Li Shi-Ming, Li He, Li Si-Yuan, Liu Luo-Ru, Kang Meng-Tian, Wang Yi-Peng, Zhang Fengju, Zhan Si-Yan, Gopinath Bamini, Mitchell Paul, Wang Ningli
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Science Key Lab, Beijing, China 2Beijing Institute of Ophthalmology, Capital Medical University, Beijing, China.
Anyang Eye Hospital, Anyang, Henan Province, China.
Invest Ophthalmol Vis Sci. 2015 Jul;56(8):4734-40. doi: 10.1167/iovs.14-15474.
To investigate whether time outdoors and a range of other activities are associated with change in spherical equivalent (SE) and axial length in Chinese children over a period of 2 years.
A total of 1997 children aged 12.7 ± 0.5 (10.9-15.6) years in the Anyang Childhood Eye Study (ACES) were examined annually (baseline and two follow-up visits). Myopia was defined as cycloplegic SE < -0.50 diopters (D). Questionnaires were administered to the students and parents at baseline to gauge time spent outdoors and on other tasks. We ran mixed linear models including age, sex, and years of follow-up.
In the full cohort of children there was a suggestive association between time spent outdoors and change in axial length; however, the effect size was very small (high versus low tertile: -0.016 mm/y, P = 0.053). The association was observed in children not myopic at baseline (high versus low tertile, -0.036 mm/y; P = 0.009) but not in those already myopic at baseline (high versus low tertile: -0.005 mm/y; P = 0.595). Time outdoors and change in SE showed similar, but nonsignificant, relationships (P > 0.05), perhaps due to insufficient statistical power. The other activities examined and parental myopia were not associated with changes in SE and axial length (P > 0.11).
Within the normal range of variation encountered in these Chinese children, a wide range of activities were largely unrelated to myopia progression at this age. However, there was suggestive evidence that greater time outdoors was associated with slower axial elongation in nonmyopic teenagers, but not in existing myopes.
研究中国儿童在2年时间里户外活动时间及一系列其他活动是否与等效球镜度（SE）和眼轴长度的变化有关。
安阳儿童眼病研究（ACES）中共有1997名年龄为12.7±0.5（10.9 - 15.6）岁的儿童接受了年度检查（基线检查及两次随访）。近视定义为散瞳后SE＜-0.50屈光度（D）。在基线时向学生和家长发放问卷，以评估户外活动时间及其他活动时间。我们运行了包含年龄、性别和随访年限的混合线性模型。
在全部儿童队列中，户外活动时间与眼轴长度变化之间存在提示性关联；然而，效应量非常小（高三分位数与低三分位数相比：-0.016 mm/年，P = 0.053）。这种关联在基线时未患近视的儿童中观察到（高三分位数与低三分位数相比，-0.036 mm/年；P = 0.009），但在基线时已患近视的儿童中未观察到（高三分位数与低三分位数相比：-0.005 mm/年；P = 0.595）。户外活动时间与SE变化呈现相似但不显著的关系（P＞0.05），可能是由于统计效能不足。所检查的其他活动及父母近视与SE和眼轴长度的变化无关（P＞0.11）。
在这些中国儿童的正常变异范围内，一系列活动在很大程度上与该年龄段的近视进展无关。然而，有提示性证据表明，户外活动时间较长与非近视青少年眼轴伸长较慢有关，但与已患近视的青少年无关。
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