Hsu Chih-Chien, Huang Nicole, Lin Pei-Yu, Fang Shao-You, Tsai Der-Chong, Chen Shing-Yi, Tsai Ching-Yao, Woung Lin-Chung, Chiou Shih-Hwa, Liu Catherine Jui-Ling
Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan.
Br J Ophthalmol. 2017 Dec;101(12):1611-1617. doi: 10.1136/bjophthalmol-2016-309299. Epub 2017 Mar 18.
To evaluate the 1-year progression of myopia and associated risk factors in second-grade primary school children.
The myopia investigation study in Taipei provided semiannual visual acuity testing and cycloplegic refraction for all second-grade primary school children (mean age: 7.49 years) in Taipei who provided parental consent. A questionnaire was distributed to the participants' parents before the first and third examinations. We evaluated 1-year follow-up data for children noted to have myopia on the first examination. Multinomial logistic regression models were applied to assess risk factors associated with myopia progression. Myopia progression was categorised, based on the change in spherical equivalent (ΔSE) over 1 year, as slow (ΔSE>-0.5 dioptres (D)), moderate (-1.0 D<ΔSE≤-0.5 D) or fast (ΔSE≤-1.0 D). Of the 4214 myopic children, data were analysed for 3256 (77.3%) who completed the 1-year follow-up evaluation.
The baseline SE was -1.43±1.1 D. The average ΔSE was -0.42±0.85 D, with 46.96%, 28.50% and 24.54% of the study subjects showing slow, moderate and fast myopia progression, respectively. When compared with slow myopia progression, fast myopia progression was associated with a greater myopic SE at baseline (OR: 0.67, 95% CI: 0.61 to 0.72) and a shorter eye-object distance when doing near work (OR: 1.45, 95% CI: 1.18 to 1.78). More outdoor activity time and self-reported cycloplegic treatment were not associated with slow myopia progression.
Children with fast annual myopia progression were more myopic at baseline and had a shorter reading distance. Our study results highlight the importance of having children keep a proper reading distance.
评估小学二年级儿童近视的1年进展情况及相关危险因素。
台北的近视调查研究为所有获得家长同意的台北小学二年级儿童（平均年龄：7.49岁）提供半年一次的视力测试和散瞳验光。在第一次和第三次检查前向参与者的家长发放问卷。我们评估了第一次检查时被发现患有近视的儿童的1年随访数据。应用多项逻辑回归模型评估与近视进展相关的危险因素。根据1年内等效球镜度（ΔSE）的变化，将近视进展分为缓慢（ΔSE > -0.5屈光度（D））、中度（-1.0 D < ΔSE ≤ -0.5 D）或快速（ΔSE ≤ -1.0 D）。在4214名近视儿童中，对完成1年随访评估的3256名（77.3%）儿童的数据进行了分析。
基线等效球镜度为-1.43 ± 1.1 D。平均ΔSE为-0.42 ± 0.85 D，分别有46.96%、28.50%和24.54%的研究对象表现出缓慢、中度和快速近视进展。与缓慢近视进展相比，快速近视进展与基线时更高的近视等效球镜度（比值比：0.67，95%置信区间：0.61至0.72）以及近距离工作时较短的眼物距离有关（比值比：1.45，95%置信区间：1.18至1.78）。更多的户外活动时间和自我报告的散瞳治疗与缓慢近视进展无关。
每年近视进展快速的儿童在基线时近视程度更高且阅读距离较短。我们的研究结果凸显了让儿童保持适当阅读距离的重要性。
