新加坡儿童散光的发病率及进展情况

PURPOSE. This study investigated the incidence and progression, as well as factors associated with changes in astigmatism in school children. METHODS. This was a prospective cohort study. Children 7 to 9 years of age, of Chinese, Malay, and Asian Indian ethnicity, were examined annually over a 4- year period. Cycloplegic autorefraction was performed. A questionnaire was used to evaluate risk factors for incidence and progression of astigmatism. RESULTS. The cumulative 3- year incidence rate of astigmatism was 33.6% (cylinder power of 0.5 D or worse) or 11.5% (cylinder power of 1.0 D or worse). Myopic children had a higher incidence rate of astigmatism than nonmyopes (P < .0.001). The mean J0 change per year was 0.012 D (95% CI: 0.007- 0.018), whereas J45 did not show a significant change each year (mean, 0.001 D per year). Chinese children had greater worsening of J0 per year (P < .0.001). Girls also had significantly greater progression of J0 than did boys (P < 0.001). Similarly, myopia at baseline (P < 0.001)- and the hours of computer use (P=0.049) were associated with a greater progression rate of J0. J0 tended to improve in children with compound hyperopic astigmatism, worsen in children with compound myopic astigmatism, and remain stable in mixed astigmatics. CONCLUSIONS. Although there was minimal progression of astigmatism in school age children (0.44- 0.53 D) over this period of follow- up, incident cases of astigmatism ( > 1.0 D) were not uncommon. The progression rate of astigmatism was affected by the ethnicity, presence of myopia, axis, and subtype of astigmatism.

学龄前儿童散光与胎儿脐带绕颈的相关性分析

探讨学龄前儿童散光与胎儿脐带绕颈的相关性分析。方法 回顾性分析100名3-6岁散光学龄前儿童的临床资料,将其作为观察组,将100名3-6岁屈光正常学龄前儿童作为对照组,分析两组的一般资料,统计影响学龄前儿童散光的单因素,并分析影响学龄前儿童散光的独立危险因素。结果 两组性别、年龄、父母散光、母乳喂养等比例相当(P>0.05),但观察组在早产、低体质量新生儿、胎儿脐带绕颈、出生时吸氧、户外活动时间、母亲吸烟史、不良用眼行为等比例均与对照组存在差异(P<0.05);Logistic回归分析显示,早产、低体质量新生儿、胎儿脐带绕颈、出生时吸氧、每天户外活动<2h、不良用眼行为是导致学龄前儿童散光的独立危险因素(P<0.05)。结论 学龄前儿童散光与胎儿脐带绕颈存在显著关联,是重要的独立危险因素之一,临床应对胎儿期存在脐带绕颈的学龄前儿童早期进行屈光检查,早发现,早干预。