Citation:Jiang DD,Chen J,Thorn F,Mao GY,Li CC,Lin Z,Vasudevan B,Huang XQ,Chen YY.Elementary school comprehensive intervention and myopia development: the Wenzhou Epidemiology of Refraction Error Study.Int J Ophthalmol 2022;15(8):1363-1369,doi:10.18240/ijo.2022.08.21
Elementary school comprehensive intervention and myopia development: the Wenzhou Epidemiology of Refraction Error Study
Received:November 14, 2020  Revised:January 26, 2022
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DOI:10.18240/ijo.2022.08.21
Key Words:myopia progression  axial length  comprehensive intervention  school children
Fund Project:Supported by National Natural Science Foundation of China (No.81873683).
                          
AuthorInstitution
Dan-Dan Jiang The Eye Hospital of Wenzhou Medical University, Wenzhou , Zhejiang Province, China
Jie Chen The Eye Hospital of Wenzhou Medical University, Wenzhou , Zhejiang Province, China
Frank Thorn Deptartment of Brain & Cognitive Sciences, MIT Cambridge, Cambridge, MA 02139, USA
Guang-Yun Mao School of Public Health, Wenzhou Medical University, Wenzhou , Zhejiang Province, China
Chun-Chun Li The Eye Hospital of Wenzhou Medical University, Wenzhou , Zhejiang Province, China
Zhong Lin The Eye Hospital of Wenzhou Medical University, Wenzhou , Zhejiang Province, China
Balamurali Vasudevan College of Optometry, MidWestern University, Glendale, AZ 84729, USA
Xiao-Qiong Huang The Eye Hospital of Wenzhou Medical University, Wenzhou , Zhejiang Province, China
Yan-Yan Chen The Eye Hospital of Wenzhou Medical University, Wenzhou , Zhejiang Province, China
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Abstract:
      AIM: To investigate the effects of school-based comprehensive intervention on myopia development in elementary school children.

    METHODS: As a part of the Wenzhou Epidemiology of Refraction Error Study, there were 1524 participating elementary students (730 girls, 47.9%) in grades 1 to 3 from three campuses of one school, aged 7.3±0.9y, who were examined twice every year for a 2.5y follow up period. Comprehensive intervention and other reminders were given at school every semester for the intervention group. The control group did not receive comprehensive intervention and did not have reminders of it.

    RESULTS: There were 651 students in the intervention group [mean age 7.3±0.9y; 294 (45.2%) girls] and 737 students in the control group [mean age 7.2±0.9y; 346 (46.9%) girls]. Overall mean myopia progression during the 2.5y follow-up was -0.49±1.04 diopters (D) in the intervention group and -0.65±1.08 D in the control group (P=0.004). The majority that not get myopia at baseline spherical equivalent (SE≤-1.0 D). Their mean myopia progression during the 2.5y follow-up was -0.37±0.89 D in the intervention group and -0.51±0.93 D in the control group (27.5% reduction, P=0.009); Overall, mean axial length elongation was less in the intervention group (0.56±0.32 mm) than in the control group (0.61±0.38 mm, 10.5% reduction, P=0.009). The percentage of close reading distance (<30 cm) in the intervention group was less than in the control group (73.4% vs 76.2%, P<0.001), the percentage of everyday perform eye exercises in the intervention group was more than in the control group (27.8% vs 20.7%, P<0.001) 30mo later.

    CONCLUSION: The comprehensive intervention program at elementary school has a significant alleviating effect on myopia progression for children during the 2.5y follow-up, especially for those non-myopia at baseline.

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