户外干预措施对儿童和青少年近视疗效的系统评价和随机对照试验荟萃分析。
Efficacy of outdoor interventions for myopia in children and adolescents: a systematic review and meta-analysis of randomized controlled trials.
机构信息
School of Physical Education, Southwest University, Chongqing, China.
Key Laboratory of Cognition and Personality, Faculty of Psychology, Ministry of Education, Southwest University, Chongqing, China.
出版信息
Front Public Health. 2024 Aug 13;12:1452567. doi: 10.3389/fpubh.2024.1452567. eCollection 2024.
OBJECTIVES
The objective of this systematic review and meta-analysis was to evaluate the overall efficacy of outdoor interventions for myopia in children and adolescents, and to provide evidence for the prevention and control of myopia.
METHODS
Randomized controlled trials of outdoor interventions for myopia in children and adolescents were identified using electronic databases and manual searches. The Revised Cochrane risk-of-bias tool for randomized trials (RoB 2) was used to assess risk of bias in randomized controlled trials. A mean difference (MD) and a risk ratio (RR) with a 95% confidence interval (CI) were used to combine effect sizes. A sensitivity analysis was performed for each outcome using a stepwise elimination method to assess whether the pooled results were significantly affected by individual studies.
RESULTS
The analysis included seven randomized controlled trials involving a total of 9,437 subjects. The meta-analysis showed marked and statistically significant improvements in spherical equivalent refraction (MD = 0.19; 95% CI 0.14 to 0.25; < 0.01), axial length (MD = -0.09; 95% CI -0.13 to -0.05; < 0.01), and myopia incidence (RR = 0.84; 95% CI 0.78 to 0.91; < 0.01) following outdoor interventions.
CONCLUSION
Outdoor interventions effectively contributed to the prevention and control of myopia in children and adolescents, positively impacting spherical equivalent refraction, axial length, and myopia incidence. Outdoor interventions were characterized by low risk and high therapeutic benefits and could serve as alternative or adjuvant approaches to medication for the treatment of myopia. Considering the advantages in terms of safety and efficacy, outdoor interventions may be considered as a preferred intervention for the treatment of myopia in children and adolescents, while susceptibility to diseases associated with sunlight, particularly UV exposure, must be taken into account.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/, Identifier CRD42024538695.
目的
本系统评价和荟萃分析的目的是评估户外活动干预对儿童和青少年近视的总体疗效，并为近视的预防和控制提供证据。
方法
通过电子数据库和手工检索，确定了针对儿童和青少年近视的户外活动干预的随机对照试验。使用修订后的 Cochrane 随机对照试验偏倚风险工具（RoB 2）评估随机对照试验的偏倚风险。使用均数差值（MD）和风险比（RR）及其 95%置信区间（CI）合并效应量。使用逐步消除法对每个结局进行敏感性分析，以评估汇总结果是否受到个别研究的显著影响。
结果
分析纳入了 7 项随机对照试验，共涉及 9437 名受试者。荟萃分析显示，球镜等效屈光度（MD=0.19；95%CI 0.14 至 0.25； < 0.01）、眼轴长度（MD=-0.09；95%CI -0.13 至 -0.05； < 0.01）和近视发生率（RR=0.84；95%CI 0.78 至 0.91； < 0.01）在户外活动干预后均有显著改善。
结论
户外活动干预措施有效促进了儿童和青少年近视的预防和控制，对球镜等效屈光度、眼轴长度和近视发生率均有积极影响。户外活动干预措施风险低，治疗效果好，可作为治疗近视药物的替代或辅助方法。考虑到安全性和疗效方面的优势，户外活动干预措施可能被视为治疗儿童和青少年近视的首选干预措施，但必须考虑与阳光相关的疾病的易感性，特别是紫外线暴露。
系统评价注册
https://www.crd.york.ac.uk/prospero/，标识符 CRD42024538695。
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