儿童屈光不正的流行病学调查现状

屈光不正已成为影响儿童视觉健康的主要原因之一.国内外学者对儿童屈光不正的流行病学研究逐步深入,但研究方法和结果不尽相同.儿童屈光不正的患病率在不同国家与地区、不同种族间差异较大,如亚洲地区的新加坡、日本、中国香港及澳门地区较高;欧美国家其次;非洲最低.相关研究发现遗传因素、环境因素(如环境光照、近距离工作、户外活动时间...     

湘潭市中小学生眼屈光不正及相关因素的流行病学调查

目的：调查湘潭市中小学生视力不良、屈光不正患病状况及近视主要影响因素,为中小学生近视防控提供科学依据。

方法：采取整群随机抽样。2018-09/12,在湘潭市区随机抽取5所全日制小学和3所中学,共6 164名学生作为调查对象,进行裸眼视力、矫正视力、眼位检查,双眼中任一眼裸眼远视力低于5.0者,进一步测量双眼屈光度数。自制调查问卷以了解近视发生相关因素。

结果：在6 164名学生中日常生活视力不良男生检出率为40.3%(1 249/3 099),女生检出率为43.8%(1 343/3 065)(P<0.01)。中小学男生近视患病率59.1% ,女生近视患病率68.7%(P<0.01)。小学生近视患病率为44.1%,远视患病率为3.0% 。初中生近视患病率为71.3%,远视患病率为 1.7%。多因素回归分析显示,年级(初中)、性别(女)、每天写作业时间(>2h)、平均每天睡眠时间(≤8h)、父母为近视是中小学生近视发生的独立危险因素(OR=1.48、1.55、1.26、1.58、2.13,均P<0.05)。

结论：湘潭市中小学生视力不良检出率高,近视发病率高,学生近视与多因素综合作用有关,需进行针对性的综合干预。     

台北地区青少年屈光不正验配资料分析

目的：探讨台北地区7～25岁青少年屈光不正,特别是近视的发生发展状况。方法：对台北地区12个验光配镜部一年内的7～25岁的青少年屈光不正患者共5002名进行统计和分析。结果：屈光不正以近视为主,从近视发生的年龄看,分性多出现在15～18岁,女性出现在13～17岁;以近视－1．50～－4．50D范围所占比例最高;球镜与柱镜比约6：4。低年龄儿童屈光不正主要有远视、复性远视散光、单纯性散光、混合性散光,所占比例为：7岁：男学童占43％、女学童占51％：8岁：男学童占23％、女学童22％。结论：在7～8岁学生中发现屈光不正而配镜多属于先天因素,如远视、散光、斜视等,青少年屈光不正以近视占最大比例,其发生和发展与升学压力有关。     

空勤人员屈光不正情况及相关因素调查分析

目的：探讨空勤人员体检中检出屈光不正者的屈光分布及分析患病的危险因素。
　　方法：随机选取2013-05/2014-05期间来院体检的1031名空勤人员,检出屈光不正的49例,并对各种屈光类型的构成与年龄、机种、职务、飞行时间等进行比较,结合空勤人员主观评定进行分析。
　　结果：检出屈光不正的49例中近视43例(88%),远视(包括远视散光)6例(12%),年龄大于50岁及飞行时间大于3000 h空勤人员检出率高,歼击机空勤人员、职务为飞行员者及用眼习惯优者屈光不正检出率低。
　　结论：空勤人员屈光不正以近视多见,年龄、飞行时间长的空勤人员高发,歼击机空勤人员、飞行员及用眼习惯良好者低发,提示空勤人员迟发性近视及用眼方式、强度和时间在空勤人员屈光不正防治训练中需加以重视。     

