The prevalence of refractive errors in college students in Israel

Dissecting the complex sex-based associations of myopia with height and weight

OBJECTIVES

To assess height and weight as possible sex-specific risk factors for bilateral myopia among young adults.

METHODS

We conducted a cross-sectional study including 101,438 pre-enlisted young adult males and females, aged 17.4 ± 0.6 and 17.3 ± 0.5 years, respectively, and born during 1971-1994. Categories of BMI (body mass index) were defined according to sex-related percentiles for 17-year-olds following U.S. Centers for Disease Control and Prevention growth charts, and subjects were divided into five height and weight categories according to sex-adjusted percentiles. Data included best-corrected visual acuity, diverse socio-demographic variables, anthropometric indices, and refractive errors, namely bilateral myopes and emmetropes.

RESULTS

The prevalence of bilateral myopia in males and females was 19.1% and 26.0%, respectively. Bilateral myopia displayed a J-shaped associated with BMI, achieving statistical significance only among males (p < 0.0001). Weight displayed a U-shaped association with bilateral myopia among both young males (p < 0.0001) and females (p < 0.005). A higher prevalence of bilateral myopia was observed only among males of the lower height category (p < 0.0001), even when controlling for BMI (from normal to obesity). In a multivariable regression model, obesity was associated with higher prevalence of bilateral myopia (OR: 1.21; 95% CI: 1.07-1.38, p = 0.002), only among males. There were no interactions of BMI with height or weight. Bilateral myopia was also associated with prehypertension among males (OR: 1.10, 95% CI: 1.04-1.15, p < 0.001).

CONCLUSIONS

A higher risk for bilateral myopia was associated with either BMI solely or height and weight, as well as pre-hypertension, in males. The possible association with low height requires further research.

Fundus Tessellation and Parapapillary Atrophy, as Ocular Characteristics of Spontaneously High Myopia in Macaques: The Non-Human Primates Eye Study

Purpose

This study aimed to evaluate the ocular characteristics associated with spontaneously high myopia in adult nonhuman primates (NHPs).

Methods

A total of 537 eyes of 277 macaques with an average age of 18.53 ± 3.01 years (range = 5-26 years), raised in a controlled environment, were included. We measured ocular parameters, including spherical equivalent (SE), axial length (AXL), and intraocular pressure. The 45-degree fundus images centered on the macula and the disc assessed the fundus tessellation and parapapillary atrophy (PPA). Additionally, optical coherence tomography (OCT) was used to measure the thickness of the retinal nerve fiber layer (RNFL).

Results

The mean SE was -1.58 ± 3.71 diopters (D). The mean AXL was 18.76 ± 0.86 mm. The prevalence rate of high myopia was 17.7%. As myopia aggravated, the AXL increased (r = -0.498, P < 0.001). Compared with non-high myopia, highly myopic eyes had a greater AXL (P < 0.001), less RNFL thickness (P = 0.004), a higher incidence of PPA (P < 0.001), and elevated grades of fundus tessellation (P < 0.001). The binary logistic regression was performed, which showed PPA (odds ratio [OR] = 4.924, 95% confidence interval [CI] = 2.375-10.207, P < 0.001) and higher grades of fundus tessellation (OR = 1.865, 95% CI = 1.474-2.361, P < 0.001) were independent risk characteristics for high myopia.

Conclusions

In NHPs, a higher grade of fundus tessellation and PPA were significant biomarkers of high myopia.

Translational Relevance

The study demonstrates adult NHPs raised in conditioned rooms have a similar prevalence and highly consistent fundus changes with human beings, which strengthens the foundation for utilizing macaques as an animal model in high myopic studies.

A retinoscopic survey of donkeys and goats

PURPOSE

Assess the refractive states of donkeys and goats.

