隨機對照設計在近視防治有效性研究中的應用

1、Eye exercises for Myopia,LIANG YuanboEye Hospital of Wenzhou Medical University,Myopia prevalence in urban and rural Chinese children,GZ: 78.4%, -1.50D,SY F: 55.0%, -0.84D,SY M: 36.7%, -0.23D,YX: 43.0%, ~ -0.50D,,Zhao (

2、2000), AJO; He (2004), IOVS; He (2007), Ophthalmology; Liang YB: unpublished data: Handan offspring study,2,HOMS: 55.6%, -1.51D,Beijing eye Study 2001: Urban adult (≥40 years): Handan Eye Study2006: Rural adult (≥40 ye

3、ars):,Xu (2005), Ophthalmology; Liang (2009), Ophthalmology,Prevalence of Myopia in urban and rural Chinese adults,3,18.8%,21.8%,Prevalence of myopia by year of birth in the Handan Eye Study 2006,%,Pro-myopia factors,C

4、on-myopia factors,-1D,Tug of war ： after 1970s,+1D,,,？,Handan Offspring Eye Study (HOMS 2010),Beijing Myopia Progression Study (BMPS 2010),Methods Aged 6-17 Same procedures for data collection Visual acuityOcular

5、biometryQuestionnairesObtained all children’s cycloplegic refraction and parental non-cylcoplegic refraction,7,DefinitionsChildren’s refractive error: average of the cycloplegic spherical equivalent (SE, sphere+1/2

6、cylinder) of both eyesParental refractive error: average of non-cycloplegic SE of father and mother (4 eyes)Refractive error difference between parents and their children = parental SE - children’s SEGenerational s

7、hift towards myopia: estimated refractive error difference at the age of 18 90% myopia stabilization at: 18 yrs [15.18±2.47]Myopia: SE ≤-0.50D; emmetropia: -0.50< SE <+0.50D; hyperopia: SE ≥+0.50D,8,Thorn. (

8、2005). Myopia progression is specified by a double exponential growth function. OVS,9,Characteristics of children and parents,10,Curves of refractive error difference from parents to children in urban (red) and rural (bl

9、ue) area as a function of children’s age and their binominal fitting curve. Plotted is the median and 25th and 75th percentile.,11 yrs,14 yrs,Most myopic vs. least myopic eye,11,Urban area,Rural area,Axial length differe

10、nce between parents and children,,Pro-myopia factors,Con-myopia factors,-1D,Tug of war ： after 1970s,+1D,,,？,What are the factors? Nutrition Education: near workOutdoor activity,Association of RED in urban area,15,,,M

11、ultiple*: adjusted for children's age and gender,16,,Multiple*: adjusted for children's age and gender,Associations of RED in rural area,One-child policy and late marriage, late childbirth ?,Maternal Reproductive

12、 Age and Progression of Refractive Error,Lin Z, Mao GY, Vasudevan B, Jin ZB,  et al. Liang YB.The Association between Maternal Reproductive Age and Progression of Refractive Error in Urban Studen

13、ts in Beijing.PLoS One. 2015,母親生育年齡與近視關系假說,2005年以前我國報道的糖妊娠期糖尿病的患病率為1-5%。而最近報道在李利平等在690例孕婦中,糖尿病的患病率已高達33.3%(230/690)。孕婦>35歲者妊娠期糖尿病的患病率是<25歲者的2.06倍Prevalence of DM in China， 1979 0.67%， 2.5%， 3.2%，

14、 2010 9.7%,,,,,,,,,Figure 3. Results of network meta-analysis using single vision spectacle lenses/placebo as referent intervention. Atr ¼ atropine; Atr H ¼ high-dose atropine(1% or 0.5%); Atr L ¼ low-d

15、ose atropine (0.01%); Atr M ¼ moderate-dose atropine (0.1%); BSLs ¼ bifocal spectacle lenses; CrI ¼ credible interval; Cyc ¼cyclopentolate; MOA ¼ more outdoor activities (14e15 hrs/wk); OK ¼

16、; orthokeratology; PASLs ¼ progressive addition spectacle lenses; PBO ¼ placebo;PBSLs ¼ prismatic bifocal spectacle lenses; PDMCLs ¼ peripheral defocus modifying contact lenses; PDMSLs ¼ periphe

17、ral defocus modifying spectaclelenses; Pir ¼ pirenzepine; RGPCLs ¼ rigid gas-permeable contact lenses SCLs ¼ soft contact lenses; SVSLs ¼ single vision spectacle lenses; Tim ¼ timolol;USVSLs &#

18、188; undercorrected single vision spectacle lenses.,,,,,,,What we can do for myopia prevention and control?,Chinese traditional medicine can contribute? AcupunctureMeihua ZhenEr zhenEye exercises,The history of eye e

19、xercises practice in China,Beijing, 1960s1972, MOE：twice daily, eye exercise 2008，New version of eye exercises,Researches on eye exercise and myopia,國際期刊發(fā)表的眼保健操論文,,,,,,,,Children’s spherical equivalent (SE) and odds ra

20、tio (OR) for myopia for each item of the eye exercises of acupoints questionnaire,Lin Z, Gao TY, Jhanji V, et al.. BMC Complement Altern Med, 2016, accepted.,Children’s convergence insufficiency symptom survey scores(CIS

21、S) and β coefficientsforeach item ofthe eye exercises of acupoints questionnaire,,,,,,,Conclusions,There is no evidence to show eye exercises is effective in preventing myopia onset or progression Difficulties in resear