Download PDF
Klin Padiatr 2017; 229(04): 234-240
DOI: 10.1055/s-0043-102938
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Prävalenz und Risikofaktoren der Kurzsichtigkeit bei Kindern und Jugendlichen in Deutschland – Ergebnisse der KiGGS-Studie

Prevalence and Risk Factors of Myopia in Children and Adolescents in Germany – Results of the KiGGS Survey
Alexander K. Schuster
1   Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz
,
Heike M. Elflein
1   Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz
,
Roman Pokora
2   Division of Pediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz
,
Michael S. Urschitz
2   Division of Pediatric Epidemiology, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz
› Author Affiliations
Further Information

Publication History

Publication Date:
17 July 2017 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Hintergrund Ziel dieser Studie ist die Bestimmung der Prävalenz von Kurzsichtigkeit (Myopie) bei Kindern und Jugendlichen in Deutschland und die Evaluation damit assoziierter Risikofaktoren.

Methodik Die Prävalenz von Myopie in Deutschland wurde durch die „Studie zur Gesundheit von Kindern und Jugendlichen in Deutschland“ (KiGGS Basiserhebung 2003–2006) erhoben (N=17,640, 49% Mädchen). Das Vorliegen einer Myopie und die Verwendung einer Sehhilfe wurden durch einen Elternfragebogen erfasst. Potentielle Risikofaktoren wurden mittels kausalem Diagramm identifiziert und mit multiplen logistischen Regressionsmodellen untersucht.

Ergebnisse Die Prävalenz von Myopie in Deutschland bei 3–17-jährigen Kindern lag bei 13,3% (95%-Konfidenzintervall 12,6–14,0%). In der Altersgruppe der 3–10 Jährigen fanden sich Zusammenhänge mit dem Alter (in 2-Jahresschritten: OR=1,78 [1,59; 2,00]) und Geschlecht (Jungen: OR=0,73 [0,57; 0,95]), aber nicht mit Freizeitverhalten oder Mediennutzung. In der Altersgruppe der 11–17 Jährigen war häufige Sportausübung (OR=0,67 [0,53; 0,84]) protektiv mit Myopie assoziiert, während der Besuch des Gymnasiums (OR=1,69 [1,32; 2,16]) mit einer Zunahme von Myopie verbunden war. Auch in dieser Gruppe war Mediennutzung nicht mit einer Myopie assoziiert.

Schlussfolgerung Kurzsichtigkeit ist in Deutschland eine der häufigsten chronischen Beeinträchtigungen im Kindes- und Jugendalter. Mädchen, Jugendliche und Gymnasiasten sind häufiger betroffen. Sportliche Aktivität könnte das Risiko für Kurzsichtigkeit reduzieren.

Abstract

Purpose To determine the population prevalence and risk factors of myopia in children and adolescents in Germany.

Methods The prevalence of myopia in Germany was computed using data from the 2003–2006 German Health Interview and Examination Survey for Children and Adolescents (N=17 640, 49% girls). Status of myopia was derived from parental questionnaire responses for myopia and the use of spectacles. Potential risk factors were identified using directed acyclic graphs and evaluated using multivariable logistic regression analysis.

Results The population prevalence of myopia in the age group 3–17 years was estimated at 13.3% (95%-confidential interval 12.6–14.0%). In the age group 3–10 years, myopia was positively associated with age (per 2 years: OR=1.78 [1.59; 2.00]) and negatively associated with male gender (OR=0.73 [0.57; 0.95]), but neither with leisure-time activities nor with media use. In the age group 11–17 years, attending a High School was positively associated with myopia (OR=1.69 [1.32; 2.16]), while regular physical activity (OR=0.67 [0.53; 0.84]) was negatively associated. Media use was not associated.

Conclusions In Germany, myopia is one of the most frequent chronic medical conditions among children and adolescents. Girls, adolescents, and pupils attending a Gymnasium are at higher risk of developing myopia while being physically active may be protective.