云南省高海拔农村多民族聚居区屈光不正患病率调查

目的:调查中国西南部高海拔农村多民族聚居区人群屈光不正患病率,获得该地区整体人群屈光不正的流行病学资料。方法:采用整群随机抽样的方法选取云南省贡山县常住居民做为调查对象。所有调查对象均接受全面的眼科检查及屈光状态检查。分析屈光不正整体情况及屈光不正发生与年龄、性别、文化程度等相关因素的关系。结果:入选对象3070例中实际接受调查人数为2422例(受检率78.9%)。对4843眼的屈光不正数据进行统计分析:正视眼2635眼(54.4%);近视1106眼(22.8%);远视1102眼(22.8%),其中散光4451眼(91.9%)。正视所占比率随年龄增长呈下降趋势(P<0.05),近视患病率不随年龄增长而增长(P>0.05),远视眼患病率随年龄增长呈上升趋势(P<0.05)。散光的发生中,顺规散光81·6%,随年龄增长顺规呈下降趋势,逆规散光15.1%,随年龄增长呈上升趋势(P<0.05)。女性远视眼患病率较男性人群高(P<0.05)。初中学历以上人群中重度近视发生率较初中以下学历人群为高(P<0.05)。结论:获得中国西南部高海拔偏远山区整体人群屈光不正统计数据,表明受教育程度越高近视发生率越高,年龄改变与散光轴向改变相关。     

中老年人屈光不正的流行病学研究进展

屈光不正是指外界物象在无调节状态下经眼的屈光系统折射后,不能准确聚焦于视网膜形成清晰的图像.随着我国步入老龄化社会,中老年人的屈光不正日益受到社会关注.本文对中老年人屈光不正的现状及发展的相关问题作一综述.     

城乡学生屈光不正调查及相关因素研究

和敏感性意义.乡村学生课余看电视时间明显多于城市学生.结论 城乡学生视力低常的主要原因是近视.影响因素主要是长时间近距离作业,遗传,环境因素等;电视对近视的影响相关性小.     

中老年人屈光不正的流行病学研究进展

屈光不正是指外界物象在无调节状态下经眼的屈光系统折射后,不能准确聚焦于视网膜形成清晰的图像.随着我国步入老龄化社会,中老年人的屈光不正日益受到社会关注.本文对中老年人屈光不正的现状及发展的相关问题作一综述.     

北京城乡限定区域人群屈光不正患病率调查

目的分析北京城乡限定地区40岁以上人群屈光不正的患病率,探讨其相关影响因素。设计人群为基础的横断面研究。研究对象2001年北京眼病研究基线调查的4439人。方法详细的问卷调查及全面的眼科检查,包括视力及屈光检查。屈光不正用等效球镜度数(SE)表示。右眼有晶状体眼最佳矫正视力≥0.5者纳入分析。主要指标各种屈光不正的患病率。结果4111人数据可供分析,平均年龄(55.49±10.18)岁。研究人群近视(SE<-0.5D)患病率为21.4%,高度近视(SE<-6.0D)1.8%,远视(SE>0.5D)19.5%,散光(柱镜度数>0.5D)36.0%,屈光参差(SE相差>0.5D)22.5%。近视、高度近视患病率随年龄增长而下降(P值均为0.001),远视、散光、屈光参差患病率随年龄增长而增高。远视、散光患病率女性高于男性,其他屈光不正未发现性别差异。逐步Logistic回归分析,大学以上文化程度者患近视的可能性是文盲的2.09倍(P=0.003),城市患病率高于农村(P<0.001)。核混浊的程度与近视患病率呈正相关,与远视患病率负相关。结论近视患病率在较年轻年龄组中较高,城市高于农村,患病率与文化程度有关,环境因素对近视的影响重要。远视、散光、屈光参差患病率随年龄增长而增高,对于研究屈光手术的远期效果研究是有参考价值。     

新疆少数民族1000例屈光不正统计分析

新疆少数民族１０００例屈光不正统计分析新疆伊犁哈萨克自治州友谊医院眼科刘金华，腊敏我国人的屈光情况，国内已有不少论述，为了进一步了解新疆少数民族的屈光情况，现将我科１９９０－１９９２年门诊屈光检查的１０００例少数民族屈光不正病例，作了统计分析如下。检...     

