学龄期儿童近视进展的回顾性研究

A retrospective study on the progression of myopia in school-age children

摘要:

目的：调查近12年学龄期儿童近视进展情况，并分析相关影响因素。方法：2000年1月至2011年12月期间在中南大学湘雅三医院进行验光的5~12岁儿童4569人次纳入研究，排除有高度近视家族史者及眼部疾病者。有1次或多次复查记录的儿童进入近视进展程度统计。所有儿童采用麻痹剂散瞳后规范验光。结果：2000~2011年间儿童的平均屈光度为-2.0 ±1.7 D；年平均屈光进展度数差异无统计学意义（F=0.95，P>0.05）。近视儿童平均年龄由2000年的10.1岁降至2011年的8.9岁（P<0.05）。2000~2011年间儿童平均进展屈光度为-0.6±0.7 D/年，其中5~8岁阶段屈光进展度数呈减慢趋势（P<0.05），而9~11岁期间近视进展加速，其中10、11岁组与7、8岁组比较差异有统计学意义（P<0.01）。多元线性回归分析显示，年龄和基线近视度数与近视进展呈正相关。结论：近12年间学龄期儿童的平均近视进展程度无明显变化，但儿童近视发生的平均年龄下降。近视度数较高的儿童尤其是10岁以上的近视儿童是预防高度近视的重点对象。

Abstract:

OBJECTIVE: To study the progression of myopia in school-age children over the past 12 years and factors influencing myopia progression. METHODS: A total of 4569 cases of 5 to 12-year-old children who had refractive examinations in the Third Xiangya Hospital, Central South University between January 2000 and December 2011 were enrolled in this study. The children had no family history of congenital high myopia or other eye diseases. Myopia progression was evaluated when the children were re-examined. The refractive state of each child was measured with cyclopiegic retinoscopy. RESULTS: The mean spherical equivalent (SE) myopia was-2.0±1.7 D between January 2000 and December 2011. There was no statistical difference in yearly myopia progression between different years. The average age of the myopic children decreased from 10.1 in 2000 to 8.9 years old in 2011 (P<0.05). Mean myopia progression was -0.6±0.7 D per year from 2000 to 2011. Myopia progression reduced gradually in 5 to 8-year-olds (P<0.05), however, it accelerated between ages 9 and 11 years. Myopia progression in 10- and 11-year-olds was significantly greater than in 7- and 8-year-olds (P<0.01). The multiple linear regression analysis demonstrated that age and baseline myopic refraction were positively related to myopia progression. CONCLUSIONS: There was no obvious change in the yearly myopia progression of the children over the past 12 years. The mean age of myopia occurrence became younger with time. More preventive measures are needed to ward off high myopia in children with moderate myopia, especially those aged over 10 years.