#61
|
|||
|
|||
Öèòàòà:
 46 ñîîáùåíèè ññûëêè ÷èòàëè? À ýòè [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] è [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] Âîâñå íå ïî 20 äåòåé.. Âîïðîñ â òîì, êàê îïðåäåëèòü òî÷íîñòü îïðåäåëåíèÿ àìåòðîïèè. Ñ ïîìîùüþ êàêîé öèêëîïëåãèè è ò.ä. Ïðåèìóùåñòâåííî êðàòêî - ðàçíèöû â òîì áóäåò ïîëíîé èëè óìåíüøåííîé êîððåêöèÿ ïðè ìèîïèè íåò. Äîêàçàí ýôôåêò àòðîïèíà è áèôîêàëüíîé êîððåêöèè. Ïîäáèðàÿ êîððåêöèþ è óìåíüøàÿ åå - ïðåâðàùàåì ýòó êîððåêöèþ â "î÷êè äëÿ îôèñà/ñðåäíåé äèñòàíöèè". Ê íèì øêîëüíèê ïðèâûêíåò åùå áûñòðåå è áóäåò ïîëüçîâàòüñÿ èìè äëÿ "êîìíàòû-òåëåâèçîðà...ïîòîì äëÿ êîìïüþòåðà, ñî âðåìåíåì äëÿ ÷òåíèÿ", à âîâñå íå äëÿ äàëè. Òàê êàê â íèõ åìó âñå ðàâíî âèäíî íå ÷åòêî. Êñòàòè, íå íàäî äóìàòü, ÷òî âñå ñ ðóññêèõ èñòî÷íèêàõ ïðèçûâàþò ê "óìåíüøåíèþ". Âû ðàáîòû Â.È.Ïîñïåëîâà ÷èòàëè? |
#62
|
|||
|
|||
Öèòàòà:
|
#63
|
|||
|
|||
Íîâûå äàííûå èññëåäîâàíèé:
[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] Very-Low-Dose Atropine Drops Slow Myopia Progression in Children Ïîä î÷åíü íèçêîé äîçîé àòðîïèíà ïîíèìàåòñÿ 0,01% â êàïëÿõ íà íî÷ü. |
#64
|
||||
|
||||
Àáñòðàêò ïåðâîèñòî÷íèêà:
Journal of Ocular Pharmacology and Therapeutics The Long-Term Results of Using Low-Concentration Atropine Eye Drops for Controlling Myopia Progression in Schoolchildren -------------------------------------------------------------------------------- To cite this article: Pei-Chang Wu, Yi-Hsin Yang, and Po-Chiung Fang. Journal of Ocular Pharmacology and Therapeutics. October 2011, 27(5): 461-466. doi:10.1089/jop.2011.0027. -------------------------------------------------------------------------------- Published in Volume: 27 Issue 5: October 19, 2011 Online Ahead of Print: August 4, 2011 -------------------------------------------------------------------------------- Full Text: • HTML • PDF for printing (150.1 KB) • PDF w/ links (140.2 KB) Pei-Chang Wu,1 Yi-Hsin Yang,2 and Po-Chiung Fang1 1Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan. 2Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. Address correspondence to: Dr. Po-Chiung Fang Department of Ophthalmology Chang Gung Memorial Hospital-Kaohsiung Medical Center 123, Dapi Rd. Niaosong Dist. Kaohsiung City 83342 Taiwan (R.O.C.) E-mail: [Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] Received: February 12, 2011 Accepted: June 29, 2011 Abstract Purpose: The purpose of this article was to evaluate the long-term efficacy of a low-concentration (LC) atropine eye drop regimen (0.05%–0.1%) for controlling myopia progression in schoolchildren. Methods: This retrospective, case–control study enrolled myopic schoolchildren who had been followed-up for at least 3 years from 1999 to 2007. Children who received LC doses of atropine eye drops [initial prescription 0.05%, if progression over −0.5 diopter (D) during a 6-month follow-up then changed to 0.1% atropine] every night at bedtime were included in the LC atropine group, and untreated children served as controls. Results: A total of 117 children were included in this study. The mean age was 8.4 years. There were 97 children in the LC atropine group and 20 children in the control group. The mean follow-up duration was 4.5 years. In a mixed model analysis, the adjusted myopia progression in the LC atropine group was −0.23 D/year, significantly lower than that of the control group, which was −0.86 D/year (P<0.001). About 80% of the treatment group had slow myopia progression (less than −0.5 D progression per year). In a multivariate analysis, factors such as initial spherical refraction with less myopia and treatment with LC atropine were significantly associated with less myopia progression, but age, sex, and initial astigmatism were not significantly associated (P<0.001, P<0.001, P=0.442, 0.494, and 0.547, respectively). Conclusion: The results of this study demonstrate that long-term and regular instillation of LC atropine eye drops is effective for controlling myopia progression and provides a possible strategy for an initial myopia regimen. Abstract Purpose: The purpose of this article was to evaluate the long-term efficacy of a low-concentration (LC) atropine eye drop regimen (0.05%-0.1%) for controlling myopia progression in schoolchildren. Methods: This retrospective, case-control study enrolled myopic schoolchildren who had been followed-up for at least 3 years from 1999 to 2007. Children who received LC doses of atropine eye drops [initial prescription 0.05%, if progression over -0.5 diopter (D) during a 6-month follow-up then changed to 0.1% atropine] every night at bedtime were included in the LC atropine group, and untreated children served as controls. Results: A total of 117 children were included in this study. The mean age was 8.4 years. There were 97 children in the LC atropine group and 20 children in the control group. The mean follow-up duration was 4.5 years. In a mixed model analysis, the adjusted myopia progression in the LC atropine group was -0.23 D/year, significantly lower than that of the control group, which was -0.86 D/year (P<0.001). About 80% of the treatment group had slow myopia progression (less than -0.5 D progression per year). In a multivariate analysis, factors such as initial spherical refraction with less myopia and treatment with LC atropine were significantly associated with less myopia progression, but age, sex, and initial astigmatism were not significantly associated (P<0.001, P<0.001, P=0.442, 0.494, and 0.547, respectively). Conclusion: The results of this study demonstrate that long-term and regular instillation of LC atropine eye drops is effective for controlling myopia progression and provides a possible strategy for an initial myopia regimen. |
#65
|
||||
|
||||
Ðîäñòâåííàÿ ñòàòüÿ:
Ophthalmology In Press, Corrected Proof - Note to users -------------------------------------------------------------------------------- doi:10.1016/j.ophtha.2011.07.031 | How to Cite or Link Using DOI Permissions & Reprints Regular article Atropine for the Treatment of Childhood Myopia: Safety and Efficacy of 0.5%, 0.1%, and 0.01% Doses (Atropine for the Treatment of Myopia 2) Audrey Chia FRANZCO1, 2, Wei-Han Chua FRCSEd(Ophth), FAMS1, 2, Yin-Bun Cheung PhD3, 4, Wan-Ling Wong Mbiostat2, Anushia Lingham SRN4, Allan Fong FRCSEd(Ophth)1, 2, Donald Tan FRCS, FRCOphth1, 2, 5, , Purchase 1 Singapore National Eye Center, Singapore 2 Singapore Eye Research Institute, Singapore 3 Duke-NUS Graduate Medical School, Singapore 4 Singapore Clinical Research Institute, Singapore 5 Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore Received 5 April 