论著

广州市越秀区青少年近视特点和危险因素分析

Analysis on the characteristics and risk factors of myopia among adolescents in Yuexiu District,Guangzhou

:541-547
 
目的 探讨广州市越秀区青少年近视特点和危险因素,为降低青少年近视发病率提供参考依据。方法 本项目采用分层随机整群抽样的研究方法,抽取分布于广州市越秀区2 774名青少年作为研究对象,根据近视检查情况将其分为近视组(n=1 657)与非近视组(n=1 117),通过问卷调查的方式,分析青少年近视整体现况、流行病学特征以及影响青少年近视发生、发展的相关行为和因素。结果 2 774名青少年中,1 657名近视,检出率为59.73%;其中女生为872名,多于男生的785名;幼儿园、小学生、初中生、高中生近视人数分别为20名、446名、484名、707名,呈升高趋势。学段、校内用眼环境、校外用眼环境、读写姿势、电子屏幕使用情况、近距离用眼情况、户外活动及睡眠情况、近视检查及矫治情况是广州市越秀区青少年近视的影响因素(P<0.05)。广州市越秀区青少年近视程度均与学段、校外用眼环境、电子屏幕使用情况、户外活动及睡眠情况、近距离用眼情况呈正相关(P<0.05),与校内用眼环境、读写姿势、近视检查及矫治情况呈负相关(P<0.05)。对不同预后组间存在统计学差异的因素进行Logistic多因素分析后得到,学段、校内用眼环境、校外用眼环境、读写姿势、电子屏幕使用情况、近距离用眼情况、户外活动及睡眠情况、近视检查及矫治情况是广州市越秀区青少年近视的相关影响因素(P<0.05)。结论 广州市越秀区青少年近视发生人群呈现高龄化,学段、校内用眼环境、校外用眼环境、读写姿势、电子屏幕使用情况、近距离用眼情况、户外活动及睡眠情况、近视检查及矫治情况是青少年近视的相关影响因素,建议加强组织学生到户外进行多种课间户外体育活动,同时鼓励家长在校外从自身做起,树立爱眼护眼好榜样,与学校共同保护孩子的视力。
Objective To explore the characteristics and risk factors of myopia among adolescents in Yuexiu District,Guangzhou,and to provide reference for reducing the incidence of myopia among adolescents.Methods This project adopted stratified random cluster sampling to select 2 774 adolescents distributed in Yuexu District,Guangzhou as the research objects,which were divided into myopia group(n=1 657)and non-myopia group(n=1 117)according to the myopic examination.Through questionnaire survey,the overall situation and epidemiological characteristics of myopia among adolescents in our district were comprehensively known,in order to explore the related behaviors and factors affecting the occurrence and development of myopia among adolescents in our district,explore reasonable intervention measures,and put forward scientific and effective myopia prevention and control technical means and strategies.Results Among 2 774 adolescents,1 657 were nearsighted(59.73%).Among them,872 were female and 785 were male.The number of myopia in kindergarten,primary school,middle school and high school students were 20,446,484 and 707 respectively,showing an increasing trend.School period,eyes use environment in school and outside school,reading and writing posture,situations of electronic screen use,close distance eye use,outdoor activities and sleep,myopia examination and correction were the relevant influencing factors on myopia of adolescents in Yuexui District of Guangzhou(P<0.05).The myopia degree of adolescents in Yuexiu District of Guangzhou was positively correlated with school period,out-of-school eyes use environment,electronic screen use,outdoor activities and sleep conditions,and close distance eyes use(P<0.05),and negatively correlated with in-school eyes use environment,reading and writing posture,myopia examination and correction conditions(P<0.05).After Logistic multivariate analysis of the factors with statistical difference between different prognostic groups,school period,eyes use environment in school and outside school,reading and writing posture,electronic screen use,close distance eyes use,outdoor activities and sleep conditions,myopia examination and correction were the relevant influencing factors on myopia of adolescents in Yuexui District of Guangzhou(P<0.05).Conclusions In Yuexiu District,Guangzhou,the population with myopia is gradually moving to a younger age.School period,eyes use environment in school and outside school,reading and writing posture,electronic screen use,close distance eyes use,outdoor activities and sleep condition,myopia examination and correction are the relevant influencing factors.It is recommended to strengthen the organization of students to go outdoors for a variety of outdoor sports activities between classes,while encouraging parents to set a good example of eye care outside the school and work with the school to protect their children’s eyesight.
眼科专题:近视防控
论著

