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Thomson K, Karouta C, Ashby R. Administration of Nicotine Can Inhibit Myopic Growth in Animal Models. Invest Ophthalmol Vis Sci 2024; 65:29. [PMID: 39292451 PMCID: PMC11412605 DOI: 10.1167/iovs.65.11.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2024] Open
Abstract
Purpose While previously investigating the mechanism by which atropine inhibits ocular growth, we observed that stimulation of nicotinic receptors can inhibit experimental myopia. This study expands on that preliminary finding and investigates the safety and efficacy of nicotinic stimulation in the inhibition of ocular growth. Methods Nicotine's ability to inhibit form-deprivation myopia (FDM), following intravitreal injection (9 chicks per group) or topical application (6 chicks per group), was investigated over three doses. The ability of nicotine to inhibit lens-induced myopia (LIM) was also tested (in 12 chicks). For ocular safety, following 4 weeks of topical treatment with nicotine (n = 10), pupillary reflex, intraocular pressure, corneal curvature/thickness, lens thickness, retinal health (retinal thickness/cell apoptosis), as well as retinal function (electroretinogram recordings) were assessed. We also examined the effects of nicotine on non-ocular autonomic functions in both chicks (n = 5) and mice (n = 5). Results Nicotine was observed to significantly inhibit the development of FDM in chicks when administered as an intravitreal injection (P < 0.05) or topical eye drops (P < 0.05), albeit not in a dose-dependent manner. Nicotine also inhibited LIM (P < 0.05) to a similar degree to that seen for FDM. Although ocular health was (for the most part) unaffected by nicotine, the highest topical dose induced a temporary reduction in cardiorespiratory output (P < 0.05). Conclusions Nicotine, administered as an intravitreal injection or topical eye drop, significantly inhibits the development of experimental myopia. Although the anti-myopic effects observed presently are interesting, the well-reported side effects (expanded on presently) and addictive properties of nicotine would preclude its clinical use.
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Affiliation(s)
- Kate Thomson
- Centre for Research in Therapeutic Solutions, Faculty of Science and Technology, University of Canberra, Bruce, Canberra, Australia
| | - Cindy Karouta
- Centre for Research in Therapeutic Solutions, Faculty of Science and Technology, University of Canberra, Bruce, Canberra, Australia
| | - Regan Ashby
- Centre for Research in Therapeutic Solutions, Faculty of Science and Technology, University of Canberra, Bruce, Canberra, Australia
- Research School of Biology, Australian National University, Acton, Australia
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Yuan H, Lv H, Li X. The gap between parental knowledge and children practice of myopia control and challenge under COVID-19: a web-based survey in China. Front Public Health 2024; 12:1344188. [PMID: 38932774 PMCID: PMC11199406 DOI: 10.3389/fpubh.2024.1344188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 06/03/2024] [Indexed: 06/28/2024] Open
Abstract
Objective To evaluate parental knowledge of myopia control, investigate its association with children's practice and refractive status, and explore their change under the outbreak of COVID-19 pandemic. Methods In this web-based survey, a self-administered questionnaire was made online available during the COVID-19 outbreak between February 1th, 2022 and August 31th, 2022 in China. Participants were recruited via social media by convenience and snowball sampling. Parents of both sexes whose children aged between 3 and 18 were eligible. The overall questionnaire was composed of four categories: demographic information, parental knowledge of myopia, children's myopia-related behaviors and their change after the COVID-19 pandemic, and children's refractive status. SPSS version 18.0 was applied to perform the statistics analysis and p < 0.05 was considered to be statistically significant. Results A total of 423 eligible families were included in our online survey. The average age of children was 11.37 ± 2.83y (male 46.1%; female 53.9%), with a myopia incidence of 83.9% (355/423). Both children's age (OR = -0.6; 95%CI = -1.12 to -0.07; p = 0.026) and family income (OR = 2.60; 95%CI = 1.13 to 4.07; p = 0.001) had independently significant impacts on parental knowledge. Unexpectedly, parental knowledge was negatively correlated with children's onset age of myopia (p = 0.002, r = -0.165) and positively correlated with spectacles wearing (p = 0.014, r = 0.131), and no correlation was found between parental knowledge and the occurrence of children myopia, current diopter, annual myopia progression and the diopter of the first glasses (all p > 0.05). We found discordance phenomenon between parents' knowledge and children's behaviors, with parental knowledge being irrelevant to children's sleeping time (p = 0.159, r = 0.069), the frequency of lying reading (p = 0.462, r = -0.036) and keeping nutrition diet (p = 0.142, r = 0.072), and positively correlated with daily homework time (p = 0.012, r = 0.123). After the outbreak of COVID-19, 77.8% (329/423) of parents admitted that their children's daily routine had been changed, with children spending more time on sleeping (p < 0.001) and electronic products (p < 0.001), and taking less time to do outdoor activities (p < 0.001). Conclusion The ideal interaction mode that establishing positive impact between parental knowledge and children practice has not been reached in China, which might be the result of insufficient parents' cognition and discordance phenomenon between parental knowledge and children's behaviors. The pandemic of COVID-19 has obviously changed children's daily routine. More efforts should be made to narrow the gap between knowledge and behaviors of myopia control, and stay alert to the potential increased risk of myopia during COVID-19.
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Affiliation(s)
- Hao Yuan
- Department of Ophthalmology, Peking University Third Hospital, Haidian, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, China
| | - Huibin Lv
- Department of Ophthalmology, Peking University Third Hospital, Haidian, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, China
| | - Xuemin Li
- Department of Ophthalmology, Peking University Third Hospital, Haidian, China
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing, China
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Zheng T, Fu W, Jiang S, Yang X. Inverse L-Shaped Association Between Body Mass Index and Myopia in Chinese Schoolchildren: A Pilot Study. J Multidiscip Healthc 2024; 17:1839-1846. [PMID: 38680876 PMCID: PMC11055557 DOI: 10.2147/jmdh.s458978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 04/09/2024] [Indexed: 05/01/2024] Open
Abstract
Purpose The prevalence of obesity and myopia in young people is increasing worldwide; however, the association between body mass index (BMI) and myopia remains controversial. This study aimed to assess the association between BMI and myopia in Chinese schoolchildren. Patients and Methods In this study, the open data for analysis were obtained from DATADRYAD website (www.datadryad.org). A total of 3658 children were enrolled in this study. Logistic regression model was used to analyze the relationship between BMI and myopia. Results Compared with individuals with lower BMI Q1 (less than 25 kg/m2), the adjusted odds ratios (ORs) for BMI and myopia were 2.15 (95% confidence interval [CI]: 1.62-2.86) in Q2 (25.0-29.9 kg/m2) and 2.39 (95% CI: 1.37-4.18) in Q3 (30.0 kg/m2 or more). Moreover, the association between BMI and myopia exhibited an inverted L-shaped curve (nonlinear; p < 0.001). When the BMI was <25 kg/m2, an increased BMI was significantly associated with a higher risk of myopia (OR = 1.244 [95% CI: 1.211-1.277], p < 0.001). However, when the BMI was ≥25 kg/m2, the association lost its significance (OR = 1.063 [95% Cl: 0.964-1.171], p = 0.219). Conclusion This study found an inverted L-shaped association between BMI and myopia in Chinese schoolchildren. A higher BMI was associated with a higher risk of myopia reaching 25 kg/m2, after which an increase in BMI was no longer associated with an increased risk of myopia.
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Affiliation(s)
- Tianli Zheng
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Science, Suzhou, Jiangsu, People’s Republic of China
| | - Weiwei Fu
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Science, Suzhou, Jiangsu, People’s Republic of China
| | - Shuang Jiang
- The Third Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, People’s Republic of China
| | - Xiaodong Yang
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, People’s Republic of China
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Science, Suzhou, Jiangsu, People’s Republic of China
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Wei D, Wang H, Huang L, Hou M, Liang HG, Shi X, Wei X, Li J, Gan L, Lv B, Deng J, Qing L. A Mendelian randomization study on the causal relationship between smoking, alcohol consumption, and the development of myopia and astigmatism. Sci Rep 2024; 14:1868. [PMID: 38253641 PMCID: PMC10803726 DOI: 10.1038/s41598-024-52316-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 01/17/2024] [Indexed: 01/24/2024] Open
Abstract
The influence of environmental factors like smoking and alcohol on myopia and astigmatism is controversial. However, due to ethical concerns, alternative study designs are urgently needed to assess causal inference, as mandatory exposure to cigarettes and alcohol is unethical. Following comprehensive screenings, 326 single nucleotide polymorphisms (SNPs) related to myopia and astigmatism were included in the dataset. To validate the causal association between exposures such as cigarette smoking, alcohol consumption, and coffee intake, and outcomes namely astigmatism and myopia, five regression models were employed. These models encompassed MR-Egger regression, random-effects inverse-variance weighted (IVW), weighted median estimator (WME), weighted model, and simple model. The instrumental variables utilized in these analyses were the aforementioned SNPs. Apply Cochran's Q test to determine heterogeneity of SNPs; if heterogeneity exists, focus on IVW model results. The IVW model showed a 1.379-fold increase in the risk of astigmatism (OR = 1.379, 95%CI 0.822~2.313, P = 0.224) and a 0.963-fold increase in the risk of myopia (OR = 0.963, 95%CI 0.666~1.393, P = 0.841) for each unit increase in smoking. For each unit increase in coffee intake, the risk of astigmatism increased 1.610-fold (OR = 1.610, 95%CI 0.444~5.835, P = 0.469) and the risk of myopia increased 0.788-fold (OR = 0.788, 95%CI 0.340~1.824, P = 0.578). For each additional unit of alcohol consumption, the risk of astigmatism increased by 0.763-fold (OR = 0.763, 95%CI 0.380~1.530, P = 0.446), and none of the differences were statistically significant. However, for each unit of alcohol consumption, the risk of myopia increased by 1.597 times, and the difference was statistically significant (OR = 1.597, 95%CI 1.023~2.493, P = 0.039). The findings indicate that alcohol consumption is a risk factor for myopia but smoking and coffee intake do not affect its development. Additionally, there is no association between smoking, alcohol consumption, coffee intake, and the risk of astigmatism.
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Affiliation(s)
- Diyao Wei
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China
| | - Huanyan Wang
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China.
| | - Ling Huang
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China
| | - Minghui Hou
- Department of Pediatrics, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China
| | - Hong-Gang Liang
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China
| | - Xiang Shi
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China
| | - Xianghui Wei
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China
| | - Jingrong Li
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China
| | - Liuzhu Gan
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China
| | - Bi Lv
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China
| | - Jiabi Deng
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China
| | - Lulu Qing
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China
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England L, O’Connor A. Do Socioeconomic Inequalities Exist Within Ophthalmology and Orthoptics in the UK?: A Scoping Review. Br Ir Orthopt J 2024; 20:31-47. [PMID: 38250169 PMCID: PMC10798172 DOI: 10.22599/bioj.338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 12/22/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction It is well documented that socioeconomic disadvantage adversely affects general health and ocular health worldwide. Within orthoptics, while clinicians recognise a relationship between socioeconomic situation and treatment outcome, no previous literature review was found to address this issue. Neither was a UK-specific literature review found to address the same issue for ophthalmology as a whole. Aim This literature review evaluates evidence for an association between socioeconomic situation and ophthalmic/orthoptic conditions and their treatment outcomes, specifically within the UK. Methods Keyword searches were conducted on Google Scholar and the University of Liverpool library catalogue. Results for the main analyses were limited to full papers, specific to the UK, written in English. Literature was only included from pre-2000 if more recent evidence was insufficient. Results There is evidence of socioeconomic disadvantage being associated with the following: reduced visual acuity; reduced attendance at diabetic retinopathy screening appointments; and delayed presentation of glaucoma, cataracts, and diabetic retinopathy. However, evidence linking socioeconomic disadvantage to AMD is mixed. There is limited evidence of the increased prevalence of amblyopia and subsequent barriers to its treatment for socioeconomically underserved children. There is also evidence of a reduction in quality of life for socioeconomically underserved adults with strabismus. Conclusions Health inequalities within ophthalmology and orthoptics are reported, but with confounding results for some conditions. Further research should explore the reasons behind the inequalities that are found and identify methods of reducing them.
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Kyei S, Kwasi Gyaami R, Abowine JB, Zaabaar E, Asiedu K, Boadi-Kusi SB, Mesuh JM, Assiamah F, Armah A, Ayerakwah PA. Risk of major myopia-associated non-communicable ocular health disorders in Ghana. PLoS One 2024; 19:e0297052. [PMID: 38236924 PMCID: PMC10795978 DOI: 10.1371/journal.pone.0297052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 12/24/2023] [Indexed: 01/22/2024] Open
Abstract
OBJECTIVE To assess the differential association of myopia with major non-communicable ocular diseases in an African clinical cohort. METHODS A five-year hospital-based retrospective study of myopia cases. Patients' folders, Optical Coherence Tomography scans, and fundus photographs were reviewed for the abstraction of relevant data. Only records that employed recognized standards and classification systems for diagnosing and staging the various ocular conditions were included. Demographic characteristics, non-cycloplegic objective refractive findings, and non-communicable eye diseases were retrieved from the records. Myopia-associated risk factors were then determined using logistic regression and correlation. RESULTS Some 16018 patients (32027 eyes) met the inclusion criteria for at least one eye comprising 50.8% males (n = 8137) and 49.2% females (n = 7881). The mean age of the patients was 43.14 ± 17.88 years (range: 2-98 years). The mean spherical equivalent± Standard deviation for myopia was -2.30±3.23 DS (range: -0.50 to -25DS). Binary logistic regression analysis showed that myopic eyes had a higher odd of AC (OR, 0.53; 95% CI, 0.50-0.57), POAG (OR, 6.0; 95% CI, 5.26-6.82), DR (OR, 10.70; 95% CI, 3.91-29.27) and cataracts (OR, 20; 95% CI, 15.32-26.20) but not dry eye (OR, 0.74, 95% CI, 0.68-0.81), macular degeneration and pterygium (OR, 0.36; 95% CI, 0.32-0.40). CONCLUSION Africans with myopia are more at risk of developing allergic conjunctivitis, cataracts, POAG, and DR but not for dry eye, macular degeneration, and pterygium.
