Pennsylvania College of Optometry, Salus University, Philadelphia, USA.
Ophthalmic Physiol Opt. 2014 May;34(3):353-61. doi: 10.1111/opo.12111. Epub 2013 Dec 18.
To evaluate the association between outdoor and nearwork activities at baseline and myopia stabilisation by age 15 in the Correction of Myopia Evaluation Trial (COMET).
Correction of Myopia Evaluation Trial enrolled 469 children (ages: 6-11 years) with spherical equivalent myopia between -1.25 and -4.50 D, who were randomised to progressive addition or single vision lenses and followed for 5 years in their original lenses. At baseline, families recorded the child's outdoor and nearwork activities for 3 days within a week. Weekly hours spent in nearwork and outdoor activities were calculated for each participant. Refractions collected over 11 years were fit using the Gompertz function to determine each participant's myopia stabilisation age. Myopia for each child was then categorized as stable/not stable by age 15.
Half (233/469) of participants had usable baseline activity diaries and refraction data that could be fit with the Gompertz function, 59.7% (139/233) had stable myopia by age 15 and 40.3% had myopia that was not yet stable. The frequency of stable myopia was similar for the two categories (median split) of outdoor activities: 60% (71/118) for ≤9.0 hours/week(-1) and 59% (68/115) for >9.0 hours/week(-1) . 56% (64/114) of children reporting >21.0 h of baseline weekly nearwork activity had stable myopia by age 15 compared to 63% (75/119) with ≤21.0 h of near work (adjusted OR = 0.74; 95% CI: 0.43-1.29). Using baseline nearwork as a continuous variable, the multivariable odds ratio for the association between baseline nearwork hours and stabilisation by age 15 is 0.98: 95% CI: 0.96-1.00, a result trending towards significance.
While time spent in outdoor activities in childhood does not appear to be related to myopia stabilisation by age 15, less near work activity might potentially be associated with myopia stabilisation by that age.
在近视评估试验（COMET）中评估基线时的户外活动和近距工作与 15 岁时近视稳定的关联。
近视评估试验招募了 469 名年龄在 6-11 岁之间的儿童（等效球镜近视度数在-1.25 至-4.50 D 之间），他们被随机分配到渐进式附加镜片或单视镜片组，并在其原始镜片中随访 5 年。在基线时，家庭在一周内记录了孩子三天的户外活动和近距工作情况。为每个参与者计算每周近距工作和户外活动的时间。使用 Gompertz 函数拟合收集的 11 年屈光度，以确定每个参与者的近视稳定年龄。然后根据 15 岁时的屈光度将每个孩子的近视分为稳定/不稳定。
有一半（233/469）的参与者有可用的基线活动日记和可以用 Gompertz 函数拟合的屈光度数据，其中 59.7%（139/233）在 15 岁时近视稳定，40.3%的近视尚未稳定。在户外活动的两个类别（中位数分割）中，稳定近视的频率相似：每周≤9.0 小时（-1）的比例为 60%（71/118），每周>9.0 小时（-1）的比例为 59%（68/115）。在基线时每周近距工作时间>21.0 小时的儿童中，有 56%（64/114）在 15 岁时近视稳定，而每周近距工作时间≤21.0 小时的儿童中，有 63%（75/119）近视稳定（调整后的 OR=0.74；95%CI：0.43-1.29）。使用基线近距工作作为连续变量，基线近距工作时间与 15 岁时稳定的多变量比值比为 0.98：95%CI：0.96-1.00，结果呈显著趋势。
虽然儿童时期户外活动时间似乎与 15 岁时的近视稳定无关，但较少的近距工作活动可能与该年龄时的近视稳定有关。
