目的：观察三种不同干预方法对隐匿性近视儿童相关眼部生物学参数的影响，探究其对隐匿性近视儿童的不同控制作用。

方法：前瞻性队列同期对照试验研究。选取2021-12/2022-05在承德医学院附属医院眼科门诊初次诊断为隐匿性近视且未经过任何相应近视控制训练的患儿60例120眼。随机分为3组，A组20例40眼给予0.01%阿托品滴眼液，B组20例40眼接受翻转拍视力训练，C组20例40眼给予七叶洋地黄双苷滴眼液。随访12 mo，观察三组患儿初诊，干预后6、12 mo时等效球镜度数(SE)、眼轴长度(AL)、角膜曲率(CC)、调节灵敏度(AF)、黄斑区视网膜厚度的变化情况。

结果：干预后6 、12 mo，三组患儿AL、SE和AF较初诊有差异(均P<0.05)，干预后6 mo与12 mo比较均有差异(均P<0.05)，B组和C组SE和AF 均高于A组(均P<0.05)，干预前后CC比较无差异(均P>0.05)。三组患儿干预后6 、12 mo外环颞侧、鼻侧、下方、黄斑中心凹视网膜厚度与初诊比较均有差异(均P<0.05)，干预后6 mo与12 mo比较均有差异(均P<0.05)。三组患儿干预前后其余黄斑区视网膜厚度比较均无差异(均P>0.05)。

结论：0.01%阿托品滴眼液防控近视作用优于翻转拍视力训练及七叶洋地黄双苷滴眼液。应用0.01%阿托品滴眼液及接受翻转拍训练可延缓隐匿性近视的进展。

METHODS:Prospective cohort concurrent controls trials. A total of 60 cases(120 eyes)of children who were initially diagnosed as latent myopia and untreated previously at ophthalmology clinic of the Affiliated Hospital of Chengde Medical University from December 2021 to May 2022 were recruited. They were randomly divided into three groups, with 20 cases(40 eyes)in group A treated with 0.01% Atropine eye drops, 20 cases(40 eyes)in group B treated with vision training with a flip chart, and 20 cases(40 eyes)in group C treated with esculin and digitalis glycosides eye drops. They were followed-up for 12 mo, and the spherical equivalent(SE), axial length(AL), corneal curvature(CC), accommodative facility(AF), and macular retinal thickness of the three groups of children were compared at 6 and 12 mo post-intervention.

RESULTS:Significant statistical differences were found in AL, SE and AF of the three groups of children at 6 and 12 mo(all P<0.05), and there were significant differences between 6 and 12 mo after the intervention(all P<0.05). SE and AF in the group B and C were higher than those in the group A(all P<0.05). However, there were no significant differences in CC before and after the intervention(all P>0.05). The retinal thickness of the temporal, nasal, inferior and macular fovea of the outer ring at 6 and 12 mo after intervention in the three groups was significantly different from that at the initial diagnosis(all P<0.05), and there was significant difference between 6 mo and 12 mo after intervention(all P<0.05). There was no significant difference in the retinal thickness of the other macular areas among the three groups before and after intervention(all P>0.05).

CONCLUSION:When it comes to preventing and controlling myopia, 0.01% Atropine is more effective than flip chart training and esculin and digitalis glycosides eye drops. Therefore, the administration of 0.01% atropine and the implementation of flip chart training can effectively slow down the advancement of latent myopia.