近视眼前房参数的影响因素

The influence factor of anterior chamber parameter in myopia eyes

:20-23
 
目的 运用Sirius系统对准分子术前患者的前房参数以及角膜中央厚度进行检测,探讨上述因素之间的相关性、规律性,以及性别、年龄对其的影响。方法 分组:对210例近视眼患者(420只眼)根据屈光度分为低度近视组,中度近视组、高度近视组。采用Sirius系统对三组检测眼进行角膜中央厚度、中央前房深度、前房容积、颞侧及鼻侧房角宽度进行测量,并采用相关性分析,单因素方差分析对检测数据进行统计学分析。结果 屈光度数绝对值与颞侧房角呈正相关,中央前房深度与前房容积呈正相关、与颞侧及鼻侧房角宽度均呈正相关。颞侧与鼻侧房角宽度亦呈正相关。年龄与中央前房深度呈负相关。不同屈光度度数组别之间颞侧房角宽度存在统计学差异性。男性中央前房深度及颞侧房角宽度明显大于女性。结论 Sirius系统可以作为一种便捷、准确且无创的角膜厚度及前房参数的测量工具。近视眼患者的前房参数与屈光度数、中央角膜厚度、年龄、性别存在一定的相关性性、规律性。
Objective To analyze the correlation and principle of anterior chamber parameter and central cornea thickness, the influence by the sexual and age in the pre-operative patients with excimer laser by using Sirius system. Methods 210 patients (410 eyes)were divided into 3 groups based on refractive status:low myopia,moderate myopia and high myopia.Central cornea thickness(CCT),anterior chamber depth(ACD),anterior chamber volume(ACV),temporal(T) and nasal anterior chamber width(N) were measured by Sirius system. The results are analyzed by correlation and one-way anova of statistics. Results A positive correlation was found in the absolute value of diopter and temporal anterior chamber width, the anterior chamber depth(ACD) and anterior chamber volume(ACV), temporal(T) and nasal anterior chamber width(N), and also in the temporal and nasal anterior chamber width. There was a negative correlation between age and temporal and nasal anterior chamber width. There were significantly statistics differences in the temporal anterior chamber width between different diopter groups. The anterior chamber depth(ACD) and temporal anterior chamber width of males were obvious deeper than females. Conclusion The Sirius system may be used as a convenient, precise and noninvasive technique in cornea thickness and anterior chamber parameter measurement. There is a definite correlation and principle in the anterior chamber parameter and diopter, central cornea thickness, age and sexual.
论著

Sirius与A超测量近视眼中央角膜厚度的比较

Comparison of central corneal thickness measurements with Sirius and ultrasound pachymetry in myopia

:35-37
 
目的 探讨Sirius与A超对不同程度近视患者中央角膜厚度(CCT)的测量差异。方法 对225例(450眼)拟行角膜屈光手术的近视患者,按低、中、高度近视分三组,依次用Sirius和A超测量CCT。 测量结果行配对t检验、 Pearson相关及 Bland-Altman分析。结果 低、中、高度近视组中,Sirius所测CCT均数分别为(542.61±29.19)μm、(543.96±27.02)μm、(547.25±22.53)μm;A超CCT均数分别为(538.51±29.12)μm、(540.98±26.56)μm、(542.19±21.64)μm。不同近视组中,Sirius测量值均略大于A超值,且两者高度正相关,差异有统计学意义(P<0.05)。Bland-Altman分析,不同近视组中,两种仪器测量CCT的一致性较好。结论 Sirius在绝大多数情况下能够替代传统的A超角膜测厚仪,但对拟行激光手术的高度近视患者应该综合考虑两种仪器测量结果。
Objective To study the measurement differences of central corneal thickness(CCT) in different degree of myopia by Sirius and ultrasound pachymetry(UP). Methods 225 myopic subjects(450 eyes)were recruited and divided into three groups according to the degree of refractive errors. The CCT were obtained from the eyes for each subjects using the Sirius and UP. Data were compared by using paired t-tests and the Pearson correlations. Bland- Altman analysis of all pairs were determined. Results The mean CCT in low myopic group obtained from Sirius and UP were (542.61±29.19)μm and(538.51±29.12)μm,respectively. The mean CCT in medium myopic group by Sirius and UP were(543.96±27.02)μm and(540.98±26.56)μm.The measured mean CCT in high myopic group were(547.25±22.53)μm and(542.19±21.64)μm by Sirius and UP. The mean CCT measurements between the two instruments were high correlated and statistically different(P<0.05) in the three groups respectively. In different myopia groups Sirius has good coincidence with UP in measuring CCT according to the Bland-Altman plot. Conclusion In vast majority of cases,Sirius can replace traditional UP in measuring CCT. But for the preopreative examination of the high myopia patients, we need to think twice about the difference between the two measurements.
眼科专题:近视防控

羽毛球颠球运动对低年级小学生近视影响的研究

Study on the impact of badminton juggling on myopia in lower grade primary school students

