Wilkinson Ben, Wilson Graham
Ophthalmology Registrar, Gisborne Hospital, Tairāwhiti District Health Board, Gisborne.
Consultant General and Paediatric Ophthalmologist, Gisborne Hospital, Tairāwhiti District Health Board; Clinical Senior Lecturer, Faculty of Medical and Health Sciences, University of Otago; Principal Investigator, Vision, The Dunedin Study.
N Z Med J. 2020 Feb 7;133(1509):9-16.
The purpose of this paper is to assess whether screening for myopia in New Zealand is valid under scrutiny of the Wilson and Jungner criteria. There is a worldwide myopia epidemic which requires urgent attention to reduce vision impairment, blindness and costs to wider society. The risks associated with myopia are under-appreciated in New Zealand, and treatments need to be refocused from correcting refractive error to preventing axial length elongation.
The Wilson and Jungner criteria was used to assess the validity of screening for myopia in New Zealand through review of the latest evidence relevant to each point within the criteria.
We found that the screening for myopia in New Zealand met 7 out of 10 of the Wilson and Jungner criteria.
The concept of a screening programme for myopia in New Zealand performed relatively well, and should be considered further. Further randomised clinical trials, which clearly identify the appropriate treatment modalities and timing, would allow the establishment of robust New Zealand specific myopia management guidelines. We would then suggest a trial of a screening programme in New Zealand setting to assess real-world feasibility and cost-effectiveness to identify early myopia and provide treatment to slow progression. Adjustments could be made to the already available screening programme, consisting of suitable reduction of screening age, and introduction of autorefractors.
本文旨在评估在威尔逊和荣格纳标准的审视下，新西兰的近视筛查是否有效。全球范围内存在近视流行问题，需要紧急关注以减少视力损害、失明以及给更广泛社会带来的成本。在新西兰，与近视相关的风险未得到充分重视，治疗需要从矫正屈光不正重新聚焦到防止眼轴长度延长。
通过回顾与该标准各点相关的最新证据，使用威尔逊和荣格纳标准来评估新西兰近视筛查的有效性。
我们发现新西兰的近视筛查符合威尔逊和荣格纳标准中的10条中的7条。
新西兰近视筛查计划的概念表现相对良好，应进一步加以考虑。进一步开展明确确定适当治疗方式和时机的随机临床试验，将有助于制定强有力的新西兰特定近视管理指南。然后，我们建议在新西兰环境中进行筛查计划试验，以评估实际可行性和成本效益，从而识别早期近视并提供治疗以减缓进展。可以对现有的筛查计划进行调整，包括适当降低筛查年龄，并引入自动验光仪。
