2022年美国眼科学会屈光不正临床实践指南解读
An interpretation of the new version of Refractive Errors Preferred Practice Pattern?
摘要2022年9月,美国眼科学会发布了最新版的屈光不正临床实践指南(PPP),该PPP基于最佳的循证医学证据,为屈光不正的诊断和矫正提供权威的指导意见。新版PPP延续了2017版严谨、全面、精细的特点,在屈光不正的定义、流行病学、分类以及诊断和矫正等多方面进行更新。如新版PPP将高度屈光不正定义为近视≥-6.0 D;远视≥+3.0 D;散光≥-3.0 D;增加关于近视防控的内容,建议每天户外活动至少2 h,选择恰当的光学防控手段,并可考虑点用低浓度阿托品滴眼液以期延缓近视的发生和发展等;丰富了近视是遗传与环境因素交互影响的循证医学证据,同时强调了未来高度近视的大流行趋势,延缓近视进展具有全球公共卫生意义。此外,新版PPP首次强调近视可引起不可逆性视力损伤,提示要推迟儿童近视发生时间,延缓近视进展速度等。笔者就新版PPP的主要内容和更新的近视防控部分内容进行介绍和解读。
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abstractsIn September 2022, the American Academy of Ophthalmology released the latest version of Refractive Errors Preferred Practice Pattern? (PPP). It provides authoritative guidance for the diagnosis and treatment of refractive errors based on the best evidence-based medical updates.The new version of Refractive Errors PPP continues the rigorous, comprehensive and detailed features of the 2017 version.Updates have been made to the definition, epidemiology, classification, and diagnosis and correction of refractive errors.For example, the new version of Refractive Errors PPP defines high refractive errors as myopia≥-6.0 D, hyperopia≥+ 3.0 D, astigmatism≥-3.0 D, adds content on myopia prevention and control, recommends outdoor activities for at least 2 hours per day, selects appropriate optical prevention and control methods, and considers the use of low-concentration atropine eye drops to delay the onset and development of myopia.It enriched the evidence-based medical evidence that myopia is an interactive influence of genetic and environmental factors, and emphasized the future pandemic trend of high myopia, and the global public health significance of delaying the progression of myopia.In addition, the new version of Refractive Errors PPP emphasizes for the first time that myopia can cause irreversible visual impairment, suggesting that it is necessary to delay the onset time of myopia in children and slow the speed of myopia progression.This article introduces and interprets the main contents and updates of the new edition of the Refractive Errors PPP.
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