2011; revised 20 July 2011; Accepted 20 July 2011. Available online: •••.. Available online 1 October 2011. Purpose Our previous study, Atropine for the Treatment of Myopia 1 (ATOM1), showed that atropine 1% eyedrops were effective in controlling myopic progression but with visual side effects resulting from cycloplegia and mydriasis. The aim of this study was to compare efficacy and visual side effects of 3 lower doses of atropine: 0.5%, 0.1%, and 0.01%. Design Single-center, double-masked, randomized study. Participants A total of 400 children aged 6–12 years with myopia of at least −2.0 diopters (D) and astigmatism of −1.50 D or less. Intervention Children were randomly assigned in a 2:2:1 ratio to 0.5%, 0.1%, and 0.01% atropine to be administered once nightly to both eyes for 2 years. Cycloplegic refraction, axial length, accommodation amplitude, pupil diameter, and visual acuity were noted at baseline, 2 weeks, and then every 4 months for 2 years. Main Outcome Measures Myopia progression at 2 years. Changes were noted and differences between groups were compared using the Huber–White robust standard error to allow for data clustering of 2 eyes per person. Results The mean myopia progression at 2 years was −0.30±0.60, −0.38±0.60, and −0.49±0.63 D in the atropine 0.5%, 0.1%, and 0.01% groups, respectively (P=0.02 between the 0.01% and 0.5% groups; between other concentrations P > 0.05). In comparison, myopia progression in ATOM1 was −1.20±0.69 D in the placebo group and −0.28±0.92 D in the atropine 1% group. The mean increase in axial length was 0.27±0.25, 0.28±0.28, and 0.41±0.32 mm in the 0.5%, 0.1%, and 0.01% groups, respectively (P < 0.01 between the 0.01% and 0.1% groups and between the 0.01% and 0.5% groups). However, differences in myopia progression (0.19 D) and axial length change (0.14 mm) between groups were small and clinically insignificant. Atropine 0.01% had a negligible effect on accommodation and pupil size, and no effect on near visual acuity. Allergic conjunctivitis and dermatitis were the most common adverse effect noted, with 16 cases in the 0.1% and 0.5% atropine groups, and no cases in the 0.01% group. |
#66
|
||||
|
||||
Åù¸ ñòàòüÿ èç BJO, 2008 ãîäà, îäíà èç ïÿò¸ðêè ñàìûõ öèòèðóåìûõ ñòàòåé BJO, ïîëíûé òåêñò, êîãî èíòåðåñóåò áëèçîðóêîñòü. Èíòåðåñíûé àáçàö Discussion (ðàçìûøëåíèÿ, ñêàæåì òàê) ñ ïîäîçðåíèåì íà òî, ÷òî èãðàåò ðîëü è ultraviolet radiation exposure, â òîì ÷èñëå.
[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] |
#67
|
||||
|
||||
Îíè ñêàòÿòñÿ ïîòîì â èòîãå äî 0,001... È âäðóã âûÿñíÿò, ÷òî âèíîâàò íå àòðîïèí. Íàäî òîëüêî ïîäîæäàòü.
|
#68
|
||||
|
||||
Öèòàòà:
mean myopia progression at 2 years was −0.30D - 0.5%, −0.38 - 0.1%, and −0.49 - 0.01% .................................................. −1.20±0.69 D in the placebo group(ATOMI) |
#69
|
|||
|
|||
Ðàçìåùó ññûëêó íà äàííûå ïî îòäàëåííûì ðåçóëüòàòàì èñïîëüçîâàíèÿ àòðîïèíà ïðè ìèîïèè. Àòî, ÷èòàþùèå ïàöèåíòû ÷àñòî èíòåðåñóþòñÿ.
[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] |
#70
|
|||
|
|||
|
#71
|
|||
|
|||
Äà ïðîöåíò íå èçâåñòåí, äëÿ ìåíÿ çäåñü âàæíûì ïîêàçàëñÿ òîò ôàêò, ÷òî ýôôåêò ñòàáèëüíûé è íå îòìå÷àåòñÿ ñèëüíîãî ïðîãðåññèðîâàíèÿ ìèîïèè ïîñëå.  ýòîì ïëàíå, äëÿ ìåíÿ , ýòî áîðüáà ñî ñëóõàìè, ò.ê. íåò, íåò , äà è ïðîñêàêèâàþò òàêèå óòâåðæäåíèÿ.
