Li S M, Kang M T, Li L, Wei S F, He X, Liu L R, Li H, Wang N L
Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing 100730, China.
Anyang Eye Hospital, Anyang 455000, China.
Zhonghua Yan Ke Za Zhi. 2022 Oct 11;58(10):754-759. doi: 10.3760/cma.j.cn112142-20211028-00509.
To analyze the longitudinal association between hyperopia reserve and the cumulative incidence of myopia in grade 1 primary school students. Cohort study. This study included 2 628 grade 1 primary school students (2 628 eyes) who without myopic at baseline from the Anyang Childhood Eye Study. There were 1 515 male and 1 113 female, aged(7.16±0.40) years. Every year, cycloplegic autorefraction was performed with 1% cyclopentolate eye drops to obtain data of hyperopia reserve. Students with different ranges of hyperopia reserve at baseline were analyzed. Axial length, anterior chamber depth, corneal curvature, lens thickness, and other parameters were obtained by ocular biometrics and compared by the independent sample test. Qualitative data were described by frequency and percentage, and comparison between groups was performed by the Chi-square test or exact probability method. Linear regression was used to analyze the association between baseline hyperopia reserve and spherical equivalent at 5 years. The average hyperopia reserve was (+1.09±0.78) diopters (D) in grade 1 non-myopic children. Axial length, anterior chamber depth, corneal radius of curvature, and lens thickness were (22.66±0.72), (2.88±0.24), (7.80±0.25) and (3.62±0.19) mm, respectively. The cumulative incidence of myopia among non-myopic grade 1 primary school students was 8.5%, 21.5%, 35.6%, 47.6% and 64.1% at 1, 2, 3, 4 and 5 years, respectively. The incidence of myopia in girls was significantly higher than that in boys at 3, 4 and 5 years. The 5-year cumulative incidence of myopia was 4.6%, 26.3%, 52.3%, 78.6%, 92.6% and 94.3%, respectively, corresponding to students with baseline hyperopia reserve of >+2.00 D,+1.50 D to +2.00 D,+1.00 D to +1.50 D,+0.50 D to +1.00 D, 0.00 D to +0.50 D and -0.50 D to 0.00 D, and the difference was statistically significant (²=490.59, <0.001). The regression equation between baseline hyperopia reserve and 5-year spherical equivalent was as follows: 5-year spherical equivalent=-3.135+1.692·baseline hyperopia reserve (=0.454, <0.001). The lower the hyperopia reserve, the higher the incidence of myopia. Monitoring children's hyperopia reserve and early protection to reduce its consumption and timely detection of children at high risk of myopia are of great significance to prevent the occurrence and development of myopia.(This article was published ahead of print on the Online-First Publishing Platform for Excellent Scientific Researches of Chinese Medical Association Publishing House on March 15, 2022).
分析一年级小学生远视储备与近视累积发病率之间的纵向关联。队列研究。本研究纳入了安阳儿童眼病研究中2628名基线时未患近视的一年级小学生（2628只眼）。其中男性1515名，女性1113名，年龄为（7.16±0.40）岁。每年使用1%环喷托酯滴眼液进行睫状肌麻痹验光以获取远视储备数据。对基线时具有不同远视储备范围的学生进行分析。通过眼部生物测量获得眼轴长度、前房深度、角膜曲率、晶状体厚度等参数，并采用独立样本t检验进行比较。定性数据用频数和百分比描述，组间比较采用卡方检验或确切概率法。采用线性回归分析基线远视储备与5年后等效球镜度之间的关联。一年级未患近视儿童的平均远视储备为（+1.09±0.78）屈光度（D）。眼轴长度、前房深度、角膜曲率半径和晶状体厚度分别为（22.66±0.72）、（2.88±0.24）、（7.80±0.25）和（3.62±0.19）mm。一年级未患近视小学生在1年、2年、3年、4年和5年时近视的累积发病率分别为8.5%、21.5%、35.6%、47.6%和64.1%。在3年、4年和5年时，女孩的近视发病率显著高于男孩。基线远视储备分别为>+2.00 D、+1.50 D至+2.00 D、+1.00 D至+1.50 D、+0.50 D至+1.00 D、0.00 D至+0.50 D和-0.50 D至0.00 D的学生，其5年近视累积发病率分别为4.6%、26.3%、52.3%、78.6%、92.6%和94.3%，差异有统计学意义（χ²=490.59，P<0.001）。基线远视储备与5年后等效球镜度的回归方程如下：5年后等效球镜度=-3.135+1.692·基线远视储备（r=0.454，P<0.001）。远视储备越低，近视发病率越高。监测儿童的远视储备并尽早保护以减少其消耗，及时发现近视高危儿童，对于预防近视的发生和发展具有重要意义。（本文于2022年3月15日在中国医学协会出版社优秀科研成果在线优先出版平台提前发表）
