de la Puente Miriam, Bilbao-Malavé Valentina, González-Zamora Jorge, Claici Aura Ortega, Bezunartea Jaione, Gomez-Arteta Leire, Alonso Elena, Hernández María, Fernández-Robredo Patricia, de Viteri Manuel Sáenz, Calvo Nerea Martín, García-Layana Alfredo, Barrio-Barrio Jesús, Recalde Sergio
Department of Ophthalmology, Clínica Universidad de Navarra, Pamplona, Spain.
Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Universidad de Navarra, Pamplona, Spain.
Front Med (Lausanne). 2024 Dec 9;11:1492180. doi: 10.3389/fmed.2024.1492180. eCollection 2024.
The prevalence of myopia has increased significantly in recent years including an earlier onset of myopia development on the pediatric population. The main objective of the study is to compare CUVAF (Conjunctival Ultraviolet Autofluorescence) in children with and without myopia to validate its usefulness as an outdoor protective biomarker.
A case-control observational study was conducted in a child cohort from subjects that attended to the Ophthalmology Department of Clínica Universidad de Navarra for an ophthalmological examination. The general exclusion criteria were (among others): amblyopia, congenital myopia, general ophthalmic disease, and any conjunctival alteration that might difficult the measurement of the CUVAF area. All participants underwent an automatic objective refraction under cycloplegic effect, biometry to measure axial length (AL) and central corneal radius (CCR), and completed a questionnaire about their lifestyle habits. A total of 4 images of the bulbar conjunctiva were taken with blue light in order to quantify the CUVAF area.
A total of 263 subjects (6 to 17 years old) were analyzed with no significant differences in demographic data between case group and control group. There were 50 non-myopic subjects (19%) and 213 myopic subjects (81%). In relation to the outdoor activities (OA), myopic subjects spent significantly fewer hours per week outdoors than the control-group ( = 0.03). About the CUVAF area, the differences between groups were statistically significant, showing that the myopic group has a significantly smaller CUVAF area than the control-group (0.33 ± 0.72 mm vs. 0.78 ± 1.22 mm; = 0.0023), likewise, the frequency of CUVAF area absence between both groups showed an odds ratio (OR) of 2.52 (CI95% 1.33-4.74). A Pearson correlation test was done, obtaining a strong significant inverse correlation between myopia degree-CUVAF area ( = 0.1877; IC95% 0.068-0.302), and also ratio (AL/CCR)-CUVAF area ( = 0.002 and = 0.04) respectively.
CUVAF is a useful biomarker for OA and it has an inverse relationship with myopia degree also in pediatric age, especially after the age of 12, so it could be useful to differentiate the risk of developing myopia. Having a CUVAF area greater than that corresponding to age, protect to myopia 2.5 times, being almost 5 times the protection in case of high myopia.
近年来，近视患病率显著上升，包括儿童群体中近视发病年龄提前。本研究的主要目的是比较近视儿童和非近视儿童的结膜紫外线自发荧光（CUVAF），以验证其作为户外保护生物标志物的有效性。
在纳瓦拉大学诊所眼科进行眼科检查的儿童队列中开展了一项病例对照观察性研究。一般排除标准包括（但不限于）：弱视、先天性近视、一般眼科疾病以及任何可能影响CUVAF面积测量的结膜病变。所有参与者在睫状肌麻痹作用下进行自动客观验光，测量眼轴长度（AL）和中央角膜半径（CCR），并完成一份关于其生活方式习惯的问卷。用蓝光拍摄4张球结膜图像，以量化CUVAF面积。
共分析了263名受试者（6至17岁），病例组和对照组的人口统计学数据无显著差异。有50名非近视受试者（19%）和213名近视受试者（81%）。关于户外活动（OA），近视受试者每周在户外花费的时间明显少于对照组（P = 0.03）。关于CUVAF面积，两组之间的差异具有统计学意义，表明近视组的CUVAF面积明显小于对照组（0.33±0.72平方毫米对0.78±1.22平方毫米；P = 0.0023），同样，两组之间CUVAF面积缺失的频率显示优势比（OR）为2.52（95%CI 1.33 - 4.74）。进行了Pearson相关性检验，近视度数与CUVAF面积之间存在强显著负相关（P = 0.1877；95%IC 0.068 - 0.302），眼轴长度与角膜曲率半径比值（AL/CCR）与CUVAF面积之间也分别存在相关性（P = 0.002和P = 0.04）。
CUVAF是一种用于户外活动的有用生物标志物，在儿童时期，尤其是12岁以后，它与近视度数呈负相关，因此对于区分近视发生风险可能有用。CUVAF面积大于相应年龄对应的面积时，对近视的保护作用是2.5倍，对于高度近视而言，保护作用几乎是5倍。
