Cheng Ching-Ying, Huang Walter, Su Kuo-Chen, Peng Mei-Ling, Sun Han-Ying, Cheng Hong-Ming
School of Optometry and Department of Ophthalmology, Chung Shan Medical University, Taichung, Taiwan.
Optom Vis Sci. 2013 Apr;90(4):400-6. doi: 10.1097/OPX.0b013e3182873449.
To investigate factors that may contribute to the myopization of urban elementary school students in Taiwan.
Grades 1 to 6 students of the same racial background (n = 1894; mean age, 6.3-11.3 years) in three schools, located in Tamsui, Taichung, and Tainan, were refracted to obtain the best corrected visual acuity. The refractive power needed for best corrected visual acuity was used for subsequent statistical analysis. On behalf of their children, parents also completed a questionnaire on six categories of potential myopization variables. Correlation between these variables and the increase or decrease in the refractive error was assessed. The predictive value of each variable was also calculated based on linear regression analysis.
The overall mean refractive error in grades 1 to 6 was -0.37, -0.68, -1.33, -1.60, -1.90, and -2.51 D, respectively. The prevalence of myopia (-1.00 D or more minus) showed a significant difference between grades 2 and 3 and, again, between grades 5 and 6. In addition, 20 potential modulating factors were evaluated; 65.9% of the change in the refractive error could be explained by four: (1) lag in optimal correction, defined as a -1.00-D deficit between new refractive error and current optical correction; (2) outdoor spectacle wear; (3) spectacles for different working distances; and (4) hours spent on reading and writing on weekdays. In contrast, outdoor time and the intake frequency of 36 food items both held very low predictive values of 0.2% and 2.5%, respectively.
Each variable associated with the refractive error has a different predictive value, either positive or negative. Ultimately, the interplay of these variables decides the outcome of the pattern and the degree of school myopia.
探讨可能导致台湾城市小学生近视化的因素。
对淡水、台中及台南三所学校中具有相同种族背景的1至6年级学生（n = 1894；平均年龄6.3 - 11.3岁）进行验光，以获得最佳矫正视力。将最佳矫正视力所需的屈光力用于后续统计分析。家长还代表孩子完成了一份关于六类潜在近视化变量的问卷。评估这些变量与屈光不正增减之间的相关性。还基于线性回归分析计算了每个变量的预测值。
1至6年级的总体平均屈光不正分别为-0.37、-0.68、-1.33、-1.60、-1.90和-2.51 D。近视（-1.00 D或更低）患病率在2年级和3年级之间以及5年级和6年级之间存在显著差异。此外，评估了20个潜在调节因素；屈光不正变化的65.9%可由以下四个因素解释：（1）最佳矫正滞后，定义为新屈光不正与当前光学矫正之间相差-1.00 D；（2）户外佩戴眼镜；（3）不同工作距离的眼镜；（4）平日读写时间。相比之下，户外时间和36种食物的摄入频率的预测值非常低，分别为0.2%和2.5%。
与屈光不正相关的每个变量都有不同的预测值，无论是正的还是负的。最终，这些变量的相互作用决定了学校近视模式和程度的结果。
