Chua Sharon Yu Lin, Ikram M Kamran, Tan Chuen Seng, Lee Yung Seng, Ni Yu, Shirong Cai, Gluckman Peter D, Chong Yap-Seng, Yap Fabian, Wong Tien-Yin, Ngo Cheryl S, Saw Seang-Mei
Saw Swee Hock School of Public Health National University of Singapore, Singapore.
Singapore Eye Research Institute, Singapore National Eye Centre, Singapore 3School of Public Health, DUKE-NUS Medical School, Singapore.
Invest Ophthalmol Vis Sci. 2015 Dec;56(13):8101-7. doi: 10.1167/iovs.15-16577.
To investigate the associations of near work, outdoor activity, and anthropometric risk factors with early-onset myopia in Singaporean preschool children.
Pregnant women who attended their first-trimester clinic at two major maternity units were recruited for the GUSTO birth cohort (n = 1236). Cycloplegic autorefraction and axial length (AL) were obtained in 3-year-old children (n = 572). Parents completed detailed questionnaires on parental myopia, near work, and outdoor activities when the child was 2 years of age. Height and weight were measured in the children at various time points from birth to 3 years of age.
Among the cohort of 572 children, 35 children (6.1%) had early-onset myopia. In multivariable regression models, compared to children whose parents were not myopic, those with two myopic parents were more likely to have a more myopic spherical equivalent (SE) (regression coefficient: -0.36; 95% confidence interval [CI]: -0.61 to -0.11) and longer AL (regression coefficient: 0.24; 95% CI: 0.10-0.39) and more likely to have myopia (odds ratio [OR] = 4.8; 95% CI: 1.4-16.6). Neither near work nor outdoor activity was associated with SE, AL, and myopia. Taller children were found to have longer AL at birth and at 12, 24, and 36 months, but there were no associations with SE.
Genetic factors may have a greater contribution to early development of refractive error compared to environmental factors.
探讨近距离工作、户外活动及人体测量风险因素与新加坡学龄前儿童早发性近视的关联。
在两个主要产科单位进行孕早期产检的孕妇被纳入GUSTO出生队列研究（n = 1236）。对3岁儿童（n = 572）进行散瞳验光和眼轴长度（AL）测量。孩子2岁时，父母完成关于父母近视、近距离工作和户外活动的详细问卷。在孩子从出生到3岁的不同时间点测量身高和体重。
在572名儿童队列中，35名儿童（6.1%）患有早发性近视。在多变量回归模型中，与父母无近视的儿童相比，父母双方均近视的儿童更有可能有更近视的等效球镜（SE）（回归系数：-0.36；95%置信区间[CI]：-0.61至-0.11）和更长的眼轴长度（回归系数：0.24；95%CI：0.10 - 0.39），且更有可能患近视（比值比[OR] = 4.8；95%CI：1.4 - 16.6）。近距离工作和户外活动均与等效球镜、眼轴长度和近视无关。发现较高的儿童在出生时以及12、24和36个月时眼轴长度更长，但与等效球镜无关联。
与环境因素相比，遗传因素可能对屈光不正的早期发展贡献更大。