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Affiliation(s)
- Samuel Kyei
- Department of Optometry and Vision Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
- Biomedical and Clinical Research Center, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Rexford Kwasi Gyaami
- Department of Optometry and Vision Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | | | - Ebenezer Zaabaar
- Department of Optometry and Vision Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Kofi Asiedu
- Department of Optometry and Vision Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Samuel Bert Boadi-Kusi
- Department of Optometry and Vision Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | | | - Frank Assiamah
- Department of Optometry and Vision Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Anthony Armah
- Department of Optometry and Vision Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Patience Ansomah Ayerakwah
- Department of Optometry and Vision Science, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
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Shi XH, Dong L, Zhang RH, Wei WB. Association between weight-adjusted waist index and myopia in adolescents and young adults: results from NHANES 1999-2008. BMC Ophthalmol 2024; 24:14. [PMID: 38191303 PMCID: PMC10775622 DOI: 10.1186/s12886-024-03282-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 01/04/2024] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Previous studies have indicated a possible link between obesity and myopia, although the results have varied. The objective of this study was to investigate the correlation between a new measure of obesity, the weight-adjusted waist index (WWI), and myopia. METHOD This cross-sectional study included individuals between the ages of 12 and 25 who participated in a noncycloplegic vision examination as part of the National Health and Nutrition Examination Survey (NHANES) conducted from 1999 to 2008. WWI was calculated as waist circumference divided by the square root of body weight. Myopia was characterized by a spherical equivalent (SE) of ≤ - 0.5 diopters (D) and further categorized into mild (-3.00D < SE≤-0.50 D), moderate (-6.00D < SE ≤-3.00 D), or high (SE≤-6.00 D). We utilized a weighted multivariable logistic regression and a generalized additive model to evaluate the correlation between WWI and myopia. Threshold effects were analyzed, and we performed subgroup analysis and interaction tests. RESULTS A grand total of 11,180 individuals were registered for the study. Decreased myopia severity was observed with higher WWI, as evidenced by elevated SE (β = 0.098, 95% CI: 0.028-0.167). Individuals in the top tertile of WWI experienced a 19.8% decrease in risk compared to those in the lowest group (OR = 0.802, 95% CI: 0.800-0.804; P for trend < 0.001). Similar associations were observed for high myopia. Gender-specific nonlinear associations were found, with different breakpoints for males (10.774) and females (10.025). In males, a significant positive association was found on the right side of the breakpoint (OR = 1.398, 95% CI: 1.038-1.884), while no significant association was found on the left side. Conversely, among females, a negative association was observed on the left side of the breakpoint (OR = 0.679, 95% CI: 0.512-0.899), whereas no notable correlation was detected on the right side. CONCLUSION Increased WWI level was linked to a lower risk of myopia and high myopia in the overall sample, with gender-specific variations.
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Affiliation(s)
- Xu Han Shi
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Tongren Hospital, Capital Medical University, 1 Dong Jiao Min Lane, Beijing, 100730, China
- Beijing Ophthalmology & Visual Sciences Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Li Dong
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Tongren Hospital, Capital Medical University, 1 Dong Jiao Min Lane, Beijing, 100730, China
- Beijing Ophthalmology & Visual Sciences Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Rui Heng Zhang
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Tongren Hospital, Capital Medical University, 1 Dong Jiao Min Lane, Beijing, 100730, China
- Beijing Ophthalmology & Visual Sciences Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Wen Bin Wei
- Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Tongren Hospital, Capital Medical University, 1 Dong Jiao Min Lane, Beijing, 100730, China.
- Beijing Ophthalmology & Visual Sciences Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
- Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
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Qu Y, Huang H, Zhang H. Association between body mass index and myopia in the United States population in the National Health and Nutrition Examination Surveys 1999 to 2008: a cross-sectional study. Eur J Med Res 2023; 28:561. [PMID: 38049883 PMCID: PMC10696841 DOI: 10.1186/s40001-023-01542-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 11/20/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND This study investigated the association between body mass index (BMI) and myopia in the United States. METHODS This cross-sectional study included 8,000 participants from the 1999 to 2008 National Health and Nutrition Examination Survey (NHANES). BMI was classified into four groups: < 18.5, 18.5 - 24.9, 25-29.9, and > 29.9. Three diagnostic thresholds were used for myopia A\B\C: spherical equivalent ≤ -0.5\-0.75\-1 diopters in the right eye. Multivariate logistic regression analysis and smooth curve fitting were performed to evaluate the association between BMI and myopia. RESULTS The incidence of myopia was 39.4%. BMI was correlated with myopia, with each 1 kg/m2 increase in BMI associated with a 1% increase in the risk of myopia (OR, 1.01; 95% CI 1.01 1.02; p < 0.05). In myopia B, after adjusting for confounding factors, compared with the reference group (BMI 18.5-24.9), participants with a BMI of 25-29.9 and greater than 29.9 had a 14% and 25% increased risk of myopia, respectively (OR 1.14; 95% CI 1.01 1.29; p = 0.037, OR 1.25; 95% CI 1.08 1.44; p = 0.003), which was similar to the results for myopic A (OR, 1.15; 95% CI 1.02 1.3; p = 0.027, OR 1.19; 95% CI 1.03 1.37; p = 0.018) and myopia C (OR 1.15; 95% CI 1.01 1.31; p = 0.035, OR 1.18; 95% CI 1.01 1.37; p = 0.032). Moreover, there was a linear relationship between myopia and BMI (p for nonlinearity = 0.767). CONCLUSIONS Myopia using all three diagnostic thresholds was positively associated with higher BMI. This suggests a potential association between myopia and higher BMI in the American population, warranting further investigations.
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Affiliation(s)
- Yaohui Qu
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, 16369 Jingshi Road, Jinan, Shandong, China
| | - Huamin Huang
- The First Affiliated Hospital of Shandong First Medical University &, Shandong Provincial Qianfoshan Hospital, 16766 Jingshi Road, Jinan, Shandong, China
| | - Hongxing Zhang
- The First Affiliated Hospital of Shandong First Medical University &, Shandong Provincial Qianfoshan Hospital, 16766 Jingshi Road, Jinan, Shandong, China.
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Tong HJ, Huang ZM, Li YL, Chen YM, Tian B, Ding LL, Zhu LL. Machine learning to analyze the factors influencing myopia in students of different school periods. Front Public Health 2023; 11:1169128. [PMID: 37333519 PMCID: PMC10270291 DOI: 10.3389/fpubh.2023.1169128] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 05/16/2023] [Indexed: 06/20/2023] Open
Abstract
Purpose We aim to develop myopia classification models based on machine learning algorithms for each schooling period, and further analyze the similarities and differences in the factors influencing myopia in each school period based on each model. Design Retrospective cross-sectional study. Participants We collected visual acuity, behavioral, environmental, and genetic data from 7,472 students in 21 primary and secondary schools (grades 1-12) in Jiamusi, Heilongjiang Province, using visual acuity screening and questionnaires. Methods Machine learning algorithms were used to construct myopia classification models for students at the whole schooling period, primary school, junior high school, and senior high school period, and to rank the importance of features in each model. Results The main influencing factors for students differ by school section, The optimal machine learning model for the whole schooling period was Random Forest (AUC = 0.752), with the top three influencing factors being age, myopic grade of the mother, and Whether myopia requires glasses. The optimal model for the primary school period was a Random Forest (AUC = 0.710), with the top three influences being the myopic grade of the mother, age, and extracurricular tutorials weekly. The Junior high school period was an Support Vector Machine (SVM; AUC = 0.672), and the top three influencing factors were gender, extracurricular tutorial subjects weekly, and whether can you do the "three ones" when reading and writing. The senior high school period was an XGboost (AUC = 0.722), and the top three influencing factors were the need for spectacles for myopia, average daily time spent outdoors, and the myopic grade of the mother. Conclusion Factors such as genetics and eye use behavior all play an essential role in students' myopia, but there are differences between school periods, with those in the lower levels focusing on genetics and those in the higher levels focusing on behavior, but both play an essential role in myopia.
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Affiliation(s)
- Hao-Jie Tong
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
| | - Ze-Min Huang
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
| | - Yu-Lan Li
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
| | - Yi-Ming Chen
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
| | - Ben Tian
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
| | - Ling-Ling Ding
- Clinical College of Anhui Medical University, Hefei, Anhui, China
| | - Li-Ling Zhu
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
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Bullimore MA, Lee SSY, Schmid KL, Rozema JJ, Leveziel N, Mallen EAH, Jacobsen N, Iribarren R, Verkicharla PK, Polling JR, Chamberlain P. IMI-Onset and Progression of Myopia in Young Adults. Invest Ophthalmol Vis Sci 2023; 64:2. [PMID: 37126362 PMCID: PMC10153577 DOI: 10.1167/iovs.64.6.2] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 03/11/2023] [Indexed: 05/02/2023] Open
Abstract
Myopia typically starts and progresses during childhood, but onset and progression can occur during adulthood. The goals of this review are to summarize published data on myopia onset and progression in young adults, aged 18 to 40 years, to characterize myopia in this age group, to assess what is currently known, and to highlight the gaps in the current understanding. Specifically, the peer-reviewed literature was reviewed to: characterize the timeline and age of stabilization of juvenile-onset myopia; estimate the frequency of adult-onset myopia; evaluate the rate of myopia progression in adults, regardless of age of onset, both during the college years and later; describe the rate of axial elongation in myopic adults; identify risk factors for adult onset and progression; report myopia progression and axial elongation in adults who have undergone refractive surgery; and discuss myopia management and research study design. Adult-onset myopia is common, representing a third or more of all myopia in western populations, but less in East Asia, where onset during childhood is high. Clinically meaningful myopia progression continues in early adulthood and may average 1.00 diopters (D) between 20 and 30 years. Higher levels of myopia are associated with greater absolute risk of myopia-related ocular disease and visual impairment, and thus myopia in this age group requires ongoing management. Modalities established for myopia control in children would be options for adults, but it is difficult to predict their efficacy. The feasibility of studies of myopia control in adults is limited by the long duration required.
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Affiliation(s)
- Mark A. Bullimore
- University of Houston, College of Optometry, Houston, Texas, United States
| | - Samantha Sze-Yee Lee
- Centre for Ophthalmology and Visual Sciences (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
| | - Katrina L. Schmid
- School of Optometry and Vision Science, Centre for Vision and Eye Research, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Jos J. Rozema
- Visual Optics Lab Antwerp (VOLANTIS), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium
| | - Nicolas Leveziel
- Department of Ophthalmology, Centre Hospitalier Universitaire de Poitiers, Poitiers, Cedex, France
| | - Edward A. H. Mallen
- School of Optometry and Vision Science, University of Bradford, Bradford, United Kingdom
| | | | | | - Pavan K. Verkicharla
- Myopia Research Lab and Infor Myopia Centre, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
| | - Jan Roelof Polling
- Ophthalmology, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands Rotterdam, The Netherlands
- Orthopics & Optometry, University of Applied Science, Utrecht, The Netherlands
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Wang W, Zhang F, Yu S, Ma N, Huang C, Wang M, Wei L, Zhang J, Fu A. Prevention of myopia shift and myopia onset using 0.01% atropine in premyopic children - a prospective, randomized, double-masked, and crossover trial. Eur J Pediatr 2023:10.1007/s00431-023-04921-5. [PMID: 36944782 DOI: 10.1007/s00431-023-04921-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 03/23/2023]
Abstract
This study aims to evaluate the efficacy of 0.01% atropine eye drops in preventing myopia shift and myopia onset in premyopic children. A prospective, randomized, double-masked, placebo-controlled, and crossover trial was conducted over 13 months. Sixty premyopic children aged 6-12 years with cycloplegic spherical equivalent refraction (SER) > - 0.75 D and ≤ + 0.50 D in both eyes were assigned in a 1:1 ratio to receive one drop of 0.01% atropine or placebo once nightly for 6 months (period 1), followed by a 1-month recovery period. Then, the 0.01% atropine group was crossed over to the placebo group, and the latter was crossed over to the 0.01% atropine group for another 6 months (period 2). The primary outcomes were changes in SER and axial length (AL), and the secondary outcomes were the proportion of myopia onset (SER ≤ - 0.75D) and fast myopic shift (change in SER ≤ - 0.25D) in the two periods. Generalized estimating equation (GEE) model performed a statistically significant treatment effect of 0.01% atropine compared with placebo (pSER = 0.02, pAL < 0.001), with a mean SER and AL difference of 0.20D (- 0.15 ± 0.26D vs. - 0.34 ± 0.34D) and 0.11 mm (0.17 ± 0.11 mm vs. 0.28 ± 0.14 mm) in period 1, and 0.17D (- 0.18 ± 0.24D vs. - 0.34 ± 0.31D) and 0.10 mm (0.15 ± 0.15 mm vs. 0.24 ± 0.11 mm) in period 2. The GEE model showed that the proportion of myopia onset (p = 0.004) and fast myopic shift (p = 0.009) was significantly lower in the 0.01% atropine group than that in the placebo group. The period effect was not statistically significant (all p > 0.05). A total of 0.01% atropine significantly prevented myopic shift, axial elongation, and myopia onset in premyopic schoolchildren in central Mainland China. CONCLUSION Within the limits of only two consecutive 6-month observation period, 0.01% atropine eye drops effectively prevented myopic shift, axial elongation, and myopia onset in premyopic children. TRIAL REGISTRATION This trial was registered in the Chinese Clinical Trial Registry (Registration number: ChiCTR2000034760). Registered 18 July 2020. WHAT IS KNOWN • Minimal studies on interventions for pre-myopia, despite the International Myopia Institute stating that preventing myopia is an "even more valuable target" for science and practice than reducing progression after onset. WHAT IS NEW • A total of 0.01% atropine eye drops may safely and effectively reduce the proportion of myopia onset and fast myopic shift in premyopic schoolchildren.
