Zhu Zhuoting, Chen Yanxian, Tan Zachary, Xiong Ruilin, McGuinness Myra Beth, Müller Andreas
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
Centre for Eye Research Australia, East Melbourne, Victoria, Australia.
Br J Ophthalmol. 2023 Feb;107(2):160-166. doi: 10.1136/bjophthalmol-2021-319306. Epub 2021 Nov 29.
In 2018, a consortium of government bodies in China led by the Ministry of Education released the (CPPNCT), aiming to reduce the incidence of myopia and control myopic progression in China. Recommendations span from home-based to school-based interventions, including time outdoors, physical activity, light exposure, near-work activity, screen time, Chinese eye exercises, diet and sleep. To date, the levels of evidence for this suite of interventions have not been thoroughly investigated. This review has summarised the evidence of the interventions recommended by the CPPNCT in myopia prevention and control. Thus, the following statements are supposed by the evidence: (1) Increasing time outdoors and reducing near-work time are effective in lowering incident myopia in school-aged children. (2) All interventions have a limited effect on myopia progression. Ongoing research may lead to a better understanding of the underlying mechanisms of myopia development, the interaction of different interventions and recommendations, confounding variables and their true effect on myopia prevention, and the identification of those most likely to respond to specific interventions. This field may also benefit from longer-term studies of the various interventions or strategies covered within this review article, to better understand the persistence of treatment effects over time and explore more novel approaches to myopia control.
2018年，由教育部牵头的中国政府机构联盟发布了《儿童青少年近视防控适宜技术指南》，旨在降低中国近视发病率并控制近视进展。建议涵盖从家庭干预到学校干预等多个方面，包括户外活动时间、体育活动、光照暴露、近距离用眼活动、屏幕使用时间、眼保健操、饮食和睡眠等。迄今为止，这套干预措施的证据水平尚未得到全面调查。本综述总结了《儿童青少年近视防控适宜技术指南》推荐的近视防控干预措施的证据。因此，证据支持以下观点：（1）增加户外活动时间和减少近距离用眼时间对降低学龄儿童近视发病率有效。（2）所有干预措施对近视进展的影响有限。正在进行的研究可能会使人们更好地理解近视发展的潜在机制、不同干预措施与建议之间的相互作用、混杂变量及其对近视预防的实际影响，以及确定那些最可能对特定干预措施产生反应的人群。该领域也可能受益于对本综述文章中涵盖的各种干预措施或策略进行的长期研究，可以更好地了解治疗效果随时间的持续性，并探索更多控制近视的新方法。