:26-31
 
    目的   研究羽毛球颠球运动对低年级小学生近视的改善效果,为制定儿童青少年近视干预方案提供依据。方法   采用方便抽样方法,抽取广州市1个城区1所小学三年级4个班共182名学生作为研究对象。基线调查完成后,以班为单位,采用随机数字表法将4个班分为干预组(2个班,91例)和对照组(2个班,91例),干预组安排羽毛球颠球项目体育活动,对照组按原教学计划安排非球类常规体育活动。比较两组干预前后筛查性近视率、视力不良率和近视进展程度。结果  干预前两组的年龄、性别、筛查性近视率、视力不良率及近视分级比较,差异均无统计学意义(P>0.05)。两组干预后的等效球镜度数(SE)比较,差异无统计学意义(P>0.05);对照组干预后的裸眼远视力(UDVA)低于干预组,△UDVA、△SE均高于干预组,差异均有统计学意义(P<0.05)。对照组新发筛查性近视率29.13%、累积筛查性近视率49.45%、累积视力不良率68.13%及近视进展程度,均高于干预组新发筛查性近视率7.69%、累积筛查性近视率34.07%、累积视力不良率52.74%及近视进展程度,差异均有统计学意义(P<0.05)。结论   羽毛球颠球运动能降低低年级小学生视力不良进展速度,减少近视的发生率及近视程度,学校可结合引起近视的因素进行灵活应用,以预防近视的发生发展。
      Objective  To study the impact of badminton juggling on the myopia of lower-grade primary school students and to provide a basis for developing myopia intervention strategies for children and adolescents.Methods  By using the convenience sampling method,182 third-grade students from four classes in a primary school in a district of Guangzhou were selected as subjects.After completing the baseline survey,the four classes were divided into an intervention group(2 classes,91 students)and a control group(2 classes,91 students)using a random number table.The intervention group was arranged to participate in badminton juggling sports activities,while the control group followed the original teaching plan without ball games.The study compared the screening rate of myopia,the rate of poor vision,and the degree of myopia progression before and after the study in both groups.Results  On baseline,there were no statistically significant differences between the two groups in terms of age,gender,rate of screening myopia,poor vision,and myopia grading(P>0.05).After 12 months,there was no statistically significant difference in the spherical equivalent(SE) comparison between the two groups(P>0.05).However,the uncorrected distance visual acuity(UDVA) of the control group after 12 months was significantly lower than that of the intervention group,and both △UDVA and △SE were significantly higher than those of the intervention group,with all differences being statistically significant(P<0.05).Incidence of screening myopia in the control group (29.13%),the cumulative rate of screening myopia(49.45%),the cumulative rate of poor vision (68.13%),and the degree of myopia progression was significantly higher than those in the intervention group,which had incidence of screening myopia at 7.69%,the cumulative rate of screening myopia at 34.07%,cumulative rate of poor vision at 52.74%.All these differences were statistically significant(P<0.05).Conclusions  Badminton juggling can slow down vision deterioration,reduce the incidence and severity of myopia in lower grade primary school students.Schools can flexibly apply these findings in conjunction with factors that contribute to myopia to prevent its occurrence and development.
眼科专题:近视防控

成年人近视的流行病学及其相关危险因素的研究进展

Advances in the epidemiology and risk factors of adult myopia

:11-17
 
      近视是一种常见的屈光不正状态,也是全球范围内普遍存在的视觉健康问题,其特征是在眼部调节放松的状态下,平行光线经眼的屈光系统折射后聚焦在视网膜前,导致视远模糊。近视通常在儿童期发生和发展,但在成年期仍可继续发生和发展。本综述对已发表的关于成年人近视发生和进展的文献进行总结,描述成年人近视的流行病学特征,包括近视率、近视发病率、近视进展率及其近视特征(屈光度及眼轴),总结成年人近视发病和进展的危险因素。了解成年人近视的发展特点和管理方式对于近视防控实践具有重要意义。
   Myopia is a common refractive error and a universal visual health problem in the world. It is characterized by the fact that parallel light rays refract through the refractive system of the eye and focus in front of the retina when the eye accommodatior is relaxed, resulting in distant blurred vision. Myopia usually occurs and develops in childhood, but can continue to occur and develop in adulthood. This review summarizes the published literature on the occurrence and progression of myopia in adults, describes the epidemiological characteristics of myopia in adults, including myopia rate, myopia incidence rate, myopia progression rate, and myopia characteristics(diopter and ocular axis) ; and summarizes the  risk factors for the occurrence and progression of myopia in adults. Understanding the developmental characteristics and management methods of adult myopia is of great significance for myopia prevention and control practice. 

眼科专题:近视防控

户外活动对近视防控作用及其机制的研究进展

Research progress on prevention and control effect and mechanism of outdoor activities on myopia LI Shukui,LENG Yunxia

:4-10
 
       近几十年来,全球近视患病率不断上升,已成为全世界主要的公共卫生问题之一。众多研究表明户外活动能有效控制近视的发生和发展。本文综述了户外活动对近视防控作用的研究进展及其作用机制,以期为近视防控提供新的思路。

     In recent decades, the prevalence of myopia has been increasing globally, becoming one of the major public health issues worldwide. Numerous studies indicate that outdoor activities can effectively control the onset and progression of myopia. This article reviews the research progress on prevention and control effect and mechanism of outdoor activities on myopia, hoping to provide new insights for myopia prevention and control. 
眼科专题:近视防控
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