Wu Jian Feng, Bi Hong Sheng, Wang Shu Mei, Hu Yuan Yuan, Wu Hui, Sun Wei, Lu Tai Liang, Wang Xing Rong, Jonas Jost B
Department of Ophthalmology, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.
Eye Institute of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.
PLoS One. 2013 Dec 23;8(12):e82763. doi: 10.1371/journal.pone.0082763. eCollection 2013.
To examine the prevalence of refractive errors and prevalence and causes of vision loss among preschool and school children in East China.
Using a random cluster sampling in a cross-sectional school-based study design, children with an age of 4-18 years were selected from kindergartens, primary schools, and junior and senior high schools in the rural Guanxian County and the city of Weihai. All children underwent a complete ocular examination including measurement of uncorrected (UCVA) and best corrected visual acuity (BCVA) and auto-refractometry under cycloplegia. Myopia was defined as refractive error of ≤-0.5 diopters (D), high myopia as ≤ -6.0D, and amblyopia as BCVA ≤ 20/32 without any obvious reason for vision reduction and with strabismus or refractive errors as potential reasons.
Out of 6364 eligible children, 6026 (94.7%) children participated. Prevalence of myopia (overall: 36.9 ± 0.6%;95% confidence interval (CI):36.0,38.0) increased (P<0.001) from 1.7 ± 1.2% (95%CI:0.0,4.0) in the 4-years olds to 84.6 ± 3.2% (95%CI:78.0,91.0) in 17-years olds. Myopia was associated with older age (OR:1.56;95%CI:1.52,1.60;P<0.001), female gender (OR:1.22;95%CI:1.08,1.39;P = 0.002) and urban region (OR:2.88;95%CI:2.53,3.29;P<0.001). Prevalence of high myopia (2.0 ± 0.2%) increased from 0.7 ± 0.3% (95%CI:0.1,1.3) in 10-years olds to 13.9 ± 3.0 (95%CI:7.8,19.9) in 17-years olds. It was associated with older age (OR:1.50;95%CI:1.41,1.60;P<0.001) and urban region (OR:3.11;95%CI:2.08,4.66);P<0.001). Astigmatism (≥ 0.75D) (36.3 ± 0.6%;95%CI:35.0,38.0) was associated with older age (P<0.001;OR:1.06;95%CI:1.04,1.09), more myopic refractive error (P<0.001;OR:0.94;95%CI:0.91,0.97) and urban region (P<0.001;OR:1.47;95%CI:1.31,1.64). BCVA was ≤ 20/40 in the better eye in 19 (0.32%) children. UCVA ≤ 20/40 in at least one eye was found in 2046 (34.05%) children, with undercorrected refractive error as cause in 1975 (32.9%) children. Amblyopia (BCVA ≤ 20/32) was detected in 44 (0.7%) children (11 children with bilateral amblyopia).
In coastal East China, about 14% of the 17-years olds were highly myopic, and 80% were myopic. Prevalence of myopia increased with older age, female gender and urban region. About 0.7% of pre-school children and school children were amblyopic.
调查中国东部学龄前和学龄儿童屈光不正的患病率以及视力丧失的患病率和原因。
在一项基于学校的横断面研究设计中采用随机整群抽样，从农村冠县和威海市的幼儿园、小学、初中和高中选取4至18岁的儿童。所有儿童均接受了全面的眼部检查，包括测量未矫正视力（UCVA）和最佳矫正视力（BCVA）以及睫状肌麻痹下的自动验光。近视定义为屈光不正≤-0.5屈光度（D），高度近视为≤-6.0D，弱视定义为BCVA≤20/32，且无任何明显的视力下降原因，斜视或屈光不正为潜在原因。
在6364名符合条件的儿童中，6026名（94.7%）儿童参与。近视患病率（总体：36.9±0.6%；95%置信区间（CI）：36.0,38.0）从4岁儿童的1.7±1.2%（95%CI：0.0,4.0）增加（P<0.001）到17岁儿童的84.6±3.2%（95%CI：78.0,91.0）。近视与年龄较大（OR：1.56；95%CI：1.52,1.60；P<0.001）、女性（OR：1.22；95%CI：1.08,1.39；P = 0.002）和城市地区（OR：2.88；95%CI：2.53,3.29；P<0.001）相关。高度近视患病率（2.0±0.2%）从10岁儿童的0.7±0.3%（95%CI：0.1,1.3）增加到17岁儿童的13.9±3.0（9%CI：7.8,19.9）。它与年龄较大（OR：1.50；95%CI：1.41,1.60；P<0.001）和城市地区（OR：3.11；95%CI：2.08,4.66；P<0.001）相关。散光（≥0.75D）（36.3±0.6%；95%CI：立5.0,38.0）与年龄较大（P<0.001；OR：1.06；95%CI：1.04,1.09）、近视屈光不正程度更高（P<0.001；OR：0.94；95%CI：0.91,0.97）和城市地区（P<0.001；OR：1.47；9%CI：1.31,1.64）相关。19名（0.32%）儿童较好眼的BCVA≤20/40。2046名（34.05%）儿童至少一只眼的UCVA≤20/40，其中1975名（32.9%）儿童的原因是屈光不正矫正不足。44名（0.7%）儿童（11名双侧弱视儿童）被检测出弱视（BCVA≤20/32）。
在华东沿海地区，约14%的17岁青少年为高度近视，80%为近视。近视患病率随年龄、女性性别和城市地区的增加而增加。约0.7%的学龄前儿童和学龄儿童患有弱视。
