Objective:To explore the effective myopia prevention and control strategy after "Anyang Childhood Eye Study" .Methods:The research data of 4981 cases (4981 eyes) of grade 1 and grade 7 students of Anyang city from October to December 2011 were collected. There were 1654 males (1654 eyes) and 1203 females (1203 eyes) in grade 1 students with the average age of (7.1±0.4) years-old (ranged from 5.7 to 9.3 years-old). Among them, there were 1065 males (1065 eyes) and 1059 females (1059 eyes) in grade 7 students with the average age of (12.7±0.5) years-old (ranged from 10.0 to 15.6 years-old). 387 students (387 eyes) in grade 1 and grade 7 students in Anyang city from November to December 2018 were randomly selected. Among them, there were 103 males (103 eyes) and 79 females (79 eyes) in grade 1 students with the average age of (6.8±0.3) years-old (ranged from 6.3 to 7.4 years-old). There were 112 males (112 eyes) and 93 females (93 eyes) in grade 7 students with the average age of (12.7±0.4) years-old (ranged from 10.8 to 14.7 years-old). Refraction were measured by noncycloplegic autorefraction for three times, and spherical equivalent (SE) were calculated. SE was described by ±s, and then the prevalence of refractive error were analyzed. During the period of "Anyang Childhood Eye Study" , the government-hospital-school tripartite model was used to prevent and control children′s myopia. The children′ diopters before and after the "Anyang Childhood Eye Study" model were compared by independent sample t test, and the prevalence of myopia before and after was compared by Chi square test.Results:In 2011, the average diopters of 2857 in grade 1 students and 2124 in grade 7 students were (-0.50±1.10) D and (-2.28±1.78) D, respectively. In 2018, the average diopters of 182 in grade 1 students and 205 in grade 7 students were (0.12±0.64) D and (- 2.02±2.01) D. There was statistically significant difference in eye diopter before and after the "Anyang Childhood Eye Study" model (t=-12.024, P<0.05). There was no significant difference in diopter in grade 7 students, but the diopter of children′myopia in 2018 was lower than that in 2011. According to the value of their diopter, they were divided into three groups: myopic group, emmetropic group and hyperopic group. In 2011, there were 1256 cases (43.96%) with myopia in grade 1 students; 1300 cases (45.50%) with emmetropia; 301 patients (10.54%) with hyperopia. There were 1860 cases (87.57%) with myopia in grade 7 students; 225 cases (10.59%) with emmetropia; 39 patients (1.84%) with hyperopia. The prevalence of children′myopia in two grades was 62.56%. In 2018, there were 31 cases (17.00%) with myopia in grade 1 students; 97 cases (53.30%) with emmetropia; 54 patients (29.67%) with hyperopia. There were 167 cases (81.46%) with myopia in grade 7 students; 30 cases (14.64%) with emmetropia; 8 cases (3.90%) with hyperopia. The prevalence of myopia in two grades was 51.16%. The prevalence of children′myopia between grade 1 and grade 7 students decreased by 17.90% over the past 7 years when the population composition ratio was considered. Chi square test showed that there was significant difference in the prevalence of children′myopia in grade 1 students, grade 7 students and the combination (χ2=49.725, 5.649, 19.259; P<0.05).Conclusions:The prevalence of children′ myopia has declined obviously in Anyang city, which suggesting that the "Anyang Childhood Eye Study" model that the myopia prevention and control platform of government-hospital-school, play a key role in the battle fightening against myopia. The myopia control should pay more attention to kindergarten and primary school students.

Purpose To determine prevalence of refractive (RA), corneal (CA) and internal astigmatism (IA), including variation with gender and spherical equivalent refraction (SE), in a population of 12-year-old Chinese children. Methods A total of 1783 students with a mean age of 12.7 years (range 10.0–15.6 years) completed comprehensive eye examinations in the Anyang Childhood Eye Study. Data of cycloplegic refraction and corneal curvature were analysed. Results Prevalences of RA, CA and IA ≥1.0 D were 17.4% (95%CI 15.6% to 19.2%), 52.8% (50.5% to 55.1%)%) and 20.9% (19.0% to 22.8%), respectively. With different limits of astigmatism axes classification, including ±15°, ±20° and ±30°, RA and CA axes were mainly ‘with-the-rule’ (WTR) (ie, correcting axis of negative cylinders at or near 180°), while those for IA axes were mainly ‘against-the-rule’ (ATR) (ie, correcting axis of negative cylinders at or near 90°). RA was not different between the genders, but girls had higher prevalence and greater means of CA and IA. RA and CA increased in students with higher ametropia (more myopia and more hyperopia) and were the highest in a high myopic group (SE≤−6 D), while IA was stable across refraction groups. Children with RA higher than 0.50 D were more likely to have lens corrections (51%, 57%, 61% and 69% for magnitudes of ≥0.50 D, ≥0.75 D, ≥1.0 D and ≥1.5 D, respectively). Conclusions Prevalence of RA in the Chinese 12-year-old children was relatively high compared with other studies. RA and CA had mainly ‘WTR’ astigmatism, while IA was mainly ATR and partially compensated for CA. Girls had greater means and prevalences of CA and IA than did boys. Both RA and CA, but not IA, increased with refractive errors away from emmetropia.

