| Background and ObjectiveIn the past half fifty years,with the popularity of electronic products and changes in the way of life and learning,the incidence rate of refractive errors,especially myopia,has been rising worldwide.In China,the incidence rate of myopia among adolescents and children is the highest all over the world,and gradually shows a trend of small age of onset,deep myopia,high incidence,and high myopia.The refractive errors makes a huge negative impact on the physical and mental health of adolescents and children in China,and has become a serious social public health problem,causing widespread social attention.Therefore,understanding the current situation of refractive development in adolescents and children in China and exploring the objective laws of refractive development will be of great benefit to the prevention and control of the occurrence and development of refractive errors,avoiding the occurrence of myopia and high myopia,which will cause irreversible damage to vision health.This study investigated the uncorrected visual acuity(UCVA),refractive situation and growth status of junior high school students in Zhengzhou,observed and analyzed the inherent relationships between the refractive status and refractive factors,in order to explore the laws of children’s refractive development,provide data support and theoretical basis of predicting,preventing and controlling myopia and other refractive errors scientifically.MethodsThis study is a cross-sectional study.Every two classes of students in the first year of junior high school of 10 middle schools in Zhengzhou were selected for eye health examinations,except for special classes(such as low vision schools,Pilot preparatory class,etc.)and current or former serious eye diseases(including congenital cataract,congenital aniridia,glaucoma,ocular trauma,intraocular surgery,etc.).All subjects were Han students.A total of 1335 subjects(2,670 eyes)were included,with an average age of 12.93 ± 0.84 years,including 682 male(1364 eyes)and 653 female students(1306 eyes).Basic information such as name,gender,date of birth,school,grade,class,and parents’ contact number are collected through the information form.The on-site inspection includes uncorrected visual acuity(UCVA),intraocular pressure(IOP),spherical equivalent(SE),slit-lamp examination,biological parameters measurement(axial length,keratometric power,central corneal thickness,anterior chamber depth,lens thickness,vitreous thickness,and white to white distance),and growth and development indicators measurement(height and weight).All data were statistically analyzed by SPSS 21.0.The difference was statistically significant at P < 0.05.Results1.The UCVA of the right eye was 0.51 ± 0.44,the rate of poor vision was 80.3%,the UCVA of the left eye was 0.54 ± 0.44,and the rate of poor vision was 77.3%.The difference was no statistically significant(P > 0.05).As to the same side of eye,the rate of poor vision of boys was lower than that of girls,the difference was statistically significant(P < 0.05);the overall incidence of poor vision was 85.7%,83.9% for boys and 87.6% for girls,the difference was no statistically significant(P > 0.05).The UCVA declines with age,and the incidence of poor vision increase with age.2.The right eye SE was-2.32 ± 2.40 D,the refractive error rate was 83.6%,the left eye was-2.02 ± 2.40 D,and 79.2%.The difference was statistically significant(P < 0.05).As to the same side of eye,the spherical equivalent of girls was lower than that of boys,the difference was no statistically significant(P > 0.05);the overall incidence of refractive error was 90.0%,90.2% for boys and 89.7% for girls.The SE declines with age.3.The right eye IOP was 16.16 ± 3.52 mmHg and the left eye was 16.33 ± 3.16 mmHg.There was no significant difference among gender or eye(P > 0.05).4.The mean corneal curvature of the right eye was 43.11 ± 1.37 D,and the left eye was 43.11 ± 1.37 D.The difference was no statistically significant(P > 0.05).As to the same side of eye,the average corneal curvature of the female was bigger than that of the male,and the difference was statistically significant(P < 0.001).There was no significant change in corneal curvature with age.5.The axial length of the right eye was 24.35 ± 1.17 mm,the left was 24.27 ± 1.20 mm.The difference was no statistically significant(P > 0.05).As to the same side of eye,axial length of the male was longer than that of the female,and the difference was statistically significant(P < 0.001).As the age increases,the axial length gradually increases.6.The right eye white to white distance was 12.14 ± 0.61 mm,and the left was 12.16 ± 0.55 mm.The difference was no statistically significant(P > 0.05).As to the same side of eye,white to white distance of the male was bigger than famale,and the difference was statistically significant(P < 0.001).There was no significant change in white to white distance with age.7.The central corneal thickness of the right eye was 542.28 ± 33.91 μm,and the left eye was 542.23 ± 33.76 μm.The difference was no statistically significant(P > 0.05).As to the same side of eye,the central corneal thickness of the males was higher than that of the females,and the difference was statistically significant(P < 0.001).There was no significant change in central corneal thickness with age.8.The anterior chamber depth of the right eye was 3.25 ± 0.28 mm,and the left eye was 3.25 ± 0.28 mm.The difference was no statistically significant(P > 0.05).As to the same side of eye,the anterior chamber depth of the male was deeper than that of the female,the difference was statistically significant(P < 0.001);there was no significant change in anterior chamber depth with age.9.The lens thickness of the right eye was 3.45 ± 0.20 mm,and the left was 3.45 ± 0.21 mm.The difference was no statistically significant(P > 0.05).As to the same side of eye,the lens thickness of boys was thinner than that of girls,and the difference was statistically significant(P < 0.05).With the increase of age,there is no significant change in lens thickness.10.The vitreous thickness of the right eye was 17.11 ± 1.12 mm,and the left eye was 17.03 ± 1.14 mm.The difference was no statistically significant(P > 0.05).As to the same side of eye,the vitreous thickness of the boys was thicker than that of the girls.The difference was statistically significant.(P < 0.001).The vitreous thickness gradually increased with age.11.The average height and weight of boys were higher than that of girls,and the difference was statistically significant(P < 0.001).The height and weight gradually increased with age.12.There was a high correlation of the refractive parameters between the eyes.The SE is positively correlated with the lens thickness,negatively correlated with IOP,mean corneal curvature,axial length,anterior chamber depth and height,no correlated with white to white distance,central corneal thickness and body weight;negatively correlated with AL/CR in the hyperopia group and myopia group.The axial length was positively correlated with age,height and weight.The corneal curvature was negatively correlated with height and weight,and no correlated with age.Conclusions1.The development of refractive status of adolescents and children is the result of the coordination of refractive factors,and influenced by gender,age,and growth and development situation.The incidence of refractive error and high myopia in Zhengzhou junior high school students is higher than the domestic average level and needs to be highly valued.2.Girls,right eyes,high intraocular pressure,AL/CR ≥ 2.99,taller height and heavier weight should be listed as key targets to strengthen the prevention and control of myopia. |
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