Strategies to control myopia in children:a review of the findings from the Anyang Childhood Eye Study

Myopia in children remains a major public health problem worldwide,especially in some Asian countries such as China,Singapore and Japan.Although many interventions have been attempted,few has been proven to be effective in controlling onset and progression of myopia in children.Environmental factors,genetic susceptibility or ethnic differences can affect the efficacy of these interventions.However,many questions remain unclear and even controversial for controlling myopia.China has the biggest population with myopia,especially for children myopia.Thus,it is of importance to present what achievements Chinese scientists have made in the field of myopia control in children.We summarize the current findings on myopia control in children from the Anyang Childhood Eye Study,including epidemiological data,clinical trials,systematic reviews and meta-analyses,and compare them with studies in other countries to find potential clues for controlling myopia in children.

The diluted atropine for inhibition of myopia progression in Korean children

AIM：To evaluate the efficacy and safety of three different concentrations of diluted atropine for the control of myopia in Korean children,and to assess the risk factors associated with rapid myopia progression.METHODS：A total of 285 children,with refractive errors within the range of-6 diopters（D）between 5 and 14 years of age were included.After using 0.01%,or 0.025%,or 0.05% atropine,for about 1y,changes in refraction,axial lengths and frequency of adverse events were analyzed.Logistic regression analyses were performed to evaluate the risk factors associated with rapid myopia progression.RESULTS：The changes in the mean spherical equivalent values were -0.134 D/mo in the before atropine group,-0.070 D/mo in the 0.01% atropine group,-0.047 D/mo in the 0.025% atropine group,and -0.019 D/mo in the 0.05% atropine group,with significant differences between the groups（P〈0.001）.The axial elongation was 0.046 mm/mo,0.037 mm/mo,0.025 mm/mo,and 0.019 mm/mo respectively,with significant differences between the groups（P=0.003）.The incidence of photophobia and near vision difficulty was not different among the three atropine groups（P=0.425and P=0.356,respectively）.Multivariate logistic regression analyses showed that only highly myopic parents were a significant predictive factor of rapid myopia progression in Korean children（odds ratio,8.155;95% confidence interval,3.626-18.342;P〈0.001）.CONCLUSION：Treatment with 0.01%,0.025% and 0.05% atropine solution inhibits myopia progression in Korean children in a dose-dependent manner.Children with highly myopic parents preferentially shows a rapid myopia progression rate.

Relationship between higher-order aberrations and myopia progression in schoolchildren: a retrospective study

AIM: To investigate the relationship between higher- order aberration (HOA) and myopic progression in schoolchildren. ·METHODS: Between April 23 2011 and August 29, 2011 in the children’s myopia outpatient clinic of the West China Hospital of Sichuan University, 148 eyes of 74 schoolchildren were reviewed. HOAs for a 6 -mm pupil were measured with an aberrometer. Myopic progression rate was defined according to the change in spherical equivalent refraction (SER) divided by the time span (years). Subjects with myopic progression rate of ≥0.50 diopters (D) were classified as the ’fast’group and the subjects with myopic progression rate of 【0.50D were classified as the’slow’group. A retrospective study was conducted to compare HOA between the two groups, using root mean square (RMS) values and Zernike coefficients. ·RESULTS: The RMS values of HOA (t =2.316, P =0.02), HOA without Z 4 0 (t =2.224, P =0.03),third-order aberrations (t’ =2.62, P =0.01), and coma (t’ =2.49, P =0.01) were significantly higher in the fast group than those in the slow group. The individual Zernike coefficients of Z 3 -1 (t = -2.072, P =0.04) and Z 5 1 (Z =-2.627, P =0.01) displayed statistically significant differences between the two groups. Significant correlations were found between the RMS values of HOA (r =0.193, P =0.019), RMS values of HOA without Z 4 0 (r =0.23, P =0.005), RMS values of coma(r =0.235,P =0.004),RMS values of third-order aberrations (r =0.243, P =0.003), and the progression rate. · CONCLUSION: Our results provide evidence of a relationship between HOA and myopic progression. In a future prospective longitudinal study, we aim to verify whether HOA is a risk factor for myopic progression.

