Department of Ophthalmology, Central Hospital of Central Finland, Jyväskylä, Finland.
Gerontology Research Centre and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
Acta Ophthalmol. 2021 Mar;99(2):171-180. doi: 10.1111/aos.14545. Epub 2020 Jul 24.
To compare 3-year myopic progression between Finnish and Singaporean children.
Myopic progression was compared between 9-year-old (mean age 9.7 ± 0.4 years, n = 92) and 11-year-old (mean age 11.7 ± 0.4 years, n = 144) Finnish (Finnish RCT) children and Singaporean children matched by age and refraction (SCORMMatched, n = 403) and 7- to 8-year-old Singaporean children matched only by refraction (SCORM Young, n = 186). Spherical equivalent (SE) was between -0.50 and -3.00 D. Refraction with cycloplegia was controlled annually for 3 years. Information on parental myopia, mother's education, time spent on near-work and outdoor time was gathered by parental questionnaire.
Three-year myopic progression was -2.08 ± 0.96 D and -1.30 ± 0.69 D in the Finnish RCT and Singaporean SCORM Matched 9-year-olds, respectively, and -1.34 ± 0.78 D, and -0.52 ± 0.44 D in the 11-year-olds, respectively (p < 0.001 between all groups). Myopic progression was fastest (-2.69 ± 0.89 D) in the SCORM 7-year-olds and similar between the SCORM Matched 9-year-olds and Finnish RCT 11-year-olds (p = 0.55). The Finnish RCT and SCORM Matched children showed significant differences in both daily near-work time (1.8 ± 1.0 versus 3.4 ± 1.9 hours per day, p < 0.001) and outdoor time (2.6 ± 0.9 versus 0.5 ± 0.4 hours per day, p < 0.001). These differences did not, however, explain the differences in myopic progression between the groups. More time spent outdoors was associated with less myopic progression in the Finnish RCT (r = 0.17, p = 0.009) group only. In the whole materials, greater myopic progression was associated with younger age at baseline (p < 0.001), younger age was associated with mother's higher education (p < 0.001), and mothers higher education was associated with myopia in both parents (p < 0.001).
Age at baseline was the most significant factor associated with myopic progression. However, at the same age and with the same initial refraction, the Finnish and Singaporean children showed different myopic progression. This result remains unexplained. Thus, age of myopia onset should be considered when comparing myopic progression between different samples and conducting treatment trials. Parental myopia may be a weak indicator of heredity of myopia.
比较芬兰和新加坡儿童的 3 年近视进展情况。
比较 9 岁（平均年龄 9.7±0.4 岁，n=92）和 11 岁（平均年龄 11.7±0.4 岁，n=144）芬兰（芬兰 RCT）儿童与年龄和屈光度匹配的新加坡儿童（SCORMMatched，n=403）和仅匹配屈光度的 7-8 岁新加坡儿童（SCORM Young，n=186）之间的 3 年近视进展情况。等效球镜（SE）在-0.50 至-3.00 D 之间。3 年来，每年通过睫状肌麻痹控制屈光。通过家长问卷收集父母近视、母亲教育程度、近距工作时间和户外活动时间等信息。
芬兰 RCT 和新加坡 SCORM Matched 9 岁儿童的 3 年近视进展分别为-2.08±0.96 D 和-1.30±0.69 D，11 岁儿童的近视进展分别为-1.34±0.78 D 和-0.52±0.44 D（所有组之间 p<0.001）。SCORM 7 岁儿童的近视进展最快（-2.69±0.89 D），与 SCORM Matched 9 岁儿童和芬兰 RCT 11 岁儿童的近视进展相似（p=0.55）。芬兰 RCT 和 SCORM Matched 儿童在每日近距工作时间（1.8±1.0 小时与 3.4±1.9 小时，p<0.001）和户外活动时间（2.6±0.9 小时与 0.5±0.4 小时，p<0.001）方面存在显著差异。然而，这些差异并不能解释两组之间近视进展的差异。在芬兰 RCT 组中，更多的户外活动时间与近视进展较少相关（r=0.17，p=0.009）。在所有材料中，近视进展与基线时年龄较小（p<0.001）相关，年龄较小与母亲受教育程度较高（p<0.001）相关，母亲受教育程度较高与父母双方均近视相关（p<0.001）。
基线年龄是与近视进展最相关的因素。然而，在相同的年龄和初始屈光度下，芬兰和新加坡儿童的近视进展情况不同。这一结果仍无法解释。因此，在比较不同样本之间的近视进展和进行治疗试验时，应考虑近视发病年龄。父母近视可能是近视遗传的一个较弱指标。
