Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
Ophthalmology. 2021 Feb;128(2):290-301. doi: 10.1016/j.ophtha.2020.07.017. Epub 2020 Jul 15.
The aim of this study was to evaluate the changes in the prevalence of myopia in Taiwanese schoolchildren over the past few decades and to analyze the risk factors for myopia.
Analysis of 8 consecutive population-based myopia surveys conducted from 1983 through 2017.
An average of 8917 (5019-11 656) schoolchildren 3 to 18 years of age were selected using stratified systematic cluster sampling or by probability proportional to size sampling.
All participants underwent complete ophthalmic evaluations. Three drops of 0.5% tropicamide were used to obtain the cycloplegic refractive status of each participant. Questionnaires were used to acquire participant data from the 1995, 2005, 2010, and 2016 surveys.
Prevalence of myopia (spherical equivalence of ≤-0.25 diopter [D]) and high myopia (≤-6.0 D) was assessed. Multivariate analyses of risk factors were conducted.
The prevalence of myopia among all age groups increased steadily. From 1983 through 2017, the weighted prevalence increased from 5.37% (95% confidence interval [CI], 3.50%-7.23%) to 25.41% (95% CI, 21.27%-29.55%) for 7-year-olds (P = 0.001 for trend) and from 30.66% (95% CI, 26.89%-34.43%) to 76.67% (95% CI, 72.94%-80.40%) for 12-year-olds (P = 0.001 for trend). The prevalence of high myopia also increased from 1.39% (95% CI, 0.43%-2.35%) to 4.26% (95% CI, 3.35%-5.17%) for 12-year-olds (P = 0.008 for trend) and from 4.37% (95% CI, 2.91%-5.82%) to 15.36% (95% CI, 13.78%-16.94%) for 15-year-olds (P = 0.039 for trend). In both the 2005 and 2016 survey samples, children who spent less than 180 minutes daily on near-work activities showed significantly lower risks for myopia developing (<60 minutes: odds ratio [OR], 0.48 and 0.56; 60-180 minutes: OR, 0.69 and 0.67). In the 2016 survey, spending more than 60 minutes daily on electronic devices was associated significantly with both myopia and high myopia (OR, 2.43 and 2.31).
The prevalence of myopia among schoolchildren increased rapidly from 1983 through 2017 in Taiwan. The major risk factors are older age and time spent on near-work activities. Use of electronic devices increased the amount of time spent on near-work and may increase the risk of developing myopia.
本研究旨在评估过去几十年中台湾地区学童近视患病率的变化，并分析近视的危险因素。
对 1983 年至 2017 年连续进行的 8 项基于人群的近视调查进行分析。
采用分层系统聚类抽样或概率与大小成正比抽样，平均选择 3 至 18 岁的 8917 名（5019-11656）学童。
所有参与者均接受全面眼科评估。使用 3 滴 0.5%托吡卡胺进行睫状肌麻痹，以获得每位参与者的屈光状态。问卷调查获取了 1995 年、2005 年、2010 年和 2016 年调查的数据。
近视（等效球镜度≤-0.25 屈光度[D]）和高度近视（≤-6.0 D）的患病率。对危险因素进行多变量分析。
所有年龄段的近视患病率均稳步上升。从 1983 年到 2017 年，加权患病率从 7 岁儿童的 5.37%（95%置信区间[CI]，3.50%-7.23%）增加到 25.41%（95% CI，21.27%-29.55%）（P=0.001，趋势检验），从 30.66%（95% CI，26.89%-34.43%）增加到 12 岁儿童的 76.67%（95% CI，72.94%-80.40%）（P=0.001，趋势检验）。高度近视的患病率也从 12 岁儿童的 1.39%（95% CI，0.43%-2.35%）增加到 4.26%（95% CI，3.35%-5.17%）（P=0.008，趋势检验），从 4.37%（95% CI，2.91%-5.82%）增加到 15 岁儿童的 15.36%（95% CI，13.78%-16.94%）（P=0.039，趋势检验）。在 2005 年和 2016 年的调查样本中，每天花在近工作活动上不到 180 分钟的儿童患近视的风险显著降低（<60 分钟：优势比[OR]，0.48 和 0.56；60-180 分钟：OR，0.69 和 0.67）。在 2016 年的调查中，每天花超过 60 分钟使用电子设备与近视和高度近视均显著相关（OR，2.43 和 2.31）。
从 1983 年到 2017 年，台湾地区学童的近视患病率迅速上升。主要危险因素是年龄较大和近工作活动时间较长。使用电子设备增加了近工作时间，可能增加近视的风险。