METHODS

Forty-two donkeys and 28 goats were enrolled. The mean ± SD ages were 7.68 ± 7.33 years for donkeys and 4.26 ± 2.33 years for goats. Seven donkeys and one goat were <6 months old. Retinoscopy was performed in alert animals, following cycloplegia in goats but not in donkeys. Normality was determined using the Kolmogorov-Smirnov test. The two primary meridians and two eyes were compared using Pearson's correlation and paired Student's t-tests. The association between refractive states and age was examined using one-way ANOVA in donkeys and a paired Student's t-test in goats. One-sample t-tests were conducted to assess if the refractive error distributions were significantly different from "0".

RESULTS

The mean ± SD spherical equivalent (SE) refractive errors of the right and left donkey eyes were -0.80 ± 1.03 D and -0.35 ± 0.95 D, respectively. The majority (86%) of the donkeys had an astigmatic refraction and eight (19%) had anisometropia. The mean SE refractive errors of the right and left goat eyes were -0.15 ± 1.1 D and -0.18 ± 1.2 D, respectively. The majority (54%) of the goat eyes had an astigmatic refraction and five (18%) had anisometropia. The right and left eye SE refractive errors were positively correlated in both species (both p = .9). Age was not correlated with refractive error in both donkeys (p = .09) and goats (p = .6).

CONCLUSIONS

Both goats and donkeys are emmetropic.

Prevalence of myopia among senior students in Fenghua, Eastern China, before and during the COVID-19 pandemic

Background

Myopia is a common cause of vision impairment worldwide. In China, the prevalence, the affected population, and the onset age of myopia are prominent issues. Prevention and intervention of myopia are great public health concerns.

Methods

This school-based retrospective study retrieved visual acuity and refractive data of senior students (grade 12th) from six high schools in Fenghua City, Zhejiang Province, eastern China, from 2016 and 2022. Noncycloplegic autorefraction was performed for refractive status. Students were divided into three subgroups by their school types. The overall myopia prevalence, as well as the prevalence of low myopia, moderate myopia, and high myopia, were calculated separately for each year. Statistical analyzes were performed using SPSS 25.0 and Graphpad Prism software.

Results

The mean myopia prevalence in Fenghua was 84.5% (95% CI: 84.0-85.0%), and a slightly downward trend was found in myopia prevalence after 2019, but the change was not statistically significant (p = 0.078). The overall prevalence of myopia was 79.6, 85.2, and 86.1% in vocational high schools, general high schools, and key high schools, respectively, with statistically significant differences (p < 0.001). The prevalence of myopia among senior students in the vocational high school was significantly lower than that in the other two high schools. There's no significant change in the overall prevalence of myopia (84.7% vs. 84.3%, p = 0.265) before and during the COVID-19 pandemic, and it remained statistically insignificant after stratifying by gender (male p = 0.207, female p = 0.918) or school types (vocational high school p = 0.112; general high school p = 0.299; key high school p = 0.393).

Conclusion

The prevalence of myopia among senior students in Fenghua is relatively high, and the COVID-19 pandemic has no significant impact on it. The prevalence of myopia among vocational high school students is lower than that of general high school and key high school. Attention should be paid to the effects of educational pressure on the prevalence of myopia among students.

The Evolution and the Impact of Refractive Errors on Academic Performance: A Pilot Study of Portuguese School-Aged Children

The relationship between vision and academic performance has been discussed for a long time, with special emphasis on visual factors associated with learning problems. The objective of this pilot study is to obtain an initial idea about the evolution and the impact of refractive errors on school-aged children. A visual examination was performed on 252 children between the ages of 6 and 11 years, which consisted of objective refraction, subjective refraction, and accommodative and binocular tests. No significant differences were observed regarding the refractive state when taking academic performance into account (p > 0.05). However, it was determined that academic performance was better among children with a negative spherical equivalent. Studies with a larger sample size must be conducted to verify the results that were attained in this present pilot study, and these must likewise look at possible ways in which strategies can be implemented in schools to reduce myopia progression.