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Affiliation(s)
- Weiqun Wang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Fengyan Zhang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Shiao Yu
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Nana Ma
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Congcong Huang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Ming Wang
- Beijing Aier Intech Eye Hospital, Beijing, 100021, China
| | - Li Wei
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Junjie Zhang
- Henan Eye Institute, Henan Provincial People's Hospital, Zhengzhou, 450000, China
| | - Aicun Fu
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China.
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Tomita M, Yamashita T, Terasaki H, Yoshihara N, Kakiuchi N, Sakamoto T. Success Rate of Swept-Source Optical Coherence Tomography Biometry of Eyes of Elementary School Students. Clin Ophthalmol 2022; 16:3607-3612. [PMID: 36345531 PMCID: PMC9636880 DOI: 10.2147/opth.s378286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 10/11/2022] [Indexed: 01/25/2023] Open
Abstract
PURPOSE To determine the success rate of swept-source optical coherence tomography (SS-OCT) biometry (OA-2000) in elementary school students. METHODS This was a prospective observational longitudinal study of 115 right eyes of elementary school students who were 8- to 9-years-old at the initial examination. Biometric measurements of the eyes were performed annually for three years, viz., during the third, fourth, and fifth grades. The success rates of obtaining data from optical biometric measurements of the axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), pupillary diameter (PD), corneal diameter (CD), and corneal curvature (CC) were determined. RESULTS The AL, CCT, and CC could be measured in all images at the three measurement times in all subjects. The success rate of the measurements of the ACD was 92.2% in the third grade and 100% in the fourth and fifth grade. The LT was successfully measured in 88.7% in the third grade, 99.1% in the fourth grade, and 100% in the fifth grade. The PD was successfully measured in 100% of the third grade, 96.0% of the fourth grade, and 100% in the fifth grade. The CD was successfully measured in 84.3% in the third grade, 66% in the fourth grade, and 100% in the fifth grade. CONCLUSION SS-OCT can obtain accurate measures of all ocular parameters in the primary school students with high success rates. However, care should be taken especially in analyzing the ACD, LT, PD, and CD because errors can occur in some cases.
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Affiliation(s)
- Masatoshi Tomita
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Takehiro Yamashita
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Hiroto Terasaki
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan,Correspondence: Hiroto Terasaki, Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan, Tel +81 99-275-5402, Fax +81 99-265-4894, Email
| | - Naoya Yoshihara
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Naoko Kakiuchi
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Taiji Sakamoto
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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Peled A, Nitzan I, Megreli J, Derazne E, Tzur D, Pinhas-Hamiel O, Afek A, Twig G. Myopia and BMI: a nationwide study of 1.3 million adolescents. Obesity (Silver Spring) 2022; 30:1691-1698. [PMID: 35894082 DOI: 10.1002/oby.23482] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 04/16/2022] [Accepted: 04/26/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This study analyzed the association between adolescent BMI and myopia severity. METHODS This cross-sectional study comprised 1,359,153 adolescents who were medically examined before mandatory military service. Mild-to-moderate and high myopia were defined based on right-eye refractive data. BMI was categorized based on the US age- and sex-matched percentiles. Logistic regression models were applied separately for women and men to estimate odds ratios (ORs) for myopia per BMI category. RESULTS A total of 318,712 adolescents had mild-to-moderate myopia and 23,569 had high myopia. Compared with low-normal BMI (reference group), adjusted ORs for mild-to-moderate and high myopia increased with increasing BMI status, reaching 1.39 (95% CI: 1.23-1.57) and 1.73 (95% CI: 1.19-2.51) for men with severe obesity, respectively, and 1.19 (95% CI: 1.12-1.27) and 1.38 (95% CI: 1.14-1.65) for women with mild obesity, respectively. ORs for mild-to-moderate and high myopia were also higher in men with underweight (OR = 1.20; 95% CI: 1.18-1.23 and OR = 1.39; 95% CI: 1.30-1.47) and women with underweight (OR = 1.06; 95% CI: 1.03-1.09 and OR = 1.12; 95% CI: 1.04-1.22). The overall size effect was greater for men than women (pinteraction < 0.001), in whom the group with severe obesity did not reach statistical significance. CONCLUSIONS BMI was associated with myopia in a J-shaped pattern, with the size effect being greater for adolescent men than women. This study indicates that both low BMI and high BMI are associated with mild-to-moderate and severe myopia.
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Affiliation(s)
- Alon Peled
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Ophthalmology, Assaf-Harofeh Medical Center, Zerifin, Israel
| | - Itay Nitzan
- Israel Defense Forces Medical Corps, Ramat Gan, Israel
| | - Jacob Megreli
- Israel Defense Forces Medical Corps, Ramat Gan, Israel
- Hebrew University-Hadassah Braun School of Public Health and Community, Jerusalem, Israel
| | - Estela Derazne
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dorit Tzur
- Israel Defense Forces Medical Corps, Ramat Gan, Israel
- Department of Military Medicine, Hebrew University, Jerusalem, Israel
| | - Orit Pinhas-Hamiel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Pediatric Endocrine and Diabetes Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center at Tel Hashomer, Ramat Gan, Israel
| | - Arnon Afek
- Central Management, Sheba Medical Center at Tel Hashomer, Ramat Gan, Israel
| | - Gilad Twig
- Israel Defense Forces Medical Corps, Ramat Gan, Israel
- Department of Military Medicine, Hebrew University, Jerusalem, Israel
- Institute of Endocrinology, Sheba Medical Center at Tel Hashomer, Ramat Gan, Israel
- Department of Epidemiology and Preventive Medicine, School of Public Health Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center Tel Hashomer, Ramat Gan, Israel
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Matsumura S, Dannoue K, Kawakami M, Uemura K, Kameyama A, Takei A, Hori Y. Prevalence of Myopia and Its Associated Factors Among Japanese Preschool Children. Front Public Health 2022; 10:901480. [PMID: 35812505 PMCID: PMC9257008 DOI: 10.3389/fpubh.2022.901480] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/19/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To investigate the prevalence of myopia and factors associated with spherical equivalent (SE), axial length (AL), and axial length to corneal radius of curvature (AL/CR) ratio among Japanese preschool children. Study Design Prospective observational study. Methods This cross-sectional study evaluated subjects aged 4–6 years from a preschool. Non-cycloplegic autorefraction was measured using the Spot Vision Screener, while AL and corneal radius (CR) were measured using the Myopia Master. Parental myopia and environmental factors were investigated using the myopia-related factor questionnaire. The worse eye with higher myopic SE was chosen for analysis, and multiple linear regression models was performed using AL, SE, and AL/CR ratio as dependent variables. Results A total of 457 out of 514 participants (239 males, 52.3%) aged 4–6 years (mean 4.77 ± 0.65 years) were included. The mean SE was 0.13 ± 0.63 D, AL was 22.35 ± 0.67 mm, CR was 7.76 ± 0.25 mm, and AL/CR ratio was 2.88 ± 0.72. The overall prevalence of myopia and high myopia were 2.9 and 0.2%, respectively. Multiple regression analysis showed that myopic SE was significantly associated with male sex (β = −0.14, p = 0.02) and parental myopia (β = −0.15, p = 0.04). Meanwhile, longer AL was significantly associated with older age (β = 0.13, p = 0.02), male sex (β = 0.44, p < 0.001), parental myopia (β = 0.24, p = 0.01), and screen time (including smartphones, tablets, and computers) (>1 h, β = 0.14, p = 0.04). A higher AL/CR was significantly associated with older age (β = 0.02, p < 0.001), male sex (β = 0.03, p < 0.001), ratio and parental myopia (β = 0.03, p = 0.02). Conclusion The prevalence of myopia and high myopia were 2.9 and 0.2%, respectively, among Japanese preschool children in 2021. Longer AL was associated with older age, male sex, parental myopia, and screen time in children aged 4–6 years. Children with a high risk of myopia can be identified early based on parental myopia information for early prevention.
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Affiliation(s)
- Saiko Matsumura
- Department of Ophthalmology, Toho University School of Medicine, Tokyo, Japan
- *Correspondence: Saiko Matsumura
| | | | - Momoko Kawakami
- Department of Ophthalmology, Toho University School of Medicine, Tokyo, Japan
| | | | | | | | - Yuichi Hori
- Department of Ophthalmology, Toho University School of Medicine, Tokyo, Japan
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15
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Myopia Genetics and Heredity. CHILDREN 2022; 9:children9030382. [PMID: 35327754 PMCID: PMC8947159 DOI: 10.3390/children9030382] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 02/19/2022] [Accepted: 03/03/2022] [Indexed: 11/18/2022]
Abstract
Myopia is the most common eye condition leading to visual impairment and is greatly influenced by genetics. Over the last two decades, more than 400 associated gene loci have been mapped for myopia and refractive errors via family linkage analyses, candidate gene studies, genome-wide association studies (GWAS), and next-generation sequencing (NGS). Lifestyle factors, such as excessive near work and short outdoor time, are the primary external factors affecting myopia onset and progression. Notably, besides becoming a global health issue, myopia is more prevalent and severe among East Asians than among Caucasians, especially individuals of Chinese, Japanese, and Korean ancestry. Myopia, especially high myopia, can be serious in consequences. The etiology of high myopia is complex. Prediction for progression of myopia to high myopia can help with prevention and early interventions. Prediction models are thus warranted for risk stratification. There have been vigorous investigations on molecular genetics and lifestyle factors to establish polygenic risk estimations for myopia. However, genes causing myopia have to be identified in order to shed light on pathogenesis and pathway mechanisms. This report aims to examine current evidence regarding (1) the genetic architecture of myopia; (2) currently associated myopia loci identified from the OMIM database, genetic association studies, and NGS studies; (3) gene-environment interactions; and (4) the prediction of myopia via polygenic risk scores (PRSs). The report also discusses various perspectives on myopia genetics and heredity.
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Cumberland PM, Bountziouka V, Hammond CJ, Hysi PG, Rahi JS. Temporal trends in frequency, type and severity of myopia and associations with key environmental risk factors in the UK: Findings from the UK Biobank Study. PLoS One 2022; 17:e0260993. [PMID: 35045072 PMCID: PMC8769366 DOI: 10.1371/journal.pone.0260993] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 11/20/2021] [Indexed: 01/13/2023] Open
Abstract
This study investigated temporal trends in the epidemiology of primary myopia and associations with key environmental risk factors in a UK population. Data were collected at recruitment (non-cycloplegic autorefraction, year of birth, sex, ethnicity, highest educational attainment, reason and age of first wearing glasses and history of eye disease) from 107,442 UK Biobank study participants aged 40 to 69 years, born between 1939 and 1970. Myopia was defined as mean spherical equivalent (MSE) ≤-1 dioptre (D). Temporal changes in myopia frequency by birth cohort (5-year bands using date of birth) and associations with environmental factors were analysed, distinguishing both type (childhood-onset, <18 years versus adult-onset) and severity (three categories: low -1.00 to -2.99D, moderate -3.00 to -5.99D or high ≥-6.00D). Overall myopia frequency increased from 20.0% in the oldest cohort (births 1939-1944) to 29.2% in the youngest (1965-1970), reflecting a relatively higher increase in frequency of adult-onset and low myopia. Childhood-onset myopia peaked in participants born in 1950-54, adult-onset myopia peaked in the cohort born a decade later. The distribution of MSE only shifted for childhood-onset myopia (median: -3.8 [IQR -2.4, -5.4] to -4.4 [IQR -3.0, -6.2]). The magnitude of the association between higher educational attainment (proxy for educational intensity) and myopia overall increased over time (adjusted Odds Ratio (OR) 2.7 [2.5, 2.9] in the oldest versus 4.2 [3.3, 5.2] in the youngest cohort), being substantially greater for childhood-onset myopia (OR 3.3 [2.8, 4.0] to 8.0 [4.2, 13]). Without delineating childhood-onset from adult-onset myopia, important temporal trends would have been obscured. The differential impact of educational experience/intensity on both childhood-onset and high myopia, amplified over time, suggests a cohort effect in gene-environment interaction with potential for increasing myopia frequency if increasing childhood educational intensity is unchecked. However, historical plateauing of myopia frequency does suggest some potential for effective intervention.
