眼轴长度在近视防控管理中的应用专家共识(2023)

Expert consensus on the application of axial length in myopia prevention and control management(2023)

当前眼轴长度(AL)的测量方法无创、便捷,结果客观、稳定。与眼屈光度数的测量结果不同,AL测量不受眼调节能力的影响,近年来在近视防控中逐渐受到关注和应用,已成为青少年近视防控管理的重要评价指标。然而,目前尚缺乏全面反映我国3~18岁儿童青少年屈光状态或屈光进展的AL参考值及针对AL测量方法、测量设备评价方法的操作规范,给儿童青少年近视筛查结果的判定、屈光档案的准确建立、屈光状态的纵向趋势观察以及测量数据的可比性等带来了很大挑战。为了促进和规范我国已有的儿童青少年眼轴数据的合理应用以及规范眼轴数据的测量和记录,《眼轴长度在近视防控管理中的应用专家共识(2023)》专家组在全国范围内广泛征求和收集目前我国在儿童青少年近视筛查和临床实践中关于AL评价的主要问题并进行分析和归纳,就我国儿童青少年AL及相关参数的定义与测量要求、人群生长发育特征、在人群横断面筛查中的应用、在屈光动态管理中的应用、AL变化与屈光度数变化的换算关系、AL联合其他参数对近视的预测效果、眼轴测量仪器的准确性评估等7个科学内容进行研究和讨论,根据对国内外重要文献进行归纳分析,结合我国的具体实践,制定《眼轴长度在近视防控管理中的应用专家共识(2023)》,为公共卫生、临床医师和相关从业人员的具体工作实践和操作过程提供相对标准化的专家建议,同时为相关政策管理者制定我国近视防控技术方案、实施近视公共卫生预防、早期近视预警和风险判断以及近视的临床控制提供指导意见,促进近视分级分类管理迈向精准化,提升防控近视发生发展的效果。

The current measurement method of axial length(AL)is non-invasive and convenient,with objective and stable results.Unlike refractive diopter,which is influenced by the eye accommodation,the measurement of AL is not affected.Therefore,AL has gradually received attention and application in myopia prevention and control in recent years,and has become an important evaluation index for myopia management in children and adolescents.However,there is currently a lack of AL reference values that comprehensively reflect the refractive status or progression of children and adolescents aged 3-18 years in China,as well as operational standards for AL measurement and measurement equipment evaluation,posing great challenges to the determination of myopia screening results,the accurate establishment of refractive profiles,the observation of longitudinal trend of refractive status,and the comparability of measurement data of children and adolescents.In order to promote and standardize the rational application of existing AL data of children and adolescents in China,as well as the measurement and recording of AL data,the Expert consensus on the application of axial length in myopia prevention and control management(2023)expert workgroup extensively solicited and collected the main issues related to AL evaluation in myopia screening and clinical practice in children and adolescents in China,and conducted analysis and summary.The expert workgroup conducted research and discussion on seven scientific contents,including the definition and measurement requirements of AL and related parameters in children and adolescents in China,the growth and development characteristics of the population,the application in cross-sectional screening of populations,the application in dynamic management of refraction,the conversion relationship between AL changes and refractive diopter changes,the predictive effect of AL combined with other parameters on myopia,and the accuracy evaluation of AL measurement instruments.Based on the summary and analysis of important literature at home and abroad and combined with the specific practices in China,the Expert consensus on the application of axial length in myopia prevention and control management(2023)was formulated to provide relatively standardized expert recommendations for public health,clinical physicians,and related practitioners in the specific working practices and operational processes.Meanwhile,the consensus aims to provide guidance for relevant policy managers to formulate programs about myopia prevention and control in China and implement public health prevention,early myopia warning and risk assessment,as well as clinical control of myopia,to promote the precision of stratified and classified management of myopia and improve the effectiveness of prevention and control of myopia onset and progression.