1.Expert consensus on stages of public health strategies for myopia prevention and control in children and adolescents.
Chinese Journal of Preventive Medicine 2023;57(6):806-814
Myopia has emerged as a public health issue with the increasing prevalence of myopia in children and adolescents in China. In the clinical diagnosis and treatment of myopia, there are clinical stages and classifications, but they are not suitable for the prevention and control of myopia at the public health level. At the public health level, because there is no staging standard for myopia, there is a lack of staging prevention and control guidance for different refractive errors. Therefore, the Public Health Ophthalmology Branch of the Chinese Preventive Medicine Association organized domestic experts in relevant fields to conduct literature searches and discuss based on the research data on myopia at home and abroad, put forward the stages of public health strategies for myopia prevention and control and corresponding group prevention and control measures for each stage to reached this experts consensus. This consensus first proposes a method for assessing myopia risk, in order to predict the occurrence and development of myopia in children and adolescents; From the perspective of public health, myopia prevention and control is further divided into four stages: myopia prodromal stage, myopia development stage, high myopia stage, and pathological myopia stage. According to this consensus, myopia prevention and control technology is targeted and implemented in different stages to provide guidance for myopia prevention and control from the perspective of public health.
Humans
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Child
;
Adolescent
;
Public Health
;
Consensus
;
Myopia/epidemiology*
;
Refractive Errors/epidemiology*
;
Asian People
;
China/epidemiology*
2.A prospective cohort study on refractive status of schoolchildren in Huangzhong District, Xining City, Qinghai Province.
Qi LIN ; En Tuan YANG ; Li LI ; Ji Feng YU ; Xue LIU ; Hua Xin ZUO ; Man Jun LIU ; Hui Hui CHU ; Yin Zheng ZHAO ; Jidi ZHANG
Chinese Journal of Preventive Medicine 2022;56(9):1251-1256
Objective: To determine the characteristics and progress of the visual acuity and refractive state of schoolchildren in Huangzhong District, Xining City, Qinghai Province in China. Methods: Cohort study. Department of Ophthalmology, Beijing Children's Hospital carried out a cohort study by collecting the visual acuity and refractive state of Grade 1-5 schoolchildren among 16 primary schools in Huangzhong District, Xining City, Qinghai Province in September 2020 and July 2021. Cycloplegic retinoscopy with eye drop which contained tropicamide (0.5%) and phenylephrine hydrochloride (0.5%) was performed in children with low vision(<1.0). Myopia was defined as the spherical equivalent (SE) ≤-0.5 D after cycloplegic retinoscopy. Measurement data was analyzed by t-test and enumeration data was analyzed by χ2 test. Multiple linear regression was used to analyze the influencing factors. Results: The 2 489 individuals with repeated tests in two years were included in the follow-up study, among whom the prevalence of myopia was 26.24%(653/2 489) in 2020, while 32.94% (820/2 489)respectively in 2021. The incidence of myopia in one school year from grades 1 to 5 was 11.19%(47/420), 5.44%(21/386), 6.39%(25/391), 11.52%(44/382) and 11.67%(30/257). The average SE of children in all grades in 2021 increased negatively from the previous year (Grade 1 to Grade 5 increased respectively: 0.40 D, 0.69 D, 0.62 D, 0.52 D and 0.37 D). Conclusions: The prevalence of myopia among schoolchildren in Huangzhong District, Xining City, Qinghai Province was relatively high. There were two peaks of myopia incidence in the first, fourth and fifth grades. Female, age, and the baseline of SE were the related influencing factors for myopia progression.
Child
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Cohort Studies
;
Female
;
Follow-Up Studies
;
Humans
;
Mydriatics
;
Myopia/epidemiology*
;
Ophthalmic Solutions
;
Phenylephrine
;
Prevalence
;
Prospective Studies
;
Tropicamide
3.Morphology and epidemiological study of idiopathic scoliosis among primary school students in Chaozhou, China.
Zemin CAI ; Ruibin WU ; Shukai ZHENG ; Zhaolong QIU ; Kusheng WU
Environmental Health and Preventive Medicine 2021;26(1):71-71
BACKGROUND:
Idiopathic scoliosis (IS) affects patients' quality of life, yet there have been few reports of its morphology and epidemiological study in the southeast region of China. The aim of this study is to access the curve characteristics, prevalence, and factors associated with IS in Chaozhou city.
