Refractive progression based on one-year follow-up and its influencing factors among primary school students in Suzhou City
WANG Yuehong1, LYU Huiling2, BAO Xinyu1, ZHANG Liye1, SHEN Hui1,2,3, HU Jia1,2,3
1. Suzhou Municipal Center for Disease Control and Prevention, Suzhou, Jiangsu 215004, China; 2. School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China; 3. Suzhou Institute for Advanced Study on Public Health, Gusu School, Nanjing Medical University, Suzhou, Jiangsu 215006, China
Abstract：Objective To analyze the changes in refractive status and its affecting factors among pupils in Suzhou City, and to provide a basis for targeted prevention and control of myopia. Methods Based on the Health Promotion Program for Children and Adolescents in Suzhou City in 2020, 30 primary schools were randomly selected to collect the data about 26,003 pupils with 2020 and 2021 eyesight records. And the eyesight records included uncorrected visual acuity based on reading the standard logarithmic visual acuity chart at the distance of 5m and non-cycloplegic refraction measured with an autorefractor. We analyzed the progression of myopia, naked-eye distant vision and spherical equivalent refraction (SER) based on one-year follow-up. Multivariate logistic regression analysis was performed to explore the factors influencing refraction progression. Results A total of 26,003 pupils were enrolled into this study, including 13,856 male pupils (accounting for 53.29%) and 13,356 urban ones (accounting for 51.36%). The results of one-year following up displayed that the overall myopia rate of the pupils increased from 40.35% to 54.76%. The average annual change in SER of the right eye was (-0.55±0.65) D, and there were statistically significant differences in the change of SER among different grades, genders, areas and baseline refractive state groups (all P<0.05). The change in uncorrected visual acuity of the right eye was (-0.08±0.16), and there were statistically significant differences in the changes among different grades, genders, body mass indexes and baseline refractive state groups (all P<0.05). Multivariate logistic regression analysis on the factors affecting medium and rapid progression of refraction revealed that prophase of myopia, low myopia, rural area and Grade VI were protective factors for medium and rapid progression of refraction (OR=0.388, OR=0.666, OR=0.862, OR=0.856, all P<0.05). Female students and Grades III & IV were risk factors for medium and rapid progression of refraction (OR=1.129, OR=1.035, OR=1.127, all P<0.05). Conclusion The results of one-year follow-up showed a myopic shift in the refractive status of the eyes in the pupils in Suzhou City. Grades, baseline refractive state, genders and areas are the factors affecting the progression of refraction. Hence prevention and control of key populations should be carried out.
王越红, 吕慧玲, 包新宇, 张俪叶, 沈蕙, 胡佳. 苏州市小学生1年屈光度进展及影响因素分析[J]. 实用预防医学, 2024, 31(5): 518-522.
WANG Yuehong, LYU Huiling, BAO Xinyu, ZHANG Liye, SHEN Hui, HU Jia. Refractive progression based on one-year follow-up and its influencing factors among primary school students in Suzhou City. , 2024, 31(5): 518-522.
[1] 国家卫生健康委. 国家卫生健康委员会2021年7月13日新闻发布会文字实录[EB/OL].(2021-07-03)[2023-03-08]. http://www.nhc.gov.cn/xcs/s3574/202107/2fef24a3b77246fc9fb36dc8943af700.shtml. [2] 任俊霞,王艳娜,李荣花. 邯郸市中小学生近视防治知识、态度和行为调查[J]. 实用预防医学,2021,28(6):740-743. [3] Yam JC,Zhang XJ,Kam KW,et al. Myopia control and prevention: from lifestyle to low-concentration atropine. The 2022 Josh Wallman Memorial Lecture[J]. Ophthalmic Physiol Opt,2023,43(3):299-310. [4] Zhang X,Fan Q,Zhang F,et al. Gene-environment interaction in spherical equivalent and myopia: an evidence-based review[J]. Ophthalmic Epidemiol,2022,29(4):435-442. [5] Donovan L,Sankaridurg P,Ho A,et al. Myopia progression rates in urban children wearing single-vision spectacles[J]. Optom Vis Sci,2012,89(1):27-32. [6] 陈鸿雁,廖娅,董磊,等. 新冠肺炎疫情前后宿迁市小学生筛查性近视率比较[J].中国学校卫生,2021,42(10):1571-1574. [7] Ge WX,Han D,Ding ZY,et al. Pediatric body mass index trajectories and the risk of hypertension among adolescents in China: a retrospective cohort study[J]. World J Pediatr,2023,19(1):76-86. [8] 陶芳标. 《儿童青少年近视防控适宜技术指南》专题解读[J]. 中国学校卫生,2020,41(2):166-168,172. [9] 项凯迪,王菁菁,潘臣炜,等. 上海地区4～14岁儿童1年屈光进展及影响因素分析[J].中国学校卫生,2022,43(9):1309-1313. [10] 国家卫生健康委办公厅关于开展第二批儿童青少年近视防控适宜技术试点工作的通知[EB/OL]. (2021-10-09)[2023-03-08]. http://www.nhc.gov.cn/jkj/s7934td/202110/0fc8a001d42345d9ac9b38842b295fe7.shtml. [11] Hu Y, Ding X, Zeng J, et al. Longitudinal changes in spherical equivalent of moderate to high hyperopia: 2- to 8-year follow-up of children at an initial age of 5.5 to 8.4 years[J]. Invest Ophthalmol Vis Sci,2019,60(8):3127-3134. [12] 黄茵. 儿童青少年近视进展趋势变化及模型构建研究[D]. 汕头:汕头大学,2021. [13] Li SM,Wei S, Atchison DA, et al. Annual incidences and progressions of myopia and high myopia in Chinese schoolchildren based on a 5-year cohort study[J]. Invest Ophthalmol Vis Sci,2022,63(1):8. [14] 刘瑛,康梦田,杨征宇,等. 涿州市学龄儿童2019—2020年近视屈光状态进展和近视眼发病率分析[J]. 中华眼科杂志,2022,58(4):265-271. [15] 黄立民,王艳,潘臣炜,等. 近视队列江苏省中部地区2年追踪调查结果[J].中国学校卫生,2022,43(9):1298-1300. [16] Russo A,Boldini A,Romano D,et al. Myopia: mechanisms and strategies to slow down its progression[J]. J Ophthalmol,2022:1004977. [17] Liao C, Ding X, Han X, et al. Role of parental refractive status in myopia progression: 12-year annual observation from the Guangzhou twin eye study[J]. Invest Ophthalmol Vis Sci,2019,60(10):3499-3506. [18] 程玉洁, 李美秀, 范之仪, 等. 太仓市中学生近视现状及相关因素分析[J]. 实用预防医学,2022,29(12):1528-1532. [19] 崔歌,陈迪,李莹. 性激素在近视发生发展中的作用机制研究进展[J].眼科新进展,2023,43(1):61-65. [20] 高青,刘懿卿,叶茜雯,等. 2018―2020年辽宁省学生近视流行变化趋势与其影响因素[J].中华疾病控制杂志,2022,26(6):673-678. [21] 符文雅,王丽卿,吴挺利,等. 海南省城乡中小学生近视现况及其差异性分析[J]. 实用预防医学,2022,29(10):1172-1176.
2024, Vol. 31 
