Abstract: Objective To analyze the variability of axial length(AL) growth in children wearing orthokeratology(OK lenses) and single-vision spectacles(SV) during online classes compared to normal school attendance, in order to provide reference for the prevention and treatment of myopia. Methods A retrospective study was conducted in children wearing OK lenses(Lucid) and SV for more than one year during their regular check-ups at Ruijin Hospital from November 2021 to January 2023. AL data of the OK lenses group were retrieved at five check-ups: 3 months before the start of the online classes, before the start of the online classes, at the end of the online classes, 3 months after the end of the online classes, and at 6 months after the end of the online classes. AL of the four durations were recorded as AL₁, AL₂, AL₃, and AL₄, respectively. The control group was composed of children wearing SV matched by age, gender, and spherical equivalent. Differences in AL and annual mean AL growth between the two groups during the online classes and in normal classes were compared, and the data were analyzed by the Kruskal-Wallis and Mann-Whitney test. Results A total of 100 eyes of 51 children in the OK lenses group and 71 eyes of 36 children in the SV group were included in the analysis. In the OK lenses group, the median values of AL₁, AL₂, AL₃, and AL₄ were 0.04, 0.09, 0.06mm, and 0.04mm, respectively. The mean AL annual growth rates in the OK lenses group(D_AL2) was0.20,0.39,0.25mm/y和0.19mm/y, respectively, and the difference was statistically significant(H=37.190,27.970,P<0.001). The D_AL2 was 10.57, 13.69, 5.63(10^-4 mm) in the three age groups(≤10, 11~12, and ≥13 years old), respectively, with a statistically significant difference(P<0.001). Conclusion During the period of blocked online classes, the AL of children wearing OK lenses grows faster than usual, and the younger the age, the faster the growth.

Key words: myopia, orthokeratology, axial length, online classes, outdoor time

摘要： 目的 观察分析佩戴角膜塑形镜(OK镜)和单光框架眼镜的儿童在密集网络授课期间与正常上学时的眼轴增长差异性,为近视防控提供依据。方法 本研究为回顾性分析研究。收集2021年11月—2023年1月在上海交通大学医学院附属瑞金医院定期复查一年以上佩戴OK镜(Lucid)以及单光框架眼镜的儿童,OK镜组记录其网课开始前3个月、网课开始前、网课结束时、网课结束后3个月以及网课结束后6个月的5次复查时的眼轴(AL),比较其四个阶段的眼轴增长量AL₁、AL₂、AL₃和AL₄。同时收集年龄、性别、等效球镜相匹配的佩戴框架眼镜组儿童做对照组,比较两组在网课期间与平时上课时眼轴增长量及年平均眼轴增长速率的差异,数据比较采用Kruskal-Wallis 和Mann-Whitney检验。结果 OK镜组共51名儿童的100只眼纳入分析,框架组共36名儿童71只眼纳入分析。OK镜组AL₁、AL₂、AL₃和 AL₄中位数分别为0.04、0.09、0.06mm和0.04mm,四组间差异有统计学意义(H=37.190,P＜0.001);四阶段眼轴增长速率中位数分别为0.20、0.39、0.25mm/年和0.19mm/年,差异有统计学意义(H=27.970,P＜0.001)。OK镜组网课期间的平均每日眼轴增长量D_AL2在三个年龄组(≤10、11~12、≥13岁)中的中位数分别是10.57、13.69、5.63(10^-4mm),差异有统计学意义(P<0.001)。结论 上网课期间,即使佩戴OK镜的儿童眼轴增长也较平时更快,且年龄越小增长越快。

关键词: 近视, 角膜塑形镜, 眼轴, 网课, 户外时间