Lanca Carla, Yam Jason C, Jiang Wen-Jun, Tham Yih-Chung, Hassan Emamian Mohammad, Tan Chuen-Seng, Guo Yin, Liu Hu, Zhong Hua, Zhu Dan, Hu Yuan-Yuan, Saxena Rohit, Hashemi Hassan, Chen Li-Jia, Wong Tien-Yin, Cheng Ching-Yu, Pang Chi-Pui, Zhu Hui, Pan Chen-Wei, Liang Yuan Bo, Fotouhi Akbar, Bi Hong-Sheng, Jonas Jost B, Saw Seang-Mei
Singapore Eye Research Institute, Singapore, Singapore.
Comprehensive Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal.
Acta Ophthalmol. 2022 May;100(3):302-311. doi: 10.1111/aos.14942. Epub 2021 Jun 17.
PURPOSE: To examine the association between near work, screen time including TV and outdoor time with myopia in children from the Sunflower Myopia Asian Eye Epidemiology Consortium (AEEC). METHODS: We analysed AEEC cross-sectional data (12 241 children) on risk factors (near work, screen time including TV and outdoor time) and myopia of six population-based studies (China, Hong Kong and Singapore). Cycloplegic refraction and axial length (AL) measurements were included. Risk factors were determined using questionnaires. Data were pooled from each study, and multivariable regression analysis was performed to evaluate the associations between risks factors and myopia, spherical equivalent (SE) and AL. RESULTS: Among the included children, 52.1% were boys, 98.1% were Chinese and 69.7% lived in urban areas. Mean±standard deviation (SD) for age was 8.8 ± 2.9 years, for SE was -0.14 ± 1.8 D and for AL was 23.3 ± 1.1 mm. Myopia prevalence was 30.6%. In multivariate analysis, more reading and writing (OR = 1.17; 95% CI, 1.11-1.24), more total near work (OR = 1.05; 95% CI, 1.02-1.09) and less outdoor time (OR = 0.82, 95% CI, 0.75-0.88) were associated with myopia (p's < 0.05). These factors were similarly associated with SE and AL (p's < 0.05), except for total near work and AL (p = 0.15). Screen time including TV was not significantly associated with myopia (p = 0.49), SE (p = 0.49) or AL (p = 0.83). CONCLUSION: In this study, increased reading and writing and decreased outdoor time were associated with myopia. Screen time may be a surrogate factor of near work or outdoor time, but further research is needed to assess its role as an independent risk factor for myopia.
目的:研究向日葵近视亚洲眼流行病学联盟(AEEC)中儿童的近距离工作、包括看电视在内的屏幕使用时间和户外活动时间与近视之间的关联。 方法:我们分析了AEEC六项基于人群的研究(中国、中国香港和新加坡)中关于危险因素(近距离工作、包括看电视在内的屏幕使用时间和户外活动时间)和近视的横断面数据(12241名儿童)。纳入了睫状肌麻痹验光和眼轴长度(AL)测量数据。危险因素通过问卷调查确定。将每项研究的数据汇总,并进行多变量回归分析,以评估危险因素与近视、等效球镜度(SE)和AL之间的关联。 结果:纳入的儿童中,52.1%为男孩,98.1%为中国人,69.7%生活在城市地区。年龄的平均值±标准差(SD)为8.8±2.9岁,SE为-0.14±1.8D,AL为23.3±1.1mm。近视患病率为30.6%。在多变量分析中,更多的阅读和书写(比值比[OR]=1.17;95%置信区间[CI],1.11-1.24)、更多的总近距离工作时间(OR=1.05;95%CI,1.02-1.09)和更少的户外活动时间(OR=0.82,95%CI,0.75-0.88)与近视相关(p值<0.05)。这些因素与SE和AL的关联类似(p值<0.05),但总近距离工作时间与AL的关联除外(p=0.15)。包括看电视在内的屏幕使用时间与近视(p=0.49)、SE(p=0.49)或AL(p=0.83)均无显著关联。 结论:在本研究中,阅读和书写增加以及户外活动时间减少与近视相关。屏幕使用时间可能是近距离工作或户外活动时间的替代因素,但需要进一步研究以评估其作为近视独立危险因素的作用。
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