Tendency for Evolution of High Myopia in 308 Chinese School Children from Xi'an City

Purpose: To observe the refractive status, especially the tendency for evolution of high myopia, in eyes of Chinese school children from Xi’an city.Methods: The study was conducted in 11514 eyes of the 5757students aged between 7~18 years in Xi’an city primary and high schools. The inclusion criterion was >-6D of the spherical equivalent refraction. The object ophthalmic examinations were done, included non-cycloplegic objective refraction, visual acuity, intraocular pressure, fundus evaluation by ophthalmologists and nurses with professional training. Specially designed questionnaires were filled in and the data were statistically analyzed with SPSS10.0.Results: Of 11514 eyes, the detection rate was 81.4%(9376eyes) for myopia and 5.3%(615 eyes) for high myopia. High myopia was found in 2.6%.(300 eyes).of right eyes, 2.7%(315 eyes) in left eyes, and 2.4%(275 eyes) were in boys and 2.9%(340 eyes) in girls. Among 12 school grades, the detection rates of high myopia increased significantly with student age, with 0.9% in the 1stgrade of primary school and12.5% in the 3rd year of senior middle school. The average refractive error of spherical equivalent refraction was(-7.43±1.29) D with 95% confidence interval(-7.54,-7.33). No significant differences were found between the right and left eyes or both genders. The distribution of myopic severity was lowest(-6D).in primary school students younger than 12 years,was higher(-8D) in junior middle school students older than13 years, and highest(-13D) in senior middle school students.Conclusion: A continuous growth was evident in the severity of high myopia throughout 12 years of primary and middle school except for the first year of primary school, with growth occurring in two transitional stages between the senior primary and junior middle school years, and between the junior and senior middle school years. The distribution of high myopia was lowest, at-6D, in primary school, increased to-8D in junior middle school, and progressed to-10D in senior middle school, indicating a high risk of development of pathologic myopia during the students’ later lifespan. The adolescent period of 13 to 18 years of age in middle school is a critical period for the development of pathological myopia over-8D.

Associations between near work, outdoor activity, parental myopia and myopia among school children in Aba, Nigeria

●AIM:To assess the influence of near work,time outdoor and parental myopia on the prevalence of myopia in school children in Aba,Nigeria.●METHODS:Primary and secondary school children aged between 8 and 15 y were randomly recruited from 12 schools in Aba.Information on family history,near work and outdoor activity was obtained using myopia risk factor questionnaire.Cycloplegic refraction was performed using autorefraction technique.Myopia was defined as spherical equivalent refraction(SER)≤-0.50 D in the poorer eye.Data were analysed for 1197(male:538 and female:659)children with full relevant data.●RESULTS:Risk of developing myopia was positively associated with parental myopia[odds ratio(OR):6.80;95%CI,2.76-16.74;P<0.01)for one myopic parent and(OR:9.47;95%CI,3.88-23.13;P<0.01)for two myopic parents,longer daily reading hour(OR:1.21;95%CI,1.03-1.42;P=0.02)and less time outdoors(OR:0.8;95%CI,0.74-0.87;P<0.01).●CONCLUSION:Parental history of myopia is the most important risk factor associated with myopia.In addition,children with both parents being myopic has increased odds of developing myopia than those with one myopic parent.It is recommended therefore,that children spend more time outdoors as this could reduce the prevalence and progression of myopia.

Prevalence of Myopia in Preschool and School Children in the Municipality of Prishtina in Kosovo