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Affiliation(s)
- Phillippa M. Cumberland
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Ulverscroft Vision Research Group, Ulverscroft Foundation, Leicester, United Kingdom
| | - Vasiliki Bountziouka
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Ulverscroft Vision Research Group, Ulverscroft Foundation, Leicester, United Kingdom
| | - Christopher J. Hammond
- Department of Ophthalmology, King’s College London, St Thomas’ Hospital Campus, London, United Kingdom
- Department of Twin Research and Genetic Epidemiology, King’s College London, St Thomas’ Hospital Campus, London, United Kingdom
| | - Pirro G. Hysi
- Department of Ophthalmology, King’s College London, St Thomas’ Hospital Campus, London, United Kingdom
| | - Jugnoo S. Rahi
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Ulverscroft Vision Research Group, Ulverscroft Foundation, Leicester, United Kingdom
- National Institute for Health Research (NIHR) Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
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Mohammadi S, Farzadfar F, Pour PM, Ashrafi E, Lashay A, Mohajer B, Lari MA. Prevalence and Burden of Refractive Errors at National and Sub-national Levels in Iran. J Ophthalmic Vis Res 2022; 17:78-88. [PMID: 35194499 PMCID: PMC8850849 DOI: 10.18502/jovr.v17i1.10173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 09/21/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose To estimate the prevalence, burden of refractive errors and their associated trend from 1990 to 2018 and geographic inequalities in Iran. Methods Data regarding the epidemiology of refractive errors was extracted from three different sources: systematic review of published literature, data from visual school screening programs, and data from Iran's national health survey (NHS). The pool of all available data on refractive errors as well as demographic, location, and socioeconomic status covariates were fitted in spatio-temporal and Gaussian process regression models to predict the prevalence of refractive errors from the years 1990 to 2018 in 31 provinces grouped by age and sex in order to calculate years lived with disability (YLDs). Results In 2018, the age-adjusted prevalence of refractive errors was 16.32% (95% uncertainty interval [UI]: 12.44-21.48%) in both sexes, 17.98% (95% UI: 13.74-23.61%) in women, and 14.66% (95% UI: 11.14-19.36%) in men. The prevalence of refractive errors reveals that it increases with age. Refractive errors contributed to 441.41 and 348.38 YLDs in men and women, respectively. The age-standardized prevalence growth was 31.30% in females and 24.32% in males from the years 1990 to 2018. Significant geographical heterogeneity was observed. The age-standardized YLDs rates of refractive errors represent an increasing trend of 28.9% increase from 1990 to 2018. Conclusion Over 28 years, the prevalence of refractive errors increased significantly. Women tend to have higher rates of prevalence. The prevalence increased in older ages. Border provinces had the lowest prevalence. Age-standardized YLDs rates of refractive errors increased by about 30%.
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Affiliation(s)
- Seyed Mohammadi
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Parinaz Mehdi Pour
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Ashrafi
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Lashay
- Translational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahram Mohajer
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Asadi Lari
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
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Terasaki H, Yamashita T, Asaoka R, Yoshihara N, Kakiuchi N, Sakamoto T. Sex Differences in Rate of Axial Elongation and Ocular Biometrics in Elementary School Students. Clin Ophthalmol 2021; 15:4297-4302. [PMID: 34737543 PMCID: PMC8558041 DOI: 10.2147/opth.s333096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/06/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To determine the relationship between the ocular biometrics and axial length (AL) elongation and its rate in elementary school children. Methods This is a prospective observational study of 102 right eyes of third-grade elementary school students who were 8 to 9 years old. All participants underwent measurements of the AL, anterior chamber depth (ACD), and lens thickness (LT) annually for 3 years. The AL elongation during the first half and second half was calculated by subtracting the AL of the 1st year from that at the 2nd year, and AL of the 3rd year minus 2nd year. The total AL elongation (TALE) was obtained by summing up the first and second half AL elongations. The growth rate change (GRC) was obtained by subtracting the first half AL elongation from second half AL elongation. Spearman correlations were used to determine the correlation between the 1st year ocular biometrics and the TALE and GRC. Results The mean TALE was 0.54 ± 0.26 mm in boys and 0.46 ± 0.31 mm in girls. The mean GRC was 0.00 ± 0.16 mm in boys and −0.04 ± 0.14 mm in girls. In boys and girls, the TALE was significantly larger in the eyes with myopic ocular biometrics such as a deeper ACD, thinner LT, and longer AL during the 1st year (|r|=0.41 to 0.46, P < 0.05). The GRC was significantly accelerated in the eyes of only the girls with hyperopic ocular biometrics such as a shallower ACD, thicker LT, and shorter AL during the 1st year (|r|=0.31 to 0.41, P<0.05). Conclusion In boys and girls, the TALE tends to be larger in eyes with myopic biometrics at the 1st year examination. The GRC tended to accelerate in the eyes with hyperopic ocular biometry during the 1st year only in girls.
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Affiliation(s)
- Hiroto Terasaki
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Takehiro Yamashita
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Ryo Asaoka
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Shizuoka, Japan.,Seirei Christopher University, Shizuoka, Japan.,Nanovision Research Division, Research Institute of Electronics, Shizuoka University, Shizuoka, Japan.,The Graduate School for the Creation of New Photonics Industries, Shizuoka, Japan
| | - Naoya Yoshihara
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Naoko Kakiuchi
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Taiji Sakamoto
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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Dyer KIC, Sanfilippo PG, White SW, Guggenheim JA, Hammond CJ, Newnham JP, Mackey DA, Yazar S. Associations Between Fetal Growth Trajectories and the Development of Myopia by 20 Years of Age. Invest Ophthalmol Vis Sci 2021; 61:26. [PMID: 33355605 PMCID: PMC7774062 DOI: 10.1167/iovs.61.14.26] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Purpose To evaluate the contribution of genetic and early life environmental factors, as reflected by fetal anthropometric growth trajectories, toward the development of myopia during childhood and adolescence. Methods This analysis included 498 singleton Caucasian participants from the Raine Study, a pregnancy cohort study based in Western Australia. Serial fetal biometric measurements of these participants were collected via ultrasound scans performed at 18, 24, 28, 34, and 38 weeks’ gestation. At a 20-year follow-up, the participants underwent a comprehensive ophthalmic examination, including cycloplegic autorefraction and ocular biometry measurements. Using a group-based trajectory modeling approach, we identified groups of participants with similar growth trajectories based on measurements of fetal head circumference (HC), abdominal circumference, femur length (FL), and estimated fetal weight (EFW). Differences between trajectory groups with respect to prevalence of myopia, axial length (AL), and corneal radius of curvature measured at the 20-year follow-up were evaluated via logistic regression and analysis of variance. Results Prevalence of myopia was highest among participants with consistently short or consistently long FLs (P = 0.04). There was also a trend toward increased prevalence with larger HC in late gestation, although not at a statistically significant level. Trajectory groups reflecting faster HC, FL, or EFW growth correlated with significantly flatter corneas (P = 0.03, P = 0.04, and P = 0.01, respectively) and a general, but not statistically significant, increase in AL. Conclusions Environmental or genetic factors influencing intrauterine skeletal growth may concurrently affect ocular development, with effects persisting into adulthood.
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Affiliation(s)
- Kathleen I C Dyer
- Centre for Ophthalmology and Visual Science, Lions Eye Institute, University of Western Australia, Perth, Western Australia, Australia.,School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia
| | - Paul G Sanfilippo
- Centre for Ophthalmology and Visual Science, Lions Eye Institute, University of Western Australia, Perth, Western Australia, Australia.,Centre for Eye Research Australia, Department of Ophthalmology, University of Melbourne, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
| | - Scott W White
- Division of Obstetrics and Gynaecology, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia.,Maternal Fetal Medicine Service, King Edward Memorial Hospital, Perth, Western Australia, Australia
| | - Jeremy A Guggenheim
- School of Optometry and Vision Science, Cardiff University, Cardiff, South Glamorgan, United Kingdom
| | - Chris J Hammond
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
| | - John P Newnham
- Division of Obstetrics and Gynaecology, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Western Australia, Australia.,Maternal Fetal Medicine Service, King Edward Memorial Hospital, Perth, Western Australia, Australia
| | - David A Mackey
- Centre for Ophthalmology and Visual Science, Lions Eye Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Seyhan Yazar
- Centre for Ophthalmology and Visual Science, Lions Eye Institute, University of Western Australia, Perth, Western Australia, Australia.,Garvan Institute of Medical Research, Sydney, New South Wales, Australia
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20
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Harb EN, Wildsoet CF. Nutritional Factors and Myopia: An Analysis of National Health and Nutrition Examination Survey Data. Optom Vis Sci 2021; 98:458-468. [PMID: 33973916 PMCID: PMC8137665 DOI: 10.1097/opx.0000000000001694] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
SIGNIFICANCE The rise in the prevalence of myopia, a significant worldwide public health concern, has been too rapid to be explained by genetic factors alone and thus suggests environmental influences. PURPOSE Relatively little attention has been paid to the possible role of nutrition in myopia. The availability of the large National Health and Nutrition Examination Survey data set, which includes results from vision examinations, offers the opportunity to investigate the relationship between several nutrition-related factors, including body metrics, and the presence and magnitude of myopia. METHODS Cross-sectional survey data sets with vision examination, demographic, body metrics, and nutritional data, collected as part of the National Health and Nutrition Examination Survey over the years of 2003 to 2008, were extracted for analysis. Based on already published basic and epidemiological studies, the following parameters were selected for study: body height and body mass index, demographics, serum vitamin D and glucose/insulin levels, and caffeine intake, using multivariable models and objectively measured refractive errors as the main outcome measure. RESULTS Data from a total of 6855 ethnically diverse Americans aged 12 to 25 years were analyzed. In final multivariate models, female sex and age were the most significant factors related to myopia status and refractive error. In general, body metrics (body mass index) or nutritional factors (serum vitamin D, glucose levels, and caffeine intake) were found to be associated with refractive error or myopia status; however, increased insulin levels were related to increased odds of having myopia. CONCLUSIONS These largely negative findings suggest that other environmental factors, such as those related to the visual environment, may contribute more to the development and/or progression of myopia and would argue for continued research in these areas in support of more evidence-based myopia clinical management.
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21
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Morgan IG, Wu PC, Ostrin LA, Tideman JWL, Yam JC, Lan W, Baraas RC, He X, Sankaridurg P, Saw SM, French AN, Rose KA, Guggenheim JA. IMI Risk Factors for Myopia. Invest Ophthalmol Vis Sci 2021; 62:3. [PMID: 33909035 PMCID: PMC8083079 DOI: 10.1167/iovs.62.5.3] [Citation(s) in RCA: 153] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Risk factor analysis provides an important basis for developing interventions for any condition. In the case of myopia, evidence for a large number of risk factors has been presented, but they have not been systematically tested for confounding. To be useful for designing preventive interventions, risk factor analysis ideally needs to be carried through to demonstration of a causal connection, with a defined mechanism. Statistical analysis is often complicated by covariation of variables, and demonstration of a causal relationship between a factor and myopia using Mendelian randomization or in a randomized clinical trial should be aimed for. When strict analysis of this kind is applied, associations between various measures of educational pressure and myopia are consistently observed. However, associations between more nearwork and more myopia are generally weak and inconsistent, but have been supported by meta-analysis. Associations between time outdoors and less myopia are stronger and more consistently observed, including by meta-analysis. Measurement of nearwork and time outdoors has traditionally been performed with questionnaires, but is increasingly being pursued with wearable objective devices. A causal link between increased years of education and more myopia has been confirmed by Mendelian randomization, whereas the protective effect of increased time outdoors from the development of myopia has been confirmed in randomized clinical trials. Other proposed risk factors need to be tested to see if they modulate these variables. The evidence linking increased screen time to myopia is weak and inconsistent, although limitations on screen time are increasingly under consideration as interventions to control the epidemic of myopia.
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Affiliation(s)
- Ian G Morgan
- Research School of Biology, Australian National University, Canberra, ACT, Australia.,State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Pei-Chang Wu
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Lisa A Ostrin
- College of Optometry, University of Houston, Houston, Texas, United States
| | - J Willem L Tideman
- Department of Ophthalmology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.,The Generation R Study Group, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Jason C Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Hong Kong Eye Hospital, Hong Kong, China.,Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong, China
| | - Weizhong Lan
- Aier School of Ophthalmology, Central South University, Changsha, China.,Aier School of Optometry, Hubei University of Science and Technology, Xianning, China.,Aier Institute of Optometry and Vision Science, Aier Eye Hospital Group, Changsha, China.,Guangzhou Aier Eye Hospital, Jinan University, Guangzhou, China
| | - Rigmor C Baraas
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Xiangui He
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China.,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Ocular Fundus Diseases, National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Padmaja Sankaridurg
- Brien Holden Vision Institute Limited, Sydney, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Seang-Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore (NUS), Singapore.,Singapore Eye Research Institute, Singapore.,Duke-NUS Medical School, Singapore
| | - Amanda N French
- Discipline of Orthoptics, Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | - Kathryn A Rose
- Discipline of Orthoptics, Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | - Jeremy A Guggenheim
- School of Optometry & Vision Sciences, Cardiff University, Cardiff, United Kingdom
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22
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Asano S, Yamashita T, Asaoka R, Fujino Y, Murata H, Terasaki H, Yoshihara N, Kakiuchi N, Sakamoto T. Retinal vessel shift and its association with axial length elongation in a prospective observation in Japanese junior high school students. PLoS One 2021; 16:e0250233. [PMID: 33886637 PMCID: PMC8062002 DOI: 10.1371/journal.pone.0250233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 04/04/2021] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To investigate retinal vessel shift (RVS) and its association with axial length (AL) elongation in junior high school students. METHODS Total 161 eyes of 161 healthy junior high school students were prospectively studied. Optical AL and anterior chamber depth (ACD) measurements, and fundus photography were performed in the first and third grades. Eyes of subjects in the first and third grade that had perfect matching among all the retinal vessels were allocated to the RVS(-) group, otherwise allocated to the RVS(+) group. In the RVS(+) group, the peripapillary retinal arteries angle (PRAA) was measured for quantitative analysis of RVS; the angle between the major retinal arteries. The variables related to PRAA were identified using model selection with the corrected Akaike information criterion. RESULTS Forty-two eyes (26.1%) were allocated to the RVS(+) group. There were seven patterns in the RVS of those in the RVS(+) group, including clockwise shift in the supra temporal area (5 eyes), infra temporal area (7 eyes), and nasal area (9 eyes); anticlockwise shift in the supra temporal area (7 eyes), infra temporal area (5 eyes), and nasal area (2 eyes); and distal shift in the temporal area (7 eyes). The optimal model for the PRAA narrowing included larger AL and body weight in the first grade, and greater AL elongation. CONCLUSION Various (seven) RVS patterns were observed in about 25% of the junior high school students within two years. RVS was associated with AL elongation, and useful to reveal the mechanism of myopic retinal stretch.
