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临床实践中近视管理态度和策略的全球趋势。

Global trends in myopia management attitudes and strategies in clinical practice.

作者信息

Wolffsohn James S, Calossi Antonio, Cho Pauline, Gifford Kate, Jones Lyndon, Li Ming, Lipener Cesar, Logan Nicola S, Malet Florence, Matos Sofia, Meijome Jose Manuel Gonzalez, Nichols Jason J, Orr Janis B, Santodomingo-Rubido Jacinto, Schaefer Tania, Thite Nilesh, van der Worp Eef, Zvirgzdina Madara

机构信息

Ophthalmic Research Group, School of Health & Life Sciences, Aston University, Birmingham, UK.

Department of Physics (Optics and Optometry), University of Florence, Italy.

出版信息

Cont Lens Anterior Eye. 2016 Apr;39(2):106-16. doi: 10.1016/j.clae.2016.02.005. Epub 2016 Feb 16.

DOI:10.1016/j.clae.2016.02.005
PMID:26895778
Abstract

PURPOSE

Myopia is a global public health issue; however, no information exists as to how potential myopia retardation strategies are being adopted globally.

METHODS

A self-administrated, internet-based questionnaire was distributed in six languages, through professional bodies to eye care practitioners globally. The questions examined: awareness of increasing myopia prevalence, perceived efficacy and adoption of available strategies, and reasons for not adopting specific strategies.

RESULTS

Of the 971 respondents, concern was higher (median 9/10) in Asia than in any other continent (7/10, p<0.001) and they considered themselves more active in implementing myopia control strategies (8/10) than Australasia and Europe (7/10), with North (4/10) and South America (5/10) being least proactive (p<0.001). Orthokeratology was perceived to be the most effective method of myopia control, followed by increased time outdoors and pharmaceutical approaches, with under-correction and single vision spectacles felt to be the least effective (p<0.05). Although significant intra-regional differences existed, overall most practitioners 67.5 (±37.8)% prescribed single vision spectacles or contact lenses as the primary mode of correction for myopic patients. The main justifications for their reluctance to prescribe alternatives to single vision refractive corrections were increased cost (35.6%), inadequate information (33.3%) and the unpredictability of outcomes (28.2%).

CONCLUSIONS

Regardless of practitioners' awareness of the efficacy of myopia control techniques, the vast majority still prescribe single vision interventions to young myopes. In view of the increasing prevalence of myopia and existing evidence for interventions to slow myopia progression, clear guidelines for myopia management need to be established.

摘要

目的

近视是一个全球性的公共卫生问题;然而,关于全球如何采用潜在的近视延缓策略尚无相关信息。

方法

通过专业机构以六种语言在全球范围内向眼科护理从业者发放一份基于网络的自填式问卷。问题涉及:对近视患病率上升的认识、对现有策略的感知效果及采用情况,以及不采用特定策略的原因。

结果

在971名受访者中,亚洲地区的关注度更高(中位数为9/10),高于其他任何大洲(7/10,p<0.001),且他们认为自己在实施近视控制策略方面比澳大拉西亚和欧洲地区更积极(8/10),而北美洲(4/10)和南美洲(5/10)最不积极(p<0.001)。角膜塑形术被认为是最有效的近视控制方法,其次是增加户外活动时间和药物治疗方法,而欠矫和单焦点眼镜被认为效果最差(p<0.05)。尽管地区内存在显著差异,但总体而言,大多数从业者(67.5(±37.8)%)将单焦点眼镜或隐形眼镜作为近视患者的主要矫正方式。他们不愿开具单焦点屈光矫正替代方案的主要理由是成本增加(35.6%)、信息不足(33.3%)和结果不可预测(28.2%)。

结论

尽管从业者了解近视控制技术的效果,但绝大多数人仍为年轻近视患者开具单焦点干预措施。鉴于近视患病率不断上升以及现有干预措施可减缓近视进展的证据,需要制定明确的近视管理指南。

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