Introduction: Myopia is the refractive anomaly of the eye in which the conjugate focus of the retina is at some finite point in front of the eye, when the eye is not accommodating. Myopia is else known as short-sightedness and is considered as one of the most frequent causes of reduced vision especially in adolescents. Adolescence is one of the life periods when most cases are diagnosed with myopia. Purpose: The aim of this study was to identify myopia in pre-school and school children (3 - 9 years old in Prishtina), to determine the prevalence of myopia among other refractive anomalies in cases included in the study;compare the prevalence of myopia in this population in Prishtina to other countries in the world;determine the effect of hereditary and socio-economic factors on the prevalence of myopia;and determine the degrees of myopia in our cases included in our study. Materials and Methods: This was a cross-sectional study involving 1027 pre-school children and pupils from 4 schools in Prishtina, aged 3 - 9 years old, who were screened for refractive anomalies, with a special focus on the incidence of myopia in this age group. The data were collected by screening children in the institutions of pre-school and primary school education, including 2 primary schools and two kindergarten during a two-year period 2010-2012 in Prishtina. Results: On the screening of pre-school and school children for refractive anomalies, were included 1027 subjects of ages 3 - 9 years old. Of the 1027 children screened 536 (52.2%) were male and 491 (47.8%) were female. Statistically, the prevalence of refractive anomalies in the total population studied is significant based on the resulting value (P Conclusions: The Prishtina study is a report of prevalence of myopia among pre-school and school-age children in the municipality. The study reveals that refractive error and myopia were significantly common finding among the study group, and the prevalence was found to be even higher in children within the school age-group. The number of newly diagnosed myopia was significant, suggesting the need for a robust school eye health programme, regular assessment of school children for refractive error and provision of timely refractive corrections.

Two different autorefractors for vision screening in children and adolescents

AIM:To compare the consistency of two autorefractors(Tianle RM-9000 and Topcon KR-800)for school-age myopia children,and to provide a basis for largescale data analysis and comparison.METHODS:The refractive error in 909 subjects(age 4–18y)were measured using both autorefractors without cycloplegia.The data were analyzed using Fourier decomposition and the correlation coefficients,intraclass correlation coefficients(ICC),and Bland-Altman limits of agreement(LoA)for each parameter were calculated.RESULTS:There was a strong correlation between the spherical equivalent(SE),sphere diopter(DS),and cylinder diopter(DC)readings of the Tianle RM-9000 and those of the Topcon KR-800,with correlation coefficient values of 0.98,0.98 and 0.83 and ICC values of 0.99,0.99 and 0.93,respectively.However,the correlation coefficients and ICC values of J0 and J45 were unreliable(R=-0.004,-0.034;both ICC<0.10).Bland-Altman analysis revealed that SE,DS,and DC measured by the Tianle RM-9000 were significantly biased toward myopia compared with the Topcon KR-800,and the mean differences were-0.072,-0.026,-0.091 D,respectively(all P<0.01).The minimum absolute value of the difference within the 95%LoA for SE,DS,and DC was 0.63 D,0.50 D,0.62 D,respectively;all these values were in the clinically acceptable range.For J0 and J45,the mean differences were close to zero(P=0.43,0.84);however,the 95%LoA were relatively wide(J0 SD:0.53;95%CI:-1.00,1.10;J45 SD:0.52;95%CI:-1.00,1.00).CONCLUSION:The two autorefractors are consistent with each other,as the differences in SE,DS,and DC were within the clinically acceptable range.Readers can compare the data measured by either device in different studies and use the two devices in the same study to generate a dataset that can be analyzed together.However,the J0 and J45 vectors are unreliable and should not be used to assess astigmatism.

The prevalence of uncorrected refractive error in urban, suburban, exurban and rural primary school children in Indonesian population

Uncorrected refractive error（URE） is a major health problem among school children. This study was aimed to determine the frequency and patterns of URE across 4 gradients of residential densities（urban, exurban, suburban and rural）. This was a cross-sectional study of school children from 3 districts in Yogyakarta and 1 district near Yogyakarta, Indonesia. The information regarding age, sex, school and school grader were recorded. The Snellen＇s chart was used to measure the visual acuity and to perform the subjective refraction. The district was then divided into urban, suburban, exurban and rural area based on their location and population. In total, 410 school children were included in the analyses（urban=79, exurban=73, suburban=160 and rural=98 school children）. Urban school children revealed the worst visual acuity（P〈0.001） and it was significant when compared with exurban and rural. The proportion of URE among urban, suburban, exurban and rural area were 10.1%, 12.3%, 3.8%, and 1%, respectively, and it was significant when compared to the proportion of ametropia and corrected refractive error across residential densities（P=0.003）. The risk of URE development in urban, suburban, exurban, and rural were 2.218（95%CI： 0.914-5.385）, 3.019（95%CI： 1.266-7.197）, 0.502（95%CI： 0.195-1.293）, and 0.130（95%CI：0.017-0.972）, respectively. Urban school children showed the worst visual acuity. The school children in urban and suburban residential area had 2 and 3 times higher risk of developing the URE.