贵州省兴义市农村和城市儿童青少年近视状况及相关因素分析

目的：:调查贵州省兴义市农村和城市儿童青少年近视的患病率,并对其影响因素进行分析。方法：:横断面调查研究。采取分层抽样的方法,于2019年8─11月选取贵州省兴义市的6─19岁学生作为研究对象,共有8 413名学生参与研究,其中7 272名学生被纳入数据分析。对所有的研究对象进行视力、屈光检查,对学生视力不良影响因素进...     

Myopic and Hyperopic Refractive Error in Adults: An Overview

This article provides an overview of the recent epidemiologic findings on myopic and hyperopic refractive error in adults. Refractive errors are common conditions with high costs associated with their correction and a cause of public health and economic concerns. Myopia and hyperopia, the most common types of refractive error, are complex multifactorial conditions with prevalences that vary across populations of different ancestral origins. Recent studies have demonstrated consistently that longitudinal changes in refractive error occur and may be part of an aging process. A cohort effect also has been demonstrated in some populations, indicating that observed changes may be due to both longitudinal changes and changes across birth cohorts. The increase in myopia at older ages appears to be due to associations with other ocular conditions such as cataract. This overview highlights major findings from recent population-based studies of persons 40 years and older on 1) the importance of uncorrected refractive error as a cause of visual impairment and 2) the epidemiology of myopic and hyperopic refractive error, regarding their prevalence, changes over time and longitudinally and associated factors. Suggestions for future directions and opportunities to advance the understanding of the epidemiology of refractive errors in adults are offered.     

Refractive error and ocular biometry in Jordanian adults

The aim of this study was to establish the prevalence of refractive errors in Jordanian adults of working age, and to study the ocular biometric correlates of refractive error in this population. Refractive error and ocular biometry were measured in 1093 Jordanian adult subjects aged 17-40 years to determine the prevalence of refractive error, and explore structural correlations of ametropia. Refractive error was measured using a Grand-Seiko GR-3100K closed-view infrared autorefractor. Ocular component measurements were made using A-scan ultrasonography and autokeratometry. The prevalence of myopia [spherical equivalent refraction (SER) less than -0.50 DS] and hyperopia (SER greater than +0.50 DS) was 53.71 and 5.67% respectively; 40.62% of the sample was emmetropic (refraction between +0.50 D and -0.50 D inclusive in both principal meridians). The distribution of SER was found to show marked leptokurtosis, exhibiting a peak between plano and 1 D of myopia. Corneal radius, anterior chamber depth, crystalline lens thickness, vitreous chamber depth and axial length (AL) parameters were normally distributed in the population studied. AL to corneal curvature ratio was not normally distributed, and showed marked leptokurtosis. Linear regression analysis showed that AL correlated most closely with spherical equivalent refractive error. This study has established a database of refractive error prevalence and ocular biometric correlates of ametropia in a Middle Eastern population of working age.     

Analysis of Refractive Outcome and Related Factors in PACG Patients after Phacotrabeculectomy

