Yu Yanze, Chen Hao, Zhang Zhe, Ye Yuhao, Shen Yang, Xu Ye, Zheng Ke, Wang Xiaoying, Jia Yingnan, Zhou Xingtao, Zhao Jing
Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China.
Key laboratory of Myopia and Related Eye Diseases, NHC, Shanghai, China.
Br J Ophthalmol. 2025 Aug 20;109(9):1064-1073. doi: 10.1136/bjo-2024-326261.
To identify factors contributing to rapid axial length (AL) growth in children aged 3-9 years.
Four thousand four hundred thirty-five children were followed from 2019 to 2022. AL and corneal curvature were measured using an IOLMaster 500, while refractometry and visual acuity were also assessed. Baseline data included demographics and parental myopia status, with annual updates on height, weight and behavioural factors. Latent class growth model was used to discover AL trajectories, whereas multiple logistic regression was used to identify determinants of rapid AL elongation.
For all participants, baseline age and parental myopia influenced AL growth. Specifically, children aged 3-6 years exhibited faster AL elongation when engaging in persistent excessive homework time (OR, 2.86, 95% CI 1.31 to 6.95) and near-work activities (OR, 2.13, 95% CI 1.12 to 4.10). For the 7-9-year group, the risk factors of rapid AL growth included being female (OR, 2.05, 95% CI 1.45 to 2.90) and need myopia correction at baseline (OR, 3.19, 95% CI 2.02 to 5.02). Notably, actively engaging in outdoor activities had a protective effect in the 7-9-year group (OR, 0.65, 95% CI 0.43 to 0.97).
This study delineates AL growth trajectories in children aged 3-9 years and highlights distinct risk factors for rapid AL growth. These findings underscore the necessity of implementing age-specific strategies for myopia prevention and control.
确定导致3至9岁儿童眼轴长度（AL）快速增长的因素。
2019年至2022年对4435名儿童进行随访。使用IOLMaster 500测量眼轴长度和角膜曲率，同时评估验光和视力。基线数据包括人口统计学和父母近视状况，每年更新身高、体重和行为因素。采用潜在类别增长模型来发现眼轴长度轨迹，而多元逻辑回归用于确定眼轴快速伸长的决定因素。
对于所有参与者，基线年龄和父母近视影响眼轴长度增长。具体而言，3至6岁儿童在持续作业时间过长（比值比[OR]，2.86；95%置信区间[CI]，1.31至6.95）和近距离工作活动时（OR，2.13；95% CI，1.12至4.10）眼轴伸长更快。对于7至9岁组，眼轴快速增长的危险因素包括女性（OR，2.05；95% CI，1.45至2.90）和基线时需要近视矫正（OR，3.19；95% CI，2.02至5.02）。值得注意的是，积极参加户外活动对7至9岁组有保护作用（OR，0.65；95% CI，0.43至0.97）。
本研究描绘了3至9岁儿童的眼轴长度增长轨迹，并突出了眼轴快速增长的不同危险因素。这些发现强调了实施针对特定年龄的近视防控策略的必要性。