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Affiliation(s)
- Shotaro Asano
- Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
| | - Takehiro Yamashita
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Ryo Asaoka
- Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Shizuoka, Japan
- Seirei Christopher University, Shizuoka, Japan
- Nanovision Research Division, Research Institute of Electronics, Shizuoka University, Shizuoka, Japan
- The Graduate School for the Creation of New Photonics Industries, Shizuoka, Japan
- * E-mail:
| | - Yuri Fujino
- Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
| | - Hiroshi Murata
- Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
| | - Hiroto Terasaki
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Naoya Yoshihara
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Naoko Kakiuchi
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Taiji Sakamoto
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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23
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Lee R, Chang RT, Wong IYH, Lai JSM, Lee JWY, Singh K. Assessment of corneal biomechanical parameters in myopes and emmetropes using the Corvis ST. Clin Exp Optom 2021; 99:157-62. [DOI: 10.1111/cxo.12341] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 08/04/2015] [Accepted: 08/06/2015] [Indexed: 11/27/2022] Open
Affiliation(s)
- Rachel Lee
- Stanford University School of Medicine, Palo Alto, California, USA,
| | - Robert T Chang
- Stanford University School of Medicine, Palo Alto, California, USA,
| | - Ian Y H Wong
- The Department of Ophthalmology, The University of Hong Kong Faculty of Medicine, Hong Kong, China,
| | - Jimmy S M Lai
- The Department of Ophthalmology, The University of Hong Kong Faculty of Medicine, Hong Kong, China,
| | - Jacky W Y Lee
- The Department of Ophthalmology, The University of Hong Kong Faculty of Medicine, Hong Kong, China,
| | - Kuldev Singh
- Stanford University School of Medicine, Palo Alto, California, USA,
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24
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Ramamurthy D, Lin chua SY, Saw S. A review of environmental risk factors for myopia during early life, childhood and adolescence. Clin Exp Optom 2021; 98:497-506. [DOI: 10.1111/cxo.12346] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 08/16/2015] [Accepted: 08/20/2015] [Indexed: 01/01/2023] Open
Affiliation(s)
- Dharani Ramamurthy
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore,
| | | | - Seang‐mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore,
- Myopia Unit, Singapore Eye Research Institute, Singapore,
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25
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Abstract
OBJECTIVES To investigate the correlation between the annual axial length (AL) elongation and associated factors in Japanese youth with myopia. METHODS This retrospective study enrolled patients aged 7 to 21 years with myopia. Axial length was measured using ocular biometry. Refractive errors and curvature radius (CR) were measured using an open-field Binocular Auto Ref/Keratometer without cycloplegia. Subjects were divided into five groups using 3-year age intervals, and the relationship between annual AL elongation and age, spherical equivalent (SE), corneal CR, and sex was evaluated. RESULTS Four hundred and eighty-two patients (184 male and 298 female subjects) with a mean age of 15.55±4.09 years were included. The annual AL elongation was largest in the youngest group (0.47±0.19) and decreased with age to 0.03±0.04 in the oldest group. The annual change in AL was associated with age and SE (P<0.01) but not with sex or CR (P>0.05). Axial length elongation stratified by age was significantly correlated with SE in the 15 to 18-year-old (R2=0.20, P<0.01) and 19 to 21-year-old (R2=0.37, P=0.01) groups, whereas there was no significant correlation in the 7 to 9-year-old group (R2=0.04, P=0.14), the 10 to 12-year-old group (R2=0.05, P=0.07), and the 13 to 15-year-old group (R2=0.01, P=0.14). CONCLUSIONS In Japanese youth with myopia, AL elongation was largest in the youngest group, decreased with age, especially in the group older than 15 years.
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26
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Patasova K, Khawaja AP, Tamraz B, Williams KM, Mahroo OA, Freidin M, Solebo AL, Vehof J, Falchi M, Rahi JS, Hammond CJ, Hysi PG. Association Between Medication-Taking and Refractive Error in a Large General Population-Based Cohort. Invest Ophthalmol Vis Sci 2021; 62:15. [PMID: 33591358 PMCID: PMC7900881 DOI: 10.1167/iovs.62.2.15] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Refractive errors, particularly myopia, are common and a leading cause of blindness. This study aimed to explore associations between medications and refractive error in an aging adult cohort and to determine whether childhood-onset refractive errors predict future medication use to provide novel insights into disease mechanisms. Methods The study compared the spherical equivalent values measured in 102,318 UK Biobank participants taking the 960 most commonly used medications. The strengths of associations were evaluated against the self-reported age of spectacle wear. The causality of refractive error changes was inferred using sensitivity and Mendelian randomization analyses. Results Anti-glaucoma drugs were associated with 1 to 2 diopters greater myopic refraction, particularly in subjects who started wearing correction in the first two decades of life, potentially due to the association of higher intraocular pressure since early years with both myopia and, later in life, glaucoma. All classes of pain-control medications, including paracetamol, opiates, non-steroidal antiinflammatory drugs, and gabapentinoids, were associated with greater hyperopia (+0.68–1.15 diopters), after correction for deprivation, education, and polypharmacy and sensitivity analyses for common diagnoses. Oral hypoglycemics (metformin, gliburonide) were associated with myopia, as was allopurinol, and participants using bronchodilators (ipratropium and salbutamol) were more hyperopic. Conclusions This study finds for the first time, to our knowledge, that medication use is associated with refractive error in adults. The novel finding that analgesics are associated with hyperopic refraction, and the possibility that multisite chronic pain predisposes to hyperopia, deserves further research. Some drugs, such as antihyperglycemic or bronchodilators, may directly alter refractive error. Intraocular pressure appears causative for myopia.
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Affiliation(s)
- Karina Patasova
- Section of Ophthalmology, School of Life Course Sciences, King's College London, United Kingdom.,Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, United Kingdom
| | - Anthony P Khawaja
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and the UCL Institute of Ophthalmology, London, United Kingdom
| | - Bani Tamraz
- Department of Clinical Pharmacy, University of California San Francisco, San Francisco, California, United States
| | - Katie M Williams
- Section of Ophthalmology, School of Life Course Sciences, King's College London, United Kingdom.,Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, United Kingdom.,NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and the UCL Institute of Ophthalmology, London, United Kingdom.,Department of Ophthalmology, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.,Institute of Ophthalmology, University College London, London, United Kingdom
| | - Omar A Mahroo
- Section of Ophthalmology, School of Life Course Sciences, King's College London, United Kingdom.,Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, United Kingdom.,NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and the UCL Institute of Ophthalmology, London, United Kingdom.,Department of Ophthalmology, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.,Institute of Ophthalmology, University College London, London, United Kingdom
| | - Maxim Freidin
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, United Kingdom
| | - Ameenat L Solebo
- UCL Great Ormond Street Hospital Institute of Child Health, London, United Kingdom
| | - Jelle Vehof
- Section of Ophthalmology, School of Life Course Sciences, King's College London, United Kingdom.,Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, United Kingdom.,University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Mario Falchi
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, United Kingdom
| | - Jugnoo S Rahi
- Institute of Ophthalmology, University College London, London, United Kingdom.,Ulverscroft Vision Research Group, University College London, London, United Kingdom
| | - Chris J Hammond
- Section of Ophthalmology, School of Life Course Sciences, King's College London, United Kingdom.,Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, United Kingdom
| | - Pirro G Hysi
- Section of Ophthalmology, School of Life Course Sciences, King's College London, United Kingdom.,Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, United Kingdom.,UCL Great Ormond Street Hospital Institute of Child Health, London, United Kingdom
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27
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Modjtahedi BS, Abbott RL, Fong DS, Lum F, Tan D. Reducing the Global Burden of Myopia by Delaying the Onset of Myopia and Reducing Myopic Progression in Children: The Academy's Task Force on Myopia. Ophthalmology 2020; 128:816-826. [PMID: 33388160 DOI: 10.1016/j.ophtha.2020.10.040] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 10/27/2020] [Accepted: 10/29/2020] [Indexed: 01/08/2023] Open
Abstract
In 2019, the American Academy of Ophthalmology (AAO) created the Task Force on Myopia in recognition of the substantial global increases in myopia prevalence and its associated complications. The Task Force, led by Richard L. Abbott, MD, and Donald Tan, MD, comprised recognized experts in myopia prevention and treatment, public health experts from around the world, and organization representatives from the American Academy of Family Physicians, American Academy of Optometry, and American Academy of Pediatrics. The Academy's Board of Trustees believes that myopia is a high-priority cause of visual impairment, warranting a timely evaluation and synthesis of the scientific literature and formulation of an action plan to address the issue from different perspectives. This includes education of physicians and other health care providers, patients and their families, schools, and local and national public health agencies; defining health policies to ameliorate patients' access to appropriate therapy and to promote effective public health interventions; and fostering promising avenues of research.
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Affiliation(s)
- Bobeck S Modjtahedi
- Department of Ophthalmology, Southern California Kaiser Permanente, Baldwin Park, California; Department of Research and Evaluation, Southern California Permanente Medical Group, Pasadena, California
| | - Richard L Abbott
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California
| | - Donald S Fong
- Department of Ophthalmology, Southern California Kaiser Permanente, Baldwin Park, California; Department of Research and Evaluation, Southern California Permanente Medical Group, Pasadena, California
| | - Flora Lum
- American Academy of Ophthalmology, San Francisco, California.
| | - Donald Tan
- Eye and Retina Surgeons, Singapore, Republic of Singapore
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28
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Axial growth and refractive change in white European children and young adults: predictive factors for myopia. Sci Rep 2020; 10:15189. [PMID: 32938970 PMCID: PMC7494927 DOI: 10.1038/s41598-020-72240-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 08/21/2020] [Indexed: 12/18/2022] Open
Abstract
This report describes development of spherical equivalent refraction (SER) and axial length (AL) in two population-based cohorts of white, European children. Predictive factors for myopic growth were explored. Participants were aged 6-7- (n = 390) and 12-13-years (n = 657) at baseline. SER and AL were assessed at baseline and 3, 6 and 9 years prospectively. Between 6 and 16 years: latent growth mixture modelling identified four SER classes (Persistent Emmetropes-PEMM, Persistent Moderate Hyperopes-PMHYP, Persistent High Hyperopes-PHHYP and Emerging Myopes-EMYO) as optimal to characterise refractive progression and two classes to characterise AL. Between 12 and 22-years: five SER classes (PHHYP, PMHYP, PEMM, Low Progressing Myopes-LPMYO and High Progressing Myopes-HPMYO) and four AL classes were identified. EMYO had significantly longer baseline AL (≥ 23.19 mm) (OR 2.5, CI 1.05-5.97) and at least one myopic parent (OR 6.28, CI 1.01-38.93). More myopic SER at 6-7 years (≤ + 0.19D) signalled risk for earlier myopia onset by 10-years in comparison to baseline SER of those who became myopic by 13 or 16 years (p ≤ 0.02). SER and AL progressed more slowly in myopes aged 12-22-years (- 0.16D, 0.15 mm) compared to 6-16-years (- 0.41D, 0.30 mm). These growth trajectories and risk criteria allow prediction of abnormal myopigenic growth and constitute an important resource for developing and testing anti-myopia interventions.
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29
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Yu B, Dai L, Chen J, Sun W, Chen J, Du L, Deng N, Chen D. Prenatal and neonatal factors for the development of childhood visual impairment in primary and middle school students: a cross-sectional survey in Guangzhou, China. BMJ Open 2020; 10:e032721. [PMID: 32912936 PMCID: PMC7482504 DOI: 10.1136/bmjopen-2019-032721] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES In this cross-sectional survey, we sought to determine the prevalence of and the influence of prenatal and neonatal factors on childhood visual impairment without correction (VIUC) in a paediatric population from Guangzhou, China. SETTING The health survey covered 11 administrative districts in Guangzhou, including 991 schools. PARTICIPANTS All of the primary and middle school students in Guangzhou were invited to complete an online questionnaire with the help of their parents. The results of physical examinations were reported by school medical departments. The results of the questionnaire were collected by the researchers. In total, 253 301 questionnaires were collected. PRIMARY OUTCOME MEASURES The students' uncorrected visual acuity (UCVA) was examined by trained optometrists by standard logarithmic visual acuity charts. VIUC was defined by UCVA (of the better eye) (UCVA <6/12) with three levels: light VIUC (UCVA ≥6/18 to <6/12), mild VIUC (UCVA ≥6/60 to <6/18) and severe VIUC (UCVA <6/60). RESULTS A total of 39 768 individuals (15.7%) had VIUC, and the rate was much higher among grade 10 to 12 students (51.4%) than among grade 1 to 6 students (6.71%). The following factors were significantly associated with an increased risk of VIUC: female gender, high birth weight, formula feeding, not having siblings, higher level of parents' education, parental myopia, much homework time and little outdoor activity. Delivery mode was not associated with the risk of VIUC. CONCLUSIONS This study validates known major prenatal/genetic, perinatal and postnatal factors for childhood VIUC. In conclusion, prenatal and perinatal factors can affect the onset of childhood VIUC, but parental myopia and postnatal factors are the main factors.