METHODS:
A cross-sectional study was performed in 2018, in which scoliosis screening was conducted among 5497 primary school students in Chaozhou city. Then, a case-control study based on the screening involving 2547 children was followed for the exploration of the associated factors. The questionnaires covering demographic characteristics, postural habits, cognition and self-sensation of scoliosis, and physical conditions were addressed for the investigation. ORs with 95%CIs were calculated based on logistic regression analysis to evaluate the factors associated with scoliosis.
RESULTS:
The prevalence of IS among primary school students was 6.15% in Chaozhou city, with 4.04% for males and 8.71% for females. The average Cobb angle was 15° (range 8 to 37°). Multiple logistic regression analysis suggested that female (OR=2.45), BMI (OR=0.67), having myopia (OR=1.49), self-sensation of scoliosis with symptoms (OR=5.52), insufficient sleep time (OR=2.65, 3.33), and less exercise time (OR=7.09, 7.29) were significantly associated with IS.
CONCLUSIONS
The prevalence of IS among primary school students in Chaozhou was at an average level, and it was significantly higher in females than in males. Lower body mass, having myopia, insufficient sleep time, and lower physical activity were associated with IS.
Case-Control Studies
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Child
;
China/epidemiology*
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Cross-Sectional Studies
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Epidemiologic Studies
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Female
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Humans
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Male
;
Myopia/complications*
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Risk Factors
;
Schools
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Scoliosis/physiopathology*
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Students
4.The Prevalence and Severity of Myopia among Suburban Schoolchildren in Taiwan.
Yo Ping HUANG ; Avichandra SINGH ; Li Ju LAI
Annals of the Academy of Medicine, Singapore 2018;47(7):253-259
INTRODUCTIONWe aimed to determine the prevalence and severity of myopia in suburban schoolchildren. The refractive error, best corrected visual acuity (BCVA) and other ocular indices of 6069 schoolchildren (aged 6 to 15 years) from elementary and junior high schools in Chiayi County, Taiwan were examined in 2013-2015.
MATERIALS AND METHODSSpherical equivalent (SE) was stratified into 4 categories: emmetropia, mild myopia, moderate myopia, and high myopia for underlying analysis. Chi-squared (χ2) tests were used to determine significant associations between myopia and BCVA and age levels. To compare statistical significance among different age levels, values of Bonferroni tests were calculated. Receiver operating characteristic (ROC) curves and correlation coefficient were calculated to assess the correlation between myopia and each ocular index.
RESULTSThe youngest subject diagnosed with myopia was a 7-year-old. Myopia had significant associations with both BCVA and age levels (95% confidence intervals [CI] = 2.553, 2.713 and -0.284, -0.248, respectively), under <0.05. Among the calculated ROC values, BCVA had the highest area of 0.676 with myopia. This further confirmed that BCVA was highly correlated with myopia in schoolchildren. Other ocular indices like intraocular pressure (IOP), pupil distance, ocular alignments, or ocular height had ROC curves below 0.5 to myopia.
CONCLUSIONThis study concluded that the onset of myopia started earlier and progressively worsened with years of investigation among the suburban schoolchildren. Myopia had significant associations with BCVA and age levels. To effectively reduce the prevalence and severity of myopia, it is time to take actions on eye care education for suburban schoolchildren.
Adolescent ; Age of Onset ; Child ; Female ; Humans ; Male ; Myopia ; diagnosis ; epidemiology ; Needs Assessment ; Population ; Prevalence ; Severity of Illness Index ; Taiwan ; epidemiology ; Visual Acuity
5.Prevalence of myopia and influencing factors among primary and middle school students in 6 provinces of China.
Jia ZHOU ; Yinghua MA ; Jun MA ; Zhiyong ZOU ; Xiangkun MENG ; Fangbiao TAO ; Chunyan LUO ; Jin JING ; Dehong PAN ; Jiayou LUO ; Xin ZHANG ; Hong WANG ; Haiping ZHAO
Chinese Journal of Epidemiology 2016;37(1):29-34
OBJECTIVETo understand the prevalence of myopia in primary and middle school students in 6 provinces and the possible influencing factors.
