State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
Research School of Biology, College of Medicine, Biology and Environment, Australia National University, Canberra, Australia.
Invest Ophthalmol Vis Sci. 2022 Mar 2;63(3):15. doi: 10.1167/iovs.63.3.15.
The prevalence of myopia increases with both age and grade for children attending school. The current study aimed to distinguish the effects of aging and grade on myopia.
Grade 1 students (706 at baseline in 2009, mean age 6.56 ± 0.29 years, range 6.00 to 6.99 years old, 55.5% boys) were followed up until 2012. Cycloplegic spherical equivalent (SE) was measured annually.
The sample in a grade was divided into three 4-month age blocks according to their birth month. Within each grade, there were no significant differences in SE between age blocks (all P > 0.05), despite an age range of one year. More myopic SE was observed in the youngest block of grade 2 compared to the oldest block of grade 1 (difference, -0.36 ± 0.08 D; P < 0.001), although age of the two blocks only differed by four months. Similarly, more myopic SE were found in the youngest block in grade 3 than the oldest block in grade 2 (differences, -0.50 ± 0.10 D; P < 0.001) and in the youngest block in grade 4 than the oldest block in grade 3 (differences, -0.82 ± 0.14 D; P < 0.001).
Exposure to schooling, rather than age, appears to be the major driver of refractive development, at least in the early years of schooling. Interventions during this period, involving reductions in educational pressure and increased time outdoors may have major effects on the subsequent development of myopia.
随着儿童上学年龄和年级的增加，近视的患病率也随之增加。本研究旨在区分年龄和年级对近视的影响。
对 2009 年基线时的一年级学生（706 人，平均年龄 6.56 ± 0.29 岁，年龄范围 6.00 至 6.99 岁，男生占 55.5%）进行了随访，随访时间截至 2012 年。每年测量睫状肌麻痹等效球镜（SE）。
按出生月份将每个年级的样本分为三个 4 个月龄的年龄组。在每个年级内，不同年龄组之间的 SE 没有显著差异（均 P > 0.05），尽管年龄范围相差一年。与一年级中最年长的年龄组相比，二年级中最年轻的年龄组 SE 更近视（差异，-0.36 ± 0.08 D；P < 0.001），尽管这两个年龄组仅相差四个月。同样，三年级中最年轻的年龄组 SE 比二年级中最年长的年龄组更近视（差异，-0.50 ± 0.10 D；P < 0.001），四年级中最年轻的年龄组 SE 比三年级中最年长的年龄组更近视（差异，-0.82 ± 0.14 D；P < 0.001）。
在校学习经历，而不是年龄，似乎是影响屈光发育的主要因素，至少在上学的早期阶段是如此。在此期间，通过减轻教育压力和增加户外活动时间来进行干预，可能会对近视的后续发展产生重大影响。
