学龄前近视儿童球镜等效屈光度的纵向变化。

Longitudinal Changes in Spherical Equivalent Refractive Error Among Children With Preschool Myopia.

机构信息

State Key Laboratory of Ophthalmology, Zhongshan Opthalmic Center, Sun Yat-Sen University, Guangzhou, China.

Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia.

出版信息

Invest Ophthalmol Vis Sci. 2019 Jan 2;60(1):154-160. doi: 10.1167/iovs.18-24862.

DOI:10.1167/iovs.18-24862

PMID:30640967

Abstract

PURPOSE

Preschool myopia generally indicated a high risk of progression to high myopia. However, no previous study has reported its longitudinal evolution. This study aimed to investigate the longitudinal changes in preschool myopia and explore the associated key determinants.

METHODS

Medical records of patients seeking refractions at Zhongshan Ophthalmic Center between 2009 and 2017 were retrospectively reviewed. Mean rates of change in spherical equivalent (SE) refractive errors were evaluated in patients with preschool myopia. Association between the rate of change in SE and patient characteristics at the initial visit were examined using linear mixed-effect regression models.

RESULTS

A total of 495 cases (median initial age: 5.12 years, interquartile range [IQR], 4.12-5.76 years) were assessed with at least 2-year follow-up. The initial median SE was -3.00 D (IQR, -5.25 to -1.75 D) and the median duration of follow-up was 3.69 years (IQR, 2.89-4.99 years). On average, myopia progressed by -0.59 ± 0.47 D/year. A total of 312 (63.0%) children demonstrated myopia progression (mean rate of change in SE ≤ -0.50 D/year in either eye) and 177 (35.8%) children demonstrated refraction stability (mean rate of change < ±0.50 D/year in both eyes). Older age (β = -0.06, P = 0.003), female sex (β = -0.09, P = 0.035), and initial lower myopic SE (β = -0.07, P < 0.001) were associated with faster myopia progression.

CONCLUSIONS

Preschool myopia on average progresses, although considerable proportion of subjects demonstrates longitudinal refraction stability. The rate of myopia progression is associated with initial patient characteristics.

摘要

目的

学龄前近视通常预示着向高度近视进展的高风险。然而，以前没有研究报告其纵向演变。本研究旨在探讨学龄前近视的纵向变化，并探讨相关的关键决定因素。

方法

回顾性分析 2009 年至 2017 年期间在中山眼科中心接受屈光检查的患者的病历。评估学龄前近视患者的等效球镜（SE）屈光误差的平均变化率。使用线性混合效应回归模型检查 SE 变化率与初始就诊时患者特征之间的关系。

结果

共评估了 495 例（中位数初始年龄：5.12 岁，四分位距 [IQR]，4.12-5.76 岁），随访时间至少 2 年。初始 SE 的中位数为-3.00 D（IQR，-5.25 至-1.75 D），随访中位数为 3.69 年（IQR，2.89-4.99 年）。平均而言，近视进展了-0.59 ± 0.47 D/年。共有 312 名（63.0%）儿童出现近视进展（双眼 SE 变化率平均在-0.50 D/年以上），177 名（35.8%）儿童表现出屈光稳定（双眼 SE 变化率<±0.50 D/年）。年龄较大（β=-0.06，P=0.003）、女性（β=-0.09，P=0.035）和初始较低的近视 SE（β=-0.07，P<0.001）与近视进展较快相关。