Anumberofrecentstudiesreportthatthetimechildrenspendengagedinoutdooractivitiesisnegativelyassociatedwiththeirriskofmyopia.Bothcross-sectionalandlongitudinalstudiesindicatethatgreatertimespentout-doorsisassociatedwithasignificantlylowermyopiaprevalenceandreducedriskofmyopiaonsetinchildhood.Althoughsomestudiesreportsignificantassociationsbetweenmyopiaprogressionandoutdooractivity,thisisnotaconsistentfindingacrossalllongitudinalstudies.Arecentmeta-analysisofstudiesexaminingtherelationshipbetweenoutdoortimeandmyopiaindicatedthattherewasa2%reductionintheoddsofhavingmyopiaforeachadditionalhourperweekspentoutdoors.最近的许多研究报告表明，儿童花在户外活动上的时间与他们近视的风险负相关。横断面研究和纵向研究均表明，户外活动时间增加，儿童近视患病率和发病风险就越低。虽然一些研究报告近视进展与户外活动之间存在显著关联，但在所有纵向研究中，这一发现并不一致。最近一项关于户外活动时间与近视关系的荟萃分析表明，每周在户外活动每多一小时，患近视的几率就会降低2%。Theseassociationshavepromptedrecentinterestinthepotentialinfluenceoflightexposureintheregulationofeyegrowthandmyopia.Sinceout-dooractivitytypicallyinvolvesexposuretohighintensitylight,ithasbeenhypothe-sizedthatincreasedexposuretobrightlightmaybetheimportantfactorunderlyingtheseprotectiveeffectsofoutdooractivity.Otherfactors,suchasthetypicalpatternofretinalfocusexperiencedinoutdoorenvironments(whichislikelytoinvolvelessnearfocusingandpotentiallylessexposuretohyperopicblur),mayalsoplayarole.这些关联促使人们对光照在调节眼睛生长和近视方面的潜在影响产生了兴趣。由于户外活动通常涉及暴露在高强光下，因此推测，增加暴露在强光下可能是这些户外活动保护作用的重要因素。其他因素，如户外环境中视网膜聚焦的典型模式(涉及较少的近聚焦和潜在的远视模糊)，也可能起作用。Recentobservationallongitudinalstudiesinhumansutilizingwearablelightsen-sorstoassessambientlightexposurehaveenabledtherelationshipbetweenlightexposureandaxialeyegrowthinchildhoodtobeexamined.Similartofindingsinanimals,bothoftheserecentstudieshavereportedthatsloweraxialeyegrowthisassociatedwithgreaterdailyambientlightexposure(witha1-logunitincreaseinlightexposurebeingassociatedwith~0.1mm/yearsloweraxialeyegrowth),withthisrelationshipreachingstatisticalsignificanceinthestudywiththelargersamplesize(n=),andborderingonsignificance(p=0.07,n=60)intheotherstudy.Arecentrandomized,controlledtrialinTaiwanexaminedtheeffectofincreasingoutdoortimeduringtheschoolday(anextra40minofoutdoortimeduringschoolrecess)uponmyopiadevelopmentandaxialeyegrowthover12months.Inthisstudy,lightexposurewasalsomonitoredusingwear-ablelightsensors,andasignificantassociationbetweengreaterlightexposureandslowermyopiaprogressionwasalsodocumented.Collectively,thesestudiessug-gestthatincreasedlightexposureisassociatedwithsloweraxialeyegrowthinthehumaneye.最近观察性纵向研究利用可穿戴式光传感器来评估环境光暴露，使光暴露与儿童眼轴生长之间的关系得以检查。与动物中的发现相似，两项最新研究报道，轴眼的较慢生长与每日的环境光暴露量大有关（光暴露量增加1-log单位与眼轴的缓慢生长?0.1mm/年有关），这种关系在具有较大样本量（n=）的研究中达到统计学显著性，而在另一项研究中接近显著性（p=0.07，n=60）。最近在台湾进行的一项随机对照试验，研究了在12个月的时间里，增加上学期间的户外时间(在课间休息时额外增加40分钟的户外时间)对近视发展和眼轴生长的影响。在本研究中，也使用可穿戴的光传感器来监测光线的暴露情况，并且也记录了强光暴露与近视进展缓慢之间的显著关联。综上所述，这些研究表明，光照增加与人眼眼轴生长缓慢有关。AveragehourlylightexposureofAustralian(redlines)andSingaporean(bluelines)childrenassessedduringschoolweekdaysusingwearablelightsensors.NotethesubstantiallygreaterlightexposurefortheAustralianchildrenatanumberofperiodsthroughouttheday.ThislowerdailyexposuretobrightoutdoorlightmaybeonefactorunderlyingthehighermyopiaprevalencetypicallyobservedinSingaporeanchildren.DashedlinesindicatetheaverageschoolstartandfinishtimesinAustralia(red)andSingapore(blue).Errorbarsrepresentthestandarderrorofthemeanonly1or2hperdaydidnotinhibitmyopia,but5hofexposuredidsignificantlyprotectagainstthedevelopmentofFDmyopia.Extendingexposuredurationfurtherto10hperdaydidnotappeartoofferfurtherprotectivebenefit.使用可穿戴光传感器评估了澳大利亚(红线)和新加坡(蓝线)儿童在校上学期间的平均每小时光照情况。值得注意的是，在一天中的许多时间段中，澳大利亚儿童的光照要明显得多。低的户外光照可能是新加坡儿童较高近视患病率的一个原因。虚线表示澳大利亚（红色）和新加坡（蓝色）的平均上学时间和结束时间。误差条代表标准误差的平均值，每天平均只有1或2小时没有抑制近视，但是暴露5小时确实可以有效地预防FD近视的发展。延长暴露时间至每天10小时似乎没有提供进一步的保护作用。Inalargelongitudinalstudy,Jonesetal.reportedthatchildrenwhoengagedinoutdooractivitiesfor14hperweekormore,exhibitedthelowestoddsofdevel-opingmyopia.Anumberofrecentrandomizedcontrolledtrialshavereportedthatinterventionsthatincreasechildren’soutdoortime(by40–80minaday)signifi-cantlyreducetheonsetofmyopiainchildhood.Inthe“Roleofout-dooractivityinmyopiastudy”,childrenwhowerehabituallyexposedtolowambientlightlevels(onaveragelessthan60minexposuretooutdoorlightperday)hadsignificantlyfasteraxialeyegrowth
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