Schlüsselwörter

Epidemiologie - Myopie - Kurzsichtigkeit - Kinder - Mediennutzung

Key words

epidemiology - myopia - prevalence - children - media use
 

  • Literatur

  • 1 Al Oum M, Donati S, Cerri L. et al. Ocular alignment and refraction in preterm children at 1 and 6 years old. Clin Ophthalmol 2014; 8: 1263-1268
    PubMedSearch in Google Scholar
  • 2 Ashby RS, Schaeffel F. The effect of bright light on lens compensation in chicks. Invest Ophthalmol Vis Sci 2010; 51: 5247-5253
    CrossrefPubMedSearch in Google Scholar
  • 3 Bourne RR, Jonas JB, Flaxman SR. et al. Prevalence and causes of vision loss in high-income countries and in Eastern and Central Europe: 1990–2010. Br J Ophthalmol 2014; 98: 629-638
    CrossrefPubMedSearch in Google Scholar
  • 4 Dolgin E. The myopia boom. Nature 2015; 519: 276-278
    CrossrefPubMedSearch in Google Scholar
  • 5 Dolle R, Schaffrath Rosario A, Stolzenberg H. The German Health Interview and Examination Survey for Children and Adolescents (KiGGS): data management. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2007; 50: 567-572
    CrossrefPubMedSearch in Google Scholar
  • 6 Filipiak-Pittroff B, Wolke G. External quality assurance in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Procedure and results. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2007; 50: 573-577
    CrossrefPubMedSearch in Google Scholar
  • 7 French AN, Morgan IG, Mitchell P. et al. Risk factors for incident myopia in Australian schoolchildren: the Sydney adolescent vascular and eye study. Ophthalmology 2013; 120: 2100-2108
    CrossrefPubMedSearch in Google Scholar
  • 8 Guggenheim JA, Northstone K, McMahon G. et al. Time outdoors and physical activity as predictors of incident myopia in childhood: a prospective cohort study. Invest Ophthalmol Vis Sci 2012; 53: 2856-2865
    CrossrefPubMedSearch in Google Scholar
  • 9 Guo Y, Liu LJ, Xu L. et al. Outdoor activity and myopia among primary students in rural and urban regions of Beijing. Ophthalmology 2013; 120: 277-283
    CrossrefPubMedSearch in Google Scholar
  • 10 He M, Xiang F, Zeng Y. et al. Effect of Time Spent Outdoors at School on the Development of Myopia Among Children in China: A Randomized Clinical Trial. Jama 2015; 314: 1142-1148
    CrossrefPubMedSearch in Google Scholar
  • 11 Holling H, Kamtsiuris P, Lange M. et al. The German Health Interview and Examination Survey for Children and Adolescents (KiGGS): study management and conduct of fieldwork. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2007; 50: 557-566
    CrossrefPubMedSearch in Google Scholar
  • 12 Holling H, Schlack R, Kamtsiuris P. et al. The KiGGS study. Nationwide representative longitudinal and cross-sectional study on the health of children and adolescents within the framework of health monitoring at the Robert Koch Institute. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2012; 55: 836-842
    CrossrefPubMedSearch in Google Scholar
  • 13 Jobke S, Kasten E, Vorwerk C. The prevalence rates of refractive errors among children, adolescents, and adults in Germany. Clin Ophthalmol 2008; 2: 601-607
    CrossrefPubMedSearch in Google Scholar
  • 14 Kamtsiuris P, Lange M, Schaffrath Rosario A. The German Health Interview and Examination Survey for Children and Adolescents (KiGGS): sample design, response and nonresponse analysis. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2007; 50: 547-556
    CrossrefPubMedSearch in Google Scholar
  • 15 Kurth BM. The German Health Interview and Examination Survey for Children and Adolescents (KiGGS): an overview of its planning, implementation and results taking into account aspects of quality management. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2007; 50: 533-546
    CrossrefPubMedSearch in Google Scholar
  • 16 Lampert T, Sygusch R, Schlack R. Use of electronic media in adolescence. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2007; 50: 643-652
    CrossrefPubMedSearch in Google Scholar
  • 17 Lange M, Kamtsiuris P, Lange C. et al. Sociodemographic characteristics in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) - operationalisation and public health significance, taking as an example the assessment of general state of health. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2007; 50: 578-589
    CrossrefPubMedSearch in Google Scholar
  • 18 Li SM, Li SY, Kang MT. et al. Near Work Related Parameters and Myopia in Chinese Children: the Anyang Childhood Eye Study. PLoS One 2015; 10: e0134514
    CrossrefPubMedSearch in Google Scholar
  • 19 Mirshahi A, Ponto KA, Hoehn R. et al. Myopia and level of education: results from the Gutenberg Health Study. Ophthalmology 2014; 121: 2047-2052
    CrossrefPubMedSearch in Google Scholar
  • 20 Morgan I, Rose K. How genetic is school myopia?. Prog Retin Eye Res 2005; 24: 1-38
    CrossrefPubMedSearch in Google Scholar
  • 21 Oner V, Bulut A, Oruc Y. et al. Influence of indoor and outdoor activities on progression of myopia during puberty. Int Ophthalmol 2016; 36: 121-125
    CrossrefPubMedSearch in Google Scholar
  • 22 Parssinen O, Kauppinen M, Viljanen A. The progression of myopia from its onset at age 8–12 to adulthood and the influence of heredity and external factors on myopic progression. A 23-year follow-up study. Acta Ophthalmol 2014; 92: 730-739
    CrossrefPubMedSearch in Google Scholar
  • 23 Robert-Koch-Institut, Abteilung für Epidemiologie und Gesundheitsmonitoring (2013): KiGGS-Basiserhebung – „Studie zur Gesundheit von Kindern und Jugendlichen in Deutschland“. Public Use File 4. Version. http://dx.doi.org/10.7797/9-200306-1-1-4
    PubMed
  • 24 Rudnicka AR, Kapetanakis VV, Wathern AK et al. Global variations and time trends in the prevalence of childhood myopia, a systematic review and quantitative meta-analysis: implications for aetiology and early prevention. Br J Ophthalmology 2016
    PubMed
  • 25 Saxena R, Vashist P, Tandon R. et al. Prevalence of myopia and its risk factors in urban school children in Delhi: the North India Myopia Study (NIM Study). PLoS One 2015; 10: e0117349
    CrossrefPubMedSearch in Google Scholar
  • 26 Schenk L, Ellert U, Neuhauser H. Children and adolescents in Germany with a migration background. Methodical aspects in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2007; 50: 590-599
    CrossrefPubMedSearch in Google Scholar
  • 27 Textor J, Hardt J, Knuppel S. DAGitty: a graphical tool for analyzing causal diagrams. Epidemiology 2011; 22: 745
    PubMedSearch in Google Scholar
  • 28 Williams KM, Bertelsen G, Cumberland P. et al. Increasing Prevalence of Myopia in Europe and the Impact of Education. Ophthalmology 2015; 122: 1489-1497
    CrossrefPubMedSearch in Google Scholar