각막굴절교정학용 렌즈가 소아의 근시 진행에 미치는 영향
Effect of Orthokeratologic Lenses on Myopic Progression in Childhood
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초록
목적: 각막굴절교정학용 렌즈와 소아의 근시 진행의 관련성을 분석하고, 근시 진행에 영향을 미치는 인자에 대해 알아보고자 한다. 대상과 방법: 각막굴절교정학용 렌즈를 1년 이상 착용한 31안에서 착용 2주, 6개월, 12개월 후 현성굴절력검사로 구면렌즈대응치를 측정했다. 성별, 나이, 초기 구면렌즈대응치를 맞추어 동일한 수의 대조군을 정했다. 결과: 구면렌즈대응치 변화량을 착용 후 2주-6개월(-0.17 ± 0.50D), 6개월-1년(-0.04 ± 0.76D), 2주-1년(-0.21 ± 0.78D)으로 나눈후 대조군(-0.38 ± 0.42D, -0.44 ± 0.38D, -0.82 ± 0.68D)과 비교하면 6개월-1년, 2주-1년 간의 변화량이 차이를 보였다(p＜0.05). 환자군의 1년간 구면렌즈대응치의 변화량을 -0.5디옵터를 기준으로 두 군으로 나눈 후 초기 검사 결과를 비교하면 각막윤부직경이유의한 차이가 있었고, 구면렌즈대응치의 변화량과 각막윤부직경 사이에 유의한 상관관계가 있었다(Pearson’s r=-0.471, p＜0.05). 결론: 근시 진행이 대조군에 비해 각막굴절교정학용 렌즈 착용군에서 느렸다. 각막윤부직경이 작을수록 근시 진행이 느릴 수 있음을확인하였다.
Abstract
Purpose: The present study assessed the influence of overnight orthokeratology (ortho-k) on the myopic progression in Korean children and analyzed factors affecting myopic progression. Methods: The ortho-k group was comprised of 31 patients satisfying the inclusion criteria for ortho-k. In the ortho-k group,spherical equivalent refractive error (SER) was measured at baseline, and after 2 weeks, 6 and 12 months. The control group was comprised of 31 patients who were matched according to age, gender, and baseline SER of the ortho-k subjects. Results: In the ortho-k group, the mean ± SD changes in SER from 2 weeks to 6 months, 6 to 12 months, and 2 weeks to 12 months were -0.17 ± 0.50 D, -0.04 ± 0.76 D, and -0.21 ± 0.78 D, respectively. In the control group, the changes in SER from baseline to 6 months, 6 to 12 months, and baseline to 12 months were -0.38 ± 0.42 D, -0.44 ± 0.38 D, and -0.82 ± 0.68D, respectively. Significant differences were found between changes in SER from 6 to 12 months and from baseline to 12months (p < 0.05). In the ortho-k group, relationships between the changes of SER for 1 year and the numeric values of baseline measurements were analyzed. When comparing the results between the group of SER change ≥ -0.5 D with the group of SER change < -0.5 D, numeric values of white-to-white diameters of the 2 groups were different, and a significant correlation was found between the range of SER change and the white-to-white diameter (Pearson’s r = -0.471, p = 0.008). Conclusions: Ortho-k is effective for slowing myopic progression. The smaller the white-to-white diameter, the slower the myopic progression could be.
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