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Affiliation(s)
- Bolan Yu
- BioResource Research Center, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Lijuan Dai
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Juanjuan Chen
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wen Sun
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jingsi Chen
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Lili Du
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Nali Deng
- Health Promotion Centre for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou, China
| | - Dunjin Chen
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Obstetrics, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Fu A, Watt K, M Junghans B, Delaveris A, Stapleton F. Prevalence of myopia among disadvantaged Australian schoolchildren: A 5-year cross-sectional study. PLoS One 2020; 15:e0238122. [PMID: 32853278 PMCID: PMC7451552 DOI: 10.1371/journal.pone.0238122] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 08/09/2020] [Indexed: 01/14/2023] Open
Abstract
Purpose Myopia prevalence is influenced by environmental factors including heritability and social disadvantage. The current prevalence of myopia among disadvantaged school children in Australia has not been reported. Therefore, this study analyses refractive data for children from rural and outer suburban areas. Methods The records of 4,365 children aged 6–15 visiting a city-based government-school respite care center during the years 2014/2016/2018 were analyzed for right eye non-cycloplegic spherical equivalent refraction (SER). The prevalence of myopia (SER≤-0.50D) was compared with historical data. Results The prevalence of myopia was 3.5%, 4.4% and 4.3% in 2014, 2016 and 2018, respectively. The prevalence of myopia increased with age (P<0.0001), but was not related to sex or year of testing (all P >0.05). The overall mean SER was 0.89±0.86D, 0.62±0.89D and 0.56±0.95 in 2014, 2016 and 2018, respectively. Mean SER was associated with year of testing, age (all P <0.0001) and sex (P = 0.03). Mean SER decreased slightly from 2014 to 2018 and demonstrated a significant shift towards less hyperopia with increasing age. Mean SER of females was higher than that of males and decreased faster than in males with age (P interaction = 0.03). Conclusions Myopia prevalence increased with age. The mean SER decreased slightly from 2014 to 2018. Sex differences in the rate of change with age was observed. Compared with 40 years ago, the prevalence of myopia has doubled, but it remains significantly lower than in school children of a similar age living in established urban areas that are regarded as having a higher socioeconomic status.
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Affiliation(s)
- Aicun Fu
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Kathleen Watt
- School of Optometry and Vision Science, UNSW, Sydney, Australia
| | | | | | - Fiona Stapleton
- School of Optometry and Vision Science, UNSW, Sydney, Australia
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Yu AY, Shao H, Pan A, Wang Q, Huang Z, Song B, McAlinden C, Huang J, Chen S. Corneal biomechanical properties in myopic eyes evaluated via Scheimpflug imaging. BMC Ophthalmol 2020; 20:279. [PMID: 32652982 PMCID: PMC7353814 DOI: 10.1186/s12886-020-01530-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 06/26/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND To investigate the biomechanical properties of the cornea in myopic eyes using corneal visualization Scheimpflug technology (Corvis ST). The relationships between the biomechanical properties of the cornea and the degree of myopia were also investigated. METHODS 265 eyes of 265 subjects were included. Based on spherical equivalent (SE) in diopters (D), participants were divided into four groups: low myopia/control (SE: - 0.50 to - 3.00D), moderate myopia (SE: - 3.00 to - 6.00D), high myopia (SE: - 6.00 to - 10.00D) and severe myopia (SE greater than - 10.00D). Axial length (AL), anterior segment parameters, and corneal biomechanical properties were obtained with the Lenstar LS900, Pentacam HR and Corvis ST, respectively. RESULTS Mean (±SD) SE was - 7.29 ± 4.31D (range: - 0.63 to - 25.75D). Mean AL was 26.31 ± 1.82 mm (range: 21.87 to 31.94 mm). Significant differences were detected within the four groups in terms of six corneal biomechanical parameters: deformation amplitude (DA), time from start until second applanation (A2-time), length of flattened cornea at the second applanation (A2-length), corneal velocity during the first and second applanation (A2-velocity), time from start to highest concavity (HC-time), and central curvature at highest concavity (HC radius). AL was positively associated with DA whereas negatively associated with A1-velocity and A2-length. SE was positively associated with A2-time, HC-time and A2-velocity, whereas negatively associated with DA. IOP was positively associated with four corneal biomechanical parameters and negatively associated with three parameters. CONCLUSIONS Eyes with severe myopia showed greater DA, lesser A2 time, HC time, and faster A2-velocity compared to low to high myopia. This suggests the cornea becomes weaker and more deformable with elongation of axial length with corresponding increases in myopia. DA, A2-time and A2-velocity could be useful corneal biomechanical indicators in patients with myopia.
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Affiliation(s)
- A-Yong Yu
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Key Laboratory of Vision Science, Ministry of Health Peoples Republic of China, Wenzhou, Zhejiang, China
| | - Hui Shao
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Anpeng Pan
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Key Laboratory of Vision Science, Ministry of Health Peoples Republic of China, Wenzhou, Zhejiang, China
| | - Qinmei Wang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Key Laboratory of Vision Science, Ministry of Health Peoples Republic of China, Wenzhou, Zhejiang, China
| | - Zixu Huang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Benhao Song
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Colm McAlinden
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China
- Department of Ophthalmology, Singleton Hospital, Swansea Bay University Health Board, Swansea, UK
| | - Jinhai Huang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.
- Key Laboratory of Vision Science, Ministry of Health Peoples Republic of China, Wenzhou, Zhejiang, China.
- Eye Hospital of Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang, 325027, China.
| | - Sisi Chen
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.
- Key Laboratory of Vision Science, Ministry of Health Peoples Republic of China, Wenzhou, Zhejiang, China.
- Eye Hospital of Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang, 325027, China.
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Association of anthropometric measures across the life-course with refractive error and ocular biometry at age 15 years. BMC Ophthalmol 2020; 20:269. [PMID: 32641126 PMCID: PMC7341653 DOI: 10.1186/s12886-020-01480-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 05/22/2020] [Indexed: 11/10/2022] Open
Abstract
Background A recent Genome-wide association meta-analysis (GWAS) of refractive error reported shared genetics with anthropometric traits such as height, BMI and obesity. To explore a potential relationship with refractive error and ocular structure we performed a life-course analysis including both maternal and child characteristics using data from the Avon Longitudinal Study of Parents and Children cohort. Methods Measures collected across the life-course were analysed to explore the association of height, weight, and BMI with refractive error and ocular biometric measures at age 15 years from 1613children. The outcome measures were the mean spherical equivalent (MSE) of refractive error (dioptres), axial length (AXL; mm), and radius of corneal curvature (RCC; mm). Potential confounding variables; maternal age at conception, maternal education level, parental socio-economic status, gestational age, breast-feeding, and gender were adjusted for within each multi-variable model. Results Maternal height was positively associated with teenage AXL (0.010 mm; 95% CI: 0.003, 0.017) and RCC (0.005 mm; 95% CI: 0.003, 0.007), increased maternal weight was positively associated with AXL (0.004 mm; 95% CI: 0.0001, 0.008). Birth length was associated with an increase in teenage AXL (0.067 mm; 95% CI: 0.032, 0.10) and flatter RCC (0.023 mm; 95% CI: 0.013, 0.034) and increasing birth weight was associated with flatter RCC (0.005 mm; 95% CI: 0.0003, 0.009). An increase in teenage height was associated with a lower MSE (− 0.007 D; 95% CI: − 0.013, − 0.001), an increase in AXL (0.021 mm; 95% CI: 0.015, 0.028) and flatter RCC (0.008 mm; 95% CI: 0.006, 0.010). Weight at 15 years was associated with an increase in AXL (0.005 mm; 95% CI: 0.001, 0.009). Conclusions At each life stage (pre-natal, birth, and teenage) height and weight, but not BMI, demonstrate an association with AXL and RCC measured at age 15 years. However, the negative association between refractive error and an increase in height was only present at the teenage life stage. Further research into the growth pattern of ocular structures and the development of refractive error over the life-course is required, particularly at the time of puberty.
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Bullimore MA, Richdale K. Myopia Control 2020: Where are we and where are we heading? Ophthalmic Physiol Opt 2020; 40:254-270. [DOI: 10.1111/opo.12686] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 03/20/2020] [Accepted: 03/24/2020] [Indexed: 12/16/2022]
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Terasaki H, Yamashita T, Tanaka M, Nakao K, Sakamoto T. Relationship Between Funduscopic Conus and Optic Disc Factors Associated with Myopia in Young Healthy Eyes. Invest Ophthalmol Vis Sci 2020; 61:40. [PMID: 32097477 PMCID: PMC7329628 DOI: 10.1167/iovs.61.2.40] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Purpose To determine the relationship between funduscopic findings in myopic eyes and the prevalence and structure of the conus in the optical coherence tomographic (OCT) images. Methods A prospective observational cross-sectional study of 121 right eyes of 121 young healthy volunteers. All participants underwent color fundus photography (CFP), scanning laser ophthalmoscopy, and OCT. Based on the OCT analyses, the area between the edge of the ellipsoid zone (EZ) and that of choroid was defined as the “choroidal conus (CC)”, and the area between the edge of the choroid and the scleral edge as the “scleral conus (SC)”. The eyes were classified into three groups such as the non-conus (NC) group, CC group, and SC group. The differences in the axial length, optic disc tilt, ovality ratio, papillomacular position angle, and peripapillary nerve fiber elevation (pNFE) between the three groups were determined. Results CFPs detected a conus in 79 eyes (65.3 %). The outer border of the conus in CFPs corresponded with the edge of the EZ in the OCT in all subjects. Thirty-seven eyes had CC alone (CC group) and 42 eyes had both CC and SC (SC group). The CC and SC groups had longer axial lengths and more frequent pNFEs than the NC group. There was a significant difference in the optic disc tilt and ovality ratio between the CC and SC groups. Conclusions The eyes with SC tend to have larger optic disc tilt and smaller ovality ratio than the eyes with CC only.
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Xie Z, Long Y, Wang J, Li Q, Zhang Q. Prevalence of myopia and associated risk factors among primary students in Chongqing: multilevel modeling. BMC Ophthalmol 2020; 20:146. [PMID: 32295555 PMCID: PMC7161106 DOI: 10.1186/s12886-020-01410-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 03/30/2020] [Indexed: 02/08/2023] Open
Abstract
Background The prevalence of myopia and associated risk factors among children in Chongqing has not yet been determined. This study investigated the prevalence of myopia and possible relationships between myopia and several related factors among school children in Chongqing. Methods This cross-sectional study assessed a sample of 997 children (7–13 years of age) attending primary school in Chongqing. Data were obtained from visual acuity and refractive error measurements and a structured questionnaire. Myopia was defined as visual acuity < 5.0 and refractive error (spherical equivalent) of < − 0.50 diopters (D) in either eye. Multilevel modeling was applied to investigate potential risk factors. Results The overall prevalence of myopia was 33.9% [95% confidence interval (CI) = 31.0–36.8]; myopia prevalence significantly increased with age. Girls were at a higher risk of myopia than boys [odds ratio (OR) = 1.449, 95% CI = 1.060–1.979]. Children with paternal myopia (OR = 2.130, 95% CI = 1.376–3.297) or maternal myopia (OR = 1.861, 95% CI =1.153–3.002) had a higher risk of myopia than those without myopic parents. Children who spent more than 1 h daily outdoors were less likely to have myopia; meanwhile, children who did homework more than 3 h daily (OR = 2.237, 95% CI = 1.041–4.804), watched television more than 3 h daily (OR = 2.106, 95% CI = 1.200–3.697), or played electronics more than 1 h daily (OR = 2.983, 95% CI = 2.088–4.262) had a higher risk of myopia. Conclusions Myopia in school children is a serious public health problem in Chongqing. Myopia was significantly positively associated with higher age, female sex, parental myopia, and spending a long time indoors; notably, playing with electronics had the greatest influence on the risk of myopia.
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Affiliation(s)
- Zhihao Xie
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, #16, Section 3, Renmin Nan Lu, Chengdu, Sichuan, 610041, People's Republic of China
| | - Yue Long
- Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China
| | - Jingxuan Wang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, #16, Section 3, Renmin Nan Lu, Chengdu, Sichuan, 610041, People's Republic of China
| | - Qiaoqiao Li
- School of Education, Soochow University, Suzhou, China
| | - Qiang Zhang
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, #16, Section 3, Renmin Nan Lu, Chengdu, Sichuan, 610041, People's Republic of China.
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Biyik KZ, Tideman JWL, Polling JR, Buitendijk GHS, Jaddoe VVW, Larsen M, Klaver CCW. Subfoveal choroidal thickness at age 9 years in relation to clinical and perinatal characteristics in the population-based Generation R Study. Acta Ophthalmol 2020; 98:172-176. [PMID: 31386803 DOI: 10.1111/aos.14178] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 06/07/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE To assess the association between clinical and perinatal characteristics and subfoveal choroidal thickness in 9-year-old children. METHODS The study included data from the population-based Generation R cohort, whose participants underwent cycloplegic refractometry, ocular biometry, height, weight and subfoveal choroidal thickness measurements using a swept-source optical coherence tomography (SS-OCT) instrument. Birth parameters were obtained using medical records. Statistical analyses were performed using multivariate regression models adjusted for age, ethnicity and sex. RESULTS A total of 1018 children (52.5% girls, 47.5% boys) with a mean age of 9.9 ± 0.3 years and a mean cycloplegic spherical equivalent refraction of 0.80 ± 1.1 D in boys and 0.81 ± 1.4 in girls were eligible for analysis. The subfoveal choroid was 17 μm thicker in girls (298 ± 60.6 μm) than in boys (281 ± 55.0 μm; p < 0.001), a difference of 9.1 μm persisting after adjustment for age, ethnicity and axial length (p = 0.017). Subfoveal choroidal thickness decreased with increasing ocular axial length (-16.2 μm/mm, 95% CI -21.2 to -12.4, p < 0.001) and with increasing myopic refraction (-10.0 μm/D, 95% CI 6.8-13.1; p < 0.001, adjusted for age, ethnicity, axial length and sex) while it increased with increasing body height (1.3 μm/cm, 95% CI 0.8 to 1.9, p < 0.001). Additionally, choroidal thickness increased with increasing birthweight (13.0 μm/kg; 95% CI 0.006-0.020; p < 0.001) and increasing size for gestational age (8.2 μm/kg; 95% CI 4.6-11.8; p < 0.001). Smoking up until the time that pregnancy became known was associated with a thinner choroid (p = 0.016). There was no detectable effect of alcohol consumption. The distributions of axial length, refraction and choroidal thickness were narrower than in older populations. CONCLUSION The subfoveal choroid was thicker in girls than in boys, and higher body height, higher birthweight and larger size for gestational age were associated with a thicker subfoveal choroid. The implications of these findings for myopia development need further evaluation in longitudinal studies.
