Effect Of Acupuncture On Peripheral Refraction In Children And Adolescents With Myopia

Objective: To observe the distribution characteristics of peripheral refraction in children and adolescents with different degrees of ametropia and its relationship with ocular biological parameters such as axial length and corneal curvature,to explore the relationship between peripheral refraction and the occurrence and development of myopia;to explore the possible therapeutic mechanism of acupuncture in the treatment of myopia by observing the effect of acupuncture on peripheral refraction in children and adolescents with myopia.Methods: Part one: A cross-sectional study was conducted among 130 ametropic children(260 eyes)who participated in myopia screening in Menyuan County,Qinghai Province.According to the equivalent spherical diopter measured by computer optometry after mydriasis,the subjects were divided into three groups: moderate and high myopia group,low myopia group,emmetropia and hyperopia group.Visual acuity,intraocular pressure,axial length,corneal curvature and peripheral refractive error in horizontal direction of retina were measured,including 15 ° nasal(N15 °),30 ° nasal(N30°),temporal 15°(T15 °),temporal 30°(T30 °).The relative peripheral refractive error(RPRE),the resolution of astigmatism in 180 ° and 45 ° axis(J180 and J45),mean corneal curvature(Km),axial length(AL)were measured and analyzed among the three groups.The correlation of foveal equivalent spherical diopter(M0),RPRE,AL,Km were analyzed.Part two: 30 cases(60 eyes)of myopic children and adolescents with moderate and low myopia were selected from the center for prevention and treatment of low vision in our hospital.A self-control study was carried out to compare the naked eye vision,central diopter,peripheral diopter,axial length and lens thickness before and after acupuncture treatment.Results: 1.In the horizontal direction of N15 °,N30 °,T15 ° and T30 ° of retina,there were significant differences in RPRE among moderate and high myopia group,low myopia group,emmetropia and hyperopia group(P < 0.05);Except N30 °,there were no significant differences in J180 and J45 among the three groups(P > 0.05);There were significant differences in RPRE between the nasal and temporal parts of retina(P < 0.001);There were significant differences in axial length among the three groups.There was no significant difference in the mean corneal curvature among the three groups(P > 0.05);The difference between M0 and T15 °,T30 ° and N30 ° was statistically significant(P < 0.001).There was a negative correlation between axial length and RPRE(r =-0.51,-0.484,-0.389,P < 0.001);Axial length was positively correlated with RPRE(r =-0.328,-0.254,-0.222,P < 0.001);Axial length was negatively correlated with M0(r =-0.663,P < 0.001);Km was negatively correlated with axial length(r =-0.257,P < 0.001).2.Before acupuncture treatment,the uncorrected visual acuity was 0.45 ± 0.23,the axial length was 24.06 ± 0.58 mm,and the lens thickness was 3.34 ± 0.11 mm.After acupuncture treatment,the uncorrected visual acuity was 0.52 ± 0.22,The axial length was 24.06 ± 0.58 mm,and the lens thickness was 3.33 ± 0.11 mm.There was significant difference in the uncorrected visual acuity before and after treatment,and the uncorrected visual acuity improved significantly after treatment(P < 0.001);there was no significant difference in the axial length before and after treatment(P > 0.05);there was significant difference in the lens thickness before and after treatment,and the lens thickness after treatment was lower than that before treatment(P < 0.001).(paired sample mean t test).Conclusion: The results showed that the distribution of nasal and temporal peripheral refraction in children and adolescents was asymmetric;the peripheral refraction of myopic eyes was relative hyperopia,and the nasal side was more significant than the temporal side;the temporal peripheral refraction of emmetropic and hyperopic eyes was relative myopia,but the nasal side was not significant;the relative peripheral refraction was correlated with the degree of myopia and axial length;Acupuncture intervention has a good effect on children and adolescents with myopia.It can effectively improve the uncorrected visual acuity,reduce the lens thickness,reduce the fovea equivalent spherical diopter,and reduce the peripheral relative hyperopia defocusing degree of myopia.