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Kuoliene K, Danieliene E, Tutkuviene J. Eye morphometry, body size, and flexibility parameters in myopic adolescents. Sci Rep 2024; 14:6787. [PMID: 38514709 PMCID: PMC10958051 DOI: 10.1038/s41598-024-57347-w] [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: 04/13/2023] [Accepted: 03/18/2024] [Indexed: 03/23/2024] Open
Abstract
The aim of this study was to investigate the anatomical and physiological ocular parameters in adolescents with myopia and to examine the relations between refractive error (SER), ocular biometry, body size and flexibility parameters in myopic adolescents. A cross-sectional study of 184 myopic adolescents, aged 15 to 19 years was conducted. Refractive error and corneal curvature measures of the eye were evaluated using an autorefractometer under cycloplegia. Central corneal thickness was determined by contact pachymetry. The ocular axial length, anterior and vitreous chamber depth, and lens thickness were measured using A-scan biometry ultrasonography. Height and body weight were measured according to a standardized protocol. Body mass index (BMI) was subsequently calculated. Beighton scale was used to measure joint flexibility. Body stature was positively correlated with ocular axial length (r = 0.39, p < 0.001) and vitreous chamber depth (r = 0.37, p < 0.001). There was a negative correlation between height and SER (r = - 0.46; p < 0.001). Beighton score and body weight had weak positive correlations with axial length and vitreous chamber depth, and a weak negative correlation with SER. A significantly more negative SER was observed in the increased joint mobility group (p < 0.05; U = 5065.5) as compared to normal joint mobility group: mean - 4.37 ± 1.85 D (median - 4.25; IQR - 6.25 to - 3.25 D) and mean - 3.72 ± 1.66 D (median - 3.50; IQR - 4.75 to - 2.25 D) respectively. There was a strong association between height and axial length, as well as SER. Higher degree of myopia significantly correlated with greater Beighton score (increased joint mobility).
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Affiliation(s)
- Kristina Kuoliene
- Department of Anatomy, Histology and Anthropology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Egle Danieliene
- Clinic of Ear, Nose, Throat and Eye Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Janina Tutkuviene
- Department of Anatomy, Histology and Anthropology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
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Bikbov MM, Kazakbaeva GM, Fakhretdinova AA, Tuliakova AM, Iakupova EM, Panda-Jonas S, Gilemzianova LI, Garipova LA, Khakimov DA, Islamova LI, Pokhilko NI, Jonas JB. Associations between axial length, corneal refractive power and lens thickness in children and adolescents: The Ural Children Eye Study. Acta Ophthalmol 2024; 102:e94-e104. [PMID: 37144825 DOI: 10.1111/aos.15692] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/02/2023] [Accepted: 04/21/2023] [Indexed: 05/06/2023]
Abstract
PURPOSE To assess relationships between ocular biometric parameters in dependence of age and sex in children and adolescents. METHODS In the Ural Children Eye Study, a school-based cohort study, 4933 children underwent an ophthalmological and general examination. RESULTS Complete biometric measurements were available for 4406 (89.3%) children. Cycloplegic refractive error (mean: -0.87 ± 1.73 diopters (D); median: -0.38 D; range: -19.75 D to +11.25 D) increased (multivariable analysis; r2 = 0.73) with shorter axial length (β: -0.99; non-standardized regression coefficient B: -1.64; 95% CI: -1.68, -1.59) and lower corneal refractive power (β: -0.55; B: -0.67; 95% CI: -0.70, -0.64), in addition to higher cylindrical refractive error (β: 0.10; B: 0.34; 95% CI: 0.27, 0.41), thinner lens (β: -0.11; -0.85; 95% CI: -1.02, -0.69) and male sex (β: 0.15; B: 0.50; 95% CI: 0.42, 0.57). In univariate analysis, decrease in refractive error with older age was more significant (β: -0.38 vs. β: -0.25) and steeper (B: -0.22 (95% CI: -0.24, -0.20) vs. B: -0.13 (95% CI: -0.15, -0.11)) in girls than boys, particularly for an age of 11+ years. Axial length increased with older age (steeper for age <11 years) (B: 0.22 (95% CI: 0.18, 0.25) vs. 0.07 (95% CI: 0.05, 0.09)). In multivariable analysis, axial length increased with lower refractive error (β: -0.77; B: -0.42; 95% CI: -0.43, -0.40) and lower corneal refractive power (β: -0.54; B: -0.39; 95% CI: -0.41, -0.38), in addition to older age (β: 0.04; B: 0.02; 95% CI: 0.01, 0.03), male sex (β: 0.13; B: 0.23; 95% CI: 0.21, 0.32), higher cylindrical refractive error (β: 0.05; B: 0.09; 95% CI: 0.05, 0.14) and thinner lens (β: -0.14; B: -0.62; 95% CI: -0.72, -0.51). The axial length/corneal curvature (AL/CR) ratio increased until the age of 14 years (β: 0.34; B: 0.017; 95% CI: 0.016, 0.019; p < 0001), and then became independent of age. The AL/CR ratio increased (r2 = 0.78) mostly with higher corneal refractive power (β: 0.25; B: 0.02; 95% CI: 0.02, 0.02; p < 0.001), lower refractive error (β: -0.75; B: -0.05; 95% CI: -0.05, -0.05; p < 0.001), thinner lens thickness (β: -01.6; B: -0.09; 95% CI: -0.10, -0.08; p < 0.001) and older age (β: 0.16; B: 0.006; 95% CI: 0.005, 0.007; p < 0.001). CONCLUSIONS In this multiethnic group of school children in Russia, the age-related increase in myopic refractive error was more significant and steeper in girls, particularly for the age group of 11+ years. Determinants of higher myopic refractive error were longer axial length, higher corneal refractive power, lower cylindrical refractive error, thicker lens and female sex.
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Affiliation(s)
| | | | | | | | - Ellina M Iakupova
- Ufa Eye Research Institute, Ufa, Russia
- Ufa Eye Institute, Ufa, Russia
| | | | | | | | | | | | | | - Jost B Jonas
- Privatpraxis Prof Jonas und Dr Panda-Jonas, Heidelberg, Germany
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
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Zhang J, Li R, Zhang Y, Li C, Xu B, Qi X. Associations between body size and visual impairment of first-year university students in Chongqing: A cross-sectional study. Medicine (Baltimore) 2024; 103:e35763. [PMID: 38215114 PMCID: PMC10783220 DOI: 10.1097/md.0000000000035763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 10/03/2023] [Indexed: 01/14/2024] Open
Abstract
The relationship between body size and visual impairment (VI) presents a controversial topic in the health sciences. This study aims to evaluate and clarify the potential associations between these 2 variables. We conducted a cross-sectional study on first-year students enrolled in 2022 at the Southwest University of Political Science & Law. The students underwent a series of physical examinations and visual acuity tests. Visual impairment was classified into 3 categories: mild, moderate, or severe. We used logistic regression analysis to examine the association between body size and VI. Our findings indicated a high prevalence of VI among first-year university students; more than 80% of them were affected. In bivariate analysis, height and weight were negatively related to the presence of VI. However, BMI (body mass index) was not related to VI. By adjusting all available confounders, no associations between BMI (OR = 1.002, 95% CI = 0.974-1.032, P = .877), height (OR = 0.998, 95% CI = 0.967-1.010, P = .298), weight (OR = 0.999, 95% CI = 989-1.009, P = .860), and mild-severe VI were found in females. For males, the ORs were 0.988 (95% CI = 0.955-1.021, P = .459), 0.980 (95% CI = 0.954-1.006, P = .135), and 0.995 (95% CI = 0.985-1.004, P = .285) for BMI, height, and weight, respectively. Among young adults demonstrating high academic performance in high schools, the cessation of physical growth, combined with potential eye strain resulting from overuse, may mitigate any previously observed positive associations between physical status and VI in younger children.