Accommodation function comparison following use of contact lens for orthokeratology and spectacle use in myopic children: a prospective controlled trial

AIM： To study effects of orthokeratology（Ortho-k） on accommodation function in myopic children. METHODS： A prospective, non-randomized, case-control study was performed from September to October 2016. Eighty-three children with myopia were divided into two groups. One group was treated with the rigid contact lens for overnight Ortho-k, and the other was treated with single-vision spectacle lens（SVL）. Accommodation function were assessed by accommodative amplitude（AA）, accommodative sensitivity（AS）, accommodative lag（Lag）, negative relative accommodation（NRA）, and positive relative accommodation（PRA） before and 1, 3, 6 and 12 mo after treated. RESULTS： Totally 72 myopic children were finished the follow-up： 37 in Ortho-k group and 35 in SVL group. Wearing time had a significant effect on AA, AS, Lag, and NRA of myopic children in two groups（all P〈0.05）. Meanwhile, there was an interaction effect between wearing time and wearing types（FAA=5.3, FAS=45.5, FLag=7.0, FNRA=3.7, all P〈0.05）. However, the between-group difference of AA（F=0.1）, AS（F=3.2）, Lag（F=1.1）, NRA（F=0.3）, and PRA（F=0.1） showed no significance. AA, AS, NRA, Lag and PRA were improved significantly in Ortho-k group within 1 to 6 mo after wearing. CONCLUSION： Wearing Ortho-k can improve the accommodation function of myopic children, which might be one of the mechanisms for myopia control.

Topographic distribution features of the choroidal and retinal nerve fiber layer thickness in Wenzhou schoolaged children

AIM:To explore the topographic distribution features of choroidal thickness(CT)and retinal nerve fiber layer thickness(RNFLT),and determine the relationship between CT and ocular parameters in school-aged children.METHODS:The healthy school-aged children with low myopia or emmetropia in Wenzhou were recruited for this cross-sectional study.With high-density optical coherence tomography(HD-OCT)combined with MATLAB software,the CT and RNFLT values in the macular area were measured at different locations and compared.Statistical analyses were performed to evaluate the correlation between CT and ophthalmic parameters,such as spherical equivalent(SE)and the axial length(AL).RESULTS:A total of 279 school-aged children with 8.00±1.35 years of mean age(range,6-10 y)were included.The mean AL was 23.66±0.86 mm.The mean CT in CT-C(264.31±48.93μm)was thicker than that in CT-N1(249.54±50.52μm),and the average CT in the parafoveal region was also thicker than that in CT-N2(235.65±50.63μm).The subfoveal CT also varied substantially across refractive errors(P<0.001),and those with myopia(250.59±47.01μm)exhibited a thinner choroid compared with those with emmetropia(278.74±48.06μm).CT positively correlated with AL(y=11.12 x-4.15;R^2=0.18),and positively correlated with SE(y=90.07 x+17.916;R^2=14.2).The average RNFLT was thickest in the peripapillary region(236.35±19.03μm),the mean RNFLT-S(131.10±15.16μm)was thicker than the RNFLT-I(128.20±16.59μm),and the mean RNFLT-T(76.54±11.99μm)was thicker than the RNFLT-N(64.28±8.55μm).The variations in the RNFLT between quadrants did differ between those with myopia and emmetropia(P<0.05).CONCLUSION:We establish demographic information for the choroid and RNFLT.These findings provide information that should be considered in future analyses of the CT and RNFLT in OCT studies in school-aged children.

