Nakamura Yo, Hieda Osamu, Nakai Yoshinori, Nakata Mitsuko, Sotozono Chie, Kinoshita Shigeru
Department of Ophthalmology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Hirokoji-agaru, Kawaramachi-dori, Kamigyo-ku, Kyoto, 602-0841, Japan.
Department of Medical Welfare, Osaka University of Human Sciences, Osaka, Japan.
Jpn J Ophthalmol. 2025 Sep 2. doi: 10.1007/s10384-025-01272-6.
To investigate and analyze gender-related differences in myopia prevalence and factors associated with myopia progression in school-aged children.
Observational study.
This study involved 2,298 eyes (boys = 1194 eyes; girls=1104 eyes) of 1149 school children (597 boys; 552 girls) in two elementary/junior high schools in Kyoto Japan, examined from 2013 through 2022. Gender differences in all grades were evaluated in regard to subjective and objective refractive error (RE), axial length (AL), corneal keratometry, higher-order aberrations (HOAs), and a questionnaire regarding environmental factors of myopia progression.
In the girls in all grades, corneal keratometry was steeper and AL was shorter (p<0.05), coma-like and total aberration (in 6mm) corneal HOAs, coma-like, spherical-like, and total aberration (in 6mm) ocular HOAs were larger (p<0.05), in addition, only spherical aberration (in 4mm) corneal HOAs were smaller. In all grades, no gender-related differences were found in myopia prevalence (Grade 1: boys = 6.1%; girls = 6.5%, Grade 9: boys = 60.4%; girls = 65.4%) as well as RE. The questionnaire findings revealed that in all grades the girls spent more time reading and less time playing mobile-phone-app games (p<0.001).
In Japanese school children, AL was shorter in the girls than in the boys, although, no gender-related differences were observed in myopia prevalence. The steeper cornea in girls might be associated with that discrepancy, and partially with gender differences of HOAs. Gender-specific differences of AL and HOAs should be considered in the analysis of myopia progression in school-aged children.
调查和分析学龄儿童近视患病率的性别差异以及与近视进展相关的因素。
观察性研究。
本研究纳入了日本京都两所小学/初中的1149名学龄儿童（597名男孩；552名女孩）的2298只眼睛（男孩 = 1194只眼睛；女孩 = 1104只眼睛），研究时间为2013年至2022年。评估了所有年级在主观和客观屈光不正（RE）、眼轴长度（AL）、角膜曲率测量、高阶像差（HOAs）以及一份关于近视进展环境因素的问卷方面的性别差异。
在所有年级的女孩中，角膜曲率更陡峭，眼轴长度更短（p<0.05），彗差样和总像差（6mm处）角膜高阶像差、彗差样、球差样和总像差（6mm处）眼内高阶像差更大（p<0.05），此外，仅4mm处的球差角膜高阶像差更小。在所有年级中，近视患病率（一年级：男孩 = 6.1%；女孩 = 6.5%，九年级：男孩 = 60.4%；女孩 = 65.4%）以及屈光不正方面未发现性别差异。问卷结果显示，在所有年级中，女孩阅读时间更多，玩手机应用游戏的时间更少（p<0.001）。
在日本学龄儿童中，女孩的眼轴长度比男孩短，尽管在近视患病率方面未观察到性别差异。女孩角膜更陡峭可能与这种差异有关，部分与高阶像差的性别差异有关。在分析学龄儿童近视进展时应考虑眼轴长度和高阶像差的性别特异性差异。
