Refractive Error Study in Children: Results from Shunyi District, China
Refractive Error Study in Children: Results from Shunyi District, China
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DOI：
10.1016/s0002-9394(99)00452-3
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发表时间：
2000-04-01
影响因子：
4.2
通讯作者：
Ellwein, LB
中科院分区：
文献类型：
--
作者：
Zhao, JL;Pan, XJ;Ellwein, LB
目的：评估中华人民共和国北京东北部顺义区学龄儿童屈光不正和视力损害的患病率。
方法：采用基于村庄集群的随机抽样方法，确定5至15岁儿童的样本。利用居民户口簿对所选村庄中符合条件的儿童进行统计，并确定他们当前就读的学校。1988年5月至1998年7月期间，在29个集群的132所学校对儿童进行了眼科检查，包括视力测量、睫状肌麻痹后视网膜检影、睫状肌麻痹后自动验光、眼球运动评估以及外眼、眼前节、眼介质和眼底检查。在3所学校对所有视力下降的儿童以及部分视力正常的儿童进行了独立重复测量，以进行质量保证监测。
结果：共统计了4338户家庭的6134名儿童，对5884名儿童（95.9%）进行了检查。至少一只眼未矫正视力、现视力和最佳矫正视力为0.5（20/40）或更差的患病率分别为12.8%、10.9%和1.8%；0.4%的儿童双眼最佳矫正视力为0.5或更差。在1236只视力下降的眼中，89.5%是由屈光不正引起的，弱视占5%，其他原因占1.5%，其余4%原因不明。5岁儿童中基本没有单眼近视度数在-0.5屈光度或更低的情况，但到15岁时，男性增加到36.7%，女性增加到55.0%。在相同年龄范围内，远视度数在2屈光度或更高的情况，男性从8.8%、女性从19.6%下降到两者均低于2%。女性患近视和远视的风险均显著更高。
结论：顺义区学龄儿童因近视导致的视力下降是一个重要的公共卫生问题。超过9%的儿童可从配镜中受益。需要进一步研究以确定近视患病率的上升趋势是否在15岁之后仍持续，以及对于较新出生队列，近视的发展是否正在发生变化。（《美国眼科杂志》2000年；129:427 - 435。©2000，爱思唯尔科学公司，版权所有）
PURPOSE: To assess the prevalence of refractive errors and vision impairment in school-age children in Shunyi District, northeast of Beijing, the Peoples Republic of China.METHODS: Random selection of village-based clusters was used to identify a sample of children 5 to 15 years of age. Resident registration books were used to enumerate eligible children in the selected villages and identify their current school. Ophthalmic examinations were conducted in 132 schools on children from 29 clusters during May 1988 to July 1998, including visual acuity measurements, cycloplegic retinoscopy, cycloplegic autorefraction, ocular motility evaluation, and examination of the external eye, anterior segment, media, and fundus. Independent replicate measurements of all children with reduced vision and a sample of those with normal vision were done for quality assurance monitoring in three schools.RESULTS: A total of 6,134 children from 4,338 households were enumerated, and 5,884 children (95.9%) were examined. The prevalence of uncorrected, presenting, and best visual acuity 0.5 (20/40) or worse in at least one eye was 12.8%, 10.9%, and 1.8%, respectively; 0.4% had best visual acuity 0.5 or worse in both eyes. Refractive error was the cause in 89.5% of the 1,236 eyes with reduced vision, amblyopia in 5%, other causes in 1.5%, with unexplained causes in the remaining 4%. Myopia -0.5 diopter or less in either eye was essentially absent in 5-year-old children, but increased to 36.7% in males and 55.0% in females by age 15. Over this same age range, hyperopia 2 diopters or greater decreased from 8.8% in males and 19.6% in females to less than 2% in both. Females had a significantly higher risk of both myopia and hyperopia.CONCLUSIONS: Reduced vision because of myopia is an important public health problem in school-age children in Shunyi District. More than 9% of children could benefit from prescription glasses. Further studies are needed to determine whether the upward trend in the prevalence of myopia continues far beyond age 15 and whether the development of myopia is changing for more recent birth cohorts. (Am J Ophthalmol 2000;129:427-435. (C) 2000 by Elsevier Science Inc, All rights reserved.).