多焦点近视离焦眼镜联合阿托品滴眼液对轻中度儿童近视的治疗效果

目的:探讨多焦点近视离焦眼镜(DIMS)联合阿托品滴眼液对轻中度儿童近视的治疗效果。方法:选取90例(180眼)近视儿童为研究对象,根据治疗方法不同分为A组(n=36)、B组(n=30)和C组(n=24)。A组儿童佩戴框架眼镜治疗;B组儿童佩戴DIMS治疗;C组儿童佩戴DIMS联合0.01%阿托品滴眼液治疗,各组疗程均为12个月。比较各组患儿治疗前、治疗6个月及12个月后的裸眼视力、眼压、屈光度、眼轴长度、中央前房深度、角膜厚度及角膜曲率。结果:治疗6个月、12个月后,各组患儿裸眼视力均呈下降趋势,且C组<B组<A组(P<0.05);眼压、中央前房深度、角膜厚度、角膜曲率差异无统计学意义(P>0.05)。治疗12个月后,各组患儿屈光度、眼轴长度比较:C组<B组<A组(P<0.05)。结论:DIMS有利于延缓轻中度近视儿童近视进展,控制屈光度及眼轴增长,且与低浓度阿托品滴眼液联用效果更优。

3907例儿童近视早期眼底改变在不同眼轴的分布及其人工智能量化监控指标

目的采用人工智能技术对儿童近视早期眼底的微量变化进行定性、定量分析,结合相关眼生物参数,探索近视发展的内在规律,为儿童近视防控工作中的早期发现、及时监测、适时调整提供敏感指标。方法横断面研究。对3907例18岁以下门诊顺序就诊儿童的眼底及相关生物参数进行采集,并按年龄分为6组,眼轴分为8组。分别采用SW‐9000眼科光学生物测量仪、SW‐8800眼底照相机,OSE‐2800眼科光学相干断层扫描仪和EVisionAI依未眼底智能分析云平台。依据SHI’标准中国眼健康档案及诊断体系,每一位患者每次就诊均按设计流程进行11项+眼生物参数进行完整的数据采集。近视早期眼底指标依次有垂直杯/盘(C/D)比、豹纹状改变和弧形斑。采用SPSS 19.0(SPSS Inc,Chicago,IL,USA)进行统计,包括χ2分析、ANOVA方差分析和多元逐步线性回归分析。结果3907例18岁以下儿童中,男生55.8%,女生44.2%;右眼和左眼分别50%。就诊高峰为6~11岁(64%)。眼轴23.5~25.5 mm占总人数的53.5%。眼轴25.5 mm以上各组占16.9%。垂直C/D比0.4~0.5占77%(χ2检验,P=0.000);眼轴24.5 mm以下各组呈现1级或无豹纹状改变,弧形斑多为生理改变;眼轴24.5~25.5 mm组呈现4级豹纹状改变;眼轴24.5 mm以上各组主要表现为3级弧形斑,26.5 mm以上眼轴为4级弧形斑(P组间=0.000,P总=0.000,P相关性<0.002)。结论24.5 mm眼轴可作为学龄儿童近视防控的监测关键拐点,豹纹状改变0.1、弧形斑1 PD视为诊断指标,豹纹状改变0.04~0.09、弧形斑2/3 PD视为病理性改变前期或高危期诊断指标。

近视针刺法联合指针疗法防控儿童低中度近视的疗效观察

目的 探讨近视针刺法联合指针疗法防控儿童低中度近视临床疗效。方法 选取2020年1月—2022年10月期间首都医科大学附属北京同仁医院就诊的低中度近视儿童86例,按随机数字表方法分为对照组和观察组,每组各43例。对照组给予配镜治疗,观察组在对照组基础上予近视针刺法联合指针疗法。治疗1个月后,观察两组患儿治疗前后临床疗效,治疗前后中医证候评分,裸眼视力,屈光度,眼轴长度,调节幅度。结果 治疗后两组患儿观察组临床总有效率93.02%(40/43)明显高于对照组74.42%(32/43),差异有统计学意义(P<0.05)。治疗后两组患儿中医证候评分均较治疗前降低,差异有统计学意义(P<0.05);且观察组中医证候评分明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患儿裸眼视力及屈光度均较治疗前升高,差异有统计学意义(P<0.05);且观察组裸眼视力及屈光度均明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患儿眼轴长度及调节幅度均较治疗前升高,差异有统计学意义(P<0.05);且观察组眼轴增长幅度低于对照组,调节幅度高于对照组,差异有统计学意义(P<0.05)。结论 近视针刺法联合指针疗法防控儿童低中度近视临床疗效显著。

