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中国儿童近距工作相关参数与近视:安阳儿童眼病研究

Near Work Related Parameters and Myopia in Chinese Children: the Anyang Childhood Eye Study.

作者信息

Li Shi-Ming, Li Si-Yuan, Kang Meng-Tian, Zhou Yuehua, Liu Luo-Ru, Li He, Wang Yi-Peng, Zhan Si-Yan, Gopinath Bamini, Mitchell Paul, Wang Ningli

机构信息

Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University, Beijing, China.

Anyang Eye Hospital, Anyang, Henan Province, China.

出版信息

PLoS One. 2015 Aug 5;10(8):e0134514. doi: 10.1371/journal.pone.0134514. eCollection 2015.

Abstract

PURPOSE

To examine the associations of near work related parameters with spherical equivalent refraction and axial length in Chinese children.

METHODS

A total of 1770 grade 7 students with mean age of 12.7 years were examined with cycloplegic autorefraction and axial length. Questions were asked regarding time spent in near work and outdoors per day, and near work related parameters.

RESULTS

Multivariate models revealed the following associations with greater odds of myopia: continuous reading (> 45min), odds ratio [OR], 1.4; 95% confidence interval [CI], 1.1-1.8; close television viewing distance (≤ 3m), OR, 1.7; 95% CI, 1.2-2.3; head tilt when writing, OR, 1.3; 95% CI, 1.1-1.7, and desk lighting using fluorescent vs. incandescent lamp, OR, 1.5; 95% CI, 1.2-2.0. These factors, together with close reading distance and close nib-to-fingertip distance were significantly associated with greater myopia (P<0.01). Among near work activities, only reading more books for pleasure was significantly associated with greater myopia (P=0.03). Television viewing distance (≤ 3 m), fluorescent desk light, close reading distance (≤20 cm) and close nib-to-fingertip distance (≤ 2 cm) were significantly associated with longer axial length (P<0.01). Reading distance, desk light, and reading books for pleasure had significant interaction effects with parental myopia.

CONCLUSIONS

Continuous reading, close distances of reading, television viewing and nib-to-fingertip, head tilt when writing, reading more books for pleasure and use of fluorescent desk light were significantly associated with myopia in 12-year-old Chinese children, which indicates that visual behaviors and environments may be important factors mediating the effects of near work on myopia.

摘要

目的

研究中国儿童中与近视相关的参数与等效球镜度及眼轴长度之间的关联。

方法

对1770名平均年龄为12.7岁的七年级学生进行了睫状肌麻痹下的自动验光和眼轴长度测量。询问了他们每天在近距离工作和户外活动的时间,以及与近距离工作相关的参数。

结果

多变量模型显示,以下因素与近视几率增加相关:持续阅读(>45分钟),比值比[OR]为1.4;95%置信区间[CI]为1.1 - 1.8;看电视距离近(≤3米),OR为1.7;95%CI为1.2 - 2.3;写字时头部倾斜,OR为1.3;95%CI为1.1 - 1.7,以及使用荧光灯而非白炽灯作为书桌照明,OR为1.5;95%CI为1.2 - 2.0。这些因素,连同近距离阅读距离和笔尖到指尖的近距离,与近视程度增加显著相关(P<0.01)。在近距离工作活动中,只有为了消遣阅读更多书籍与近视程度增加显著相关(P = 0.03)。看电视距离(≤3米)、荧光书桌灯、近距离阅读距离(≤20厘米)和笔尖到指尖的近距离(≤2厘米)与眼轴长度更长显著相关(P<0.01)。阅读距离、书桌灯以及为了消遣阅读书籍与父母近视有显著的交互作用。

结论

持续阅读、近距离阅读、看电视及笔尖到指尖的距离、写字时头部倾斜、为了消遣阅读更多书籍以及使用荧光书桌灯与12岁中国儿童的近视显著相关,这表明视觉行为和环境可能是介导近距离工作对近视影响的重要因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c19/4526691/254acfd0b0d1/pone.0134514.g001.jpg

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