从证据到实践:有效预防儿童青少年近视的关键要素  

From evidence to practice:key elements for effective prevention of myopia in children and adolescents

作　　者：何鲜桂[1] He Xiangui(Shanghai Eye Diseases Prevention and Treatment Center/Shanghai Eye Hospital,School of Medicine,Tongji University,National Clinical Research Center for Eye Diseases,Shanghai 200331,China)

机构地区：[1]上海市眼病防治中心/同济大学附属眼科医院,国家眼部疾病临床医学研究中心,上海200331

出　　处：《中华实验眼科杂志》2025年第4期301-307,共7页Chinese Journal Of Experimental Ophthalmology

基　　金：国家自然科学基金(82273648);上海市科学技术委员会优秀学术带头人计划(22XD1422900);上海市卫生健康委员会学科带头人人才计划(2022XD032);上海市第六轮公共卫生体系建设三年行动计划重点学科建设项目(GWVI-11.1-30);上海市第六轮公共卫生体系建设三年行动计划(GWVI-7)。

摘　　要：儿童青少年近视防控目前已成为我国健康战略任务,预防近视发生、降低青少年近视患病率是重要目标。当前亟待推行防控并重、前移预防关口和聚焦重点人群策略。如何精准评估个体风险、匹配差异化预防需求、优化群体和个体预防技术方案实现资源利用最大化等,仍是提高近视预防效果和效率亟待解决的关键问题。本文基于当前循证证据,针对预防青少年近视的关键要素进行论述,包括通过评估个体远视储备水平和抓住近视前期,早期识别高风险人群;探索简便易行的远视储备测量与屈光分类方法;结合遗传、环境和行为等多维参数,建立和优化风险预测模型工具;针对不同年龄段、风险水平制定个性化防控策略,在个体和群体水平合理、综合选择户外活动、光学干预或药物干预等明确有效手段。以期为探索近视预防的研究方向、促进个性精准近视防控实践和加快下降儿童青少年近视患病率提供参考。The prevention and control of myopia in children and adolescents has become a strategic health task in China,with the important goals of preventing myopia onset and reducing the incidence of myopia in adolescents.Currently,it is urgent to implement a strategy that emphasizes both prevention and control,advances the prevention checkpoint,and focuses on key populations.At present,how to accurately assess individual risks,how to meet differentiated prevention needs,how to optimize group and individual prevention technology solutions to maximize resource utilization,etc.,are still key issues that urgently need to be addressed to improve the effectiveness and efficiency of myopia prevention.Based on current evidence,this paper discusses key elements of myopia prevention in children and adolescents.These include the assessment of individual hyperopia reserve to identify high-risk individuals at an early stage,the development of simplified methods to measure hyperopia reserve and classify refractive status,and the establishment and refinement of risk prediction models by integrating genetic,environmental,and behavioral factors.Additionally,personalized prevention strategies should be tailored to different age groups and risk levels,with appropriate and comprehensive interventions-such as outdoor activities,optical correction,and pharmaceutical treatments-at both the individual and population levels.This paper aims to provide a reference for research directions in myopia prevention,promote personalized and precise myopia prevention and control practices,and accelerate the reduction of myopia rates in children and adolescents.

关 键 词：近视 儿童 青少年 预防 远视储备 个性化干预 

分 类 号：R778.1[医药卫生—眼科]