2023年中国6省儿童青少年视力不良与筛查性近视分布情况

目的了解我国6省儿童青少年视力不良和筛查性近视的分布特征,为制定有效的近视防控策略提供科学的参考依据.方法于2023年3-7月在项目组调查6省中,采用非概率抽样方法抽取181981名儿童青少年进行远视力筛查和电脑验光,采用χ^(2)检验比较不同性别、学段及城乡儿童青少年视力不良与筛查性近视的检出差异.结果儿童青少年视力不良检出率为60.4%,筛查性近视检出率为51.0%.χ^(2)检验结果显示,女性的视力不良与筛查性近视检出率分别为63.5%和53.8%,均高于男性的57.6%和48.4%;幼儿园儿童青少年视力不良检出率为68.2%,高于小学1~3年级(34.4%)、小学4~6年级(53.7%)、初中(70.6%),低于高中(83.0%);幼儿园儿童青少年筛查性近视检出率为8.6%,低于小学1~3年级(20.2%)、小学4~6年级(46.8%)、初中(67.3%)、高中(80.5%).城市儿童青少年的视力不良检出率为61.1%,高于乡村儿童青少年的59.4%;城市儿童青少年的筛查性近视检出率为50.7%,低于乡村儿童青少年的51.4%;以上差异均有统计学意义(P<0.05).结论我国儿童青少年视力不良与筛查性近视检出率均较高,未来应提升公众对视力保护的意识,制定科学有效的近视防控策略,以降低未来儿童青少年近视的发生率.

子午流注法穴位贴敷联合视力调节训练对儿童青少年低度近视的影响研究

目的:探讨子午流注法穴位贴敷联合视力调节训练对儿童青少年低度近视的影响。方法:选取2022年12月~2023年12月于我院接受治疗的100例患者进行研究。分组方法选择随机数字表法,分成两组各50例。对照组接受常规视力调节训练,观察组在此基础上接受子午流注法穴位贴敷干预。比较两组患儿的治疗效果以及干预前后裸眼远视力、屈光度、不同动脉的血流平均值、眼球生物测量参数检测结果的变化情况。结果:观察组治疗总有效率为96.00%,高于对照组的78.00%,统计学结果有显著差异(P<0.05);观察组干预后裸眼远视力高于对照组干预后,统计学结果有显著差异(P<0.05);观察组干预后基底动脉(BA)、左侧椎动脉(LVA)、右侧椎动脉(RVA)血流平均值均高于对照组干预后,统计学结果有显著差异(P<0.05);观察组干预后眼轴低于对照组干预后,中央角膜厚度高于对照组干预后,统计学结果有显著差异(P<0.05)。结论:在视力调节训练基础上实施子午流注法穴位贴敷能够提升儿童青少年低度近视的治疗效果,改善患儿视功能,值得临床推荐。

不同健康教育方式对儿童青少年近视防控作用的研究进展

我国儿童青少年近视率居世界前位,并伴有低龄化和重度化趋势。视力问题与儿童青少年的身心健康密切相关。健康教育在预防和控制近视的发生发展中发挥了积极作用。本研究聚焦于健康教育对儿童青少年近视的作用,从理论模型、传播方式和传播对象3个方面就健康教育对儿童青少年近视的预防和控制作用进行综述,旨在为儿童青少年近视发生发展的预防和控制研究提供有效方式,减少近视所带来的公共卫生问题。

