Chen J, He X G, Wang J J, Xie H, Du L L, Yang J L X, Huang J N, Zou H D, Xu X
Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Division of Ophthalmology Shanghai General Hospital, Shanghai Jiao Tong University, National Clinical Research Center for Eye Diseases, Shanghai 200040, China.
Zhonghua Yan Ke Za Zhi. 2021 Apr 11;57(4):261-267. doi: 10.3760/cma.j.cn112142-20201228-000851.
To predict the prevalence of myopia among Chinese students aged 6-18 years under different intervention scenarios from 2021 to 2030. The multi-state Markov model was developed based on the transition process of study stages and myopia statuses. The development of myopia was simplified into two statuses: non-myopia and myopia. Students aged 6-18 years were also divided according to their study stages including senior kindergarten, primary school (from Grade 1 to 6), junior school (from Grade 1 to 3) and high school (from Grade 1 to 3). The parameters were extracted from the National Myopia Investigation in 2018 and published articles of cohort studies. The transition probability was applied to simulate the intervention scenarios, and sensitivity analysis was carried out. The cumulative incidence of myopia among Chinese school-aged children and adolescents would increase consistently. It would be 91.3% (min to max: 83.7% to 96.7%) upon graduation from high school. Without any intervention, the myopia prevalence would increase to 61.8% (min to max: 55.4% to 69.5%) by 2030 among Chinese school-aged children and adolescents. And the myopia prevalence among students in primary schools, junior schools and high schools would be 45.6% (min to max: 40.2% to 54.3%), 81.3% (min to max: 72.6% to 91.0%) and 90.5% (min to max: 82.4% to 96.7%), respectively, all higher than the national target. If the interventions could achieve 70% of the desired effect, the myopia prevalence would be lower than the national target at each stage. Without effective interventions, the prevalence of myopia among students aged 6-18 years may keep increasing in the next ten years. If the interventions achieve the desired effect, the national target for myopia prevention and control could be reached. It is urgent to identify more effective interventions and call on the whole society to participate in the myopia prevention action to achieve the national goal by 2030. (.
预测2021年至2030年不同干预情景下中国6至18岁学生的近视患病率。基于学习阶段和近视状态的转变过程建立了多状态马尔可夫模型。近视的发展被简化为两种状态:非近视和近视。6至18岁的学生也根据其学习阶段进行划分,包括幼儿园大班、小学(1至6年级)、初中(1至3年级)和高中(1至3年级)。参数从2018年全国近视调查和队列研究的发表文章中提取。应用转移概率模拟干预情景,并进行敏感性分析。中国学龄儿童和青少年的近视累积发病率将持续上升。高中毕业时将达到91.3%(最小值至最大值:83.7%至96.7%)。在没有任何干预的情况下,到2030年中国学龄儿童和青少年的近视患病率将增至61.8%(最小值至最大值:55.4%至69.5%)。小学、初中和高中学生的近视患病率将分别为45.6%(最小值至最大值:40.2%至54.3%)、81.3%(最小值至最大值:72.6%至91.0%)和90.5%(最小值至最大值:82.4%至96.7%),均高于国家目标。如果干预措施能达到预期效果的70%,则各阶段的近视患病率将低于国家目标。在没有有效干预的情况下,6至18岁学生的近视患病率在未来十年可能会持续上升。如果干预措施达到预期效果,则可以实现近视防控的国家目标。迫切需要确定更有效的干预措施,并呼吁全社会参与近视预防行动,以在2030年前实现国家目标。