Objective: To study the refractive outcome and related factors in primary angle closure glaucoma (PACG) patients 3 months after phacotrabeculectomy. Methods: This was a prospective clinical study. Fifty-one eyes of 51 patients with PACG and co-existing cataract who underwent phacotrabeculectomy at the EyeCenter of the Second Hospital of Jilin University from December 2018 to September 2019 were enrolled. Patients with intraocular pressure (IOP) ≤21 mmHg (1 mmHg=0.133 kPa) were classified as the normal IOP group and patients with IOP >21 mmHg were classified as the high IOP group. Anterior chamber depth (ACD), axial length (AL) and keratometry were measured by AL-scan, and the SRK-T formula of AL-scan software was used to calculate the intraocular lense power and predict the refractive outcome. Subjective refraction was performed at 3 months. According to postoperative refractive error (RE), the patients were divided into a myopia group (RE <-0.5 D), hyperopia group (RE >0.5 D) and no refractive error group (-0.5 D≤RE≤0.5 D). A Chi-square test was used to compare the distribution of refractive errors between the normal and high IOP groups. The preoperative biological parameters of the myopia group and hyperopia group were compared by an independent t-test, and a paired sample t-test was used to compare the biological parameters before and after surgery. Results: In the normal IOP group, there were 4 patients with myopia (17%), 3 patients with hyperopia (12%), and 17 patients without refractive error (71%); in the high IOP group, there were 7 patients with myopia (26%), 16 patients with hyperopia (59%), and 4 patients without refractive error (15%). The reduction of AL in patients with high IOP was greater than that in patients with normal IOP, and the difference was statistically significant (t=-4.308, P<0.001). The preoperative ACD of the hyperopia group was shallower than that of the myopia group, and the preoperative AL was shorter than that of myopia group. The difference was statistically significant (t=3.226, P=0.03; t=4.993, P<0.001). With keratometry, there was no significant difference between the two groups (t=-1.143, P=0.263). There was a negative correlation between postoperative RE and preoperative ACD and AL (r=-0.32, P=0.023; r=-0.52, P<0.001); there was no significant correlation between postoperative RE and keratometry (r=0.15, P=0.101). Conclusions: Compared with normal IOP, PACG patients with high IOP have more RE, and most of them are hyperopic RE. In addition, the shallower the ACD and the shorter the AL were, the refractive outcome of PACG patients after phacotrabeculectomy more likely tends to be hyperopia.     

PACG患者青白联合手术后的屈光状态及影响因素

目的：探讨原发性闭角型青光眼（PACG）患者行青光眼白内障联合手术后3个月的屈光状态以及相 关影响因素。方法：前瞻性临床研究。选择2018年12月至2019年9月于吉林大学第二医院眼科中 心行小梁切除联合白内障超声乳化摘除及人工晶状体植入术（简称青白联合术）的PACG合并白内障 患者51例（51眼）。术前用药后眼压≤21 mmHg（1 mmHg=0.133 kPa）患者作为正常眼压组（24例）, >21 mmHg作为高眼压组（27例）。所有患者术前使用AL-scan测量前房深度（ACD）、眼轴长度（AL）、 角膜曲率,并通过该仪器内置的SRK-T公式预测术后屈光度。随访至术后3个月行综合验光。根据 术后屈光误差（RE）将患者分为近视误差组（RE<-0.5 D）、远视误差组（RE>0.5 D）、无屈光误差组 （-0.5 D≤RE≤0.5 D）。正常眼压组与高眼压组患者术后屈光误差分布比较采用卡方检验,近视误 差组与远视误差组患者术前生物参数比较采用独立样本t检验,手术前后生物参数比较采用配对样 本t检验。结果：正常眼压组患者术后近视误差4例（17%）,远视误差3例（12%）,无屈光误差17例（71%）; 高眼压组患者近视误差7例（26%）,远视误差16例（59%）,无屈光误差4例（15%）。高眼压组患者 术后AL缩短程度大于正常眼压组患者,组间差异有统计学意义（t=-4.308,P<0.001）。远视误差组 患者术前ACD浅于近视误差组患者,术前AL短于近视误差组患者,组间差异比较均有统计学意 义（t=3.226,P=0.03;t=4.993,P<0.001）;近视误差组与远视误差组间的角膜曲率差异无统计学意义 （t=-1.143,P=0.263）。术后RE与术前ACD、AL均呈负相关（r=-0.32,P=0.023;r=-0.52,P<0.001）, 与术前角膜曲率无相关性（r=0.15,P=0.101）。结论：相对于术前眼压正常的PACG患者,术前高眼 压患者青白联合术后屈光误差发生的比例更高,且大多是远视屈光误差。另外,PACG患者青白联 合术后总体上存在术前ACD越浅,AL越短,术后屈光状态越倾向于远视的趋势。     