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Affiliation(s)
- Jing Zhang
- Department of Health Management, The Second Hospital Affiliated to Chongqing Medical University, Chongqing, China
| | - Ruili Li
- Department of Health Management, The Second Hospital Affiliated to Chongqing Medical University, Chongqing, China
| | - Yong Zhang
- Department of Health Management, The Second Hospital Affiliated to Chongqing Medical University, Chongqing, China
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Cuihong Li
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Bingwu Xu
- School of Public Health, Chongqing Medical University, Chongqing, China
| | - Xiaoya Qi
- Department of Health Management, The Second Hospital Affiliated to Chongqing Medical University, Chongqing, China
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Laan D, Tan ETC, Huis In Het Veld PI, Jellema HM, Jenniskens K. Myopia progression in children during home confinement in the COVID-19 pandemic: A systematic review and meta-analysis. JOURNAL OF OPTOMETRY 2024; 17:100493. [PMID: 37879184 PMCID: PMC10618773 DOI: 10.1016/j.optom.2023.100493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 08/20/2023] [Accepted: 09/19/2023] [Indexed: 10/27/2023]
Abstract
PURPOSE Myopia is a growing pandemic, especially in children, who risk low vision later in life. Home confinement during the COVID-19 pandemic may have increased myopia progression through increased screentime, decreased time outdoors and increased near work activities. The aim of this study is to compare progression of myopia in children during home confinement period in the COVID-19 pandemic with pre-COVID-19 progression. METHODS On January 2023 PubMed, EMBASE and Cochrane were searched for relevant studies. Studies meeting the following criteria were eligible for inclusion: children (under 18 years), home confinement due to COVID-19, spherical equivalent refractive (SER) and axial length (AL) measurements and a follow-up period to measure progression. Quality appraisal was performed by two reviewers independently using the Joanna Briggs Institute tool for cohort studies. Outcomes for myopia were assessed through meta-analysis, analyzing SER (random effects) and AL (fixed effects). RESULTS Hundred and two articles were identified in the search, of which five studies were included in the analysis. Risk of bias is moderate with a few critical flaws in the studies. Myopia progressed more rapidly during the COVID-19 pandemic compared to the pre-COVID-19 period, both in terms of SER (-0.83D [95 %CI, -1.22, -0.43] and AL (0.36 mm [95 %CI, 0.13, 0.39]). CONCLUSION Progression of myopia during the COVID-19 pandemic accelerated more rapidly compared to the pre-COVID-19 period. Impact of home confinement on myopia may be considered when future lockdown measures are being contemplated.
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Affiliation(s)
- Daisy Laan
- Clinical Sciences for Health Professionals, Program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht University, The Netherlands; Department of Ophthalmology, Flevoziekenhuis, Almere, The Netherlands.
