Chua Sharon Y L, Sabanayagam Charumathi, Cheung Yin-Bun, Chia Audrey, Valenzuela Robert K, Tan Donald, Wong Tien-Yin, Cheng Ching-Yu, Saw Seang-Mei
Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
Ophthalmic Physiol Opt. 2016 Jul;36(4):388-94. doi: 10.1111/opo.12305.
To investigate the effect of age of myopia onset on the severity of myopia later in life among myopic children.
In this prospective study, school children aged 7-9 years from the Singapore Cohort Of the Risk factors for Myopia (SCORM) were followed up till 11 years (n = 928). Age of myopia onset was defined either through questionnaire at baseline (age 7-9 years) or subsequent annual follow-up visits. Age of onset of myopia was a surrogate indicator of duration of myopia progression till age 11 years. Cycloplegic refraction and axial length were measured at every annual eye examination. High myopia was defined as spherical equivalent of ≤-5.0 D. A questionnaire determined the other risk factors.
In multivariable regression models, younger age of myopia onset (per year decrease) or longer duration of myopia progression was associated with high myopia (odds ratio (OR) = 2.86; 95% CI: 2.39 to 3.43), more myopic spherical equivalent (regression coefficient (β) = -0.86 D; 95% CI: -0.93 to -0.80) and longer axial length (β = 0.28 mm; 95% CI: 0.24 to 0.32) at aged 11 years, after adjusting for gender, race, school, books per week and parental myopia. In Receiver Operating Curve (ROC) analyses, age of myopia onset alone predicted high myopia by 85% (area under the curve = 0.85), while the addition of other factors including gender, race, school, books per week and parental myopia only marginally improved this prediction (area under the curve = 0.87).
Age of myopia onset or duration of myopia progression was the most important predictor of high myopia in later childhood in myopic children. Future trials to retard the progression of myopia to high myopia could focus on children with younger age of myopia onset or with longer duration of myopia progression.
研究近视儿童近视发病年龄对其日后近视严重程度的影响。
在这项前瞻性研究中，对来自新加坡近视风险因素队列研究（SCORM）的7至9岁学龄儿童进行随访至11岁（n = 928）。近视发病年龄通过基线（7至9岁）问卷调查或随后的年度随访确定。近视发病年龄是至11岁时近视进展持续时间的替代指标。每次年度眼部检查时测量睫状肌麻痹验光和眼轴长度。高度近视定义为等效球镜度≤-5.0 D。通过问卷确定其他风险因素。
在多变量回归模型中，调整性别、种族、学校、每周读书量和父母近视情况后，近视发病年龄越小（每年降低）或近视进展持续时间越长，与11岁时高度近视（比值比（OR）= 2.86；95%置信区间：2.39至3.43）、更高度数的等效球镜度（回归系数（β）= -0.86 D；95%置信区间：-0.93至-0.80）和更长的眼轴长度（β = 0.28 mm；95%置信区间：0.24至0.32）相关。在受试者工作特征曲线（ROC）分析中，仅近视发病年龄可预测85%的高度近视（曲线下面积 = 0.85），而加入包括性别、种族、学校、每周读书量和父母近视等其他因素后，对该预测的改善甚微（曲线下面积 = 0.87）。
近视发病年龄或近视进展持续时间是近视儿童儿童期后期高度近视的最重要预测因素。未来延缓近视进展为高度近视的试验可聚焦于近视发病年龄较小或近视进展持续时间较长的儿童。
