中国儿童近视和高度近视的患病率及时间趋势：一项系统评价与荟萃分析，并对2020年至2050年进行预测
Prevalence and temporal trends in myopia and high myopia children in China: a systematic review and meta-analysis with projections from 2020 to 2050.
作者信息
Pan Wei, Saw Seang-Mei, Wong Tien Yin, Morgan Ian, Yang Zhikuan, Lan Weizhong
机构信息
Aier Academy of Ophthalmology, Central South University, Changsha, Hunan, China.
Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.
出版信息
Lancet Reg Health West Pac. 2025 Jan 27;55:101484. doi: 10.1016/j.lanwpc.2025.101484. eCollection 2025 Feb.
BACKGROUND
Myopia rates have risen in the past decades in China. New strategies for the prevention and control of myopia are now available, and understanding the prevalence and future trends in myopia and high myopia in children and adolescents in China may provide insights into the impact of implementing these measures. The study aims to provide updated data on the prevalence of myopia and high myopia in children and to project temporal trends in prevalence from 2020 to 2050 in China.
METHODS
A systematic review and meta-analysis searching several databases in both English and Chinese: PubMed, Web of Science, Science Direct, China National Knowledge Infrastructure (CNKI), Wanfang, China Science and Technology Journal Database (CSTJ) with date limits from 01/01/2010 to 11/23/2024 was conducted. We included population-based or school-based studies in China that determined the myopia prevalence, based on the cycloplegic refraction, in children under 20. Studies with a response rate <70% or sample size <200 were excluded. A fixed-effect meta-analysis was used, and projections were made based on three scenarios: experience-based, maximum growth (maximum near-work, minimal outdoor time), and minimum growth (2 h outdoor time daily).
FINDINGS
From 6555 reports, 82 studies with 218,794 participants were included. The overall myopia prevalence was 36.6% (95% CI: 36.4%, 36.8%), with rates of 2.6% in ages 0-4, 22.0% in ages 5-9, 45.4% in ages 10-14, and 67.2% in ages 15-19. High myopia prevalence was 5.3% overall, with rates of 0.1% in ages 0-4, 1.1% in ages 5-9, 3.0% in ages 10-14, and 9.5% in ages 15-19. Projections for 2030 under minimum growth, experience-based, and maximum growth scenarios were 26.8%, 46.2%, 56.0%; 2040 were 19.6%, 54.4%, 65.6%; and 2050 were 14.4%, 61.3%, 71.9%, respectively.
INTERPRETATION
China is facing a substantial and potentially worsening epidemic of childhood myopia. This information will provide data for guiding implementation and evaluating the effectiveness of existing and new nationwide myopia prevention and control programs.
FUNDING
The Science and Technology Innovation Program of Hunan Province, China (2023RC1079, 2024RC5002).
背景
在过去几十年里，中国的近视率有所上升。目前已有预防和控制近视的新策略，了解中国儿童和青少年近视及高度近视的患病率和未来趋势，可能有助于洞察实施这些措施的影响。本研究旨在提供中国儿童近视和高度近视患病率的最新数据，并预测2020年至2050年患病率的时间趋势。
方法
进行了一项系统评价和荟萃分析，检索了中英文的多个数据库：PubMed、科学网、科学Direct、中国知网（CNKI）、万方、中国科技期刊数据库（CSTJ），时间限制为2010年1月1日至2024年11月23日。我们纳入了中国基于人群或学校的研究，这些研究根据睫状肌麻痹验光确定20岁以下儿童的近视患病率。应答率<70%或样本量<200的研究被排除。采用固定效应荟萃分析，并基于三种情景进行预测：基于经验的情景、最大增长情景（最大近距工作时间、最小户外时间）和最小增长情景（每天2小时户外时间）。
结果
从6555篇报告中，纳入了82项研究，共218,794名参与者。总体近视患病率为36.6%（95%CI：36.4%，36.8%），0-4岁年龄组为2.6%，5-9岁年龄组为22.0%，10-14岁年龄组为45.4%，15-19岁年龄组为67.2%。高度近视总体患病率为5.3%，0-4岁年龄组为0.1%，5-9岁年龄组为1.1%，10-14岁年龄组为3.0%，15-19岁年龄组为9.5%。在最小增长、基于经验和最大增长情景下，2030年的预测患病率分别为26.8%、46.2%、56.0%；2040年分别为19.6%、54.4% 、65.6%；2050年分别为14.4%、61.3%、71.9%。
解读
中国正面临着儿童近视这一严重且可能日益恶化的流行病。这些信息将为指导实施和评估现有及新的全国性近视防控项目的有效性提供数据。
资金来源
中国湖南省科技创新计划（2023RC1079，2024RC5002）。
Zotero 插件