| | - Emily T C Tan
- Clinical Sciences for Health Professionals, Program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht University, The Netherlands
| | | | - Hinke Marijke Jellema
- Department of Ophthalmology, University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Kevin Jenniskens
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Utrecht, The Netherlands
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Ma LU, Yu X, Gong L, Wei L, Peng Z, Wang K, Li Y, Zhou J, Zhao M. Evaluating the optimised font size and viewing time of online learning in young children: a multicentre cross-sectional study. BMJ Paediatr Open 2023; 7:10.1136/bmjpo-2022-001835. [PMID: 37185652 PMCID: PMC10151978 DOI: 10.1136/bmjpo-2022-001835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 03/14/2023] [Indexed: 05/17/2023] Open
Abstract
OBJECTIVES Near viewing distance (VD) and longer viewing times are associated with myopia. This study aimed to identify the font size and viewing time that guarantee the appropriate VD and pixels per degree (PPD) for children's online learning. DESIGN This cross-sectional study comprised two experiments. In experiment A, participants read text in five font sizes on three backlit displays (a personal computer, a smartphone and a tablet), an E-ink display and paper for 5 min per font size. In experiment B, participants watched videos for 30 min on three backlit displays. SETTING The Peking University People's Hospital in Beijing (China) and the School of Ophthalmology and Optometry, Wenzhou Medical University (Zhejiang Province, China). PARTICIPANTS Thirty-five participants completed experiment A. Ten of them participated in experiment B. PRIMARY AND SECONDARY OUTCOME MEASURES VDs were measured by Clouclip. The corresponding PPD was calculated. RESULTS In experiment A, font size and display type significantly affected VD (F(4840)=149.44, p<0.001, ES (Effect size)=0.77; F(4840), p<0.001, ES=0.37). VDs were >33 cm for all five font sizes on the PC, the tablet and paper and for 18-pt on the smartphone and 16-pt on E-ink. PPD for 16-pt on the PC, 14-pt on the tablet and all five font sizes on the phone were >60. In experiment B, VD increased over the four previous 5 min periods but decreased slightly on tablets and PCs in the fifth 5 min period. PPD was >60. CONCLUSION Children demonstrated different VDs and PPDs based on font size and display type. To ensure a 33 cm VD and 60 PPD, the minimum font size for online reading should be 18-pt on smartphones, 16-pt on PCs and E-ink, 10.5-pt on tablets and 9-pt on paper. More attention should be given to children's VD with continuous video viewing of more than 25 min. TRIAL REGISTRATION NUMBER ChiCTR2100049584.
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Affiliation(s)
- L U Ma
- Department of Ophthalmology & Clinical Centre of Optometry, Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
- Institute of Medical Technology, Peking University Health Science Centre, Beijing, China
| | - Xi Yu
- School of Ophthalmology and Optometry, Affiliated Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ling Gong
- School of Ophthalmology and Optometry, Affiliated Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Lili Wei
- School of Ophthalmology and Optometry, Affiliated Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zisu Peng
- Department of Ophthalmology & Clinical Centre of Optometry, Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
- Institute of Medical Technology, Peking University Health Science Centre, Beijing, China
| | - Kai Wang
- Department of Ophthalmology & Clinical Centre of Optometry, Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
- Institute of Medical Technology, Peking University Health Science Centre, Beijing, China
| | - Yan Li
- Department of Ophthalmology & Clinical Centre of Optometry, Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Jiawei Zhou
- School of Ophthalmology and Optometry, Affiliated Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Mingwei Zhao
- Department of Ophthalmology & Clinical Centre of Optometry, Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
- Institute of Medical Technology, Peking University Health Science Centre, Beijing, China
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Harrington S, O'Dwyer V. The association between time spent on screens and reading with myopia, premyopia and ocular biometric and anthropometric measures in 6- to 7-year-old schoolchildren in Ireland. Ophthalmic Physiol Opt 2023; 43:505-516. [PMID: 36843144 DOI: 10.1111/opo.13116] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 01/30/2023] [Accepted: 02/09/2023] [Indexed: 02/28/2023]
Abstract
