Atchison David A, Li Shi-Ming, Li He, Li Si-Yuan, Liu Luo-Ru, Kang Meng-Tian, Meng Bo, Sun Yun-Yun, Zhan Si-Yan, Mitchell Paul, Wang Ningli
Beijing Tongren Eye Center Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University, Beijing, China 2School of Optometry & Vision Science and Institute of Health & Biomedical.
Beijing Tongren Eye Center Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University, Beijing, China.
Invest Ophthalmol Vis Sci. 2015 Sep 1;56(10):6162-70. doi: 10.1167/iovs.15-17200.
To test the hypothesis that relative peripheral hyperopia predicts development and progression of myopia.
Refraction along the horizontal visual field was measured under cycloplegia at visual field angles of 0°, ±15°, and ±30° at baseline, 1 and 2 years in over 1700 initially 7-year-old Chinese children, and at baseline and 1 year in over 1000 initially 14-year olds. One refraction classification for central refraction was "nonmyopia, myopia" (nM, M), consisting of nM greater than -0.50 diopters (D; spherical equivalent) and M less than or equal to -0.50 D. A second classification was "hyperopia, emmetropia, low myopia, and moderate/high myopia" (H, E, LM, MM) with H greater than or equal to +1.00 D, E, -0.49 to +0.99 D, LM, -2.99 to -0.50 D, and MM less than or equal to -3.00 D. Subclassifications were made on the basis of development and progression of myopia over the 2 years. Changes in central refraction over time were determined for different groups, and relative peripheral refraction over time was compared between different subgroups.
Simple linear regression of central refraction as a function of relative peripheral refraction did not predict myopia progression as relative peripheral refraction became more hyperopic: relative peripheral hyperopia and relative peripheral myopia predicted significant myopia progression for 0% and 35% of group/visual field angle combinations, respectively. Subgroups who developed myopia did not have more initial relative peripheral hyperopia than subgroups who did not develop myopia.
Relative peripheral hyperopia does not predict development nor progression of myopia in children. This calls into question the efficacy of treatments that aim to slow progression of myopia in children by "treating" relative peripheral hyperopia.
检验相对周边远视预测近视发生和进展这一假设。
对1700多名初始年龄为7岁的中国儿童在基线、1年和2年时，以及对1000多名初始年龄为14岁的儿童在基线和1年时，于睫状肌麻痹状态下测量水平视野0°、±15°和±30°视角处的屈光情况。中央屈光的一种分类是“非近视、近视”（nM、M），其中nM大于-0.50屈光度（D；球镜等效度），M小于或等于-0.50 D。第二种分类是“远视、正视、低度近视和中度/高度近视”（H、E、LM、MM），其中H大于或等于+1.00 D，E为-0.49至+0.99 D，LM为-2.99至-0.50 D，MM小于或等于-3.00 D。根据2年内近视的发生和进展进行亚组分类。确定不同组中央屈光随时间的变化，并比较不同亚组相对周边屈光随时间的变化。
随着相对周边屈光变得更加远视，中央屈光作为相对周边屈光函数的简单线性回归并不能预测近视进展：相对周边远视和相对周边近视分别仅对0%和35%的组/视野角组合预测了显著的近视进展。发生近视的亚组初始相对周边远视并不比未发生近视的亚组更多。
相对周边远视不能预测儿童近视的发生和进展。这对旨在通过“治疗”相对周边远视来减缓儿童近视进展的治疗方法的有效性提出了质疑。