Association Between Medication-Taking and Refractive Error in a Large General Population-Based Cohort

PurposeRefractive errors, particularly myopia, are common and a leading cause of blindness. This study aimed to explore associations between medications and refractive error in an aging adult cohort and to determine whether childhood-onset refractive errors predict future medication use to provide novel insights into disease mechanisms.MethodsThe study compared the spherical equivalent values measured in 102,318 UK Biobank participants taking the 960 most commonly used medications. The strengths of associations were evaluated against the self-reported age of spectacle wear. The causality of refractive error changes was inferred using sensitivity and Mendelian randomization analyses.ResultsAnti-glaucoma drugs were associated with 1 to 2 diopters greater myopic refraction, particularly in subjects who started wearing correction in the first two decades of life, potentially due to the association of higher intraocular pressure since early years with both myopia and, later in life, glaucoma. All classes of pain-control medications, including paracetamol, opiates, non-steroidal antiinflammatory drugs, and gabapentinoids, were associated with greater hyperopia (+0.68–1.15 diopters), after correction for deprivation, education, and polypharmacy and sensitivity analyses for common diagnoses. Oral hypoglycemics (metformin, gliburonide) were associated with myopia, as was allopurinol, and participants using bronchodilators (ipratropium and salbutamol) were more hyperopic.ConclusionsThis study finds for the first time, to our knowledge, that medication use is associated with refractive error in adults. The novel finding that analgesics are associated with hyperopic refraction, and the possibility that multisite chronic pain predisposes to hyperopia, deserves further research. Some drugs, such as antihyperglycemic or bronchodilators, may directly alter refractive error. Intraocular pressure appears causative for myopia.     

The Role of GJD2(Cx36) in Refractive Error Development

Refractive errors are common eye disorders characterized by a mismatch between the focal power of the eye and its axial length. An increased axial length is a common cause of the refractive error myopia (nearsightedness). The substantial increase in myopia prevalence over the last decades has raised public health concerns because myopia can lead to severe ocular complications later in life. Genomewide association studies (GWAS) have made considerable contributions to the understanding of the genetic architecture of refractive errors. Among the hundreds of genetic variants identified, common variants near the gap junction delta-2 (GJD2) gene have consistently been reported as one of the top hits. GJD2 encodes the connexin 36 (Cx36) protein, which forms gap junction channels and is highly expressed in the neural retina. In this review, we provide current evidence that links GJD2(Cx36) to the development of myopia. We summarize the gap junctional communication in the eye and the specific role of GJD2(Cx36) in retinal processing of visual signals. Finally, we discuss the pathways involving dopamine and gap junction phosphorylation and coupling as potential mechanisms that may explain the role of GJD2(Cx36) in refractive error development.     

上海市闸北区和田路小学小学生屈光状态随访1a结果分析

目的:了解上海市闸北区和田路小学小学生屈光状态变化,分析屈光状态变化与各影响因素的关系。方法:以2011-05被调查的上海市闸北区和田路小学6~12岁的全体在校学生为样本进行为期1a的调查,总计303名606眼。所有调查对象均检查年龄(age)、身高(height,H)、体质量(weight,W)、裸眼视力(uncorrected visual acuity,UCVA)、球镜屈光度(diopter of spherical,DS)、柱镜屈光度(diopter of cylinder,DC)、等效球镜(spherical equivalent,SE)、眼轴长度(axial length,AL)及角膜曲率(corneal curvature,K),并分析整体屈光状态变化趋势及各相关因素与屈光状态变化的关系。结果:入选调查对象606眼平均SE变化-0.45±0.60D,平均AL增长0.32±0.25mm,AL增长与SE度数变化呈正相关(r=0.409,P<0.01),其中有473眼向近视方向发展(SE的变化为负值),占总体的78.1%。AL增长与W增长相关性分析发现,W增长在4~6kg/年,AL增长最慢(0.28±0.20mm,P=0.004);AL增长在6~8岁组最快(0.39±0.24mm,P<0.01)。H增长与DS,DC,SE及AL增长均无明显统计学意义(P>0.05)。2012年视力不良(UCVA<1.0)发生率(47.0%)比2011年(31.5%)明显增高;10岁以上组(52%)比10岁以下组高10%。结论:上海市闸北区和田路小学小学生中,屈光状态的进展主要以近视为主,儿童屈光状态进展与眼轴及生长发育密切相关。     