PURPOSE More time spent on near tasks has consistently been associated with the promotion of myopia. The World Health Organization advises limiting daily screentime to less than 2 h for children aged five and over. This study explored the relationship between time spent on screens and reading/writing with refractive status, ocular biometric and anthropometric factors in 6- to 7-year-olds in Ireland. METHODS Participants were 723 schoolchildren (377 boys [51.8%]), mean age 7.08 (0.45) years. The examination included cycloplegic autorefraction (1% cyclopentolate hydrochloride), ocular biometry (Zeiss IOLMaster), height (cm) and weight (kg). Screentime and reading/writing time were reported by parents/legal guardians by questionnaire. Myopia (≤-0.50D) and premyopia (>-0.50D ≤ 0.75D) risk assessments were performed using logistic regression, and multivariate linear regression was used to analyse continuous variables. RESULTS Reported daily screentimes were 31% <1 h, 49.5% 1-2 h, 15.6% 2-4 h and 3.9% >4 h. Reading/writing times were 42.2% frequently, 48.0% infrequently and 9.8% seldom/never. Linear regression, controlling for age and ethnicity, revealed >2 h/day on screens was associated with a more myopic spherical equivalent [β = -1.15 (95% confidence intervals {CIs}: 1.62-0.69, p < 0.001)], increased refractive astigmatism (β = 0.29, CI: 0.06-0.51, p = 0.01), shorter corneal radius (β = 0.12, CI: 0.02-0.22, p = 0.02), higher axial length/corneal radius (β = 0.06, CI: 0.03-0.09, p < 0.001), heavier weight (β = 1.60, CI: 0.76-2.45, p < 0.001) and higher body mass index (BMI) (β = 1.10, CI: 0.28-1.12, p < 0.001). Logistic regression, controlling for age and ethnicity, revealed daily screentime >2 h was associated with myopia (OR = 10.9, CI: 4.4-27.2, p = 0.01) and premyopia (OR = 2.4, CI: 1.5-3.7, p < 0.001). Frequent reading/writing was associated with screentime ≤2 h/day (OR = 3.2, CI: 1.8-5.8, p < 0.001). CONCLUSION Increased screentime was associated with a more myopic refraction, higher axial length/corneal radius ratio, increased odds of myopia, premyopia, higher degrees of astigmatism, increased weight, BMI and decreased reading/writing time. Dedicated education programmes promoting decreased screentime in children are vital to prevent myopia and support eye and general health.
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Affiliation(s)
- Síofra Harrington
- School of Physics, Clinical, and Optometric Sciences, and Centre for Eye Research Ireland, Technological University Dublin, Dublin, Ireland
| | - Veronica O'Dwyer
- School of Physics, Clinical, and Optometric Sciences, and Centre for Eye Research Ireland, Technological University Dublin, Dublin, Ireland
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Zhou H, Bai X. A Review of the Role of the School Spatial Environment in Promoting the Visual Health of Minors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1006. [PMID: 36673762 PMCID: PMC9859487 DOI: 10.3390/ijerph20021006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 12/28/2022] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
Rising childhood myopia rate has detrimental health consequences that pose a considerable challenge to health systems. The school spatial environment, which is where students are for the longest period of time, has a high health value for myopia systematic intervention. While research has demonstrated associations between physical daylight environments, medical gene and visual health, the literature currently lacks a synthesis of evidence that will act as a spatially-organized resource for school designers. This study is based on literature from the period 2000-2022 and has been taken from the Web of Science, scopus, Medline and CNKI core collection database. Collaboration, literature co-citation and quantitative and qualitative analysis, in addition to keyword co-occurrence are adopted to conduct a visual health research review. The results indicate that intensive near work activity (as a risk factor) and longer time spent outdoors (as a protective factor), are involved in visual health factors. Two main research themes are obtained and relate to: (1) The environment of visual work behavior (especially the near work learning environment) and adaptable multimedia learning environment; and (2) the environment of outdoor exposure behavior. Furthermore, with the variation of educational demands, models and concepts, there are different demands for near work behavior, and this study makes an important contribution by pointing to two future research directions, including the accurate and controllable environment of near work behavior, which operate in accordance with various educational mode requirements and the active design of the environment of outdoor exposure behavior. In referring to differences between regions and countries, as well as the development of the educational environment, it provides insight into how these demands can be controlled.
