Department of Twin Research & Genetic Epidemiology, King's College London, London, UK.
Ophthalmic Physiol Opt. 2013 May;33(3):339-45. doi: 10.1111/opo.12042. Epub 2013 Mar 20.
School-age myopia is becoming more common in Asia and North America; data from the United Kingdom has suggested a significant amount of myopia develops after the age of 17 years. Age of spectacle wear has been used as a proxy of myopia severity in a recent large genome-wide association study. The purpose of this study was to examine the age of onset of spectacle wear in a large British twin cohort, to examine the reliability and reproducibility of self-reported age of onset as a proxy measure of myopia severity, and to see if there is evidence in the UK of a rising prevalence of myopia.
Non-cycloplegic autorefraction was performed on over 6000 subjects from the Twins UK cohort, a large, well-characterized volunteer cohort of British, predominantly Caucasian female twins, between 1998 and 2010. Questionnaires asking age of first spectacle wear were conducted in 2003 and 2008. Myopia was defined as worse than or equal to -1.00 Dioptres, and adult onset myopia as occurring on or after the age of 17 years.
Autorefractive data was available on 6097 participants at a mean age of 53 years. The mean S.E. was -0.36 D (S.D. 2.67, range -25.13 to +9.38). 1705 subjects (28%) were myopic with a mean refractive error of -3.54 (S.D. 2.51, range -25.13 to -1.00) and the median age of first glasses wear was 15 years (mean 18.4 years, S.D. 12.24, range 0-74). Of those who provided an age at which they first wore glasses in both questionnaire sources (n = 628), there was median difference in response of 0 years (S.D. 7.18, mean 0.7, maximum 53). A statistically significant cohort effect for increased myopia prevalence across a range of age groups between 1998-1999 and 2008-2010 was identified, with myopia prevalence increasing from 27% to 34% in those aged 50-54 and from 16% to 32% in those aged 55-59.
Almost half the myopes in this UK-based population wore glasses after the age of 17; further research into adult-onset myopia is required. Although self-reported age of glasses is reproducible and reflects severity, it only explains approximately 15% of the variance of spherical equivalent, so is a rough proxy of refractive error, but still may be useful in large-scale population studies without access to refraction. We have demonstrated a significant cohort effect for increased myopia prevalence in the UK population over a 10-year period.
学龄期近视在亚洲和北美变得越来越普遍；来自英国的数据表明，17 岁后会有大量近视发生。在最近的一项大型全基因组关联研究中，眼镜佩戴年龄被用作近视严重程度的替代指标。本研究的目的是在一个大型英国双胞胎队列中检查眼镜佩戴的起始年龄，检验自我报告的起始年龄作为近视严重程度替代指标的可靠性和可重复性，并观察英国是否有近视患病率上升的证据。
1998 年至 2010 年间，对来自英国双胞胎队列的 6000 多名受试者进行了非睫状肌自动折射检查。该队列是一个大型的、特征明确的英国白种人女性双胞胎志愿者队列。2003 年和 2008 年进行了首次戴眼镜年龄的问卷调查。近视定义为>-1.00 屈光度，成年后发生的近视定义为 17 岁及以后。
在平均年龄为 53 岁的 6097 名参与者中，可获得自动折射数据。平均标准差为-0.36 D（标准差 2.67，范围-25.13 至+9.38）。1705 名受试者（28%）近视，平均屈光度为-3.54（标准差 2.51，范围-25.13 至-1.00），首次戴眼镜的中位数年龄为 15 岁（平均 18.4 岁，标准差 12.24，范围 0-74）。在那些在两个问卷来源中都提供了首次戴眼镜年龄的人（n=628）中，响应中位数差异为 0 年（标准差 7.18，均值 0.7，最大值 53）。1998-1999 年至 2008-2010 年期间，各年龄组的近视患病率均出现统计学显著的队列效应，50-54 岁人群的近视患病率从 27%上升到 34%，55-59 岁人群的近视患病率从 16%上升到 32%。
在这个英国人群中，近一半的近视患者在 17 岁后戴眼镜；需要进一步研究成人期近视。尽管自我报告的戴眼镜年龄具有可重复性且反映了严重程度，但它只能解释大约 15%的球镜等效的方差，因此是屈光不正的大致替代指标，但在没有折射检查的情况下，仍可能对大规模人群研究有用。我们已经证明，在英国人群中，近视患病率在 10 年内出现了显著的队列效应。