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Affiliation(s)
- Kevser Zehra Biyik
- Department of Ophthalmology and Department of Epidemiology Erasmus Medical Center Rotterdam The Netherlands
- Department of Ophthalmology Rigshospitalet Glostrup Denmark
- Faculty of Health Sciences University of Copenhagen Copenhagen Denmark
| | - Jan Willem L. Tideman
- Department of Ophthalmology and Department of Epidemiology Erasmus Medical Center Rotterdam The Netherlands
| | - Jan Roelof Polling
- Department of Ophthalmology and Department of Epidemiology Erasmus Medical Center Rotterdam The Netherlands
- Department of Orthoptics School of Applied Science Utrecht Utrecht The Netherlands
| | - Gabriëlle H. S. Buitendijk
- Department of Ophthalmology and Department of Epidemiology Erasmus Medical Center Rotterdam The Netherlands
| | | | - Michael Larsen
- Department of Ophthalmology Rigshospitalet Glostrup Denmark
| | - Caroline C. W. Klaver
- Department of Ophthalmology and Department of Epidemiology Erasmus Medical Center Rotterdam The Netherlands
- Department of Ophthalmology Radboud UMC Nijmegen The Netherlands
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Associations Between Screen Exposure in Early Life and Myopia amongst Chinese Preschoolers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17031056. [PMID: 32046062 PMCID: PMC7037286 DOI: 10.3390/ijerph17031056] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/04/2020] [Accepted: 02/05/2020] [Indexed: 12/12/2022]
Abstract
This study aimed to explore the association between screen exposure in early life and preschool myopia. During the baseline survey of the Longhua Child Cohort Study (LCCS), data of 29,595 preschoolers were collected via a caregiver-reported questionnaire regarding children’s socio-demographic characteristics, visual status, screen exposure and relevant parental information. Data of 26,433 preschoolers with normal eyesight or myopia were included in the analysis and cox regression modelling was employed to assess the associations. Results suggested the hypothesis that screen exposure in early life could be significantly and positively associated with preschool myopia, and in agreement with this hypothesis was the association being strengthened with the increasing daily exposure duration and total years of exposure; in the stratification analysis based on the presence of parental myopia, these associations still existed, and the strength of associations was stronger in preschoolers with myopic parents than those without. Moreover, a statistically significant association was only observed between initial screen exposure that occurred during 0–1-years old and myopia for preschoolers without myopic parents, while the significant associations were observed between initial screen exposure that occurred during 0–1, 1–2, 2–3, and after 3 years old and myopia for preschoolers who had myopic parents, with the strongest association found in the group of children initially exposed to electronic screens during 0–1 year old. Thus our findings indicated the hypothesis that screen exposure in early life might be associated with the occurrence of preschool myopia, and that the postnatal first year might be the sensitive period for the association. However, it is premature to conclude that early screen time leads to myopia with current data. Further longitudinal studies performed with cycloplegia are necessary to verify the hypothesis and shed light on the more urgent question whether early screen exposure contributes to the later myopia epidemic of school-aged children.
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Tse JSH, Lam TC, Cheung JKW, Sze YH, Wong TK, Chan HHL. Data on assessment of safety and tear proteome change in response to orthokeratology lens - Insight from integrating clinical data and next generation proteomics. Data Brief 2020; 29:105186. [PMID: 32071970 PMCID: PMC7013139 DOI: 10.1016/j.dib.2020.105186] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 01/18/2020] [Accepted: 01/21/2020] [Indexed: 11/29/2022] Open
Abstract
Breath-O™ Correct Ortho-K lenses are newly designed ortho-K lenses which are made from a silicon and fluoride containing methacrylate compound. This compound is said to be more flexible, durable and less likely to break compared to traditional Ortho-K lenses. The special design of this Ortho-K lens can reshape the corneal profile to induce temporary myopic reduction while producing beneficial peripheral hyperopic defocus for myopia control. To evaluate the safety and ocular surface responses of overnight Ortho-K wear over 1 and 3 months using this new type of material, we evaluated the clinical parameters (corneal integrity, corneal biomechanics, corneal endothelial health, non-invasive keratographical break-up time) and profiled the change of global tear proteome on healthy young subjects using next generation proteomics (SWATH-MS). The acquired mass spectrometric data were processed and analyzed using a cloud based Oneomics™ bioinformatic platform. All raw data generated from Information-dependent acquisition (IDA) and SWATH acquisitions were accepted and published in the Peptide Atlas public repository for general release (http://www.peptideatlas.org/PASS/PASS01367).
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Cheng X, Xu J, Brennan NA. Accommodation and its role in myopia progression and control with soft contact lenses. Ophthalmic Physiol Opt 2019; 39:162-171. [PMID: 30994197 DOI: 10.1111/opo.12614] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 03/18/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE To examine the impact of contact lens optical design on accommodative behaviour of children and the correlation between myopia progression and the accommodative response of the eye while wearing a contact lens designed for myopia control. METHODS A post-hoc analysis was conducted on data from a previously published myopia control trial. A total of 109 subjects (aged 8 to 11 years, myopia: -0.75 to -4.00 D) wore either a Control (single-vision, n = 57) or a Test (with positive spherical aberration, +SA, n = 52) soft contact lens, binocularly for 1 year. Accommodative response was measured as the subject observed targets at -1.00 to -4.00 D vergence using the Grand Seiko WAM-5500 open-field autorefractor (www.grandseiko.com). Slope of accommodative response (SAR) as well as distance and near phoria and stimulus accommodative convergence/accommodation (AC/A) were compared between each group at baseline without study lenses and at 1-week and 1-year visits with study lenses. The SAR was also compared to changes in axial length (AL) and spherical equivalent cycloplegic auto refraction (SECAR). RESULTS At baseline, there was no significant difference in SAR between the two study groups (ΔSAR = -0.039, p = 0.84). At 1 week, mean SAR of the Test group was significantly less than for the Control group (ΔSAR = -0.203, p < 0.0001), an effect that persisted to 1 year (ΔSAR = -0.129, p < 0.0001). In the Test group, greater SAR was associated with less change in AL (regression coefficient: -0.59 mm, p < 0.0001) and SECAR (regression coefficient: 1.12 D, p = 0.006) at 1 year. In the Control group, associations between SAR and change in AL and SECAR were not statistically significant. Compared to the Control group, eyes of the Test group appeared to be more exophoric with study lenses, however, the difference between the two groups was only significant at 1 week for distance phoria and 1 year for near phoria. CONCLUSION The soft contact lens with +SA for controlling myopia progression resulted in an apparent decrease in mean accommodation. Within the Test group, reduced accommodative response correlated with greater myopia progression, suggesting some subjects in the Test group utilised the +SA for near viewing, inducing hyperopic defocus at the retina. Accordingly, the potential impact of a lens optics on accommodative function should be considered during design of myopia control lenses.
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Affiliation(s)
- Xu Cheng
- Johnson & Johnson Vision, Jacksonville, Florida, USA
| | - Jing Xu
- Johnson & Johnson Vision, Jacksonville, Florida, USA
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Abstract
Refractive errors are the product of a mismatch between the axial length of the eye and its optical power, creating blurred vision. Uncorrected refractive errors are the second leading cause of worldwide blindness. One refractive error currently attracting significant scientific interest is myopia, mostly owing to the recent rise in its prevalence worldwide and associated ocular disease burden. This increase in myopia prevalence has also been rapid, suggesting environmental influences in addition to any genetic influences on eye growth. This review defines refractive errors, describes their prevalence, and presents evidence for the influence of genetic and environmental factors related to refractive error development.
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Affiliation(s)
- Elise N. Harb
- School of Optometry, University of California, Berkeley, California 94720, USA;,
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Morris TT, Guggenheim JA, Northstone K, Williams C. Geographical Variation in Likely Myopia and Environmental Risk Factors: A Multilevel Cross Classified Analysis of A UK Cohort. Ophthalmic Epidemiol 2019; 27:1-9. [PMID: 31466484 PMCID: PMC6961303 DOI: 10.1080/09286586.2019.1659979] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Purpose: Previous studies have demonstrated positive associations between myopia and environmental risk factors such as urbanization. However, these have failed to account for the clustering of individuals within geographical areas, opening analyses to theoretical and statistical limitations. We demonstrate how a multilevel modelling approach can provide a more nuanced understanding of the relationship between geography and myopia. We examined longitudinal associations between onset of myopia and urban/rural status or population density. Methods: Data were collected over 5 visits during an 8-year period for a UK cohort of 3,512 children. Associations between incident myopia (spherical equivalent ≤ −1.00 diopters) and both urban/rural status and population density were examined using discrete time multilevel hazard models which allow the partitioning of variance into different neighborhood and school areas. Results: There was evidence for an association between myopia and higher population density (Hazard Ratio = 1.14; 95% CI = 1.032 to 1.26) after adjustment for a range of risk factors. There was no strong evidence that urban/rural status was associated with incident myopia. Only a minor amount of variation in myopia was attributable to geographical areas (<2.2%), and this was not explained by rurality or population density. Conclusion: Our findings contrast with previous studies and raise the possibility that some of the results reported may have been driven by confounding bias whereby geographical differences in myopia are driven by lifestyle factors that are correlated with geographical setting.
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Affiliation(s)
- Tim T Morris
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | | | | | - Cathy Williams
- Bristol Medical School, University of Bristol, Bristol, UK
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Wolffsohn JS, Flitcroft DI, Gifford KL, Jong M, Jones L, Klaver CCW, Logan NS, Naidoo K, Resnikoff S, Sankaridurg P, Smith EL, Troilo D, Wildsoet CF. IMI - Myopia Control Reports Overview and Introduction. Invest Ophthalmol Vis Sci 2019; 60:M1-M19. [PMID: 30817825 PMCID: PMC6735780 DOI: 10.1167/iovs.18-25980] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
With the growing prevalence of myopia, already at epidemic levels in some countries, there is an urgent need for new management approaches. However, with the increasing number of research publications on the topic of myopia control, there is also a clear necessity for agreement and guidance on key issues, including on how myopia should be defined and how interventions, validated by well-conducted clinical trials, should be appropriately and ethically applied. The International Myopia Institute (IMI) reports the critical review and synthesis of the research evidence to date, from animal models, genetics, clinical studies, and randomized controlled trials, by more than 85 multidisciplinary experts in the field, as the basis for the recommendations contained therein. As background to the need for myopia control, the risk factors for myopia onset and progression are reviewed. The seven generated reports are summarized: (1) Defining and Classifying Myopia, (2) Experimental Models of Emmetropization and Myopia, (3) Myopia Genetics, (4) Interventions for Myopia Onset and Progression, (5) Clinical Myopia Control Trials and Instrumentation, (6) Industry Guidelines and Ethical Considerations for Myopia Control, and (7) Clinical Myopia Management Guidelines.
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Affiliation(s)
- James S Wolffsohn
- Ophthalmic Research Group, Aston University, Birmingham, United Kingdom
| | - Daniel Ian Flitcroft
- Children's University Hospital, University College Dublin and Dublin Institute of Technology, Dublin, Ireland
| | - Kate L Gifford
- Private Practice and Queensland University of Technology, Queensland, Australia
| | - Monica Jong
- Brien Holden Vision Institute and School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Lyndon Jones
- Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Caroline C W Klaver
- Department of Ophthalmology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nicola S Logan
- Ophthalmic Research Group, Aston University, Birmingham, United Kingdom
| | - Kovin Naidoo
- African Vision Research Institute, University of KwaZulu-Natal, Durban, South Africa
| | - Serge Resnikoff
- Brien Holden Vision Institute and School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Padmaja Sankaridurg
- Brien Holden Vision Institute and School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Earl L Smith
- College of Optometry, University of Houston, Houston, Texas, United States
| | - David Troilo
- SUNY College of Optometry, State University of New York, New York, New York, United States
| | - Christine F Wildsoet
- Berkeley Myopia Research Group, School of Optometry & Vision Science Program, University of California Berkeley, Berkeley, California, United States
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Gifford KL, Richdale K, Kang P, Aller TA, Lam CS, Liu YM, Michaud L, Mulder J, Orr JB, Rose KA, Saunders KJ, Seidel D, Tideman JWL, Sankaridurg P. IMI - Clinical Management Guidelines Report. Invest Ophthalmol Vis Sci 2019; 60:M184-M203. [PMID: 30817832 DOI: 10.1167/iovs.18-25977] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Best practice clinical guidelines for myopia control involve an understanding of the epidemiology of myopia, risk factors, visual environment interventions, and optical and pharmacologic treatments, as well as skills to translate the risks and benefits of a given myopia control treatment into lay language for both the patient and their parent or caregiver. This report details evidence-based best practice management of the pre-, stable, and the progressing myope, including risk factor identification, examination, selection of treatment strategies, and guidelines for ongoing management. Practitioner considerations such as informed consent, prescribing off-label treatment, and guides for patient and parent communication are detailed. The future research directions of myopia interventions and treatments are discussed, along with the provision of clinical references, resources, and recommendations for continuing professional education in this growing area of clinical practice.
