Discipline of Orthoptics, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia.
Ophthalmology. 2013 Jul;120(7):1482-91. doi: 10.1016/j.ophtha.2012.12.018. Epub 2013 Mar 22.
To determine the prevalence, incidence, and change in refractive errors for Australian schoolchildren and examine the impact of ethnicity and sex.
Population-based cohort study.
The Sydney Adolescent Vascular and Eye Study, a 5- to 6-year follow-up of the Sydney Myopia Study, examined 2760 children in 2 age cohorts, 12 and 17 years. Longitudinal data were available for 870 and 1202 children in the younger and older cohorts, respectively.
Children completed a comprehensive examination, including cycloplegic autorefraction (cyclopentolate 1%; Canon RK-F1). Myopia was defined as ≤-0.50 diopters (D) and hyperopia as ≥+2.00 D right eye spherical equivalent refraction.
Baseline and follow-up refraction.
Prevalence of myopia increased between baseline and follow-up for both the younger (1.4%-14.4%; P<0.0001) and older cohorts (13.0%-29.6%; P<0.0001). The annual incidence of myopia was 2.2% in the younger cohort and 4.1% in the older. Children of East Asian ethnicity had a higher annual incidence of myopia (younger 6.9%, older 7.3%) than European Caucasian children (younger 1.3%, older 2.9%; all P<0.0001). The prevalence of myopia in European Caucasian children almost doubled between the older (4.4%; 95% confidence interval [CI], 3.0-5.8) and younger samples (8.6%; 95% CI, 6.7-10.6) when both were aged 12 years. Children with ametropia at baseline were more likely to have a significant shift in refraction (hyperopia: odds ratio [OR], 3.4 [95% CI, 1.2-9.8]; myopia: OR, 6.3 [95% CI, 3.7-10.8]) compared with children with no refractive error. There was no significant difference in myopia progression between children of European Caucasian and East Asian ethnicity (P = 0.7).
In Sydney, myopia prevalence (14.4%, 29.6%) and incidence (2.2%, 4.1%) was low for both age cohorts, compared with other locations. However, in European Caucasian children at age 12, the significantly higher prevalence of myopia in the younger sample suggests a rise in prevalence, consistent with international trends. Progression of myopia was similar for children of East Asian and European Caucasian ethnicity, but lower than reported in children of East Asian ethnicity in East Asia, suggesting that environmental differences may have some impact on progression.
确定澳大利亚学童的屈光不正患病率、发病率和变化，并探讨种族和性别的影响。
基于人群的队列研究。
悉尼青少年血管和眼部研究是悉尼近视研究的 5 至 6 年随访研究，共纳入了 2 个年龄队列的 2760 名儿童，分别为 12 岁和 17 岁。在较年轻和较年长的队列中，分别有 870 名和 1202 名儿童获得了纵向数据。
儿童完成了全面的检查，包括睫状肌麻痹性自动折射（环戊酮 1%；佳能 RK-F1）。近视定义为≤-0.50 屈光度（D），远视定义为≥+2.00 D 右眼球镜等效折射。
基线和随访时的屈光度。
在较年轻（1.4%-14.4%；P<0.0001）和较年长队列（13.0%-29.6%；P<0.0001）中，近视的患病率均在基线和随访期间增加。较年轻队列的近视年发病率为 2.2%，较年长队列为 4.1%。东亚裔儿童的近视年发病率更高（较年轻组 6.9%，较年长组 7.3%），而欧洲白种人儿童的发病率较低（较年轻组 1.3%，较年长组 2.9%；均 P<0.0001）。当两个年龄组均为 12 岁时，欧洲白种人儿童的近视患病率（4.4%；95%置信区间[CI]，3.0-5.8）几乎是较年轻样本（8.6%；95% CI，6.7-10.6）的两倍。与无屈光不正的儿童相比，基线时存在屈光不正的儿童更有可能出现明显的屈光度变化（远视：优势比[OR]，3.4[95% CI，1.2-9.8]；近视：OR，6.3[95% CI，3.7-10.8]）。欧洲白种人和东亚裔儿童的近视进展无显著差异（P = 0.7）。
与其他地区相比，悉尼的近视患病率（14.4%，29.6%）和发病率（2.2%，4.1%）在两个年龄组均较低。然而，在 12 岁的欧洲白种人儿童中，较年轻样本中近视患病率的显著升高表明患病率有所上升，这与国际趋势一致。东亚和欧洲白种人儿童的近视进展相似，但低于东亚东亚裔儿童的报告，这表明环境差异可能对进展有一定影响。