ÏÎ ïîâîäó êîíöåíòðàöèè, æäåì ðåçóëüòàòîâ èññëåäîâàíèé ñâåðõìàëûõ äîç. Èññëåäîâàíèÿ àíîíñèðîâàíû Æäåì |
#72
|
||||
|
||||
 òîæå âðåìÿ:
Ophthalmology. 2009 Mar;116(3):572-9. Epub 2009 Jan 22. Atropine for the treatment of childhood myopia: effect on myopia progression after cessation of atropine. CONCLUSIONS: After stopping treatment, eyes treated with atropine demonstrated higher rates of myopia progression compared with eyes treated with placebo. However, the absolute myopia progression after 3 years was significantly lower in the atropine group compared with placebo. Íó è Àâåòèñîâ, ïðèâîäÿùèé â ïðèìåð Ãðóáåðà: Öèòàòà:
|
#73
|
|||
|
|||
Ñïàñèáî çà èíòåðåñíûé ìàòåðèàë
Õî÷åòñÿ îòìåòèòü, ÷òî àòðîïèíèçàöèÿ ïðîâîäèëàñü òîëüêî äâà ãîäà è ïîòîì çàêîí÷èëàñü ñ ìàêñèìàëüíûì âîçðàñòîì ñàìîãî ñòàðøåãî ðåáåíêà 12 ëåò ( ìèíèìàëüíûé 6) , ÷òî, îáû÷íî íå ïëàíèðóåòñÿ ïðè íàçíà÷åíèè äëèòåëüíîé àòðîïèíèçàöèè. Ó àçèàòîâ ïî ìíåíèþ íåêîòîðûõ èñëåäîâàòåëåé ( ïîèùó ññûëêè, åñëè áóäåò ñïðîñ) ìèîïèÿ ðàñòåò áûñòðåå, ÷åì ó åâðîïåéöåâ. Íàñêîëüêî âåðíî îöåíèâàòü ðîñò ìèîïèè â èñêóññòâåííî ñîçäàííûõ óñëîâèÿõ àíèçîìåòðîïèè? ( èññëåäîâàíèÿ ïðîâîäèëèñü íà îäíîì ãëàçó). Ñîîòâåòñòâåííî , îäèí ãëàç îòëè÷àëñÿ îò äðóãîãî ïî çàâåðøåíèè èññëåäîâàíèÿ. Îòñþäà, äëÿ ìåíÿ åùå îäèí âîïðîñ âîçíèêàåò, îòâåò íà êîòîðûé ÿ íå çíàþ. Åñëè êîíðîëü ðîñòà ãëàçà îñóùåñòâëÿåòñÿ íà óðîâíå âçàèìîäåéñòâèÿ ñåò÷òàòêè è ñêëåðû, òî ïî÷åìó â áîëüøèíñòâå ñëó÷àåâ ìû èìååì ïðèìåðíî îäèíàêîâóþ ìèîïèþ íà îáîèõ ãëàçàõ ( ÷èñòî âåðîÿòíîñòíî ìèîïèÿ ìîãëà áû ðàñòè î÷åíü ðàçíîîáðàçíî). Ò.å. íàñêîëüêî áîëåå âûñîêàÿ ìèîïèÿ íà îäíîì ãëàçó , ìîæåò ïîäñòåãèâàòü òîò ( ÷åðåç àêêîìîäàöèþ èëè åùå ÷åãî íå çíàþ), íà êîòîðîì ìèîïèÿ ìåíüøå. È íå ìîæåò ëè ýòî áûòü ïðè÷èíîé áîëåå áûñòðîãî ðîñòà ìèîïèè â äàííîì ñëó÷àå, âåäü ïî èññëåäîâàíèÿì íà îáîèõ ãëàçàõ ìíîãèå ïèøóò, ÷òî ýôôåêò ñòàáèëåí. |
