上海市儿童青少年视力及矫正情况

张波; 戚紫怡; 王菁菁; 刘思辰; 杨金柳行; 陈军; 杜林琳; 何鲜桂; 高玮

doi:10.16835/j.cnki.1000-9817.2025001

上海市儿童青少年视力及矫正情况

doi: 10.16835/j.cnki.1000-9817.2025001

张波¹,
戚紫怡^{1, 2},
王菁菁¹,
刘思辰¹,
杨金柳行¹,
陈军¹,
杜林琳¹,
何鲜桂^{1, 2},
高玮^1, ,

1.
上海市眼病防治中心/同济大学附属眼科医院临床研究中心，200331
2.
上海交通大学医学院附属第一人民医院眼科/国家眼部疾病临床医学研究中心

基金项目:

上海市卫生健康委员会学科带头人计划项目 2022XD032

上海市眼病防治中心院级临床研究培育项目 21LC01009

上海市卫生健康委员会卫生行业临床研究专项青年项目 20214Y0429

上海市卫生健康委员会卫生行业临床研究专项青年项目 20214Y0427

详细信息

作者简介:
张波(1990-)，男，江西省人，大学本科，国家一级技师，主要研究方向为儿童青少年近视防控

通讯作者:
高玮，E-mail: gaowei1108@hotmail.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 G478 R778.1⁺⁵
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出版历程
- 收稿日期: 2024-07-18
- 修回日期: 2024-10-24
- 网络出版日期: 2025-01-25
- 刊出日期: 2025-01-25

Visual acuity and corrected visual acuity of children and adolescents in Shanghai City

ZHANG Bo¹,
QI Ziyi^{1, 2},
WANG Jingjing¹,
LIU Sichen¹,
YANG Jinliuxing¹,
CHEN Jun¹,
DU Linlin¹,
HE Xiangui^{1, 2},
GAO Wei^{1
, ,}

1.
Department of Clinical Research, Shanghai Eye Disease Prevention and Treatment Center/Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai (200331), China

摘要

摘要: 目的了解上海地区儿童青少年的视力和矫正情况，为制定预防儿童青少年近视和保护视力的干预措施提供科学依据。方法 2022年10—12月，采用分层整群随机抽样方法选择上海地区16个市辖区的幼儿园(≥5岁)、小学、初中、普通高中和职业高中47 034名学生作为研究对象，根据《中小学生屈光不正筛查规范》，采用《标准对数视力表》对学生进行裸眼视力和矫正视力检查，并收集一般信息。分析视力不良在不同年龄儿童中的检出率及严重程度分布，采用χ²检验、多因素Logistic回归分析探讨视力不良的相关因素。结果儿童青少年视力不良检出率为76.2%，女生(78.8%)高于男生(73.8%)，汉族儿童青少年(76.2%)高于少数民族儿童青少年(71.2%)，城区儿童青少年(76.7%)高于郊区儿童青少年(75.8%)，差异均有统计学意义(χ²值分别为162.6，10.4，5.5，P值均＜0.05)。随着年龄增长，视力不良检出率呈先下降后上升的趋势，7岁儿童视力不良检出率最低(53.8%)，17岁时的视力不良检出率高达89.6%(χ_趋势²=3 467.0，P < 0.05)。重度视力不良占比较高，达56.6%；儿童青少年视力不良严重程度与年龄呈正相关(r=0.45，P＜0.05)。多因素Logistic回归分析结果显示，年龄、体质量指数、性别、民族、城郊均与儿童青少年视力不良均有关(OR值分别为1.18，1.01，1.38，0.79，0.88，P值均＜0.05)。在中重度视力不良者中，戴镜率为62.8%，戴镜后矫正视力合格率仅为44.8%；其中女生(64.9%)戴镜率高于男生(60.6%)，普通高中生戴镜率最高(83.9%)，性别和学段间差异均有统计学意义(χ²值分别为57.7，4 592.8，P值均＜0.05)。结论中重度视力不良的儿童青少年戴镜率较低，戴镜后部分儿童青少年的矫正视力仍未达标。应注重提升家校对眼保健和视力矫正的认知，同时加强眼保健服务提供的可及性。
- 视力，低 /
- 视力矫正 /
- 回归分析 /
- 儿童 /
- 青少年
Abstract: Objective To investigate the visual acuity and correction conditions of children and adolescents in Shanghai, so as to provide a scientific basis for developing intervention measures to prevent myopia and protect vision among children and adolescents. Methods From October to December 2022, a stratified cluster random sampling survey was conducted, involving 47 034 students from 16 municipal districts in Shanghai, covering kindergartens (≥5 years), primary schools, middle schools, general high schools and vocational high schools. According to the Guidelines for Screening Refractive Errors in Primary and Secondary School Students, the Standard Logarithmic Visual acuity Chart was used to examine naked vision and corrected vision of students, and general information was collected. The distribution and severity of visual impairment in different age groups were analyzed, and χ² tests and multivariate Logistic regression were used to explore factors associated with visual impairment. Results The detection rate of visual impairment among children and adolescents was 76.2%, with a higher rate among females (78.8%) than males (73.8%), higher among Han ethic students (76.2%) than minority students (71.2%), and higher among urban students (76.7%) than suburban students (75.8%), all with statistically significant differences (χ²=162.6, 10.4, 5.5, P < 0.05). The rate of visual impairment initially decreased and then increased with age, reaching its lowest at age 7 (53.8%) and peaking at age 17 (89.6%) (χ_trend²=3 467.0, P < 0.05). Severe visual impairment accounted for the majority, at 56.6%, and there was a positive correlation between the severity of visual impairment and age among children and adolescents (r=0.45, P < 0.05). Multivariate Logistic regression showed that age, BMI, gender, ethnicity and urban-suburban status were associated with visual impairment (OR=1.18, 1.01, 1.38, 0.79, 0.88, P < 0.05). Among those with moderate to severe visual impairment, the rate of spectacle lens usage was 62.8%, yet only 44.8% of those who used spectacle lens had fully corrected visual acuity. Females (64.9%) had higher spectacle lens usage rates than males (60.6%), and general high school students had the highest spectacle lens usage (83.9%), and there were statistically significant differences in gender and academic stages (χ²=57.7, 4 592.8, P < 0.05). Conclusions The rate of spectacle lens usage among students with moderate to severe visual impairment is relatively low, and even after using spectacle lens, some students still do not achieve adequate corrected visual acuity. Efforts should focus on enhancing public awareness of eye health and refractive correction and improving the accessibility of related health services.
- Vision, low /
- Visual correction /
- Regression anlysis /
- Child /
- Adolescent
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表 1 不同人口统计学特征儿童青少年视力不良检出率比较

