近视从8至12岁发病到成年期的进展情况以及遗传和外部因素对近视进展的影响。一项为期23年的随访研究。

The progression of myopia from its onset at age 8-12 to adulthood and the influence of heredity and external factors on myopic progression. A 23-year follow-up study.

作者信息

Pärssinen Olavi, Kauppinen Markku, Viljanen Anne

机构信息

Department of Ophthalmology, Central Hospital of Central Finland, Jyväskylä, Finland; Department of Health Sciences and Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland.

出版信息

Acta Ophthalmol. 2014 Dec;92(8):730-9. doi: 10.1111/aos.12387. Epub 2014 Mar 27.

DOI:10.1111/aos.12387

PMID:24674576

Abstract

PURPOSE

To examine myopic progression and factors connected with myopic progression.

METHODS

Myopic schoolchildren, with no previous spectacles, 119 boys and 121 girls, were recruited during 1983-1984 to a randomized 3-year clinical trial of bifocal treatment of myopia with a subsequent 20-year follow-up. Participants' mean age at Baseline was 10.9, ranging from 8.7 to 12.8 years. An ophthalmological examination was carried out annually for 3 years and twice thereafter at ca. 10-year intervals. Additional refraction values were received from prescriptions issued by different ophthalmologists and opticians. Altogether, 1915 refraction values were available. Reading distance and accommodation were measured at each control visit. Data on parents' myopia, daily time spent on reading and close work, outdoor activities and watching television were gathered with a structured questionnaire.

RESULTS

Using bifocals (+1.75 add) or reading without glasses or accommodation stimulus during the 3-year period in childhood did not correlate with adulthood refraction. Short reading distance in childhood predicted higher adulthood myopia among females. The factors predicting faster myopic progression were parents' myopia and less time spent on sports and outdoor activities at childhood. Time spent on reading and close work in childhood was related to myopic progression during the first 3 years but did not predict adulthood myopia. Myopia throughout follow-up was higher among those who watched television <3 hr daily than those who spent more time watching television. Mean myopic progression 8 years after age 20-24 was -0.45 D ± 0.71 (SD), and in 45% of cases, progression was ≥0.5 D.

CONCLUSIONS

In nearly half of the cases, myopia beginning at school continued to progress into adulthood. Higher adulthood myopia was mainly related to parents' myopia and less time spent on sports and outdoor activities in childhood.

摘要

目的

研究近视进展情况以及与近视进展相关的因素。

方法

1983年至1984年期间，招募了119名男孩和121名女孩，这些近视学龄儿童此前未佩戴过眼镜，他们参与了一项为期3年的双焦点治疗近视随机临床试验，随后进行了20年的随访。参与者基线时的平均年龄为10.9岁，年龄范围在8.7岁至12.8岁之间。连续3年每年进行一次眼科检查，此后大约每10年进行两次检查。从不同眼科医生和验光师开具的处方中获取额外的验光值。总共获得了1915个验光值。每次复诊时测量阅读距离和调节能力。通过结构化问卷收集有关父母近视情况、每日阅读和近距离工作时间、户外活动时间以及看电视时间的数据。

结果

在儿童期的3年中使用双焦点眼镜（附加度数为+1.75）或不戴眼镜阅读或无调节刺激与成年后的验光结果无关。儿童期阅读距离短预示着成年后女性近视度数更高。预测近视进展更快的因素是父母近视以及儿童期花在运动和户外活动上的时间较少。儿童期花在阅读和近距离工作上的时间与最初3年的近视进展有关，但不能预测成年后的近视情况。在整个随访期间，每天看电视少于3小时的人比看电视时间更长的人近视度数更高。20至24岁后8年的平均近视进展为-0.45 D±0.71（标准差），45%的病例进展≥0.5 D。