METHODSPrimary and middle school students were selected through multistage cluster sampling in 60 primary and middle schools in 6 provinces in China. The questionnaire survey and eyesight test were conducted among all the students selected according to the national student's physique and health survey protocol. Pearson chi-square test and binary multivariate logistic regression analysis were done to identify the influencing factors for myopia in students.
RESULTSThe prevalence of myopia among primary and middle school students surveyed was 55.7%, the gender specific difference was statistically significant (59.7% for girls, 51.9% for boys) (P<0.01). The prevalence of myopia increased with age obviously. The prevalence was 35.8% in age group 6-8 years, 58.9% in age group 10-12 years, 73.4% in age group 13-15 years and 81.2% in age group 16-18 years, the differences were statistically significant (P<0.001). Single factor and multivariate analysis showed that parents' myopia, distance between computer screen and eyes, distance less than 30 cm between eyes and book while reading, distance less than 10 cm between chest and the table edge while studying, distance less than 3 cm between fingers and pen tip, sleep time, average outdoor activity time during last week, school sport activities in the afternoon, the size of television set at home, time spent on watching TV and playing computer were the influencing factors for myopia.
CONCLUSIONSThe prevalence of myopia is till high in primary and middle school students. Myopia is associated with both genetic factors and individual eye health related behaviors.
Adolescent ; Child ; China ; epidemiology ; Female ; Health Behavior ; Health Surveys ; Humans ; Logistic Models ; Male ; Multivariate Analysis ; Myopia ; epidemiology ; Parents ; Prevalence ; Schools ; Sleep ; Students ; Surveys and Questionnaires
6.Characteristics of optic disc parameters and its association in normal Chinese population: the Handan Eye Study.
Qing ZHANG ; Sizhen LI ; ; Yuanbo LIANG ; ; Fenghua WANG ; Weiwei CHEN ; Ningli WANG ;
Chinese Medical Journal 2014;127(9):1702-1709
BACKGROUNDAssessment of the optic disc and retinal nerve fiber layer (RNFL) is essential for the diagnosis and monitoring of glaucoma. Knowledge of normal optic disc topography provides a benchmark for evaluating glaucomatous pathologic changes, especially in its early stages. The purpose of this study was to evaluate the characteristics and correlation factors of the optic disc parameters using the Heidelberg Retina Tomograph II (HRT II) in a large sample of normal eyes of adult Chinese subjects.
METHODSDisc data were obtained from 6 830 subjects aged >30 years from the Handan Eye Study. All participants underwent comprehensive eye examinations and physical examinations. The associations of gender, age, body mass index, blood pressure, waist-to-hip ratio; refractive error, intraocular pressure, axial length, and disc area were assessed using simple and multiple regression analysis. The correlation between HRT II parameters was evaluated.
RESULTSOf the 7 557 eligible subjects, 6 830 took part in the study (90.4% response rate) and 2 633 normal eyes with good-quality HRT II images were selected. The mean disc area was 2.28 mm(2) (standard deviation (SD) 0.43) and mean neural rim area was 1.80 mm(2) (SD 0.29). In multiple regression analysis, optic disc area significantly correlated with age, gender, and axial length (P < 0.001). All optic disc parameters showed a significant correlation with disc area (0.054 CONCLUSIONSThe optic disc area in rural Chinese population is larger than reported in white and Japanese populations, similar to that of Indian population and urban Chinese population. Most optic disc measurements were moderately or weakly affected by disc area. In addition to the RNFL, there may be other factors affecting the rim area. The relationship between optic disc and axial length may suggest a link between larger disc area, thinning of the lamina cribrosa, and increased glaucoma susceptibility in myopic eyes.
Adult
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Female
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Glaucoma
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epidemiology
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Humans
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Male
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Middle Aged
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Myopia
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epidemiology
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Optic Disk
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anatomy & histology
7.Ocular Findings in Children with Single Umbilical Artery: A Case Series of 14 Children.
