Effect Of Near Work Behaviors On Vision Development In Primary And Middle School Students:An One-Year Follow-up Study

ObjectiveTo examine the main near work behaviors patterns and their effects on vision development in primary and middle school students.MethodsA total of 2 670 primary and middle school students were chose with stratified cluster sampling methods, their uncorrected distance visual acuity were examined using standard logarithmic visual acuity chart GB11533-2011 and their parents were surveyed by a self-designed questionnaire. Only 1 in 10 of those who completed the school based myopia screening and return the informed consent were selected to participant in the examinations of equivalent spherical diameter and corneal curvature with non-corneal ciliary muscle automatically autorefractor, anterior chamber depth and axial length with an IOL Master, examination of the vitreous and fundus with a direct ophthalmoscope, intraocular pressure with a non-contact tonometry. Main nearwork behavior patterns were performed using the principal components and factor analysis method. Characteristics of nearwork behavior patterns were descripted by using the way of c2 analyses. Spherical equivalence in the left and right eyes was highly correlated(Pearson’s correlation=0.91, P<0.001), therefore, only data for the right eyes were used. c2 analyses and simple logistic regression analyses were used to analyze the baseline distribution of naked suspected myopia among different characteristic. Multiple logistics regression analyses were used to examine the association between distance visual acuity nearwork behavior patterns and baseline naked suspected myopia after adjusted for sex, and phase of studying. Two-tailed paired t test was considered to analyze 1-Year changes and 95%CI of every factor in the cohort. Simple and multiple linear regression analyses were used to modeled 1-Year Changes of naked vision, SE and biometric changes.ResultsMain nearwork behavior patterns of the naked suspected myopia screening and professional examination were likely,namely "weekend" and "school day" near work patterns. Watching TV, reading and writing and using a computer at the weekend were the main nearwork behaviors of "weekend" pattern; watching TV, using a computer and playing mobile phone at the school day were the main nearwork behaviors of "school day" pattern. In the naked suspected myopia screening, the junior middle school and family income> 4000 were risk factors for "weekend" nearwork highest grade(T3). Male, junior high school, and father’s degrees below primary school were risk factors for "school day" nearwork highest grade(T3). In the professional examination, the Han nationality was a risk factor for "weekend" nearwork highest grade(T3). Detection rate of baseline naked suspected myopia was 35.7%. In simple linear regression analyses, naked suspected myopia rate was significantly increased associated with T3 in "weekend" nearwork but decreased with T3 in "school day" nearwork, OR values were 1.34(95% CI: 1.22-1.61)and 0.82(95% CI: 0.67-0.99) respectively; only T3 in "weekend" nearwork was associated with baseline naked suspected myopia rate when "weekend" and "school day" nearwork were took into account at a same time, OR value was 1.78(95% CI: 1.46-2.16). In multiple linear regression analyses, "weekend" and "school day" nearwork were not associated with baseline naked suspected myopia rate. 1-year changes in right eye naked vision in all the students with complete data was-0.04±0.14(P<0.01). In professional examination, 1-year changes of AL was 0.22±1.38(P <0.05); but SER、CC、CCR、ACD、AL/CCR and IOP all had no statistically significance. In simple and multiple linear regression analyses, "weekend" and "school day" nearwork were not associated with 1-year changes of naked vision and AL.ConclusionsThere are two main nearwork behaviors patterns in primary and middle school students, which are associated with family factors and behavior characteristics. Two main nearwork behaviors pattern may not associated with naked suspected myopia screening, 1-year changes of naked vision and AL.