Gwiazda Jane, Hyman Leslie, Dong Li Ming, Everett Don, Norton Tom, Kurtz Dan, Manny Ruth, Marsh-Tootle Wendy, Scheiman Mitch
New England College of Optometry, Boston, Massachusetts 02115, USA.
Ophthalmic Epidemiol. 2007 Jul-Aug;14(4):230-7. doi: 10.1080/01658100701486459.
To evaluate factors associated with the development of high myopia (worse than -6.00 D) over 7 years of follow-up in the COMET cohort.
COMET enrolled 469 ethnically diverse children (6-11 years) with myopia between -1.25 and -4.50 D. They were randomized to either progressive addition lenses (PALs) or single vision lenses (SVLs), and followed for 5 years in their original lens assignment and 2 additional years wearing either spectacles (PALs or SVLs) or contact lenses. Refractive error was measured annually by cycloplegic autorefraction and axial length by A-Scan ultrasonography. Myopia for each child was defined as the mean spherical equivalent refractive error (SER) of the 2 eyes. Analyses were based on 7 years of follow-up. Time to high myopia was analyzed by Cox proportional hazard models and linear regression. Parental refraction data were available from 240 COMET subjects.
Younger (6-7 years) versus older (11 years) age at baseline was a significant risk factor (adjusted hazard ratio (HR) = 6.6, 95% CI = 3.4, 12.7) for having high myopia within 7 years. More (SER from -2.26 to -4.50 D) vs. less (SER from -1.25 to -2.25 D) baseline myopia was also a significant risk factor for high myopia at 7 years (adjusted HR = 7.4, 95% CI = 4.4, 12.4). Gender, ethnicity, and treatment assignment were not associated with the risk of high myopia within 7 years. Increased number of myopic parents was associated with a significant risk of high myopia in the children (p = 0.008).
Children who developed high myopia during 7 years of follow-up were younger and had more myopia at baseline. They also were more likely to have two myopic parents. These children may be at greater risk for sight-threatening conditions later in life.
评估在COMET队列7年随访期间与高度近视（近视度数超过-6.00 D）发展相关的因素。
COMET招募了469名年龄在6至11岁之间、近视度数在-1.25至-4.50 D之间的不同种族儿童。他们被随机分配到渐进多焦点镜片（PALs）组或单焦点镜片（SVLs）组，在最初的镜片分配方案下随访5年，之后再额外佩戴眼镜（PALs或SVLs）或隐形眼镜2年。每年通过散瞳自动验光测量屈光不正，通过A超超声测量眼轴长度。每个孩子的近视定义为双眼平均球镜等效屈光不正（SER）。分析基于7年的随访数据。通过Cox比例风险模型和线性回归分析高度近视发生时间。有240名COMET受试者可获取父母的屈光数据。
基线时年龄较小（6至7岁）与年龄较大（11岁）相比，是7年内发生高度近视的显著危险因素（调整后风险比（HR）= 6.6，95%置信区间（CI）= 3.4，12.7）。基线近视程度较高（SER为-2.26至-4.50 D）与较低（SER为-1.25至-2.25 D）相比，也是7年时发生高度近视的显著危险因素（调整后HR = 7.4，95% CI = 4.4，12.4）。性别、种族和治疗分配与7年内发生高度近视的风险无关。近视父母数量增加与孩子发生高度近视的显著风险相关（p = 0.008）。
在7年随访期间发展为高度近视的儿童年龄较小，基线时近视程度更高。他们也更有可能有两位近视父母。这些儿童在以后的生活中可能面临更高的视力威胁性疾病风险。
