Ma Yingyan, Lin Senlin, Zhu Jianfeng, Zhao Rong, Zhang Bo, Yin Yao, Shao Yueqin, He Xiangui, Xu Xun, Zou Haidong
Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China.
Department of Ophthalmology, Shanghai General Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Front Pediatr. 2022 Apr 25;10:864233. doi: 10.3389/fped.2022.864233. eCollection 2022.
To investigate the risk factors for change in refraction and refractive components in preschoolers.
Preschool children aged 3-5 years old, from the junior and the middle grades of seven randomly selected kindergartens in Jia Ding District, Shanghai, were followed for 1 year. Cycloplegic autorefraction (1% cyclopentolate) and axial length (AL) were measured at baseline and at 1-year follow-up. Questionnaires about parental myopia and environmental risk factors, such as time of outdoors and near work, were collected.
A total of 603 right eyes of 603 children were included. Parental myopia was not associated with a change in refraction, but two myopic parents were associated with a longer change in AL (coefficient = 0.153, = 0.006), after adjusted for baseline spherical refraction, age, gender, change in height, change in weight, and environment risk factors. In the multivariate analyses, boys showed a more myopic refraction shift than girls in 1 year (coefficient = -0.150, = 0.008) and a quicker AL elongation (coefficient = 0.120, = 0.008). Time of near work, such as watching television, using computer, reading and writing, and time of outdoor activities, was not associated with a change in refraction or AL.
In preschool age, environmental risk factors were not strongly associated with the change in refraction or refractive components. Parental myopia influences the refractive development of children continuously from infancy to preschool age, which might be the biological basis of school myopia.
探讨学龄前儿童屈光及屈光成分变化的危险因素。
对上海市嘉定区随机选取的7所幼儿园小班和中班3至5岁的学龄前儿童进行为期1年的随访。在基线期和随访1年时测量睫状肌麻痹下的自动验光（1%环戊通）和眼轴长度（AL）。收集有关父母近视及环境危险因素的问卷，如户外活动时间和近距离工作时间。
共纳入603名儿童的603只右眼。经校正基线球镜屈光、年龄、性别、身高变化、体重变化及环境危险因素后，父母近视与屈光变化无关，但父母双方近视与AL变化较大有关（系数 = 0.153，P = 0.006）。在多因素分析中，男孩在1年内屈光向近视方向的变化比女孩更明显（系数 = -0.150，P = 0.008），且AL伸长更快（系数 = 0.120，P = 0.008）。看电视、使用电脑、读写等近距离工作时间以及户外活动时间与屈光或AL变化无关。
在学龄前，环境危险因素与屈光或屈光成分变化的关联不强。父母近视从婴儿期到学龄前持续影响儿童的屈光发育，这可能是学校性近视的生物学基础。
