Abstract Orthokeratology (OK) is widely used to slow the progression of myopia. Low-level laser therapy (LLLT) provides sufficient low energy to change the cellular function. This research is aimed at verifying the hypothesis that LLLT treatment could control myopia progression and comparing the abilities of OK lenses and LLLT to control the refractive error of myopia. Eighty-one children (81 eyes) who wore OK lenses, 74 children (74 eyes) who underwent LLLT treatment, and 74 children (74 eyes) who wore single-vision distance spectacles for 6 months were included. Changes in axial length (AL) were 0.23 ± 0.06 mm for children wearing spectacles, 0.06 ± 0.15 mm for children wearing OK lens, and -0.06 ± 0.15 mm for children treated with LLLT for 6 months. Changes in subfoveal choroidal thickness (SFChT) observed at the 6-month examination were -16.84 ± 7.85 μm, 14.98 ± 22.50 μm, and 35.30 ± 31.75 μm for the control group, OK group, and LLLT group, respectively. Increases in AL at 1 month and 6 months were significantly associated with age at LLLT treatment. Changes in AL were significantly correlated with the baseline spherical equivalent refraction (SER) and baseline AL in the OK and LLLT groups. Increases in SFChT at 1 month and 6 months were positively associated with age at enrolment for children wearing OK lens. At 6 months, axial elongation had decelerated in OK lens-wearers and LLLT-treated children. Slightly better myopia control was observed with LLLT treatment than with overnight OK lens-wearing. Evaluations of age, SER, and AL can enhance screening for high-risk myopia, improve the myopia prognosis, and help determine suitable control methods yielding the most benefits.
Purpose To assess the efficacy and safety of repeated low-level red-light (RLRL) therapy in myopia control in children. Design Multicenter, randomized, parallel-group, single-blind clinical trial. Participants Two hundred sixty-four eligible children 8 to 13 years of age with myopia of cycloplegic spherical equivalent refraction (SER) of –1.00 to –5.00 diopters (D), astigmatism of 2.50 D or less, anisometropia of 1.50 D or less, and best-corrected visual acuity (BCVA) of 0.0 logarithm of the minimum angle of resolution or more were enrolled in July and August 2019. Follow-up was completed in September 2020. Methods Children were assigned randomly to the intervention group (RLRL treatment plus single-vision spectacle [SVS]) and the control group (SVS). The RLRL treatment was provided by a desktop light therapy device that emits red light of 650-nm wavelength at an illuminance level of approximately 1600 lux and a power of 0.29 mW for a 4-mm pupil (class I classification) and was administered at home under supervision of parents for 3 minutes per session, twice daily with a minimum interval of 4 hours, 5 days per week. Main Outcome Measures The primary outcome and a key secondary outcome were changes in axial length and SER measured at baseline and the 1-, 3-, 6-, and 12-month follow-up visits. Participants who had at least 1 postrandomization follow-up visit were analyzed for treatment efficacy based on a longitudinal mixed model. Results Among 264 randomized participants, 246 children (93.2%) were included in the analysis (117 in the RLRL group and 129 in the SVS group). Adjusted 12-month axial elongation and SER progression were 0.13 mm (95% confidence interval [CI], 0.09–0.17mm) and –0.20 D (95% CI, –0.29 to –0.11D) for RLRL treatment and 0.38 mm (95% CI, 0.34–0.42 mm) and –0.79 D (95% CI, –0.88 to –0.69 D) for SVS treatment. The differences in axial elongation and SER progression were 0.26 mm (95% CI, 0.20–0.31 mm) and –0.59D (95% CI, –0.72 to –0.46 D) between the RLRL and SVS groups. No severe adverse events (sudden vision loss ≥2 lines or scotoma), functional visual loss indicated by BCVA, or structural damage seen on OCT scans were observed. Conclusions Repeated low-level red-light therapy is a promising alternative treatment for myopia control in children with good user acceptability and no documented functional or structural damage.
