【摘要】 目的 探讨使用角膜塑形镜(OK镜)联合低浓度阿托品的患者不同用眼行为对控制眼轴长度增长效果的影响。方法 队列研究，纳入了2018年10月～2021年7月在北京大学人民医院眼视光中心配戴OK镜且使用低浓度阿托品的5～13岁儿童青少年85例(170眼)，收集其1年内不同用眼行为相关信息。将近距离用眼时间≥7 h/d、网课时间≥1.5 h/d、电子产品时间≥1.5 h/d、单次最长用眼时间≥2 h/d归为不良用眼行为。将每个受试者的不良用眼行为进行计数，范围是0～4，进一步将其划分为≥2个不良用眼行为和≤1个不良用眼行为，采用线性回归模型评估用眼行为与眼轴长度增长之间的关联。结果 以左眼眼轴长度变化为例，在4种单一用眼行为中，拥有良好用眼行为的患者眼轴长度增长较慢，尤其是与单次用眼最长时间≥1.5 h/d相比，<1.5 h/d的患者在第3个月眼轴长度增长相对减少0.071 mm(β=-0.071, P=0.034)。综合用眼≤1种不良行为的患者，1年后眼轴长度增长相对减少0.184 mm(β=-0.184, P=0.025)。结论 良好的用眼行为对于使用OK镜联合低浓度阿托品控制眼轴长度增长的患者有积极影响，其中单次用眼时长对于眼轴长度增长的影响最大，多个不良用眼行为综合累积效应比单个行为更强。更多还原

【Abstract】 Objective To investigate the effect of different eye using behaviors on the control of axial length growth in patients using orthokeratology(Ortho-K) lens in combination with low concentration atropine. Methods This study was a cohort study. A total of 85 children and adolescents aged 5-13 years(170eyes) who wore Ortho-K lens and used low-concentration atropine in the Optometry Center of Peking University People’s Hospital from October 2018 to July 2021 were enrolled, and collected information on different eye using behaviors within one year. According to the average daily near work hours, online classes hours, electronic product usage hours, and single longest eye-using hours, the near work hours ≥7 hours/day; online classes hours ≥1.5 hours/day; electronic product usage hours ≥1.5 hours/day; single longest eye-using hours ≥2hours/day were classified as poor eye using behavior. To evaluate the cumulative effect of multiple eye using behaviors, we counted the number of negative eye using behaviors for each participant, with a range of 0 to 4,and further divided them into ≥2 poor eye using behaviors and ≤1 poor eye using behavior. Linear regression model was used to evaluate the association between eye using behavior and axial length growth, and other factors such as age, sex, parental myopia, and baseline axial length were considered. Results The changes of axial length of both eyes were similar in different eye using behaviors. Taking left eye axial length change as an example, among the 4 types of eye using behaviors, patients with good eye using behavior had slower axial length growth. Especially those with <1.5 hours/day showed a relative decrease in axial length growth of 0.071mm(β=-0.071, P=0.034) in the 3rd month compared to those with single longest eye-using time≥1.5hours/day. Patients with a synthetical eye using of ≤1 poor eye using behavior had a relative decrease in axial length growth of 0.184mm(β=-0.184, P=0.025) after 1 year. Conclusions Good eye using behaviors could have a positive impact on patients using Ortho-K lens in combination with low concentration atropine to control the progression of myopia. The single longest eye-using hours had the greatest impact on axial length control,and the cumulative effect of multiple eye using behaviors was stronger than that of a single behavior. Therefore,it is important to maintain healthy eye habits in addition to using Ortho-K lens combined with low concentration atropine to control myopia progression.更多还原