Refractive errors among children, adolescents and adults attending eye clinics in Mexico

AIM: To assess the proportion of refractive errors in the Mexican population that visited primary care optometry clinics in fourteen states of Mexico. METHODS: Refractive data from 676 856 patients aged 6 to 90y were collected from optometry clinics in fourteen states of Mexico between 2014 and 2015. The refractive errors were classified by the spherical equivalent (SE), as follows: sphere+½ cylinder. Myopia (SE>-0.50 D), hyperopia (SE>+0.50 D), emmetropia (-0.50≤SE≤+0.50), and astigmatism alone (cylinder≥-0.25 D). A negative cylinder was selected as a notation. RESULTS: The proportion (95% confidence interval) among all of the subjects was hyperopia 21.0% (20.9-21.0), emmetropia 40.7% (40.5-40.8), myopia 24.8% (24.7-24.9) and astigmatism alone 13.5% (13.4-13.5). Myopia was the most common refractive error and frequency seemed to increase among the young population (10 to 29 years old), however, hyperopia increased among the aging population (40 to 79 years old), and astigmatism alone showed a decreasing trend with age (6 to 90y; from 19.7% to 10.8%). There was a relationship between age and all refractive errors (approximately 60%, aged 50 and older). The proportion of any clinically important refractive error was higher in males (61.2%) than in females (58.3%; P<0.0001). From fourteen states that collected information, the proportion of refractive error showed variability in different geographical areas of Mexico. CONCLUSION: Myopia is the most common refractive error in the population studied. This study provides the first data on refractive error in Mexico. Further programs and studies must be developed to address the refractive errors needs of the Mexican population.     

Refractive Error among the Elderly in Rural Southern Harbin,China

Purpose: To estimate the prevalence and associated factors of refractive errors among the elderly in a rural area of Southern Harbin, China.

Methods: Five thousand and fifty seven subjects (age ≥50 years) were enumerated for a population-based study. All participants underwent complete ophthalmic evaluation. Refraction was performed by ophthalmic personnel trained in the study procedures. Myopia was defined as spherical equivalent worse than -0.50 diopters (D) and hyperopia as spherical equivalent worse than +0.50 D. Astigmatism was defined as a cylindrical error worse than 0.75D. Association of refractive errors with age, sex, and education were analyzed.

Results: Of the 5,057 responders (91.0%), 4,979 were eligible. The mean age was 60.5 (range 50–96) years old. The prevalence of myopia was 9.5% (95% confidence interval [CI], 8.5–10.1) and of hyperopia was 8.9% (95% CI, 7.9–9.5). Astigmatism was evident in 7.6% of the subjects. Myopia, hyperopia and astigmatism increased with increasing age (p<0.001, respectively). Myopia and astigmatism were more common in males, whereas hyperopia was more common in females. We also found that prevalence of refractive error weas associated with education. Myopia was more common in those with higher degrees of education, whereas hyperopia and astigmatism were more common in those with no formal education.

Conclusions: This report has provided details of the refractive status in a rural population of Harbin. The prevalence of refractive errors in this population is lower than those reported in other regions of the world.