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Affiliation(s)
- Huihui Zhou
- School of Architecture and Urban Planning, Huazhong University of Science and Technology, Wuhan 430074, China
- Hubei Engineering and Technology Research Center of Urbanization, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Xiaoxia Bai
- School of Architecture and Urban Planning, Huazhong University of Science and Technology, Wuhan 430074, China
- Hubei Engineering and Technology Research Center of Urbanization, Huazhong University of Science and Technology, Wuhan 430074, China
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Duan MM, Liu H, Zhong YL. Effect of shape deprivation on retinal thickness in myopic mice using an OCT method. Front Neurosci 2023; 17:1156990. [PMID: 37090795 PMCID: PMC10115968 DOI: 10.3389/fnins.2023.1156990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 03/17/2023] [Indexed: 04/25/2023] Open
Abstract
Purpose The purpose of this study was to study in retina thickness changes in myopic mice using optical coherence tomography (OCT). Methods There were 18 mice in the form-deprivation myopia (FDM) group,in which the left eye was not treated as a control;18 untreated mice served as a normal control group. The diopter of all mice was measured 21 days after birth (P21), before form deprivation. After 4 weeks of form deprivation (P49), the refraction, fundus, and retinal sublayer thickness of all mice were measured. Results After 4 weeks of form deprivation, the refractive power of the right eye in the FDM group was significantly higher than that in the left eye (p < 0.05). There was no significant change in the refractive power of the left eye in the FDM group compared with the normal control group. The retina, nerve fiber layer (NFL), inner nuclear layer (INL), and outer nuclear layer (ONL) in the right eye of the FDM group were significantly thinner than those of both the FDM and control groups (p < 0.05). There was no significant change in photoreceptor (PR). Conclusion Our study highlights that the myopic mice have decreased R thickness, which might reflect the potential pathological mechanism of myopia.
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Affiliation(s)
- Ming-Ming Duan
- Department of ophthalmology, the First People's Hospital of Jiujiang City, Jiujiang, Jiangxi, China
| | - Hui Liu
- Department of ophthalmology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Yu-Lin Zhong
- Department of ophthalmology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
- *Correspondence: Yu-Lin Zhong,
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Gopalakrishnan A, Hussaindeen JR, Chaudhary R, Ramakrishnan B, Arunachalam S, Balakrishnan AC, Sri J S D, Sahoo M, S R, M V, S V, Narayanan A. Results of the School Children Ocular Biometry and Refractive Error Study in South India. Turk J Ophthalmol 2022; 52:412-420. [PMID: 36578223 PMCID: PMC9811226 DOI: 10.4274/tjo.galenos.2021.90008] [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] [Indexed: 12/29/2022] Open
Abstract
Objectives Axial length (AL) is an important contributor to refraction, and growth curves are gaining importance in the prediction of myopia. This study aimed to profile the distribution of ocular biometry parameters and to identify correlates of spherical equivalent refraction (SE) among school children in South India. Materials and Methods The School Children Ocular Biometry and Refractive Error study was conducted as part of a school screening program in southern India. The enrolled children underwent tests that included vison check, refraction, binocular vision assessment, and biometry measurements. Results The study included 1382 children whose mean (standard deviation [SD]) age was 10.18 (2.88) years (range: 5-16 years). The sample was divided into 4 groups (grades 1-2, grades 3-5, grades 6-9, and grade 10) based on significant differences in right AL (p<0.001). The mean (SD) AL (range: 20.33-27.27 mm) among the four groups was 22.50 (0.64) mm, 22.88 (0.69) mm, 23.30 (0.82) mm, and 23.58 (0.87) mm, respectively. The mean SE (range: +1.86 to -6.56 D) was 0.08 (0.65 D) in class 1 and decreased with increasing grade to -0.39 (1.20 D) in grade 10. There was a significant difference in all biometry parameters between boys and girls (p<0.001). Age, AL, and mean corneal curvature were the main predictors of SE. Conclusion This study provides a profile of ocular biometry parameters among school children in South India for comparison against profiles from other regions across the country. The study data will form a reference for future studies assessing myopia in this ethnicity.
