Yotsukura Erisa, Torii Hidemasa, Mori Kiwako, Ogawa Mamoru, Hanyuda Akiko, Negishi Kazuno, Kurihara Toshihide, Tsubota Kazuo
Department of Ophthalmology, Keio University School of Medicine, Shinjuku, Tokyo, Japan.
JINS Endowed Research Laboratory for Myopia, Keio University School of Medicine, Shinjuku, Tokyo, Japan.
Ophthalmol Sci. 2024 Feb 10;4(5):100491. doi: 10.1016/j.xops.2024.100491. eCollection 2024 Sep-Oct.
To investigate the changes in axial length (AL) elongation and other ocular parameters before and during the coronavirus disease 2019 pandemic.
A longitudinal school-based study.
Public elementary schoolchildren in Tokyo (grades 1-6; age, 6-12 years) participated in this study from 2018 to 2021.
All participants underwent eye examinations and provided written consent to measurements of the noncycloplegic refraction and ocular biometry including AL, among others. The students' parents also completed a questionnaire about the students' lifestyles. We included the right eye in our analysis and compared the changes in the ocular parameters among the periods using a linear mixed-effects model for repeated measures and examined the univariate and step-wise multiple regression analyses to evaluate the associations between myopia and other covariates.
Changes in AL elongation and other ocular parameters from 2018 to 2019 (prepandemic), that of 2019 to 2020 (immediately after the pandemic onset), and that of 2020 to 2021 (during the pandemic).
A total of 578 students before the pandemic period, 432 immediately after the pandemic onset, and 457 during the pandemic period were evaluated. The changes in the ALs and spherical equivalents (SEs) a year before, immediately after onset, and during the pandemic were 0.31 mm/-0.20 diopter, 0.38 mm/-0.27 diopter, and 0.28 mm/-0.47 diopter, respectively (ALs, < 0.001; SEs, = 0.014). The results of the questionnaire showed that time spent outdoors daily had changed during the 3 years to 79, 63, and 77 minutes/day, respectively ( < 0.001). Time spent using smartphones or tablets increased year by year to 41, 52, and 62 minutes/day ( < 0.001). The greatest AL elongation occurred during the period when the shortest amount of time was spent outdoors during the 3 years.
These results suggested that the school closures and decreasing time spent outdoors might have caused greater AL elongation among schoolchildren in Tokyo; however, it is possible that, although the time spent in near work still increased, the return to the time spent outdoors to the prepandemic levels may have affected the slowing of AL elongation after lockdown.
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
研究2019冠状病毒病大流行之前及期间眼轴长度（AL）伸长及其他眼部参数的变化。
一项基于学校的纵向研究。
2018年至2021年，东京公立小学1至6年级（年龄6至12岁）的学生参与了本研究。
所有参与者均接受了眼科检查，并书面同意进行非散瞳验光及包括眼轴长度在内的眼部生物测量。学生家长还完成了一份关于学生生活方式的问卷。我们纳入右眼进行分析，并使用重复测量的线性混合效应模型比较各时间段眼部参数的变化，同时进行单变量和逐步多元回归分析，以评估近视与其他协变量之间的关联。
2018年至2019年（大流行前）、2019年至2020年（大流行开始后即刻）以及2020年至2021年（大流行期间）眼轴长度伸长及其他眼部参数的变化。
共评估了大流行前的578名学生、大流行开始后即刻的432名学生以及大流行期间的4项7名学生。大流行前一年、开始后即刻以及大流行期间眼轴长度和球镜等效度（SE）的变化分别为0.31毫米/-0.20屈光度、0.38毫米/-0.27屈光度和0.28毫米/-0.47屈光度（眼轴长度，P<0.001；球镜等效度，P = 0.014）。问卷结果显示，三年间每日户外活动时间分别变为79、63和77分钟/天（P<0.001）。使用智能手机或平板电脑的时间逐年增加，分别为41、52和62分钟/天（P<0.001）。眼轴长度伸长最多的时期是三年间户外活动时间最短的时期。
这些结果表明，学校停课以及户外活动时间减少可能导致东京小学生的眼轴长度伸长加剧；然而，尽管近距离工作时间仍在增加，但户外活动时间恢复到大流行前的水平可能影响了封锁解除后眼轴长度伸长的减缓。
本文末尾的脚注和披露中可能会有专利或商业披露信息。