目的 观察650nm红光对青少年近视进展的影响。方法 随机对照研究。在临沂市人民医院就诊的患者中，连续人选7~12岁近视患者120例(120只眼),双眼纳入研究过程，统一选取右眼数据进行分析，分为红光组60例(60只眼)和对照组60例(60只眼)。红光组采用单波长650nm红光进行防控干预,非干预时间佩戴单焦点框架眼镜，对照组佩戴单焦点框架眼镜进行日常活动。观察并比较干预前和干预后的1、3、6、12个月患者的等效球镜度(SE)、眼轴长度(AL)后极部黄斑中心凹下的脉络膜厚度(SFCT)及裸眼视力(UCVA)。采用重复测量方差分析、独立样本检验对数据进行统计学分析。结果 与干预前相比，干预13、6、12个月后,红光组SE基本保持稳定，对照组逐渐增大,两组比较差异均有统计学意义(均P<0.05);干预1、3、6、12个月后,红光组AL缩短并逐渐趋于稳定，对照组AL延长,两组比较均差异有统计学意义(均P<0.05);干预1、3.6、12个月后,红光组SFCT逐渐趋于稳定，对照组SFCT变薄，两组比较差异均有统计学意义(均P<0.05);干预1、3.6、12个月后,红光组UCVA基本保持稳定,对照组UCVA逐渐下降,两组比较差异均有统计学意义(均P<0.05)。干预后红光组未出现畏光、流泪、结膜充血、水肿、角膜上皮损伤、晶状体混浊、黄斑损害等眼部并发症，亦未发现认知障碍及行为异常。结果 650nm红光可有效延缓青少年近视进展，未见明显不良反应。
目的 观察650nm半导体激光(功率2mW)照射以视锥细胞为主的鸡视网膜后是否存在慢性光损伤，探讨该波段激光对视网膜的安全性。方法 采用随机数字表法将60只自然光线下饲养1个月的小鸡分为正常对照组、照射3-min组、照射6-min组和照射30-min组，每组15只。采用650 nm激光并按照分组不同各组小鸡双眼每日接受不同时间的激光照射。分别于激光照射后1个月(2月龄鸡)3个月(4月龄鸡)和6个月(7月龄鸡)各组任选5只进行活体光相干断层扫描(OCT)检查，测定鸡的相对视网膜面积；采用过量麻醉法处死并制备视网膜切片，行苏木精-伊红染色和TUNEL染色，分别观察各组鸡视网膜面积变化和视细胞凋亡情况；实验眼制备视网膜匀浆，分别采用TBA法和NBT法检测鸡视网膜中丙二醛质量摩尔浓度和超氧化物歧化酶(SOD)比活性;采用Western blot法检测鸡视网膜中L/M视蛋白和视紫红质蛋白的表达。结果 2月龄时鸡照射30-min组视网膜中丙二醛质量摩尔浓度高于正常对照组，差异有统计学意义(P<0.05),4月龄时激光照射6-min组和照射30-min组丙二醛质量摩尔浓度均高于正常对照组，差异均有统计学意义(P=0.026.0.003),7月龄时所有激光照射组鸡视网膜中丙二醛质量摩尔浓度均高于正常对照组，差异均有统计学意义(P=0.038、0.032、<0.01)。7月龄时激光照射30-min组鸡视网膜中 SOD比活性和视紫红质蛋白相对表达量均低于正常对照组[S0D:(140.20±5.99)(nmol/s·mg)与(160.57+3.13) (nmol/s·mg);视紫红质蛋白:0.392+0.065与0.566+0.072],差异均有统计学意义(均P<0.05)。0CT检查显示,照射3-min组、照射6-min组和照射30-min组6个月内鸡视网膜相对面积及形态与正常对照组相比无明显差别;组织病理学检查显示各照射组鸡视网膜厚度均接近正常对照组，TUNEL染色显示各组鸡视网膜细胞排列整齐，未发现TUNEL阳性染色细胞。结论 实验鸡眼接受650nm半导体激光照射时，用2mW的功率每日照射6min持续6个月不引起明显光损伤;每日照射30min持续6个月引起视网膜中自由基含量增高和视紫红质减少，提示存在光损伤。
目的：观察艾尔兴哺光仪对青少年、儿童近视的防控效果。方法：将2017年3月~2018年3月我科收治的近视少年、儿重按年龄段分为3-8岁组和9-15岁组。在3-8岁组里接受艾尔兴哺光仪治疗的近视患者30例(60只眼)作为3-8岁组治疗组；未接受艾尔兴哺光仪治疗的近视患者30例(60只眼)作为3-8岁组对照组。在9-15岁组里接受艾尔兴哺光仪治疗的近视患者30例(60只眼)作为3-8岁组治疗组;未接受艾尔兴哺光仪治疗的近视患者30例(60只眼)作为3-8岁组对照组。分别训练和观察半年后，对治疗效果进行比较。结果：半年后，3-8岁组中：治疗组屈光度平均增长0.05D，眼轴平均增长0.06mm；对照组屈光度平均增长0.87D，眼轴平均增长0.30mm；9-15岁组中：治疗组屈光度平均减少0.16D，眼轴平均减少0.02mm；对照组屈光度平均增长0.73D，眼轴平均增加 0.2mm。组间及组内比较，差异均有统计学意义，P<0.05。结论：使用艾尔兴哺光仪是控制青少年，儿童近视的有效方法。
目的：探讨650nm半导体激光照射豚鼠视网膜后的细胞损伤情况。方法：根据650nm半导体激光照射功率(2、3、4、5mW)将40只豚鼠分为4组，各组按照射次数(1、2次/d)分两个亚组，另取5只作为正常对照组。用TUNEL检测豚鼠视网膜细胞凋亡，用免疫组织化学法和医学图像分析法检测Fas蛋白的平均光密度值(AOD)，用透射电镜观察视网膜细胞的形态学变化。结果：不同照射功率组凋亡指数(AI)差异有统计学意义(P<0.05)，其中2、3mW处理组与对照组 AI无统计学差异(P>0.05)，不同照射次数对AI影响无统计学意义(P>0.05)；不同照射功率组间FasAOD有统计学差异(P<0.05)，其中2mW处理组和对照组间FasAOD无统计学差异(P>0.05)，不同照射次数对FasAOD无统计学差异(P>0.05)；透射电镜观察，2mW处理组及对照组未见明显损伤反应；3mW处理组视网膜少许细胞变性，而在4mW和5mW处理组细胞变性明显增加。结论：照射功率在3mW 以上的豚鼠视网膜存在细胞凋亡，Fas蛋白的表达也存在异常,说明3mW以上的650nm半导体激光照射豚鼠视网膜存在损伤反应。
