Aier School of Ophthalmology, Central South University, Changsha, Hunan, China.
State Key Laboratory of Software Development Environment, Beihang University, Beijing, China.
Br J Ophthalmol. 2020 Nov;104(11):1542-1547. doi: 10.1136/bjophthalmol-2019-315258. Epub 2020 Feb 19.
To reassess the association between near work, outdoor exposure and myopia in children through an objective approach.
Eighty-six children (10.13±0.48 years) were asked to wear Clouclip, a newly developed wearable device that is able to measure working distance and eye-level illuminance, for a complete week to obtain information on near work and outdoor exposure. The mean daily Clouclip wearing time was 11.72±1.14 hour. The spherical equivalent refraction was determined by cycloplegic autorefraction.
The myopic children were found to be exposed to light intensities >3000 lux (0.68±0.50 hour vs 1.02±0.53 hour, p=0.012) and >5000 lux (0.42±0.35 hour vs 0.63±0.31 hour, p=0.004) for shorter durations on average each day than the non-myopic children. Additionally, the myopic children spent more time on average each day on activities at a distance of <20 cm than non-myopic children (1.89±0.61 hour vs 1.52±0.77 hour, p=0.019). In the multivariate logistic analysis, the time spent with a higher light intensity (>3000 lux (OR=0.27, 95% CI: 0.10 to 0.72, p=0.009); >5000 lux (OR=0.11, 95% CI: 0.02 to 0.56, p=0.008)) and a working distance of <20 cm (in a circumstance of >3000 lux (OR=1.17, 95% CI: 1.09 to 1.86, p=0.038) or in that of >5000 lux (OR=1.12, 95% CI: 1.03 to 1.77, p=0.046)) were the independent protective factors and risk factors, respectively.
The current study provides novel evidence, based on objective data, to support the association between the intensity of near work, light intensity and myopia. However, the causality and the dose-effect relationship need to be investigated further.
通过客观方法重新评估儿童近距离工作、户外活动与近视的关系。
86 名儿童(10.13±0.48 岁)佩戴新开发的可穿戴设备 Clouclip 一整周,以获取近距离工作和户外活动信息。平均每天佩戴 Clouclip 的时间为 11.72±1.14 小时。通过睫状肌麻痹自动折射确定等效球镜屈光度。
与非近视儿童相比,近视儿童每天平均暴露在 3000 勒克斯以上的光强时间更短(0.68±0.50 小时比 1.02±0.53 小时,p=0.012)和 5000 勒克斯以上的光强时间更短(0.42±0.35 小时比 0.63±0.31 小时,p=0.004)。此外,近视儿童每天平均花在距离小于 20 厘米的活动上的时间也多于非近视儿童(1.89±0.61 小时比 1.52±0.77 小时,p=0.019)。在多变量逻辑分析中,暴露于更高光强(3000 勒克斯以上(OR=0.27,95%CI:0.10 至 0.72,p=0.009);5000 勒克斯以上(OR=0.11,95%CI:0.02 至 0.56,p=0.008)和近距离工作距离小于 20 厘米(在 3000 勒克斯以上的情况下(OR=1.17,95%CI:1.09 至 1.86,p=0.038)或在 5000 勒克斯以上的情况下(OR=1.12,95%CI:1.03 至 1.77,p=0.046)是独立的保护因素和风险因素。
本研究基于客观数据提供了新的证据,支持近距离工作、光照强度与近视之间的关联。然而,需要进一步研究因果关系和剂量-效应关系。