Department of Ophthalmology, The First Affiliated Hospital of Fujian Medical University, China; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong.
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong.
Am J Ophthalmol. 2020 Oct;218:199-207. doi: 10.1016/j.ajo.2020.05.026. Epub 2020 May 23.
To determine the effects on childhood myopia of parental myopia, parental education, children's outdoor time, and children's near work.
Population-based cross-sectional study.
A total of 6,155 subjects in 2,055 family trios (1 child and both parents). Cycloplegic autorefraction was measured for children and noncycloplegic autorefraction for parents. Parental education, children's outdoor time, and near work were collected by questionnaires. Children were categorized into 10 groups based on parental myopia levels. Associations of the above factors with myopia were evaluated by regression analyses. The areas under the receiver operating characteristic curve (AUROCs) for myopia were evaluated.
Mild parental myopia did not increase childhood myopia's risk, but the risk was 11.22-folds when both parents were highly myopic. Higher parental education (Father: OR 1.08, P = .046; Mother: OR 1.11, P = .001) and more reading time of children were risk factors (OR 1.21, P = .044). Reduced odds of myopia were associated with more time spent on outdoor activities (OR 0.78, P = .017). Notably, all these factors became insignificant after adjustment, except for parental myopia. Children with more severe parental myopia spent more time on reading, but less on electronic devices. Parental myopic status alone accounted for 11.82% of myopia variation in children. With age and parental myopia, the AUROC for myopia was 0.731.
Among parental and environmental factors, parental myopia confers, in a dose-related manner, the strongest independent effect on childhood myopia. Therefore children with high risk of myopia can be identified for early prevention, based on parental myopia data.
确定父母近视、父母受教育程度、儿童户外活动时间和儿童近距离工作对儿童近视的影响。
基于人群的横断面研究。
共纳入 2055 个家系的 6155 名儿童(1 名儿童及其父母双方)。对儿童进行睫状肌麻痹自动验光,对父母进行非睫状肌麻痹自动验光。通过问卷调查收集父母教育程度、儿童户外活动时间和近距离工作时间。根据父母近视程度,将儿童分为 10 组。通过回归分析评估上述因素与近视的相关性。评估受试者工作特征曲线(ROC)下面积(AUROCs)。
轻度父母近视不会增加儿童近视的风险,但当父母双方均高度近视时,风险增加 11.22 倍。父母受教育程度越高(父亲:比值比 1.08,P=0.046;母亲:比值比 1.11,P=0.001)和儿童阅读时间越多(比值比 1.21,P=0.044),近视的风险越高。更多的户外活动时间与较低的近视风险相关(比值比 0.78,P=0.017)。值得注意的是,除了父母近视,所有这些因素在调整后均变得不显著。父母近视程度越严重的儿童阅读时间越多,但电子设备使用时间越少。父母近视状况单独解释了儿童近视变异的 11.82%。随着年龄和父母近视程度的增加,近视的 AUROC 为 0.731。
在父母和环境因素中,父母近视以剂量相关的方式对儿童近视有最强的独立影响。因此,可以根据父母的近视数据,识别出近视风险较高的儿童,以便进行早期预防。