Table 1. Comparison of detection rates of visual impairment among children and adolescents across different demographic characteristics

人口学指标	选项	人数	视力不良	χ²值	P值
性别	男	24 465	18 055(73.8)	162.6	< 0.01
	女	22 569	17 787(78.8)
学段	幼儿园	2 652	1 888(71.2)	3 980.7	< 0.01
	小学	16 565	10 023(60.5)
	初中	12 648	10 443(82.6)
	普通高中	9 655	8 778(90.9)
	职业高中	5 514	4 710(85.4)
民族	汉族	46 346	35 337(76.2)	10.4	0.01
	少数民族	548	390(71.2)
	未知	140	115(82.1)
城郊	城区	20 391	15 647(76.7)	5.5	0.02
	郊区	26 643	20 195(75.8)
注： ()内数字为检出率/%。

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表 2 上海市不同年龄儿童青少年视力不良检出率及程度分布

Table 2. Detection rates and graded distribution of visual impairment among children and adolescents of different age groups in Shanghai

年龄/岁	人数	视力不良人数	视力不良分级
年龄/岁	人数	视力不良人数	轻度	中度	重度
5	2 388	1 701(71.2)	995(58.5)	621(36.5)	85(5.0)
6	3 389	2 023(59.7)	1 065(52.7)	788(39.0)	168(8.3)
7	3 247	1 748(53.8)	776(44.4)	695(39.8)	276(15.8)
8	3 389	1 971(58.2)	645(33.0)	772(39.5)	536(27.4)
9	3 388	2 147(63.4)	535(25.3)	724(34.2)	855(40.4)
10	3 214	2 179(67.8)	384(18.2)	756(35.8)	972(46.0)
11	3 210	2 490(77.6)	376(15.4)	721(29.6)	1 337(54.9)
12	3 118	2 489(79.8)	293(12.0)	649(26.6)	1 494(61.3)
13	3 086	2 605(84.4)	245(9.6)	626(24.6)	1 674(65.8)
14	3 091	2 699(87.3)	199(7.5)	542(20.5)	1 902(72.0)
15	4 745	4 205(88.6)	280(6.8)	696(16.9)	3 148(76.3)
16	4 957	4 402(88.8)	270(6.2)	663(15.3)	3 402(78.5)
17	4 887	4 379(89.6)	238(5.5)	628(14.5)	3 456(80.0)
18~20	925	804(86.9)	37(4.6)	112(14.0)	651(81.4)
总计	47 034	35 842(76.2)	6 338(17.9)	8 993(25.5)	19 956(56.6)
注： 555名儿童青少年因佩戴角膜接触镜，无法根据其裸眼视力进行视力不良分级；()内数字为检出率或构成比/%。

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表 3 上海市儿童青少年视力不良影响因素的多因素Logistic回归分析

Table 3. Multivariate Logistic regression analysis of factors influencing visual impairment among children and adolescents in Shanghai

自变量	选项	β值	标准误	OR值(95%CI)	P值
年龄		0.17	0.00	1.18(1.17~1.19)	< 0.01
BMI		0.01	0.00	1.01(1.00~1.02)	< 0.01
性别	男			1.00
	女	0.32	0.03	1.38(1.31~1.45)	< 0.01
民族	汉族			1.00
	少数民族	-0.24	0.12	0.79(0.63~0.99)	0.04
	未知	-0.03	0.25	0.97(0.59~1.59)	0.90
城郊	城区			1.00
	郊区	-0.13	0.03	0.88(0.84~0.93)	< 0.01
注：年龄、BMI为连续型变量。

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