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Prevalence and time trends of refractive error in Chinese children: A systematic review and meta-analysis
Yi Tang1,2, Aiming Chen3, Minjie Zou1
1State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China.
Insights
Refractive error (RE) is common in Chinese children, with myopia affecting 38%. Urban children face higher risks, and trends show increasing myopia and hyperopia, highlighting the need for prevention strategies.
Area of Science:
- Ophthalmology
- Pediatric Health
- Public Health
Background:
- Refractive error (RE) is a significant global health concern.
- Understanding RE prevalence and trends in children is crucial for early intervention.
Purpose of the Study:
- To determine the prevalence and temporal trends of refractive error (RE) in Chinese children under 18.
- To analyze regional and urban-rural differences in RE prevalence.
Main Methods:
- A meta-analysis was conducted on 41 studies involving over 1 million Chinese children.
- Data extraction and analysis followed standardized protocols to pool prevalence and assess time trends.
Main Results:
- The pooled prevalence of myopia was 38.0%, high myopia 2.8%, hyperopia 5.2%, and astigmatism 16.5%.
- Urban children exhibited a higher risk of RE.
- Myopia and hyperopia showed an upward trend, while high myopia and astigmatism trended downwards over time.
Conclusions:
- Refractive error is more prevalent in urban Chinese children.
- Environmental and genetic factors significantly influence RE.
- Urgent attention is needed for RE prevention and treatment strategies in China.
Background:
To investigate the prevalence and time trends of refractive error (RE) among Chinese children under 18 years old.
Methods:
PubMed, Embase, Web of Science were searched for articles that estimated prevalence of RE in Chinese children. Data of identified eligible studies was extracted by two investigators independently. Pooled prevalence of RE and its 95% confidence interval (95% CI) and the time trends of RE were investigated using Meta-analysis methods.
Results:
Of the 41 studies covering 1 051 784 subjects, the pooled prevalence of myopia, high myopia, hyperopia and astigmatism in Chinese children was 38.0% (95% confidence interval (CI) = 35.1%-41.1%), 2.8% (95% CI = 2.3%-3.4%), 5.2% (95% CI = 3.1%-8.6%) and 16.5% (95% CI = 12.3%-21.8%), respectively. Subgroup analysis show that children living in urban were at higher risk of RE. Prevalence of myopia and hyperopia were higher in Northern China compared with Southern China and high myopia and astigmatism were higher in Hong Kong, Macau and Taiwan than in mainland China. Regression analysis showed an upward trend in myopia and hyperopia and a downward trend in high myopia and astigmatism with years.
Conclusions:
The prevalence of RE is higher in urban areas than in rural for Chinese children. The much higher prevalence of myopia and astigmatism in China compared with foreign countries indicates the important role played by environment and genetic factors. Considering the large magnitude of refractive errors, much more attention should still be paid to RE prevention and treatment strategy development in China.