Introduction: Myopia is recognized as a pro- gressive eye disease. The aim of this study was to evaluate the frequency and associated factors of clinically significant axial length (AL) shorten- ing among myopic children following repeated low-level red light (RLRL) therapy.
Methods: The clinical data that were collected for the myopic children aged 3–17 years who received an RLRL therapy delivered by home- use desktop light device that emitted light at 650 nm for at least 1 year, were reviewed. The clinical data included AL, spherical equivalent refraction (SER), and visual acuity measured at baseline and follow-up. The primary outcomes were frequency of AL shortening of[0.05 mm,[0.10 mm, and[0.20 mm per year, and associated factors of AL shortening per year.
Introduction: Axial length (AL) elongation in myopia is considered irreversible. We aimed to systemically report unexpected AL shortening observed in a randomized clinical trial (RCT) after repeated low-level red-light (RLRL) therapy.
Methods: This is a post hoc analysis of a multi- center, single-masked RCT. Two hundred sixty- four myopic children aged 8–13 years allocated to RLRL treatment (intervention group) or a sin- gle vision spectacle (SVS, control group) were included. AL was measured using an IOL-master 500 at baseline, 1-, 3-, 6-, and 12-month follow- up visits. AL shortening was defined as AL reduction from baseline to follow-up visits at three cutoffs: [ 0.05 mm, [ 0.10 mm, and [ 0.20 mm. Frequency of AL shortening at differ- ent cutoffs was calculated. Analysis was done with intent to treat (ITT).
Introduction: Myopia is recognized as a pro- gressive eye disease. The aim of this study was to evaluate the frequency and associated factors of clinically significant axial length (AL) shorten- ing among myopic children following repeated low-level red light (RLRL) therapy.
Methods: The clinical data that were collected for the myopic children aged 3–17 years who received an RLRL therapy delivered by home- use desktop light device that emitted light at 650 nm for at least 1 year, were reviewed. The clinical data included AL, spherical equivalent refraction (SER), and visual acuity measured at baseline and follow-up. The primary outcomes were frequency of AL shortening of[0.05 mm,[0.10 mm, and[0.20 mm per year, and associated factors of AL shortening per year.