#74
|
||||
|
||||
Öèòàòà:
Myopia progression at 2 years. Changes were noted and differences between groups were compared using the Huber-White robust standard error to allow for data clustering of 2 eyes per person. Íå çíàþ, íàñêîëüêî ýòî êðóòîå ðåøåíèå, íî ïî-âèäèìîìó äîïóñòèìîå) |
#75
|
|||
|
|||
Ôðàãìåíò îáçîðà "Àíàëèç ìåòîäîâ ñòàáèëèçàöèè áëèçîðóêîñòè îñíîâàííûõ íà äîêàçàòåëüñòâàõ"
Ïðåäñòàâëÿåò áîëüøîé èíòåðåñ êàê äàëüøå áóäåò âåñòè ñåáÿ ìèîïèÿ ïîñëå ïðåêðàùåíèÿ ëå÷åíèÿ àòðîïèíîì. Òàêèå èññëåäîâàíèÿ áûëè ïðîâåäåíû â Ñèíãàïóðå Tong L. et al., â 2009 ãîäó. Ïî äèçàéíó ýòî áûëî ðàíäîìèçèðîâàííîå äâîéíîå ñëåïîå ïëàöåáî êîíòðîëèðóåìîå èññëåäîâàíèå ó 400 äåòåé, êîòîðûì â òå÷åíèå 2 ëåò çàêàïûâàëè àòðîïèí 1% îäíîêðàòíî íà íî÷ü. Öåëü: îöåíèòü ñòåïåíü ïðîãðåññèðîâàíèÿ ìèîïèè ïîñëå ïðåêðàùåíèÿ ëå÷åíèÿ. Íàáëþäåíèå çà äåòüìè ïðîâîäèëîñü â òå÷åíèå 1 ãîäà ïîñëå ïðåêðàùåíèÿ ëå÷åíèÿ ìèîïèè àòðîïèíîì. Ðåçóëüòàòû: ïîñëå ïðåêðàùåíèÿ èñïîëüçîâàíèÿ àòðîïèíà ñðåäíÿÿ ñòåïåíü ïðîãðåññèðîâàíèÿ â òå÷åíèå ãîäà ñîñòàâèëà -1,14±0,8 Ä, òîãäà êàê â ãëàçàõ äåòåé ïîëó÷àâøèõ ïëàöåáî ïðîãðåññèðîâàíèå ñîñòàâèëî -0,38±0,39 (Ð<0,0001). Îäíàêî â öåëîì ïîñëå 3 ëåò ó÷àñòèÿ â èñïûòàíèè (ñ 2 ãîäàìè ëå÷åíèÿ àòðîïèíîì) â ãëàçàõ äåòåé, ïîëó÷àâøèõ àòðîïèí, ñòåïåíü ìèîïèè áûëà ñóùåñòâåííî íèæå, ÷åì â ãëàçàõ äåòåé, ïîëó÷àâøèõ ïëàöåáî -4,29±1,67 è -5,22±1,38 ñîîòâåòñòâåííî (Ð<0,0001). Àâòîðû ïðèøëè ê çàêëþ÷åíèþ, ÷òî ïîñëå ïðåêðàùåíèÿ ëå÷åíèÿ ìèîïèÿ áûñòðåå ïðîãðåññèðîâàëà íà ãëàçàõ äåòåé ïîëó÷àâøèõ àòðîïèí îòíîñèòåëüíî ïëàöåáî. Îäíàêî àáñîëþòíàÿ ïðîãðåññèÿ áëèçîðóêîñòè ïîñëå 3 ëåò áûëà çíà÷èòåëüíî íèæå â ãðóïïå àòðîïèíà ïî ñðàâíåíèþ ñ ïëàöåáî [118]. |