Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
Myopia Research Group, Singapore Eye Research Institute, Singapore.
Br J Ophthalmol. 2023 Jan;107(1):133-139. doi: 10.1136/bjophthalmol-2021-318918. Epub 2021 Apr 15.
BACKGROUND/AIMS: To evaluate the association of reported time outdoors and light exposure patterns with myopia among children aged 9 years from the Growing Up in Singapore Towards Healthy Outcomes birth cohort.
We assessed reported time outdoors (min/day), light exposure patterns and outdoor activities of children aged 9 years (n=483) with a questionnaire, the FitSight watch and a 7-day activity diary. Light levels, the duration, timing and frequency of light exposure were assessed. Cycloplegic spherical equivalent (SE), myopia (SE≤-0.5 D) and axial length (AL) of paired eyes were analysed using generalised estimating equations.
In this study, 483 (966 eyes) multiethnic children (50.0% boys, 59.8% Chinese, 42.2% myopic) were included. Reported time outdoors (mean±SD) was 100±93 min/day, and average light levels were 458±228 lux. Of the total duration children spent at light levels of ≥1000 lux (37±19 min/day), 76% were spent below 5000 lux. Peak light exposure occurred at mid-day. Children had 1.7±1.0 light exposure episodes/day. Common outdoor activities were walks, neighbourhood play and swimming. Greater reported time outdoors was associated with lower odds of myopia (OR=0.82, 95% CI 0.70 to 0.95/hour increase daily; p=0.009). Light levels, timing and frequency of light exposures were not associated with myopia, SE or AL (p>0.05).
Reported time outdoors, light levels and number of light exposure episodes were low among Singaporean children aged 9 years. Reported time outdoors was protective against myopia but not light levels or specific light measures. A multipronged approach to increase time outdoors is recommended in the combat against the myopia epidemic.
背景/目的：评估儿童户外活动时间和光照模式与近视的相关性，研究对象为新加坡成长至健康结局队列研究中 9 岁儿童。
我们使用问卷、Fitsight 手表和 7 天活动日记评估了 9 岁儿童的户外活动时间（分钟/天）、光照模式和户外活动情况。评估光照水平、光照时长、光照时间和光照频率。使用广义估计方程分析双眼的睫状肌麻痹等效球镜（SE）、近视（SE≤-0.5 D）和眼轴长度（AL）。
本研究共纳入 483 名（966 只眼）多民族儿童（50.0%为男孩，59.8%为华裔，42.2%为近视）。报告的户外活动时间（平均值±标准差）为 100±93 分钟/天，平均光照水平为 458±228 勒克斯。在儿童处于≥1000 勒克斯的总时长（37±19 分钟/天）中，76%的时间处于 5000 勒克斯以下。光照峰值出现在中午。儿童每天有 1.7±1.0 次光照暴露。常见的户外活动包括散步、社区玩耍和游泳。报告的户外活动时间越多，患近视的几率越低（OR=0.82，95%CI 0.70 至 0.95/小时增加，每日；p=0.009）。光照水平、光照时间和频率与近视、SE 或 AL 无关（p>0.05）。
9 岁新加坡儿童的户外活动时间、光照水平和光照暴露次数较低。报告的户外活动时间与近视呈负相关，但与光照水平或特定光照措施无关。建议采取多管齐下的方法增加户外活动时间，以对抗近视流行。
