价值:一项随机对照试验的最新荟萃分析
背景:本系统综述和荟萃分析旨在比较0.01%阿托品联合角膜塑形术(AOK)与单独角膜塑形术(OK)对减缓儿童近视进展的效果。方法:检索MEDLINE,检索PubMed、Embase、Scopus、Web of Science、CENTRAL (Cochrane CENTRAL Register of Controlled Trials)、VIP中文电子数据库和万方数据库,检索自建库至2024年8月19日期间与综述主题相关的随机对照试验(RCTs)。主要终点是轴向长度(AL) (mm)的变化。次要结果是球面等效屈光度(SER) (Diopter)、瞳孔直径(PD) (mm)、调节幅度(AA) (Diopter)和眼压(IOP) (mmHg)。结果:纳入10篇文章,对应8项rct。荟萃分析发现,在6个月(MD: -0.10 95% CI: -0.14, -0.06 I2 = 48%)、12个月(MD: -0.08 95% CI: -0.10, -0.07 I2 = 0%)和24个月(MD: -0.14 95% CI: -0.19, -0.08 I2 = 0%)时,AOK与单独OK相比,AL的变化显著减少。合并分析发现,与单独使用OK相比,AOK并没有减少SER的进展(MD: 0.06 95% CI: -0.00, 0.12 I2 = 7%),也没有增加PD (MD: 0.63 95% CI: 0.40, 0.85 I2 = 86%)。合并分析还发现,与单独的OK相比,AOK有降低AA的趋势,但没有显著结果(MD: -0.45 95% CI: -1.00, 0.10 I2 = 59%)。meta分析未显示AOK组和OK组IOP变化有统计学意义(MD: -0.49 95% CI: -1.48, 0.50 I2 = 51%)。结论:与单独使用AOK相比,AOK在减缓儿童近视进展方面似乎更有效。
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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来源期刊
Frontiers in Pediatrics
Frontiers in Pediatrics Medicine-Pediatrics, Perinatology and Child Health
CiteScore
3.60
自引率
7.70%
发文量
2132
审稿时长
14 weeks
期刊介绍: Frontiers in Pediatrics (Impact Factor 2.33) publishes rigorously peer-reviewed research broadly across the field, from basic to clinical research that meets ongoing challenges in pediatric patient care and child health. Field Chief Editors Arjan Te Pas at Leiden University and Michael L. Moritz at the Children''s Hospital of Pittsburgh are supported by an outstanding Editorial Board of international experts. This multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide. Frontiers in Pediatrics also features Research Topics, Frontiers special theme-focused issues managed by Guest Associate Editors, addressing important areas in pediatrics. In this fashion, Frontiers serves as an outlet to publish the broadest aspects of pediatrics in both basic and clinical research, including high-quality reviews, case reports, editorials and commentaries related to all aspects of pediatrics.
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