COVID-19 封锁对意大利 5-12 岁儿童屈光不正的影响：一项多中心回顾性研究。
Effect of COVID-19 lockdown on refractive errors in Italian children aged 5-12 years: A multi-center retrospective study.
机构信息
Department of Sense Organs, Faculty of Medicine and Dentistry, 9311Sapienza University of Rome, Rome, Italy.
Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, 9311Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
出版信息
Eur J Ophthalmol. 2023 Jan;33(1):112-122. doi: 10.1177/11206721221106135. Epub 2022 Jun 9.
PURPOSE
to explore the potential consequences of the COVID-19 lockdown on the prevalence of myopia among Italian children aged 5-12 years.
MATERIALS AND METHODS
retrospective multicenter study conducted in Italy. Population: children aged 5-12. Selection: random selection of children who received an eye exam between 2016 to 2021. Inclusion criteria: healthy children presenting for a routine eye exam. Exclusion criteria: presence of ocular comorbidities other than refractive error, such as blepharoptosis, media opacities, corneal or retinal dystrophies, strabismus, amblyopia, or concurrent therapy with atropine 0.01%. Outcome measure: age and spherical equivalent (SE) measured in diopters (D) in the right eye (RE) in cycloplegia. Statistical analysis: ANOVA test.
RESULTS
total of 803 children. In the years prior to COVID-19, the mean SE ± SD of healthy age-school children was: 0.54 ± 1.49 D in 2016; 0.43 ± 1.84 D in 2017; 0.34 ± 1.41 D in 2018; 0.35 ± 1.75 D in 2019 (ANOVA, p = .659). In 2021, the mean SE changed to -0.08 ± 1.44 D (ANOVA, p = .005). Mean age was comparable in all groups (ANOVA, p = .307). The prevalence of myopes (SE ≤-0.5D) and hyperopes (SE ≥ 2D) was respectively 24.10% and 9.64% among children aged 60-96 months, and 63.86% and 6.02% among children aged 97-144 months. These values represent a statistically-significant increase in the number of myopes (Chi-square, p = .016) and decrease in the number of hyperopes (Chi-square, p = .001), as compared to previous years (.06 and.48 respectively).
CONCLUSION
this retrospective study shows a statistically-significant decrease in the mean SE in children aged 5-12 in the year following the COVID-19 lockdown. The percentage of myopes has increased significantly, while the percentage of hyperopes has decreased. The lifestyle changes caused by the lockdown led children to spend more time on near-work activities and digital devices, and less time outdoors. These are known risk factors for the development and progression of myopia. Studies in different countries are encouraged.
目的
探讨 COVID-19 封锁对意大利 5-12 岁儿童近视患病率的潜在影响。
材料和方法
这是一项在意大利进行的回顾性多中心研究。研究对象为 5-12 岁儿童。研究方法为随机选择 2016 年至 2021 年期间接受眼部检查的儿童。纳入标准：接受常规眼部检查的健康儿童。排除标准：存在除屈光不正以外的眼部合并症，如上睑下垂、介质混浊、角膜或视网膜营养不良、斜视、弱视或同时接受 0.01%阿托品治疗。观察指标：右眼在睫状肌麻痹下的年龄和球镜等效（SE），以屈光度（D）表示。统计学分析：方差分析。
结果
共纳入 803 名儿童。在 COVID-19 之前的几年中，健康学龄儿童的 SE 平均值 ± 标准差分别为：2016 年 0.54 ± 1.49 D；2017 年 0.43 ± 1.84 D；2018 年 0.34 ± 1.41 D；2019 年 0.35 ± 1.75 D（方差分析，p = .659）。2021 年，SE 平均值变为-0.08 ± 1.44 D（方差分析，p = .005）。所有组别的平均年龄均无差异（方差分析，p = .307）。60-96 个月儿童中近视（SE ≤-0.5D）和远视（SE ≥ 2D）的患病率分别为 24.10%和 9.64%，97-144 个月儿童中分别为 63.86%和 6.02%。这表明近视儿童的数量显著增加（卡方检验，p = .016），远视儿童的数量显著减少（卡方检验，p = .001），与前几年相比（分别为 0.06 和 0.48）。
结论
这项回顾性研究显示，COVID-19 封锁后，5-12 岁儿童的 SE 平均值呈统计学显著下降。近视儿童的比例显著增加，而远视儿童的比例下降。封锁导致的生活方式改变使儿童更多地从事近距离工作活动和使用数字设备，户外活动时间减少。这些都是近视发展和进展的已知危险因素。鼓励在不同国家开展研究。
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