目的:评价不同浓度阿托品滴眼液对儿童近视控制的效果。
方法:我们基于随机对照试验(RCT)进行了贝叶斯随机效应网络荟萃分析。主要结果包括球面等效误差(SER)的变化和轴向长度(AL)的变化,采用平均差(MD)和95%可信间期(CrI)评价疗效.
结果:28项RCTs(6608名儿童)纳入本综述。比较十种阿托品滴眼液(0.0025%,0.005%,0.01%,0.02%,0.025%,0.05%,0.1%,0.25%,0.5%和1%浓度)与安慰剂,SER变化的MD和95%CrIs为-0.006(-0.269,0.256)D,0.216(-0.078,0.508)D,0.146(0.094,0.199)D,0.167(0.039,0.297)D,0.201(0.064,0.341)D,0.344(0.251,0.440)D,0.255(0.114,0.396)D,0.296(0.140,0.452)D,0.331(0.215,0.447)D,和0.286(0.195,0.337)D,分别。AL变化的MD和95%CrIs为-0.048(-0.182,0.085)mm,-0.078(-0.222,0.066)mm,-0.095(-0.130,-0.060)mm,-0.096(-0.183,-0.009)mm,-0.083(-0.164,-0.004)mm,-0.114(-0.176,-0.056)mm,-0.134(-0.198,-0.032)mm,-0.174(-0.315,-0.061)mm,-0.184(-0.291,-0.073)mm,和-0.171(-0.203,-0.097)mm,分别。无论是由SER还是AL评估,1%浓度居功效首位,但是畏光的风险是0.01%浓度的17倍。
结论:0.01%或更高浓度的阿托品滴眼液可有效控制近视,而0.0025%和0.005%的浓度可能不会。随着浓度的增加,效果趋于增加,1%的浓度可能具有最强的效果。
OBJECTIVE: To estimate the effect of
atropine eyedrops at different concentrations for myopia control in children.
METHODS: We conducted a Bayesian random-effects network meta-analysis based on randomized controlled trials (RCT). Primary outcomes include changes in spherical equivalent error (SER) and changes in axial length (AL), mean difference (MD) together with 95% credible interval (CrI) were used to evaluate the efficacy.
RESULTS: 28 RCTs (6608 children) were included in this
review. Comparing ten
atropine eyedrops (0.0025%, 0.005%, 0.01%, 0.02%, 0.025%, 0.05%, 0.1%, 0.25%, 0.5% and 1% concentrations) with the placebo, the MDs and 95%CrIs of changes in SER are -0.006 (-0.269, 0.256) D, 0.216 (-0.078, 0.508) D, 0.146 (0.094, 0.199) D, 0.167 (0.039, 0.297) D, 0.201 (0.064, 0.341) D, 0.344 (0.251, 0.440) D, 0.255 (0.114, 0.396) D, 0.296 (0.140, 0.452) D, 0.331 (0.215, 0.447) D, and 0.286 (0.195, 0.337) D, respectively. The MDs and 95%CrIs of changes in AL are -0.048 (-0.182, 0.085) mm, -0.078 (-0.222, 0.066) mm, -0.095 (-0.130, -0.060) mm, -0.096 (-0.183, -0.009) mm, -0.083 (-0.164, -0.004) mm, -0.114 (-0.176, -0.056) mm, -0.134 (-0.198, -0.032) mm, -0.174 (-0.315, -0.061) mm, -0.184 (-0.291, -0.073) mm, and -0.171 (-0.203, -0.097) mm, respectively.Whether evaluated by SER or AL, 1% concentration ranks first in efficacy, but the risk of photophobia is 17 times higher than 0.01% concentration.
CONCLUSIONS: 0.01% or higher concentration
atropine eyedrops are effective for myopia control, while 0.0025% and 0.005% concentrations may not. As the concentration increases, the effect tends to increase, 1% concentration may have the strongest effect.