Jongshin KIM ; Kyo Hoon PARK ; Jeong Min HWANG
Korean Journal of Ophthalmology 2014;28(2):155-158
PURPOSE: Single umbilical artery (SUA) is the most common malformation of the umbilical cord. However, there have been no studies on the ocular findings in SUA, except for one case report. This study aimed to investigate the ocular findings in children with SUA. METHODS: Fourteen children (eight boys and six girls) with SUA were evaluated retrospectively. All children underwent a complete ophthalmologic examination. RESULTS: The prevalence of abnormal ocular findings in children was up to 42.9%. Refractive errors are detected in four eyes (14.3%): myopia > or =-1.50 diopters (D) in one eye (3.6%) and hyperopia > or =+2.00 D in three eyes (10.7%). Epiblepharon was found in three children (21.4%), and strabismus was detected in one child (7.1%). CONCLUSIONS: Approximately half of the children with SUA showed abnormal ocular findings, therefore, our case series highlight the need for a comprehensive ocular examination and larger prospective research studies in young patients with SUA.
Child, Preschool
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Eyelid Diseases/*congenital/epidemiology
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Eyelids/*abnormalities
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Female
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Humans
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Hyperopia/diagnosis/*epidemiology
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Infant
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Male
;
Myopia/diagnosis/*epidemiology
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Prevalence
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Republic of Korea/epidemiology
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Retrospective Studies
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Single Umbilical Artery/*epidemiology
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Strabismus/*epidemiology
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Umbilical Arteries/*abnormalities
9.Heredity factor in myopia development among a sample in Klang Valley, Malaysia.
Sharanjeet KAUR ; Noor Islam RAMLI ; Sumithira NARAYANASAMY
Chinese Medical Journal 2012;125(19):3522-3525
BACKGROUNDDevelopment of myopia among young children is often contributed to the refractive status of the parents. This study was conducted to determine whether myopia can be inherited across the generation among a sample in the Klang Valley. Three generations involved are: G1 (grandparents), G2 (parents) and G3 (children).
METHODSSixty-two families were screened and forty families were selected to participate in this study. The inclusion criterion is having at least one myopic member in any of the three generations. Subjects (G2) were first asked to fill up a questionnaire form before their refractive status was determined by clinical examination that provided acuity of 6/6 or better. Refractive status of G1 was determined using information from the questionnaire while for G2 and G3 through clinical examination.
RESULTSGenerally, the prevalence of myopia is seen to increase throughout the generations from G1 being the lowest (25.6%) to G3 being the highest (41.1%). Strong genetic influence can be found between G1 and G2 as majority of myopes in G2 is when both parents were myopic. However, although the prevalence of myopia increased from G2 to G3, there was no strong genetical influence. Majority of subjects in G3 were non-myopes when both their parents were myopic.
CONCLUSIONParental history accounts for a limited proportion of variance in myopia development.
Adolescent ; Adult ; Aged ; Family Health ; Female ; Humans ; Malaysia ; epidemiology ; Male ; Middle Aged ; Myopia ; epidemiology ; genetics ; Retrospective Studies ; Surveys and Questionnaires ; Young Adult
10.Correlations between Magnitude of Refractive Error and Other Optical Components in Korean Myopes.
Sangkyu LEE ; Boyun KIM ; Tae Hoon OH ; Hyun Seung KIM
Korean Journal of Ophthalmology 2012;26(5):324-330
PURPOSE: We evaluated ocular optical components and their interrelationships in myopic Korean patients. METHODS: In this prospective observational study, 1,011 consecutive patients were recruited from a refractive surgery clinic. The best-corrected visual acuity was >20 / 20 in all patients. The refractive error, axial length (AL), anterior chamber depth (ACD), lens thickness (LT), and vitreous chamber depth (VCD) were measured by an autorefractor and partial coherence laser interferometry (IOL Master). Central corneal thickness (CCT) was measured by ORBscan II topography. RESULTS: The refractive errors had a positive correlation with LT but negative correlations with AL, ACD, VCD, and CCT. As the axial length increased, the ACD, VCD, and CCT increased but the LT decreased. The CCT had a positive correlation with gender, refractive errors, ACD, VCD, and AL but no correlation with age. The mean CCT was increased in proportion to the increase in AL. CONCLUSIONS: In myopic Korean patients, as axial elongation progressed, the VCD and ACD deepened and the CCT thickened but the LT decreased. The CCT had a positive correlation with the degree of myopia and the AL.
Adult
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Female
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Humans
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Male
;
Middle Aged
;
Myopia/*epidemiology/therapy
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Prospective Studies
;
Refractive Errors/*epidemiology/therapy
;
Republic of Korea/epidemiology
;
Visual Acuity

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