北京城乡地区学龄儿童的视力损害与眼镜佩戴情况
Visual impairment and spectacle use in schoolchildren in rural and urban regions in Beijing.
作者信息
Guo Yin, Liu Li Juan, Xu Liang, Lv Yan Yun, Tang Ping, Feng Yi, Meng Lei, Jonas Jost B
机构信息
1 Tongren Eye Care Center, Beijing Tongren Hospital, Capital Medical University, Beijing - China.
出版信息
Eur J Ophthalmol. 2014 Mar-Apr;24(2):258-64. doi: 10.5301/ejo.5000348. Epub 2013 Aug 7.
PURPOSE
To determine prevalence and associations of visual impairment and frequency of spectacle use among grade 1 and grade 4 students in Beijing.
METHODS
This school-based, cross-sectional study included 382 grade 1 children (age 6.3 ± 0.5 years) and 299 grade 4 children (age 9.4 ± 0.7 years) who underwent a comprehensive eye examination including visual acuity, noncycloplegic refractometry, and ocular biometry.
RESULTS
Presenting visual acuity (mean 0.04 ± 0.17 logMAR) was associated with younger age (p = 0.002), hyperopic refractive error (p<0.001), and male sex (p = 0.03). Presenting visual impairment (presenting visual acuity ≤20/40 in the better eye) was found in 44 children (prevalence 6.64 ± 1.0% [95% confidence interval (CI) 4.74, 8.54]). Mean best-corrected visual acuity (right eyes -0.02 ± 0.04 logMAR) was associated with more hyperopic refractive error (p = 0.03) and rural region of habitation (p<0.001). The prevalence of best-corrected visual impairment (best-corrected visual acuity ≤20/40 in the better eye) was 2/652 (0.30 ± 0.21% [95% CI 0.00, 0.72]). Undercorrection of refractive error was present in 53 children (7.99 ± 1.05%) and was associated with older age (p = 0.003; B 0.53; OR 1.71 [95% CI 1.20, 2.42]), myopic refractive error (p = 0.001; B -0.72; OR 0.49 [95% CI 0.35, 0.68]), and longer axial length (p = 0.002; B 0.74; OR 2.10 [95% CI 1.32, 3.32]). Spectacle use was reported for 54 children (8.14 ± 1.06%). Mean refractive error of the worse eyes of these children was -2.09 ± 2.88 D (range -7.38 to +7.25 D).
CONCLUSIONS
Factors associated with presenting visual impairment were older age, myopic refractive error, and higher maternal education level. Despite a prevalence of myopia of 33% in young schoolchildren in Greater Beijing, prevalence of best-corrected visual impairment (0.30% ± 0.21%), presenting visual impairment (6.64% ± 1.0%), and undercorrection of refractive error (7.99% ± 1.05%) were relatively low.
目的
确定北京一年级和四年级学生视力损害的患病率、相关性以及眼镜佩戴频率。
方法
这项基于学校的横断面研究纳入了382名一年级儿童（年龄6.3±0.5岁）和299名四年级儿童（年龄9.4±0.7岁），他们接受了包括视力、非散瞳验光和眼部生物测量在内的全面眼部检查。
结果
就诊时视力（平均0.04±0.17 logMAR）与年龄较小（p = 0.002）、远视性屈光不正（p<0.001）和男性（p = 0.03）相关。44名儿童存在就诊时视力损害（较好眼就诊时视力≤20/40）（患病率6.64±1.0%[95%置信区间（CI）4.74, 8.54]）。平均最佳矫正视力（右眼-0.02±0.04 logMAR）与更多的远视性屈光不正（p = 0.03）和居住在农村地区（p<0.001）相关。最佳矫正视力损害（较好眼最佳矫正视力≤20/40）的患病率为2/652（0.30±0.21%[95%CI 0.00, 0.72]）。53名儿童（7.99±1.05%）存在屈光不正矫正不足，且与年龄较大（p = 0.003；B 0.53；OR 1.71[95%CI 1.20, 2.42]）、近视性屈光不正（p = 0.001；B -0.72；OR 0.49[95%CI 0.35, 0.68]）和眼轴较长（p = 0.002；B 0.74；OR 2.10[95%CI 1.32, 3.32]）相关。54名儿童（8.14±1.06%）报告佩戴眼镜。这些儿童较差眼的平均屈光不正为-2.09±2.88 D（范围-7.38至+7.25 D）。
结论
与就诊时视力损害相关的因素包括年龄较大、近视性屈光不正和母亲教育水平较高。尽管大北京地区小学生近视患病率为33%，但最佳矫正视力损害（0.30%±0.21%）、就诊时视力损害（6.64%±1.0%）和屈光不正矫正不足（7.99%±1.05%）的患病率相对较低。
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