1) to determine the prevalence and incidence of myopia (primary outcomes), and the process of refractive development among the populations of 6-year-old and 12-year-old children over periods of 5 years, respectively; 2) to evaluate the associations or causal relationship of potentially modifiable environmental factors with myopia so as to provide clues for intervention (primary outcomes); 3) to document the prevalence of other vision disorders such as amblyopia, strabismus, hyperopia, astigmatism, color blindness and so on (secondary outcomes); 4) to explore the possible causes of these vision disorders among children (secondary outcomes).

  • General Information of Study
    • Overview
      Name Anyang Childhood Eye Study
      Project Number CCC2018051001
      Website N.A.
      Investigators
      Ningli Wang
      Institutions Beijing Tongren Hospital, Capital Medical University
      Contacts
      Shi-Ming Li
      Funding the Ministry of Science and Technology, the Major International (Regional) Joint Research Project of the National Natural Science Foundation of China (81120108007);the Major State Basic Research Development Program of China (‘‘973’’ Program, 2011CB504601) of the Ministry of Science and Technology.
      Objectives 1) to determine the prevalence and incidence of myopia (primary outcomes), and the process of refractive development among the populations of 6-year-old and 12-year-old children over periods of 5 years, respectively;
      2) to evaluate the associations or causal relationship of potentially modifiable environmental factors with myopia so as to provide clues for intervention (primary outcomes);
      3) to document the prevalence of other vision disorders such as amblyopia, strabismus, hyperopia, astigmatism, color blindness and so on (secondary outcomes);
      4) to explore the possible causes of these vision disorders among children (secondary outcomes).
      Start Date October, 2011
      End Date July, 2017
    • Study Design
      Number of Participants 5160
      Age Range 6~15 years old
      Geographic Distribution Anyang city, Henan Province
      General Information of Study Design and Sample Methods Stratified cluster sampling
      Inclusion Criteria The children in Anyang city who met the standard of the subject were randomly included in this cohort. The inspection items and related standards refer to the Sydney Childhood Eye Study in Australia, and the children's myopia cohort study in Singapore and the United States.
      Exclusion Criteria Children who are unable to live permanently in Anyang or are unable to complete the inspection and follow-up.
    • Other Information
      Key Achievements The "Anyang Childhood Eye Study" (ACES) has studied the children myopia from the aspects of eyeball development, environmental factors, genetic and optical model. It has included 5160 children, and has established the largest database of Chinese children's eye growth parameters and is currently the world's largest children myopia cohort. It found that time outdoors has early protective effect on children without myopia and near work related environmental risk factors for children myopia. These findings have provided strong evidence for myopia prevention and intervention in children, and have been rated as one of the top ten achievements of ophthalmology in China in 2015. The series of research reports from the Anyang Childhood Eye Study have been cited into the "Chinese myopia prevention and treatment guidelines" launched by National Health Commission of the People’s Republic of China. The work on Evidence-based evaluation about myopia intervention has been referenced to the latest version of “Refractive Errors & Refractive Surgery Preferred Practice Pattern” of the American Academy of Ophthalmology clinical guidelines in 2018. The reports on amblyopia and strabismus were also cited to the amblyopia section of the the American Academy of Ophthalmology clinical guidelines in 2018.
      Marker Papers 1. Li SM, Li H, Li SY, et al. Time outdoors and myopia progression over 2 years in Chinese children: The Anyang Childhood Eye Study. Invest Ophthalmol Vis Sci 2015;56(8):4734-40. doi: 10.1167/iovs.14-15474.
      2. Li SM, Wang N, Zhou Y, et al. Paraxial schematic eye models for 7- and 14-year-old Chinese children. Invest Ophthalmol Vis Sci 2015;56(6):3577-83. doi: 10.1167/iovs.15-16428.
      3. Li SM, Li SY, Liu LR, et al. Peripheral refraction in 7- and 14-year-old children in central China: the Anyang Childhood Eye Study. Br J Ophthalmol 2015;99(5):674-79. doi: 10.1136/bjophthalmol-2014-305322.
      4. Li SY, Li SM, Zhou YH, et al. Effect of undercorrection on myopia progression in 12-year-old children. Graefes Arch Clin Exp Ophthalmol 2015;253(8):1363-8. doi: 10.1007/s00417-015-3053-8.
      5. Li SM, Liu LR, Li SY, et al. Design, methodology and baseline data of a school-based cohort study in central China: the Anyang Childhood Eye Study. Ophthalmic Epidemiol 2013;20(6):348-59. doi: 10.3109/09286586.2013.842596.
      6. 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(8):e0134514. doi: 10.1371/journal.pone.0134514.
      7. Sun YY, Li SM, Li SY, et al. Effect of uncorrection versus full correction on myopia progression in 12-year-old children. Graefes Arch Clin Exp Ophthalmol 2017;255(1):189-95. doi: 10.1007/s00417-016-3529-1.
      8. Atchison DA, Li SM, Li H, et al. Relative peripheral hyperopia does not predict development and progression of myopia in children. Invest Ophthalmol Vis Sci 2015;56(10):6162-70. doi: 10.1167/iovs.15-17200.
      9. Zhu BD, Li SM, Li H, et al. Retinal nerve fiber layer thickness in a population of 12-year-old children in central China measured by iVue-100 spectral-domain optical coherence tomography: the Anyang Childhood Eye Study. Invest Ophthalmol Vis Sci 2013;54(13):8104-11. doi: 10.1167/iovs.13-11958.
      10. Fu J, Li SM, Liu LR, et al. Prevalence of amblyopia and strabismus in a population of 7th-grade junior high school students in Central China: the Anyang Childhood Eye Study (ACES). Ophthalmic Epidemiol 2014;21(3):197-203. doi: 10.3109/09286586.2014.904371.
      Strength 1. Implementation according to international standards, including clinical phenotype, genotype and environmental factors.
      2. Rich variables, cyclopentolate autorefraction.
      3. High frequency follow-up by once a year.
      Weakness 1. The sample size is slightly smaller.
      2. The follow-up was relatively shorter.