COVID-19 대유행이 아트로핀 점안 소아 환자의 근시 진행 속도에 미치는 영향
Effect of COVID-19 Pandemic on Myopia Progression in Pediatric Patients Treated with Atropine Eyedrops
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목적: 아트로핀 약물 치료를 시행하는 소아 근시 환자에서 COVID-19 대유행이 아트로핀 치료 효과에 미치는 영향에 대해 연구하였다. 대상과 방법: 근시로 저농도 아트로핀(atropine sulfate 0.01%) 점안 치료를 시행하는 소아 환자들의 12개월간 의무기록을 후향적으로분석하였다. 2013년 7월부터 2020년 1월 사이 아트로핀 약물 치료를 시작하여 12개월 이상 시행한 군과 2020년 2월부터 2021년 7월사이 아트로핀 약물 치료를 시작하여 12개월 이상 시행한 군을 비교하였다. 저농도 아트로핀을 매일 1회 점안하도록 하며 치료 시작시, 12개월 후 우안의 안축장 및 구면렌즈대응치를 측정하였다. 결과: 72명의 환자 중 COVID-19 대유행 이전 아트로핀 치료 시행군(A군)은 34명, 이후 아트로핀 치료 시행군(B군)은 38명이었다. 12개월 동안 저농도 아트로핀 점안 후 굴절이상 변화는 A군에서 -0.58 ± 0.47 diopters (D), B군에서 -0.84 ± 0.56 D (p-value=0.045) 로 두 군 간 유의미한 차이를 보였다. 안축장 변화는 아트로핀 점안 12개월 차에 A군에서 0.30 ± 0.23 mm, B군에서 0.50 ± 0.31 mm로증가하였다(p-value=0.011). 결론: COVID-19 대유행 이후 근시 진행 억제를 위한 저농도 아트로핀 점안 치료 효과가 감소하였다.
Abstract
Purpose: We investigated the impact of the COVID-19 pandemic on myopia progression in pediatric patients who received low-dose atropine (0.01%) eye drops. Methods: We retrospectively analyzed the medical records of pediatric patients who received ≥ 12 months of low-dose atropine (atropine sulfate 0.01%) eye drops for myopia. The beginning of the COVID-19 pandemic was defined as February 2020. Patients were divided into two groups for comparative analysis. Patients in group A received low-dose atropine for ≥ 12 months between July 2013 and January 2020, whereas patients in group B received low-dose atropine between February 2020 and July 2021; atropine eye drops were administered once daily. The spherical equivalent and axial length of the right eye were measured at the initiation of treatment and after 12 months. Results: Among the 72 patients, 34 in group A received low-dose atropine before the COVID-19 pandemic, whereas 38 in group B received low-dose atropine after the COVID-19 pandemic. After 12 months of treatment with low-dose atropine eye drops, the changes in spherical equivalent were -0.58 ± 0.47 diopters (D) in group A and -0.84 ± 0.56 D in group B (p = 0.045). Moreover, the changes in axial length were 0.30 ± 0.23 mm in group A and 0.50 ± 0.31 mm in group B (p = 0.011). Conclusions: The efficacy of low-dose atropine eye drops in pediatric myopia patients has decreased since the beginning of the COVID-19 pandemic.
참고문헌 (18)
- He M, "Effect of time spent outdoors at school on the development of myopia among children in China : a randomized clinical trial", JAMA, 314, pp.1142~1148 (2015)
- Lingham G, "How does spending time outdoors protect against myopia? A review", Br J Ophthalmol, 104, pp.593~599 (2020)
- Huang HM, "The association between near work activities and myopia in children-a systematic review and meta-analysis", PLoS One, 10, pp.e0140419~ (2015)
- Wen L, "Objectively measured near work, outdoor exposure and myopia in children", Br J Ophthalmol, 104, pp.1542~1547 (2020)
- Huang J, "Efficacy comparison of 16 interventions for myopia control in children : a network meta-analysis", Ophthalmology, 123, pp.697~708 (2016)
- Lam CS, "Myopia control effect of defocus incorporated multiple segments(DIMS)spectacle lens in Chinese children : results of a 3-year follow-up study", Br J Ophthalmol, 106, pp.1110~1114 (2022)
- Bao J, "One-year myopia control efficacy of spectacle lenses with aspherical lenslets", Br J Ophthalmol, 106, pp.1171~1176 (2022)
- Morens DM, "Escaping Pandora's box-another novel coronavirus", N Engl J Med, 382, pp.1293~1295 (2020)
- Yum HR, "Influence of coronavirus disease 2019on myopic progression in children treated with low-concentration atropine", PLoS One, 16, pp.e0257480~ (2021)
- Lin Z, "The influence of near work on myopic refractive change in urban students in Beijing : a three-year follow-up report", Graefes Arch Clin Exp Ophthalmol, 254, pp.2247~2255 (2016)
- Sherwin JC, "The association between time spent outdoors and myopia in children and adolescents : a systematic review and meta-analysis", Ophthalmology, 119, pp.2141~2151 (2012)
- Pawar N, "COVID-19 myopia, myopia of pandemic : are we heading towards unpredictable high myopic era?", Indian J Ophthalmol, 70, pp.3158~3160 (2022)
- Wang J, "Progression of myopia in schoolaged children after COVID-19 home confinement", JAMA Ophthalmol, 139, pp.293~300 (2021)
- Young FA, "The nature and control of myopia", J Am Optom Assoc, 48, pp.451~457 (1977)
- Coleman DJ, "Unified model for accommodative mechanism", Am J Ophthalmol, 69, pp.1063~1079 (1970)
- Wang IJ, "The effect of intravitreal injection of atropine on the proliferation of scleral chondrocyte in vivo", J Ocul Pharmacol Ther, 14, pp.337~343 (1998)
- Lind GJ, "Muscarinic acetylcholine receptor antagonists inhibit chick scleral chondrocytes", Invest Ophthalmol Vis Sci, 39, pp.2217~2231 (1998)
- Upadhyay A, "Biological mechanisms of atropine control of myopia", Eye Contact Lens, 46, pp.129~135 (2020)