UNASSIGNED：调查COVID-19大流行期间中国西藏和重庆儿童和青少年的近视进展和屈光状态的相关因素。
UNASSIGNED：进行了一项基于人群的横断面研究，以比较近视和高度近视的发生率，轴向长度（AL），球形当量(SE)，户外活动时间,数字设备使用，和2021年重庆和西藏受近视影响的儿童和青少年视力检查频率。
UNASSIGNED：共检查了来自重庆的2,303名学生和来自西藏的1,687名学生。两组的近视和高度近视的总体患病率分别为53.80％和7.04％。43.86和1.30%，分别在每种情况下。重庆学生的AL比西藏学生的AL更长（23.95vs.23.40mm,分别为；p<0.001)。西藏近视眼父母学生的平均SE低于重庆近视眼父母学生(-2.57±2.38屈光度(D)vs.-2.30±2.34D,分别)(p<0.001)。相反，重庆市区学生的平均SE低于西藏学生（-2.26±2.25Dvs.-1.75±1.96D,分别为；p<0.001)。重庆学生的SE（-2.44±2.22D）低于藏族学生（当户外活动超过2.5小时时，平均SE：-1.78±1.65D（p=0.0001）。例如,61.35%的西藏学生每天户外活动时间超过2.5小时，相比之下，重庆的学生占43.04%。相应地,西藏学生使用数字设备的比例(64.43%)低于重庆(100%)。对于后者,38.62%的重庆学生使用数字设备上网时间超过2.5小时，而西藏学生则为10.49%。与西藏学生（平均SE：-2.68±1.85D）相比，重庆学生（平均SE：-1.90±1.98D）对视觉状态的监测更高（p=0.0448），最佳检查的频率是每6个月一次。户外活动时间被确定为两个受检人群中近视的常见危险因素，重庆的比值比（ORs）为1.84（95%CI：1.79-1.90），西藏的比值比为0.84（95%CI：0.73-0.96）。重庆地区数字屏幕时间与近视和高度近视相关,OR为1.15（95%CI：1.08-1.22）和1.06（95%CI：0.94-1.77），分别。数字屏幕时间也是西藏高度近视的危险因素（OR：1.21，95％CI：0.77-1.61）。使用的数字设备类型也与西藏的近视和高度近视有关（OR：1.33，95％CI：1.06-1.68和OR：1.49，95％CI：0.84-2.58）。最后,发现西藏组的检查频率与高度近视相关（OR：1.79，95％CI：0.66-2.71）。
未经评估：根据我们的数据，我们观察到,西藏儿童和青少年屈光不正的患病率明显低于重庆.这些结果可能是由于户外活动时间延长，以及表征西藏儿童和青少年群体的数字设备的类型和使用时间。建议重庆的父母和孩子将从提高对近视进展及其预防的认识中受益。
To investigate myopia progression and associated factors of refractive status among children and adolescents in Tibet and Chongqing in
China during the COVID-19 pandemic.
A population-based cross-sectional study was conducted to compare rates of myopia and high myopia, axial length (AL), spherical equivalent (SE), outdoor activity time, digital device use, and frequency of visual examinations for children and adolescents affected by myopia in Chongqing and Tibet in 2021.
A total of 2,303 students from Chongqing and 1,687 students from Tibet were examined. The overall prevalence of myopia and high myopia in these two groups were 53.80 and 7.04% vs. 43.86 and 1.30%, respectively in each case. The Chongqing students had a longer AL than the group from Tibet (23.95 vs. 23.40 mm, respectively; p < 0.001). The mean SE of the students with myopic parents in Tibet was lower than that of the students in Chongqing with myopic parents (-2.57 ± 2.38 diopters (D) vs. -2.30 ± 2.34 D, respectively) (p < 0.001). Conversely, the mean SE of the students from urban areas in Chongqing was lower than that of the students in Tibet (-2.26 ± 2.25 D vs. -1.75 ± 1.96 D, respectively; p < 0.001). The Chongqing students exhibited lower SE (-2.44 ± 2.22 D) than their Tibetan counterparts (mean SE: -1.78 ± 1.65 D (p = 0.0001) when spending more than 2.5 h outdoors. For example, 61.35% of the students in Tibet spent more than 2.5 h outdoors daily, compared with 43.04% of the students in Chongqing. Correspondingly, the proportion of students using digital devices in Tibet (64.43%) was lower than that in Chongqing (100%). For the latter, 38.62% of the students in Chongqing spent more than 2.5 h online using digital devices compared to 10.49% of the students in Tibet. Greater monitoring of visual status was observed for the Chongqing students (mean SE: -1.90 ± 1.98 D) compared with students in Tibet (mean SE: -2.68 ± 1.85 D) (p = 0.0448), with the frequency of optimal examinations being every 6 months. Outdoor activity time was identified as a common risk factor for myopia in both of the populations examined, with odds ratios (ORs) of 1.84 (95% CI: 1.79-1.90) in Chongqing and 0.84 (95% CI: 0.73-0.96) in Tibet. Digital screen time was associated with myopia and high myopia in Chongqing, with ORs of 1.15 (95% CI: 1.08-1.22) and 1.06 (95% CI: 0.94-1.77), respectively. Digital screen time was also found to be a risk factor for high myopia in Tibet (OR: 1.21, 95% CI: 0.77-1.61). The type of digital devices used was also associated with myopia and high myopia in Tibet (OR: 1.33, 95% CI: 1.06-1.68 and OR: 1.49, 95% CI: 0.84-2.58, respectively). Finally, examination frequency was found to correlate with high myopia in the Tibet group (OR: 1.79, 95% CI: 0.66-2.71).
Based on our data, we observed that the prevalence of refractive errors in children and adolescents was significantly lower in Tibet than in Chongqing. These results are potentially due to prolonged outdoor activity time, and the type and time of use for digital devices that characterize the group of children and adolescents from Tibet. It is recommended that parents and children in Chongqing would benefit from increased awareness regarding myopia progression and its prevention.
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