Ophthalmology, Sheba Medical Center at Tel Hashomer, Tel Hashomer, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Br J Ophthalmol. 2020 Apr;104(4):535-540. doi: 10.1136/bjophthalmol-2019-314752. Epub 2019 Aug 13.
Myopia is a worldwide epidemic. Plethora of treatments are offered to decrease myopia progression. In this study, we compared between different geographical areas worldwide the practice patterns used by paediatric ophthalmologists to decrease the progression of myopia.
Global responses to a questionnaire were analysed (n=794) for demographic variations. Pharmacological, optical and behavioural categories were defined as effective or ineffective based on the current scientific peer reviewed literature.
Treatment rates varied significantly between geographical regions (mean 57%, range 39%-89%, p<0.001). Nearly all participants who treat myopia used at least one form of effective treatment, regardless of location (98%, p=0.16). Among those prescribing pharmacological treatments, European physicians offered the lowest rate of effective treatment compared with other regions (85% vs mean 97%). Rates of effective optical treatment varied significantly between locations (p<0.001), from 16% (Central-South America) to 56% (Far East). Most treating respondents advocated behavioural modifications (92%), between 87% (North America) and 100% (Central Asia). Nearly all respondents used combinations of treatment modalities (95%)-mostly pharmacological, optical and behavioural combination. However, combination rates varied significantly between regions (p<0.001).
The utility of treatment to decrease myopia progression differs significantly across the world both in type, combination and efficacy.
Paediatric ophthalmologists involvement and proficiency in myopia progression treatment varies around the world. This may entail promoting continuous medical education and other incentives to increase the number and proficiency of paediatric ophthalmologist to have a more effective impact to control the myopia epidemic in children.
近视是一种全球性的流行疾病。有很多治疗方法被用来减缓近视的发展。在这项研究中,我们比较了全球不同地区的儿科眼科医生在减缓近视发展方面的实践模式。
对问卷调查的全球回复进行了分析(n=794),以了解人口统计学方面的差异。根据当前的科学同行评议文献,将药物治疗、光学治疗和行为治疗分为有效或无效两类。
治疗率在地理位置上差异显著(平均值为 57%,范围为 39%-89%,p<0.001)。几乎所有治疗近视的参与者都至少使用了一种有效的治疗方法,无论其位置如何(98%,p=0.16)。在使用药物治疗的医生中,欧洲医生提供的有效治疗率最低,与其他地区相比为 85%(vs 平均值 97%)。有效光学治疗率在地理位置上差异显著(p<0.001),从 16%(中南美洲)到 56%(远东地区)。大多数治疗的受访者提倡行为改变(92%),从 87%(北美)到 100%(中亚)。几乎所有的受访者都使用了多种治疗方法的组合(95%)-主要是药物、光学和行为组合。然而,组合率在地理位置上差异显著(p<0.001)。
治疗近视进展的效果在全球范围内因类型、组合和疗效的不同而有很大差异。
世界各地的儿科眼科医生在参与和熟练程度方面存在差异。这可能需要促进持续的医学教育和其他激励措施,以增加儿科眼科医生的数量和熟练程度,从而对控制儿童近视流行产生更有效的影响。