Abstract:AIM: To investigate the epidemiological characteristics and changing trends of myopia among children and adolescents in Bijie from 2021 to 2025, and to provide scientific evidence for formulating regional myopia prevention and control strategies.
METHODS:This was a longitudinal cross-sectional study. Stratified cluster sampling method was used to select students from 48 primary schools, 25 middle schools, and 8 high schools from urban and rural districts and counties of Bijie. From 2021 to 2025, annual examinations were performed, including uncorrected visual acuity, corrected visual acuity, corneal curvature, refractive error, axial length, and fundus examination. Questionnaires were also administered to collect information on visual health-related influencing factors. Myopia was defined as spherical equivalent refraction(SE)≤-0.50 D under non-cycloplegic autorefraction. The multivariate logistic regression model was used to analyze the myopia status and its influencing factors among children and adolescents.
RESULTS: From 2021 to 2025, the age- and sex-standardized myopia prevalence rates among children and adolescents in Bijie were 42.37%, 44.57%, 47.32%, 49.98%, and 52.91%, respectively, showing a significant upward trend year by year(P<0.001). The overall standardized myopia prevalence rate was 47.61%. The myopia rate increased with higher educational stage, and the differences were statistically significant(P<0.001). The myopia rates in girls were higher than those in boys over the 5 y, with statistically significant differences(P<0.001). Multivariable logistic regression analysis identified gender(female vs male: OR=1.17, 95%CI: 1.15-1.19), school stage(junior high school vs primary school: OR=2.14, 95%CI: 2.09-2.19; senior high school vs primary school: OR=3.60, 95%CI: 3.53-3.68), daily outdoor activity time <2 h(OR=3.25, 95%CI: 2.98-3.54), both parents with myopia(OR=2.87, 95%CI: 2.63-3.13), daily near work time ≥4 h(OR=2.56, 95%CI: 2.35-2.79), electronic screen use ≥2 h/d(OR=2.18, 95%CI: 2.01-2.37), incorrect reading and writing posture(OR=3.94, 95%CI: 3.87-4.02), residence in a karst landform region(OR=1.32, 95%CI: 1.18-1.48), and absence of professional equipment in school vision screening(OR=1.27, 95%CI: 1.15-1.41)as risk factors for myopia(all P<0.001).
CONCLUSION: From 2021 to 2025, the myopia rate among children and adolescents in Bijie shows an increasing trend, indicating a severe situation for myopia prevention and control, with tendencies toward younger age of onset and higher myopia. It is necessary to establish a prevention and control system led by the government, with multi-departmental collaboration and school-family linkage, and to carry out targeted health education and intervention measures.