Objective: To predict the prevalence of myopia among Chinese students aged 6-18 years under different intervention scenarios from 2021 to 2030. Methods: The multi-state Markov model was developed based on the transition process of study stages and myopia statuses. The development of myopia was simplified into two statuses: non-myopia and myopia. Students aged 6-18 years were also divided according to their study stages including senior kindergarten, primary school (from Grade 1 to 6), junior school (from Grade 1 to 3) and high school (from Grade 1 to 3). The parameters were extracted from the National Myopia Investigation in 2018 and published articles of cohort studies. The transition probability was applied to simulate the intervention scenarios, and sensitivity analysis was carried out. Results: The cumulative incidence of myopia among Chinese school-aged children and adolescents would increase consistently. It would be 91.3% (min to max: 83.7% to 96.7%) upon graduation from high school. Without any intervention, the myopia prevalence would increase to 61.8% (min to max: 55.4% to 69.5%) by 2030 among Chinese school-aged children and adolescents. And the myopia prevalence among students in primary schools, junior schools and high schools would be 45.6% (min to max: 40.2% to 54.3%), 81.3% (min to max: 72.6% to 91.0%) and 90.5% (min to max: 82.4% to 96.7%), respectively, all higher than the national target. If the interventions could achieve 70% of the desired effect, the myopia prevalence would be lower than the national target at each stage. Conclusions: Without effective interventions, the prevalence of myopia among students aged 6-18 years may keep increasing in the next ten years. If the interventions achieve the desired effect, the national target for myopia prevention and control could be reached. It is urgent to identify more effective interventions and call on the whole society to participate in the myopia prevention action to achieve the national goal by 2030. (Chin J Ophthalmol, 2021, 57: 261-267).
目的： 预测不同干预效果下我国6~18岁学生未来10年近视眼患病率。 方法： 将近视眼的发生简化为非近视眼和近视眼2个离散状态的转换，并将6~18岁儿童青少年根据年龄对应到幼儿园大班、小学（一年级至六年级）、初中（初一至初三）及高中（高一至高三），构建多状态马尔可夫（Markov）模型。模型参数主要来自2018年全国近视眼调查数据和已发表的文献，其中干预效果通过调整状态转换概率来模拟，同时对预测结果进行敏感性分析。 结果： 根据模型预测结果，我国6~18岁学生在不同学段毕业时的累积近视眼风险不断上升，到高中毕业时累积近视眼发病风险为91.3%（83.7%~96.7%）。如果未采取有效干预措施，我国6~18岁学生至2030年近视眼患病率将为61.8%（55.4%~69.5%），其中小学45.6%（40.2%~54.3%），初中81.3%（72.6%~91.0%），高中90.5%（82.4%~96.7%）。当干预效果达到70%或以上，各学段预测的近视眼患病率最大值可低于我国2030年近视眼防控目标。 结论： 若无有效干预措施，未来10年我国近视眼患病率将持续上升；为实现我国2030年近视眼防控目标，目前干预措施需取得理想效果，并且亟待探索且推广效果更优的近视眼干预措施。（中华眼科杂志，2021， 57：261-267）.