OBJECTIVE:To investigate the distribution of spherical equivalent and ocular biometric parameters in a population of grade 7 children in central China.METHODS:2 363 grade 7 students of junior high schools were randomly sampled. The students have been examined at baseline and followed up annually. Detailed questionnaires and most of the ocular examinations were performed. Spherical equivalent (Seq) was calculated as sphere +1/2 cylinder from cycloplegic autorefraction. Myopia was defined as spherical equivalent ≤ -0.5D, hyperopia as spherical equivalent ≥ +0.5D and emmetropia between -0.5D and +0.5D. The Lensar LS900 was used to measure corneal curvatures, axial length and anterior chamber depth. Right eyes results were analyzed.RESULTS:Among 2 267 children who have the baseline examination, 1 839 children participated the follow up examination(response rate, 81.1%), with an mean age of 14.7 years (range, 12.9-17.6) and male ratio of 48.4%. The mean spherical equivalent refraction was (-2.62 ± 2.19)D. The prevalence rates of myopia, high myopia, emmetropia and hyperopia were 82.7%, 7.1%, 9.8% and 7.5%. The cumulative incidence rates of myopia and high myopia were 47.1% and 4.5% respectively. Axial length, anterior chamber depth, and corneal curvature were normally distributed. The mean axial length, anterior chamber depth, and corneal curvature were (24.8 ± 1.1)mm, (3.18 ± 0.25)mm, (42.8 ± 1.4)D and (43.9 ± 1.6)D respectively. Axial length was longer, anterior chamber depth was deeper, and corneal were flatter in the male(P = 0.000). Axial length and anterior chamber depth correlated negatively with refraction.CONCLUSIONS:A moderate myopic distribution of refraction was present in the grade 9 students in central China. The prevalence rates of myopia and high myopia were relatively high in this 14-year-old population compared to other countries. It is necessary to strengthen the prevention of juvenile myopia.

Objecttive To evaluate the present eyesight conditions of the teenage students in AnYang and to provide information and evidence for eyesight protection among students.Methods four junior middle school students(11460 subjects)data were selected for analyzed according randomized sampling method.Right eyes data were used.Results Among all students the prevalence of poor eyesight was 70.9 %,The difference among three grade is significant(P<0.05);the poor eyesight prevalence of male and female objects were 65.4 % and 76.8 % respectively,The difference in male and female eyesight is also significant(P<0.05).Conclusion with the increase of the grade,the prevalence of poor eyesight were arising,the prevalence of poor eyesight is higher in female than in male.

BACKGROUND:Screening for amblyopia at earliest is important for early treatment and better prognosis. This study aimed to evaluate the validity of uncorrected distant and near visual acuity (VA) and stereoacuity for screening amblyopia in grade-1 students in primary school in central China. METHODS:By stratified cluster sampling, 3112 grade-1 students from 11 Anyang primary schools were selected for the study. All the participants underwent uncorrected distant and near VA, stereopsis test, cycloplegic refraction, best corrected VA (BCVA), cover test, and ocular movement examination. VA was measured with a logarithm of the minimum angle of resolution (logMAR) chart. Stereoacuity was measured with the Lang II stereo card and TNO test. Amblyopia was defined as the BCVA less than or equal to 0.1 logMAR units of any eye in the absence of significant pathological abnormalities. The sensitivity, specificity, and positive and negative predictive value of uncorrected VA and stereoacuity for amblyopia were analyzed. RESULTS:Out of the 3112 eligible students, 2893 (92.96%) completed the examinations. The average age of the students was (7.10 ± 0.41) years. Screened by distant VA with low cutoff (logMAR 0.1), high cutoff (logMAR 0.0), and near VA (logMAR 0.0), 31.64%, 73.18%, and 50.23% students were abnormal, respectively. Screened by stereopsis test, only 4.69% students were abnormal. Diagnosed by a senior pediatric ophthalmologist, 61 students had amblyopia. The sensitivities of distant VA with low/high cutoff and near VA were 92.31%, 100%, and 80.77%, respectively, whereas that of stereoacuity by TNO test was 15.38%. Simultaneous testing of either two of the three tests improved the sensitivity. CONCLUSIONS:Distant VA test of high cutoff alone displays a high sensitivity but a low specificity. Simultaneous testing of distant VA of low cutoff and stereoacuity is a better choice to balance between sensitivity and specificity.

