Ophthalmology Department, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Sports, Health and Arts, Chongqing Municipal Education Commission, Chongqing, China.
Front Public Health. 2022 Oct 13;10:993728. doi: 10.3389/fpubh.2022.993728. eCollection 2022.
To investigate myopia progression and associated factors of refractive status among children and adolescents in Tibet and Chongqing in China during the COVID-19 pandemic.
A population-based cross-sectional study was conducted to compare rates of myopia and high myopia, axial length (AL), spherical equivalent (SE), outdoor activity time, digital device use, and frequency of visual examinations for children and adolescents affected by myopia in Chongqing and Tibet in 2021.
A total of 2,303 students from Chongqing and 1,687 students from Tibet were examined. The overall prevalence of myopia and high myopia in these two groups were 53.80 and 7.04% vs. 43.86 and 1.30%, respectively in each case. The Chongqing students had a longer AL than the group from Tibet (23.95 vs. 23.40 mm, respectively; < 0.001). The mean SE of the students with myopic parents in Tibet was lower than that of the students in Chongqing with myopic parents (-2.57 ± 2.38 diopters (D) vs. -2.30 ± 2.34 D, respectively) ( < 0.001). Conversely, the mean SE of the students from urban areas in Chongqing was lower than that of the students in Tibet (-2.26 ± 2.25 D vs. -1.75 ± 1.96 D, respectively; < 0.001). The Chongqing students exhibited lower SE (-2.44 ± 2.22 D) than their Tibetan counterparts (mean SE: -1.78 ± 1.65 D ( = 0.0001) when spending more than 2.5 h outdoors. For example, 61.35% of the students in Tibet spent more than 2.5 h outdoors daily, compared with 43.04% of the students in Chongqing. Correspondingly, the proportion of students using digital devices in Tibet (64.43%) was lower than that in Chongqing (100%). For the latter, 38.62% of the students in Chongqing spent more than 2.5 h online using digital devices compared to 10.49% of the students in Tibet. Greater monitoring of visual status was observed for the Chongqing students (mean SE: -1.90 ± 1.98 D) compared with students in Tibet (mean SE: -2.68 ± 1.85 D) ( = 0.0448), with the frequency of optimal examinations being every 6 months. Outdoor activity time was identified as a common risk factor for myopia in both of the populations examined, with odds ratios (ORs) of 1.84 (95% CI: 1.79-1.90) in Chongqing and 0.84 (95% CI: 0.73-0.96) in Tibet. Digital screen time was associated with myopia and high myopia in Chongqing, with ORs of 1.15 (95% CI: 1.08-1.22) and 1.06 (95% CI: 0.94-1.77), respectively. Digital screen time was also found to be a risk factor for high myopia in Tibet (OR: 1.21, 95% CI: 0.77-1.61). The type of digital devices used was also associated with myopia and high myopia in Tibet (OR: 1.33, 95% CI: 1.06-1.68 and OR: 1.49, 95% CI: 0.84-2.58, respectively). Finally, examination frequency was found to correlate with high myopia in the Tibet group (OR: 1.79, 95% CI: 0.66-2.71).
Based on our data, we observed that the prevalence of refractive errors in children and adolescents was significantly lower in Tibet than in Chongqing. These results are potentially due to prolonged outdoor activity time, and the type and time of use for digital devices that characterize the group of children and adolescents from Tibet. It is recommended that parents and children in Chongqing would benefit from increased awareness regarding myopia progression and its prevention.
调查 COVID-19 大流行期间中国西藏和重庆儿童和青少年近视进展及相关屈光状态的因素。
本研究采用基于人群的横断面研究，比较了 2021 年重庆和西藏儿童和青少年近视和高度近视的发生率、眼轴（AL）、等效球镜（SE）、户外活动时间、数字设备使用以及视觉检查频率。
共检查了来自重庆的 2303 名学生和来自西藏的 1687 名学生。两组的总体近视和高度近视患病率分别为 53.80%和 7.04%，43.86%和 1.30%。重庆学生的 AL 比西藏学生长（23.95 毫米比 23.40 毫米；<0.001）。西藏近视父母的学生的平均 SE 低于重庆近视父母的学生（-2.57 ± 2.38 屈光度（D）比-2.30 ± 2.34 D；<0.001）。相反，重庆城区学生的平均 SE 低于西藏学生（-2.26 ± 2.25 D 比-1.75 ± 1.96 D；<0.001）。当每天户外活动时间超过 2.5 小时时，重庆学生的 SE （-2.44 ± 2.22 D）比西藏学生低（平均 SE：-1.78 ± 1.65 D；=0.0001）。例如，西藏有 61.35%的学生每天户外活动时间超过 2.5 小时，而重庆只有 43.04%的学生。相应地，西藏学生使用数字设备的比例（64.43%）低于重庆（100%）。对于后者，重庆有 38.62%的学生每天上网使用数字设备的时间超过 2.5 小时，而西藏只有 10.49%的学生。重庆学生的视力监测频率（平均 SE：-1.90 ± 1.98 D）高于西藏学生（平均 SE：-2.68 ± 1.85 D）（=0.0448），最佳检查频率为每 6 个月一次。户外活动时间是两个研究人群中近视的共同危险因素，重庆的优势比（OR）为 1.84（95%CI：1.79-1.90），西藏的 OR 为 0.84（95%CI：0.73-0.96）。数字屏幕时间与重庆的近视和高度近视有关，OR 分别为 1.15（95%CI：1.08-1.22）和 1.06（95%CI：0.94-1.77）。数字屏幕时间也是西藏高度近视的危险因素（OR：1.21，95%CI：0.77-1.61）。西藏学生使用的数字设备类型也与近视和高度近视有关（OR：1.33，95%CI：1.06-1.68 和 OR：1.49，95%CI：0.84-2.58）。最后，检查频率与西藏组的高度近视相关（OR：1.79，95%CI：0.66-2.71）。
根据我们的数据，我们观察到重庆儿童和青少年近视的患病率明显低于西藏。这些结果可能是由于西藏儿童和青少年户外活动时间长，以及数字设备的类型和使用时间与西藏儿童和青少年的特点有关。建议重庆的家长和孩子提高对近视进展及其预防的认识。