不同浓度阿托品对中国儿童近视控制效果的Meta分析

目的系统评价不同浓度阿托品对中国儿童近视的控制效果。方法计算机检索PubMed、Embase、The Cochrane Library、Web of Science、CBM、WanFang Data、VIP和CNKI数据库,搜集关于阿托品控制儿童近视的研究,检索时限均从建库至2023年4月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.4软件进行Meta分析。结果共纳入32项研究,包括7种不同浓度阿托品对比安慰剂的结果。Meta分析结果显示,与安慰剂相比,0.1 g•L^(-1)阿托品对等效球镜度变化有显著的影响[MD=0.39,95%CI(0.26,0.52),P<0.05],能够显著抑制眼轴长度的增加[MD=-0.18,95%CI(-0.24,-0.12),P<0.05]。其他浓度中,0.2 g•L^(-1)、0.5 g•L^(-1)及10 g•L^(-1)阿托品均对近视的控制均有较好的效果。结论现有证据显示,与安慰剂相比,0.1 g•L^(-1)、0.2 g•L^(-1)、0.5 g•L^(-1)及10 g•L^(-1)阿托品对儿童近视等效球镜度及眼轴长度的控制均有较好的效果,其中0.1 g•L^(-1)阿托品可能具有最好的效果。

基于海派儿科推拿思想防治儿童青少年近视临床观察

目的探讨基于海派儿科推拿思想防治儿童青少年近视的临床效果。方法选择2021年3月—2022年7月于江西儿童医院眼科或小儿推拿就诊的青少年近视患者120例,采用非随机的平行对照及自愿原则分为推拿组60例和对照组60例。推拿组采用海派儿科推拿进行治疗,对照组采用近视治疗仪治疗,经5周治疗后进行效果统计分析。结果推拿组患者治疗后裸眼远视力优于对照组(P<0.05),屈光度低于对照组(P<0.05)。推拿组总有效率为98.33%(59/60),高于对照组的83.33%(50/60)(P<0.05)。结论青少年近视呈现低龄化趋势,有效预防近视发生与控制近视发展属于公共卫生问题。此研究采用海派儿科推拿进行干预,能在传承一指禅推拿技巧的同时,与传统小儿推拿相融合,临床效果显著,同时能提高青少年免疫力,易于被青少年接受。

基于家庭层面的儿童青少年近视防控影响因素定性研究

目的基于家庭层面,探讨影响儿童青少年近视防控的主要因素,为合理制定儿童青少年近视防控干预措施、政策提供理论参考。方法于2023年4-12月,采取非概率抽样法选取我国部分省市中参与过儿童青少年近视防控调查的120名家长开展焦点小组访谈。基于社会生态学理论,采用Nvivo 12.0主题框架分析法对定性资料进行编码和分析。结果访谈结果显示,限制电子产品使用时间、多户外活动、定期复查视力、学校积极开展相关健康教育以及社区的积极宣传等是预防儿童青少年近视发生发展的促进因素;家长及儿童青少年时间紧张、家长视力保健行为意识薄弱、学校开展近视防控活动形式单一、学校未能很好落实视力筛查政策等是主要障碍因素。结论家长时间观念、视力保健行为意识较弱,学校层面近视防控活动形式单一,以及视力筛查制度等政策落实是预防儿童青少年近视发生发展的影响因素,故未来可通过开展健康教育、推进多样化近视防控活动、落实视力筛查制度等干预措施,延缓儿童青少年近视的发生发展。

韦企平论治儿童青少年近视临证思路

我国近视患病基数大、治疗困难,若进展至高度近视,可造成多种并发症,包括黄斑出血、视网膜裂孔、视网膜脱离等。韦企平认为,本病的病机为先天不足、后天失养、神光失调,主张内外同治、补养结合、注重调护,强调“健脾不在补贵在运”是近视防治的关键,体现了“运脾”在论治中的重要地位,但治脾又不唯脾,兼顾补肝、养心、滋肾。同时根据病情给予个性化的外治疗法,包括针法、推拿、药物外敷、耳穴压丸等。在治疗的过程中,当注重改善用眼习惯及生活调护等。本文通过总结韦企平防治儿童青少年近视的思路,发挥中医药的特色优势,预防近视的发生,减缓近视的进展,为近视防控的国家战略贡献力量。