Lin Zhong, Gao Tie Ying, Vasudevan Balamurali, Ciuffreda Kenneth J, Liang Yuan Bo, Jhanji Vishal, Fan Su Jie, Han Wei, Wang Ning Li
The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, No. 270 West College Road, Wenzhou, Zhejiang, 325027, China.
Handan Eye Hospital, Handan, Hebei, China.
BMC Ophthalmol. 2017 Nov 17;17(1):203. doi: 10.1186/s12886-017-0598-9.
The near work and outdoor activity are the most important environmental risk factors for myopia. However, data from Chinese rural children are relatively rare and remain controversial. Therefore, the purpose of this study was to evaluate the relationship of both near work and outdoor activities with refractive error in rural children in China.
In this cross-sectional study, 572 (65.1%) of 878 children (6-18 years of age) were included from the Handan Offspring Myopia Study (HOMS). Information from the parents on these children, as well as the parent's non-cycloplegic refraction, were obtained from the database of the Handan Eye Study conducted in the years 2006-2007. A comprehensive vision examination, including cycloplegic refraction, and a related questionnaire, were assessed on all children.
The overall time spent on near work and outdoor activity in the children was 4.8 ± 1.6 and 2.9 ± 1.4 h per day, respectively. Myopic children spent more time on near work (5.0 ± 1.7 h vs.4.7 ± 1.6 h, p = 0.049), while no significant difference was found in outdoor activity hours (2.8 ± 1.3 h vs. 3.0 ± 1.4 h, p = 0.38), as compared to non-myopic children. In the multiple logistic analysis, in general, no association between near work and myopia was found after adjusting for the children's age, gender, parental refractive error, parental educational level, and daily outdoor activity hours [odds ratio (OR), 95% confidence interval (CI): 1.10, 0.94-1.27]. However, a weak protective effect of the outdoor activity on myopia was found (OR, 95% CI: 0.82, 0.70-0.96), after adjusting for similar confounders.
In general, no association between near work and myopia was found, except for the high near work subgroup with moderate outdoor activity levels. A weak protective effect of outdoor activity on myopia in Chinese rural children was observed.
近距离工作和户外活动是近视最重要的环境危险因素。然而，来自中国农村儿童的数据相对较少且仍存在争议。因此，本研究的目的是评估中国农村儿童近距离工作和户外活动与屈光不正之间的关系。
在这项横断面研究中，从邯郸子代近视研究（HOMS）的878名儿童（6 - 18岁）中纳入了572名（65.1%）。这些儿童的父母信息以及父母的非散瞳验光结果，来自于2006 - 2007年进行的邯郸眼病研究数据库。对所有儿童进行了包括散瞳验光在内的全面视力检查以及相关问卷调查。
儿童每天花在近距离工作和户外活动上的总时间分别为4.8±1.6小时和2.9±1.4小时。与非近视儿童相比，近视儿童花在近距离工作上的时间更多（5.0±1.7小时对4.7±1.6小时，p = 0.049），而在户外活动时间上未发现显著差异（2.8±1.3小时对3.0±1.4小时，p = 0.38）。在多因素逻辑分析中，一般而言，在调整了儿童的年龄、性别、父母屈光不正、父母教育水平和每日户外活动时间后，未发现近距离工作与近视之间存在关联[比值比（OR），95%置信区间（CI）：1.10，0.94 - 1.27]。然而，在调整了类似混杂因素后，发现户外活动对近视有微弱的保护作用（OR，95%CI：0.82，0.70 - 0.96）。
一般而言，除了中等户外活动水平的高近距离工作亚组外，未发现近距离工作与近视之间存在关联。观察到户外活动对中国农村儿童近视有微弱的保护作用。
