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儿童及青少年近视与眼病的发生发展特点及防控效果:中国西南地区一项基于学校的回顾性队列研究。

Developmental characteristics and control effects of myopia and eye diseases in children and adolescents: a school-based retrospective cohort study in Southwest China.

机构信息

Department of Clinical Data Research, Chongqing Emergency Medical Center; Chongqing University Central Hospital, Chongqing University, Chongqing, China.

Chongqing Health Statistics Information Center, Chongqing, China.

出版信息

BMJ Open. 2024 Sep 25;14(9):e083051. doi: 10.1136/bmjopen-2023-083051.

Abstract

OBJECTIVES

To characterise the prevalence of myopia and eye diseases among school adolescents and children in Southwest China, and to evaluate the effectiveness of myopia control tools.

DESIGN

Retrospective cohort study.

SETTING

Across 95 basic education institutions in Southwest China.

PARTICIPANTS

96 146 children aged 3-17 years from a school-based survey conducted between 2019 and 2021.

PRIMARY OUTCOME MEASURES

The data of vision assessment and eye disease examination of school students were analysed, including a total of four surveys once per semester. The prevalence of myopia categorised as low (-0.5D to -3.0D), moderate (-3.0D to -6.0D) and high (≥-6.0D), along with the prevalence of significant ocular diseases, was assessed. Stratified analyses were conducted to investigate the impact of correction time on visual acuity (VA) and biological parameters. Subsequently, the subjects across the groups were matched using the nearest neighbour method, followed by multidimensional statistical analysis.

RESULTS

The prevalence of myopia among the surveyed students was 38.39%. After controlling for confounding variables, the statistical analysis revealed a 0.1 increase in mean VA within the orthokeratology group and a 0.1 decrease in VA within the spectacle group (p<0.001), with statistically significant differences in corneal radius, corneal curvature and equivalent spherical lens (p<0.05). Multivariate analysis indicated a statistically significant reduction in VA in the ophthalmopathy group compared with the control group (p=0.031). Furthermore, it was demonstrated that the risk of eye disease during vision correction was greater among older students than their younger counterparts (OR>1), and that female students exhibited a higher risk than male students (OR=1.5).

CONCLUSIONS

The current high prevalence of myopia and eye diseases among Southwest China's school youths demands public health attention. Minors wearing orthokeratology lenses at night, especially in primary school, exhibit significantly improved naked-eye vision. However, vigilant eye healthcare during the correction period is crucial, especially for girls.

摘要

目的

描述中国西南地区学校青少年近视和眼部疾病的流行情况,并评估近视防控工具的效果。

设计

回顾性队列研究。

地点

中国西南地区 95 所基础教育机构。

参与者

2019 年至 2021 年期间,在一项基于学校的调查中,对 96146 名 3-17 岁的儿童进行了视力评估和眼部疾病检查。

主要结局测量

对学生视力评估和眼病检查的数据进行分析,每学期进行一次共四次调查。评估近视的患病率,分为低度(-0.5D 至-3.0D)、中度(-3.0D 至-6.0D)和高度(≥-6.0D),以及显著眼部疾病的患病率。进行分层分析以调查矫正时间对视力(VA)和生物学参数的影响。随后,使用最近邻法对各组受试者进行匹配,然后进行多维统计分析。

结果

调查学生的近视患病率为 38.39%。在校正了混杂变量后,统计分析显示角膜塑形镜组的平均 VA 增加了 0.1,而框架镜组的 VA 下降了 0.1(p<0.001),角膜半径、角膜曲率和等效球镜(p<0.05)有统计学差异。多变量分析表明,与对照组相比,眼病组的 VA 显著降低(p=0.031)。此外,研究表明,视力矫正期间眼部疾病的风险在年龄较大的学生中高于年龄较小的学生(OR>1),女性学生的风险高于男性学生(OR=1.5)。

结论

中国西南地区学校青少年近视和眼部疾病的高患病率需要引起公共卫生关注。未成年人夜间佩戴角膜塑形镜,特别是在小学,裸眼视力显著提高。然而,在矫正期间需要警惕眼部保健,尤其是对女孩而言。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e110/11429369/9830eeca54e5/bmjopen-14-9-g001.jpg

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