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Affiliation(s)
- Kate L Gifford
- Private Practice and Queensland University of Technology, Brisbane, Queensland, Australia
| | | | - Pauline Kang
- University of New South Wales, Sydney, New South Wales, Australia
| | - Thomas A Aller
- Private Practice and University of California, Berkeley, United States
| | - Carly S Lam
- The Hong Kong Polytechnic University, Hong Kong
| | - Y Maria Liu
- University of California, Berkeley, California, United States
| | | | - Jeroen Mulder
- University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Janis B Orr
- Aston University, Birmingham, United Kingdom
| | - Kathryn A Rose
- University of Technology Sydney, New South Wales, Australia
| | | | - Dirk Seidel
- Glasgow Caledonian University, Glasgow, United Kingdom
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Stander J, Dalla Valle L, Taglioni C, Liseo B, Wade A, Cortina-Borja M. Analysis of paediatric visual acuity using Bayesian copula models with sinh-arcsinh marginal densities. Stat Med 2019; 38:3421-3443. [PMID: 31144351 DOI: 10.1002/sim.8176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Revised: 03/04/2019] [Accepted: 03/20/2019] [Indexed: 11/10/2022]
Abstract
We analyse paediatric ophthalmic data from a large sample of children aged between 3 and 8 years. We use a Bayesian additive conditional bivariate copula regression model with sinh-arcsinh marginal densities with location, scale, and shape parameters that depend smoothly on a covariate. We perform Bayesian inference about the unknown quantities of our model using a specially tailored Markov chain Monte Carlo algorithm. We gain new insights about the processes, which determine transformations in visual acuity with respect to age, including the nature of joint changes in both eyes as modelled with the age-related copula dependence parameter. We analyse posterior predictive distributions to identify children with unusual sight characteristics, distinguishing those who are bivariate, but not univariate outliers. In this way, we provide an innovative tool that enables clinicians to identify children with unusual sight who may otherwise be missed. We compare our simultaneous Bayesian method with a two-step frequentist generalised additive modelling approach.
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Affiliation(s)
- Julian Stander
- School of Computing, Electronics and Mathematics, University of Plymouth, Plymouth, UK
| | - Luciana Dalla Valle
- School of Computing, Electronics and Mathematics, University of Plymouth, Plymouth, UK
| | | | - Brunero Liseo
- Department of Methods and Models for Territories, Economy and Finance, University of Rome La Sapienza, Rome, Italy
| | - Angie Wade
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Mario Cortina-Borja
- Great Ormond Street Institute of Child Health, University College London, London, UK
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Shapira Y, Mimouni M, Machluf Y, Chaiter Y, Saab H, Mezer E. The Increasing Burden of Myopia in Israel among Young Adults over a Generation: Analysis of Predisposing Factors. Ophthalmology 2019; 126:1617-1626. [PMID: 31474440 DOI: 10.1016/j.ophtha.2019.06.025] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 06/03/2019] [Accepted: 06/20/2019] [Indexed: 12/18/2022] Open
Abstract
PURPOSE To determine the trends in prevalence of myopia in Israeli young adults over approximately a generation, as well as associated factors and variation in the impact of these factors on myopia prevalence in this region over time. DESIGN Retrospective, cross-sectional study. PARTICIPANTS One hundred four thousand six hundred eighty-nine consecutive persons 16 to 19 years of age born between 1971 and 1994 who had not yet enlisted in the Israeli Army but had completed the medical profiling process. METHODS Using data collected at a north Israel recruitment center, the prevalence of myopia over time was estimated, and a polynomial regression analysis was performed to assess significance of nonlinear trends. Associations of demographic and socioeconomic factors with myopia were assessed, and trends over time were analyzed using a factorial logistic regression. MAIN OUTCOME MEASURES The primary outcome measure was factors associated with the prevalence of myopia over time. The secondary outcome measure was a description of the change in prevalence of myopia over time. RESULTS The prevalence of myopia increased 1.284-fold over 24 years from 20.4% among participants born between 1971 and 1982 to 26.2% among participants born between 1983 and 1994. A quite similar increase was observed among males (from 17.9% to 22.7%, respectively) and females (from 23.9% to 30.8%, respectively). The factors found to be associated with myopia were as follows: more recent date of birth, female gender, more years of education, being the eldest child, non-Israeli ethnic origin, and urban residence. However, there were significant trends over time in the effects of some of these factors, most notably an attenuation of the difference between participants of different religions in the recent birth-years period. Most of these associations and trends were observed in both males and females separately, with some gender-specific variations. Immigrants from Ethiopia who were raised in Israel were highly more likely to demonstrate myopia than those who arrived at an older age. CONCLUSIONS This study demonstrated an increase in the prevalence of myopia and the possible associations of urbanization- and higher education-related factors among several subpopulations and the risk for myopia developing.
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Affiliation(s)
- Yinon Shapira
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel
| | - Michael Mimouni
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel; Bruce and Ruth Rappaport Faculty of Medicine, Technion, Israel Institute of Technology.
| | - Yossy Machluf
- Israel Defense Forces, Medical Corps, Israel; Shamir Research Institute, University of Haifa, Kazerin, Israel
| | | | - Haitam Saab
- Israel Defense Forces, Medical Corps, Israel
| | - Eedy Mezer
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel; Bruce and Ruth Rappaport Faculty of Medicine, Technion, Israel Institute of Technology
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Prevalence of and risk factors for refractive error: a cross-sectional study in Han and Mongolian adults aged 40-80 years in Inner Mongolia, China. Eye (Lond) 2019; 33:1722-1732. [PMID: 31160702 DOI: 10.1038/s41433-019-0469-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 12/05/2018] [Accepted: 04/26/2019] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To assess the prevalence of and risk factors for refractive error (RE) in Han and Mongolian adults aged 40-80 years in Inner Mongolia in China and to identify ethnic differences in RE between these populations. METHODS Our cross-sectional study is part of the China National Health Survey (CNHS). The age-adjusted prevalence of RE in Han and Mongolian adults aged 40-80 in Inner Mongolia were compared. A multivariable logistic regression model was used to identify risk factors. RESULTS Among 2090 people, the age-adjusted prevalence of myopia (SE < -0.5D), hyperopia (SE > 0.5D), high myopia (SE < -6.0D) and astigmatism (cylinder ≥ 0.5D) were 29.4% (95% confidence interval (CI), 27.4-31.3%), 28.4% (95% CI, 26.4-30.5%), 3.6% (95% CI, 2.8-4.4%) and 65.9% (95% CI, 63.9-67.9%), respectively. The age-adjusted prevalence of myopia in the Han population was higher than that in the Mongolian population (31.8% vs. 23.0%, p < 0.001), but the prevalence of hyperopia was lower (25.8% vs. 35.3%, p = 0.002). In the multivariable logistic regression, ethnicity was associated with myopia (p = 0.001) and hyperopia (p = 0.001). Myopia was also associated with age, time spent in rural areas (p < 0.001) and middle/high school and undergraduate/graduate education levels (p = 0.027 and p < 0.001, respectively, compared with lower education levels). Additionally, age, height (p = 0.015) and pterygium (p = 0.014) were associated with hyperopia. CONCLUSIONS Ethnicity is closely related to RE in Inner Mongolia in mainland China. Our study investigates differences in prevalence of and risk factors for RE between the Han and Mongolian populations, which could not be explained by differences in the risk factors investigated in this study.
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Plotnikov D, Williams C, Guggenheim JA. Association between birth weight and refractive error in adulthood: a Mendelian randomisation study. Br J Ophthalmol 2019; 104:214-219. [PMID: 31097437 DOI: 10.1136/bjophthalmol-2018-313640] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 04/05/2019] [Accepted: 04/26/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Pathological myopia is one of the leading causes of blindness globally. Lower birth weight (BW) within the normal range has been reported to increase the risk of myopia, although findings conflict. We sought to estimate the causal effect of BW on refractive error using Mendelian randomisation (MR), under the assumption of a linear relationship. METHODS Genetic variants associated with BW were identified from meta-analysis of a genome-wide association study (GWAS) for self-reported BW in 162 039 UK Biobank participants and a published Early Growth Genetics (EGG) consortium GWAS (n=26 836). We performed a one-sample MR analysis in 39 658 unrelated, adult UK Biobank participants (independent of the GWAS sample) using an allele score for BW as instrumental variable. A two-sample MR sensitivity analysis and conventional ordinary least squares (OLS) regression analyses were also undertaken. RESULTS In OLS analysis, BW showed a small, positive association with refractive error: +0.04 D per SD increase in BW (95% CI 0.02 to 0.07; p=0.002). The one-sample MR-estimated causal effect of BW on refractive error was higher, at +0.28 D per SD increase in BW (95% CI 0.05 to 0.52, p=0.02). A two-sample MR analysis provided similar causal effect estimates, with minimal evidence of directional pleiotropy. CONCLUSIONS Our study suggests lower BW within the normal range is causally associated with a more myopic refractive error. However, the impact of the causal effect was modest (range 1.00 D covering approximately 95% of the population).
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Affiliation(s)
- Denis Plotnikov
- School of Optometry & Vision Sciences, Cardiff University, Cardiff, UK
| | - Cathy Williams
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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Ye S, Liu S, Li W, Wang Q, Xi W, Zhang X. Associations between anthropometric indicators and both refraction and ocular biometrics in a cross-sectional study of Chinese schoolchildren. BMJ Open 2019; 9:e027212. [PMID: 31079086 PMCID: PMC6530363 DOI: 10.1136/bmjopen-2018-027212] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To identify associations between anthropometric indicators (height, weight and body mass index (BMI)) and both refraction and ocular biometrics in Chinese schoolchildren in Tianjin, China. DESIGN Cross-sectional study. PARTICIPANTS A total of 482 (86.07%) students (6-15 years old) with no history of ocular or systemic pathologies were enrolled in this study. METHODOLOGY Height and weight were measured using standardised protocols. Ocular biometrics (axial length (AL), vitreous chamber depth (VCD) and corneal curvature (CC)) were measured by a low-coherence optical reflectometry device. Cycloplegic refraction was measured using autorefraction. The AL/CC ratio and spherical equivalent refraction (SER) were calculated. Myopia was defined as SER ≤-0.50 dioptres (D). Multiple linear regression analysis was performed to explore the associations between anthropometric indicators (height, weight and BMI) and both refraction and ocular biometrics. RESULTS The overall prevalence of myopia was 71.16%. Overall, only height was associated with ALs, VCDs, AL/CC ratios and refractions after controlling for age, gender, parental myopia, family income, reading and writing distance and time spent outdoors. Furthermore, age-specific results demonstrated that height and weight were independently associated with refraction in participants aged 6-8 years and 9-11 years participants. Higher heights in schoolchildren were associated with longer ALs (regression coefficient b=+0.25 for each 10 cm difference in height, p<0.01), deeper VCDs (b=+0.23, p<0.01), higher AL/CC ratios (b=+0.04, p<0.01) and more negative refractions (b=-0.48, p<0.01). Heavier weights were also associated with longer ALs (+0.29 mm, p<0.01), deeper VCDs (+0.29 mm, p<0.01), higher AL/CC ratios (+0.04, p<0.01) and more negative refractions (-0.48 D, p<0.01). CONCLUSIONS Height and weight remained independently related to refraction and various ocular biometrics during the early adolescent growth period after adequately controlling for covariates, which could support the idea that a shared mechanism may regulate the coordinated growth of body and eye size in children.
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Affiliation(s)
- Sheng Ye
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Shengxin Liu
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wenlei Li
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Qifan Wang
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wei Xi
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xin Zhang
- School of Public Health, Tianjin Medical University, Tianjin, China
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VanderVeen DK, Kraker RT, Pineles SL, Hutchinson AK, Wilson LB, Galvin JA, Lambert SR. Use of Orthokeratology for the Prevention of Myopic Progression in Children. Ophthalmology 2019; 126:623-636. [DOI: 10.1016/j.ophtha.2018.11.026] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 11/20/2018] [Accepted: 11/20/2018] [Indexed: 11/17/2022] Open
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Hoseini-Yazdi H, Vincent SJ, Collins MJ, Read SA, Alonso-Caneiro D. Wide-field choroidal thickness in myopes and emmetropes. Sci Rep 2019; 9:3474. [PMID: 30837507 PMCID: PMC6401121 DOI: 10.1038/s41598-019-39653-w] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Accepted: 01/23/2019] [Indexed: 12/19/2022] Open
Abstract
There is a paucity of knowledge regarding the normal in-vivo thickness of the choroid beyond the macula (~17°). In this study, the choroidal thickness of 27 healthy young adults was examined across the macular (the central 5 mm including the fovea, parafovea, and perifovea) and extra-macular (a 5-14 mm annulus including the near-periphery and periphery) regions using wide-field optical coherence tomography, and compared between emmetropes (n = 14) and myopes (n = 13). The choroid progressively thinned beyond the parafovea (350 ± 86 µm) towards the periphery (264 ± 44 µm), and was thickest superiorly (355 ± 76 µm) and thinnest nasally (290 ± 79 µm). Choroidal thickness also varied with refractive error; myopes exhibited a thinner choroid than emmetropes in the macular region (311 ± 88 vs. 383 ± 66 µm), however, this difference diminished towards the periphery (251 ± 48 vs. 277 ± 37 µm). Meridional variations in choroidal thickness were not different between myopes and emmetropes. In conclusion, the choroid was thickest within the perifovea; thinned substantially towards the periphery, and exhibited the minimum and maximum peripheral thinning superiorly and nasally across a 55° region respectively. Choroidal thinning associated with myopia was more pronounced in the macular than extra-macular regions.
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Affiliation(s)
- Hosein Hoseini-Yazdi
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia.
| | - Stephen J Vincent
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| | - Michael J Collins
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| | - Scott A Read
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| | - David Alonso-Caneiro
- Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
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