Progression of Juvenile Myopia and Its Related Factors
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目的： 了解青少年近视进展情况并分析其相关影响因素。 方法： 纵向调查研究。通过随机抽取的方式选取青岛市黄岛区1所小学（3~6年级）和1所中学（7年级、8年级）中的6个年级，其中每个年级随机选取2个班级，共纳入320名近视学生作为研究对象。先于2018年1月寒假期间完成对所有入选学生裸眼远视力、电脑验光、裂隙灯显微镜、睫状肌麻痹验光及最佳矫正视力检查并获取基线数据。再于2019年1月寒假期间再次重复上述检查获取随访数据并通过现场调查问卷的方式获取受检者1年内包括近距离工作时间、户外活动时间等影响因素的相关信息。采用ANOVA、χ2检验、Logistic单因素和多因素回归分析方法等对相关数据进行统计分析。 结果： 共获得296名（92.5%）学生的完整数据。所有学生随访1年后的近视等效球镜度（SE）增长（-0.56±0.62） D（t=7.71，P<0.001），其中6年级近视进展最快（P<0.001）。各年级男、女生近视进展速度差异无统计学意义。入选近视学生中双亲均近视的比例最高，其次为单亲近视，双亲均无近视的比例最低（χ2=27.92，P<0.001）。单因素回归分析显示近视进展与双亲近视[OR=1.68，95%可信区间（CI）：1.22~2.13，P=0.042]、近距离工作距离<30 cm（OR=1.23，95% CI：1.02~1.59，P<0.001）、连续近距离工作时间≥30 min（OR=1.34, 95% CI：1.02~1.61，P=0.021）有相关性；进一步多元回归分析显示，近视进展仅与连续近距离工作时间≥30 min（OR=1.28, 95% CI：1.08~1.68，P=0.042）有相关性。 结论： 所有受检者随访1年的SE增长为（-0.56±0.62）D。各年级近视进展速度呈先快后慢的规律，其中，6年级（13岁）可能是近视进展速度变慢的一个转折点。连续近距离工作时间≥30 min是影响近视进展的重要危险因素。 Objective: To investigate juvenile myopia progression and analyze its related factors. Methods: Longitudinal investigation and research. Six grades from a primary school (grade 3 to grade 6) and a middle school (grade 7 and grade 8) in Huangdao District of Qingdao were selected by random sampling, of which two classes were selected for each grade. A total of 320 myopic students were included in the study. During the winter vacation in January 2018, all the selected students' naked eye far vision, autorefraction, slit-lamp microscope, cycloplegic refraction and best corrected visual acuity examination were completed and baseline data were obtained. One year later, during the winter vacation in January 2019, the above examinations were repeated again to obtain follow-up data, and the relevant information of the affected factors including near work time, outdoor activities time and so on was obtained through on-site questionnaire. All the data were statistically analyzed by ANOVA, χ2 test and logistic univariate and multivariate regression analysis. Results: A total of 296 (92.5%) students' complete data were obtained. One year later, the average increase of spherical equivalent (SE) in all students was about (-0.56±0.62)D (t=7.71, P<0.001), and the myopia progression in grade 6 was the fastest (P<0.001). There was no significant difference in the myopia progression between boys and girls. Among the selected myopic students, the proportion of two myopic parent was the highest, followed by one myopic parent, and no myopic parent was the lowest (χ2=27.92, P<0.001). In univariate analysis, myopia progression was statistically correlated with two myopic parent[odds ratio (OR)=1.68, 95% confidence interval (CI): 1.22-2.13, P=0.042], near work distance <30 cm ( OR=1.23, 95% CI: 1.02-1.59, P<0.001), continuous near work≥30 min (OR=1.34, 95% CI: 1.02-1.61, P=0.021). However, in multivariate models, only continuous near work≥30 min was significantly associated with myopia progression (OR=1.28, 95% CI: 1.08-1.68, P=0.042). Conclusions: The SE in all students increased by an average of (-0.56±0.62)D in one year. The progression of myopia in all grades showed a law of fast first and then slow. Among them, the sixth grade (13 years old) might be a turning point for the slow progression of myopia. Continuous near work time was an important risk factor for the progression of myopia.
Objective: To investigate juvenile myopia progression and analyze its related factors. Methods: Longitudinal investigation and research. Six grades from a primary school (grade 3 to grade 6) and a middle school (grade 7 and grade 8) in Huangdao District of Qingdao were selected by random sampling, of which two classes were selected for each grade. A total of 320 myopic students were included in the study. During the winter vacation in January 2018, all the selected students' naked eye far vision, autorefraction, slit-lamp microscope, cycloplegic refraction and best corrected visual acuity examination were completed and baseline data were obtained. One year later, during the winter vacation in January 2019, the above examinations were repeated again to obtain follow-up data, and the relevant information of the affected factors including near work time, outdoor activities time and so on was obtained through on-site questionnaire. All the data were statistically analyzed by ANOVA, χ2 test and logistic univariate and multivariate regression analysis. Results: A total of 296 (92.5%) students' complete data were obtained. One year later, the average increase of spherical equivalent (SE) in all students was about (-0.56±0.62)D (t=7.71, P<0.001), and the myopia progression in grade 6 was the fastest (P<0.001). There was no significant difference in the myopia progression between boys and girls. Among the selected myopic students, the proportion of two myopic parent was the highest, followed by one myopic parent, and no myopic parent was the lowest (χ2=27.92, P<0.001). In univariate analysis, myopia progression was statistically correlated with two myopic parent[odds ratio (OR)=1.68, 95% confidence interval (CI): 1.22-2.13, P=0.042], near work distance <30 cm ( OR=1.23, 95% CI: 1.02-1.59, P<0.001), continuous near work≥30 min (OR=1.34, 95% CI: 1.02-1.61, P=0.021). However, in multivariate models, only continuous near work≥30 min was significantly associated with myopia progression (OR=1.28, 95% CI: 1.08-1.68, P=0.042). Conclusions: The SE in all students increased by an average of (-0.56±0.62)D in one year. The progression of myopia in all grades showed a law of fast first and then slow. Among them, the sixth grade (13 years old) might be a turning point for the slow progression of myopia. Continuous near work time was an important risk factor for the progression of myopia.
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