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小学生近视的发展:台北近视调查研究

Myopia Development Among Young Schoolchildren: The Myopia Investigation Study in Taipei.

作者信息

Tsai Der-Chong, Fang Shao-You, Huang Nicole, Hsu Chih-Chien, Chen Shing-Yi, Chiu Allen Wen-Hsiang, Liu Catherine Jui-Ling

机构信息

National Yang-Ming University School of Medicine, Taipei, Taiwan 2Department of Ophthalmology, National Yang-Ming University Hospital, Yilan, Taiwan.

Children and Family Research Center, National Taiwan University, Taipei, Taiwan.

出版信息

Invest Ophthalmol Vis Sci. 2016 Dec 1;57(15):6852-6860. doi: 10.1167/iovs.16-20288.

Abstract

PURPOSE

To investigate the annual incidence of myopia and associated factors among young schoolchildren in Taipei City.

METHODS

The Myopia Investigation Study in Taipei was a citywide, population-based cohort study. During the fall 2013 semester (baseline), a total of 11,590 grade 2 schoolchildren completed ocular examination and were included for further analysis. A parent-completed questionnaire was administered to collect data on risk factors for myopia development. Follow-up visits were arranged biannually over 3 years. The first-year results are reported here. Schoolchildren who were emmetropic/hyperopic at baseline and had myopia (spherical equivalent ≤ -0.5 diopters) in either eye at follow-up were identified as having incident myopia.

RESULTS

Among 7376 baseline nonmyopic participants, 6794 (92.1%) were examined during the first-year follow-up, and 1856 (25.2%) with incident myopia were identified. The incidence density of myopia was 31.7 (95% confidence interval [CI]: 30.6-32.8) per 100 person-years. Cox hazard proportional regression analysis revealed that participants who were emmetropic at baseline (hazards ratio [HR]: 19.37; 95% CI: 4.84-77.57), who had two myopic parents (HR: 1.21; 95% CI: 1.04-1.42), and who spent ≥5 hours every week on after-school tutoring programs (HR: 1.12; 95% CI: 1.02-1.22) had greater risk for incident myopia. By contrast, protective factors included suburban area of residence (HR: 0.91; 95% CI: 0.83-1.00) and spending ≥30 minutes outdoors after school every weekday (HR: 0.90; 95% CI: 0.82-0.99).

CONCLUSIONS

This study provides population-based data on the annual incidence of myopia among Taiwanese schoolchildren, and found that baseline refractive status, parental myopia, area of residence, time outdoors after school on weekdays, and time spent on after-school tutoring programs are associated with risk of new-onset myopia.

摘要

目的

调查台北市小学生近视的年发病率及相关因素。

方法

台北市近视调查研究是一项全市范围的基于人群的队列研究。在2013年秋季学期(基线期),共有11,590名二年级小学生完成了眼部检查并纳入进一步分析。通过家长填写问卷收集近视发展危险因素的数据。在3年中每半年安排一次随访。本文报告第一年的结果。基线期为正视/远视且随访时任一眼出现近视(等效球镜度≤ -0.5屈光度)的小学生被确定为发生了新发近视。

结果

在7376名基线期非近视参与者中,6794名(92.1%)在第一年随访时接受了检查,其中1856名(25.2%)被确定为发生了新发近视。近视的发病密度为每100人年31.7例(95%置信区间[CI]:30.6 - 32.8)。Cox风险比例回归分析显示,基线期为正视的参与者(风险比[HR]:19.37;95%CI:4.84 - 77.57)、有两位近视父母的参与者(HR:1.21;95%CI:1.04 - 1.42)以及每周参加课外辅导班≥5小时的参与者(HR:1.12;95%CI:1.02 - 1.22)发生新发近视的风险更高。相比之下,保护因素包括居住在郊区(HR:0.91;95%CI:0.83 - 1.00)以及每个工作日放学后在户外活动≥30分钟(HR:0.90;95%CI:0.82 - 0.99)。

结论

本研究提供了基于人群的台湾小学生近视年发病率数据,并发现基线屈光状态、父母近视情况、居住地区、工作日放学后户外活动时间以及参加课外辅导班的时间与新发近视风险相关。

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