PURPOSE:To report the design, methods and baseline data of the Anyang Childhood Eye Study (ACES), aiming to determine the prevalence, incidence and risk factors of myopia and other ocular diseases in children in central China. METHODS:The ACES was a school-based cohort study conducted in Anyang city. Students have been examined and will be followed-up annually for 3-5 years. Ocular examinations included visual acuity, identification of amblyopia and strabismus, ocular biometry, optical coherence tomography, retinal photography, cycloplegic autorefraction, accommodative response, peripheral refraction, visual perception and so on. A questionnaire survey was performed to collect risk factors for myopia including near work, outdoor activity, parental myopia, birth history, habits of wearing spectacles and reading, living habits, food habits and so on. RESULTS:Of 3112 grade 1 and 2363 grade 7 students eligible for the ACES, 2893 (93.0%) and 2267 (95.9%) participated in the study, with a mean age of 7.1 years (range 5.7-9.3 years) and 12.7 years (range 10.0-15.9 years), and proportions of male to be 57.8% and 50.0%, respectively. The prevalence rates of myopia, high myopia, emmetropia and hyperopia were 3.9%, 0.1%, 72.9% and 23.3% in grade 1, and 67.3%, 2.7%, 31.4% and 1.2% in grade 7, respectively. Similar data were found in the children confined in 6-year-old and 12-year-old ages. CONCLUSIONS:The ACES is the first large-scale cohort study in China with baseline response rates over 90%. Continuous documentation of changes and risk factors of refractive errors in these cohorts would provide new insights into myopia control in school-aged children.

Objective To systematically evaluate the effects of under correction and full correction of myopia in slowing the progression of myopia in schoolchildren aged 6 to 16 years. Methods Meta-analysis. We searched MEDLINE (1966-2010.10), EMBASE (1950-2010.10), the Cochrane Library, Clinicaltrials.gov, CBM (1980-2010.10) and the Chinese Clinical Trial Registry, and related conference proceedings. The articles retrieved were independently screened by two reviewers. The quality of the selected trials was assessed using a Jadad scale. Review Manager 5.0 software was used to perform the meta-analysis of the extracted data. And the fail-safe N was calculated to assess the potential for publication bias. Results Five trials were included with a total of 428 subjects, of whom 215 subjects had a full correction of their myopia. The results of the meta-analysis showed that the weighted mean difference in the change of myopia progression between the under correction group and the full correction group was-0.26 D (95%CI:-0.60-0.09, P=0.14). After excluding the three trials with a Jadad score of less than 3, a fixed-effects sensibility analysis was conducted and the results showed that the weighted mean difference in the change of myopia progression between the two groups was-0.21 D (95%CI:-0.32--0.10, P=0.0002). The number of fail-safe N was 8. Conclusion Full correction of myopia may slightly slow the progression of myopia in school-aged children compared to under correction of myopia, which needs to be further verified by high-quality randomized controlled trials.

Myopia in school-aged children is a major public health problem in Asians that has been extensively studied. Multifocal lenses (MLs) are advocated as a substitute for single vision lenses (SVLs) to slow myopia progression in children, but results vary greatly across studies. We systematically searched currently available randomized controlled trials that compared the effects of MLs and SVLs in children. A meta-analysis of nine of these trials showed that MLs with powers ranging from +1.50 to +2.00D were associated with a statistically significantly decrease in myopia progression in school-aged children compared with SVLs. The benefit was greater in children with a higher level of myopia at baseline and sustained for a minimum of 24 months. Asian children appeared to have greater benefit from intervention with MLs than white children.