Eppenberger Leila Sara, Sturm Veit
Department of Health Sciences & Technology, ETH, Zurich, Switzerland.
Eye Department, Cantonal Hospital, St. Gallen, Switzerland.
Clin Ophthalmol. 2020 Jul 2;14:1875-1890. doi: 10.2147/OPTH.S245192. eCollection 2020.
The development of myopia as a refractive disorder seems to hold multifactorial causes. Among others, increased time exposed to natural light outdoors is regarded as possible effective preventive measure against myopia development. The objective of this review is to analyse and summarize the evidence investigating the association between time outdoors and myopia prevalence and progression.
A review, restricted to articles published in the last ten years, was conducted. The literature search for the included articles was performed in the following databases: PubMed, the Cochrane Library, Web of Science and Scopus. If predefined inclusion criteria were met, the studies were further categorized and data were summarized and individually evaluated.
Two cross-sectional studies, 7 prospective cohort studies and 3 intervention studies were reported in this review, representing the data of a total of 32,381 participants. The majority of the studies found an inverse association between myopia incidence/prevalence and increased time outdoors. The association between time outdoors and myopia progression on the other hand remains debatable; one recent randomized controlled trial indicating a protective value of increased time outdoors for further progression in myopic children.
In summary, increasing time exposed to outdoor light seems to be a simple and effective preventive measure to decrease myopia prevalence. Also, contrasting previous review work, it may represent a potential strategy for myopia progression control. Future investigation is necessary to better define and quantify outdoor time and its effects on myopia.
近视作为一种屈光不正疾病，其发展似乎有多种因素。其中，增加户外活动时间被认为是预防近视发展的有效措施之一。本综述的目的是分析和总结有关户外活动时间与近视患病率及进展之间关联的研究证据。
进行了一项综述，仅限于过去十年发表的文章。在以下数据库中检索纳入的文章：PubMed、Cochrane图书馆、科学引文索引和Scopus。如果符合预定义的纳入标准，对研究进行进一步分类，并对数据进行汇总和单独评估。
本综述报告了两项横断面研究、七项前瞻性队列研究和三项干预研究，共涉及32381名参与者的数据。大多数研究发现近视发病率/患病率与户外活动时间增加呈负相关。另一方面，户外活动时间与近视进展之间的关联仍存在争议；最近一项随机对照试验表明，增加户外活动时间对近视儿童的进一步进展具有保护作用。
总之，增加户外活动时间似乎是降低近视患病率的一种简单有效的预防措施。此外，与之前的综述工作不同，这可能是控制近视进展的一种潜在策略。未来有必要进行进一步研究，以更好地界定和量化户外活动时间及其对近视的影响。
