Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China.
Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China.
Graefes Arch Clin Exp Ophthalmol. 2024 Jan;262(1):295-303. doi: 10.1007/s00417-023-06149-3. Epub 2023 Jul 6.
To describe the association of refraction development and axial length (AL) in young children and provide new insights into the progression of cylinder power.
Children (2-3 grades) were enrolled from primary schools in Shanghai and followed up for two years. Cycloplegic refraction, AL, and corneal curvature radius were measured. Refraction parameters were compared among groups with different AL, AL1 (AL < 23.5 mm), AL2 (23.5 mm ≤ AL < 24.5 mm), and AL3 (AL ≥ 24.5 mm). Multiple regression analysis was used to explore risk factors of diopter of cylinder (DC) progression.
In total, out of 6891 enrolled children, 5961 participants (7-11 yrs) were included in the final analysis. Over the two-year period, the cylinder power significantly changed, and those with longer AL had more rapid DC progression over the two years (AL1, -0.09 ± 0.35 D; AL2, -0.15 ± 0.39 D; AL3, -0.29 ± 0.44 D) (P < 0.001). The change in DC was independently associated with AL at baseline (P < 0.001). The proportion of with-the-rule astigmatism increased from 91.3% to 92.1% in AL1 group, from 89.1% to 91.8% in AL2 group and from 87.1% to 92.0% in AL3 group.
Young children with long AL experienced rapid progression of cylinder power. Both the control of myopia progression and attention to the correction of astigmatism are necessary in the health management of children with long AL. The significantly increased AL in participants might contribute to both the extent and direction of astigmatism.
描述儿童屈光发育与眼轴（AL）的相关性，并深入了解柱镜屈光度进展的规律。
本研究从上海市的小学招募儿童（2-3 年级），并进行了为期两年的随访。测量睫状肌麻痹验光、AL 和角膜曲率半径。比较了不同 AL 组（AL<23.5mm 为 AL1 组，23.5mm≤AL<24.5mm 为 AL2 组，AL≥24.5mm 为 AL3 组）之间的屈光参数。采用多元回归分析探讨柱镜屈光度进展的危险因素。
在总共招募的 6891 名儿童中，有 5961 名（7-11 岁）参与者被纳入最终分析。在两年期间，柱镜屈光度显著变化，眼轴较长的儿童在两年内柱镜屈光度进展更快（AL1 组为-0.09±0.35D；AL2 组为-0.15±0.39D；AL3 组为-0.29±0.44D）（P<0.001）。基线时 AL 与 DC 的变化独立相关（P<0.001）。顺规散光的比例从 AL1 组的 91.3%增加到 92.1%，从 AL2 组的 89.1%增加到 91.8%，从 AL3 组的 87.1%增加到 92.0%。
眼轴较长的儿童柱镜屈光度进展迅速。在眼轴较长儿童的健康管理中，既要控制近视进展，又要重视散光的矫正。参与者中 AL 的显著增加可能导致散光的程度和方向发生变化。