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Affiliation(s)
- Aparna Gopalakrishnan
- *Srimathi Sundari Subramanian Department of Visual Psychophysics, Unit of Medical Research Foundation, Myopia Clinic, Chennai, India
| | - Jameel Rizwana Hussaindeen
- *Srimathi Sundari Subramanian Department of Visual Psychophysics, Unit of Medical Research Foundation, Myopia Clinic, Chennai, India,* Address for Correspondence: Srimathi Sundari Subramanian Department of Visual Psychophysics, Unit of Medical Research Foundation, Myopia Clinic, Chennai, India E-mail:
| | - Romans Chaudhary
- The Sankara Nethralaya Academy, Unit of Medical Research Foundation, Chennai, India
| | - Bhavatharini Ramakrishnan
- *Srimathi Sundari Subramanian Department of Visual Psychophysics, Unit of Medical Research Foundation, Myopia Clinic, Chennai, India
| | - Sushil Arunachalam
- *Srimathi Sundari Subramanian Department of Visual Psychophysics, Unit of Medical Research Foundation, Myopia Clinic, Chennai, India
| | | | - Deepika Sri J S
- Elite School of Optometry, Unit of Medical Research Foundation, Chennai, India
| | - Manaswini Sahoo
- Elite School of Optometry, Unit of Medical Research Foundation, Chennai, India
| | - Robin S
- Elite School of Optometry, Unit of Medical Research Foundation, Chennai, India
| | - Varsaharinya M
- Elite School of Optometry, Unit of Medical Research Foundation, Chennai, India
| | - Vishnupriya S
- Elite School of Optometry, Unit of Medical Research Foundation, Chennai, India
| | - Anuradha Narayanan
- Elite School of Optometry, Unit of Medical Research Foundation, Chennai, India
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Chen Y, Wang W, Wang J, Chen X, Zhu Z, Li J, He M. Normal range of ocular biometry in healthy children: A systemic review and meta-analysis of 33,559 individuals under seven years of age. Ophthalmic Physiol Opt 2022; 42:1264-1275. [PMID: 36062302 DOI: 10.1111/opo.13043] [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: 06/19/2022] [Revised: 08/05/2022] [Accepted: 08/07/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE To conduct a systemic review and meta-analysis on the normative range of ocular biometry in healthy children under seven years of age. METHODS A literature search was performed using the PubMed (MEDLINE) database. The main outcomes were normative values of axial length (AL), central corneal thickness (CCT), cornea curvature (CC), anterior chamber depth (ACD), lens thickness (LT) and vitreous chamber depth (VCD). Pooled estimates were obtained with a random-effects meta-analysis. Multivariate meta-regressions ascertained the moderator-related trends. RESULTS We included 47 studies for a total of 33,559 subjects. The pooled ALs for 0.0-1.9 years, 2.0-3.9 years and 4.0-6.9 years were 18.33 mm (95% confidence interval [CI] 17.57-19.09), 21.71 mm (21.49-21.93) and 22.37 mm (22.29-22.45), respectively. Children aged 0.0-1.9 years had a greater CCT (576.70 μm, 567.20-586.21), steeper cornea (7.41 mm, 7.16-7.65) and shallower ACD (2.46 mm, 2.23-2.69). LT ranged from 3.65 to 3.74 mm for 0-6 years, and VCD increased from 11.94 mm at birth to 15.36 mm at 4.0-6.9 years. Differences in AL between East Asian and non-East Asian children were found below two years of age (17.30 mm vs. 18.40 mm, p = 0.008) and for CC at 4.0-6.9 years of age (7.82 mm vs. 7.79 mm, p = 0.004). In a multivariate meta-regression, AL, CC, ACD and VCD increased with age (p < 0.05 for all), while CCT decreased with age (p = 0.0007). CONCLUSIONS This study reports normative data for ocular biometry in children. Few differences were found with ethnicity in the ocular biometry of infants and pre-schoolers.
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Affiliation(s)
- Yanxian Chen
- Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Jun Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Xu Chen
- Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China
| | - Zhuoting Zhu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Jinying Li
- Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China
| | - Mingguang He
- Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
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Liu W, Liu W, Wang C. Ocular biometric parameters of mild hyperopia to mild myopia children aged 6-14 years from Wenzhou optometry center: A cross-sectional study. Front Med (Lausanne) 2022; 9:992587. [PMID: 36275830 PMCID: PMC9583929 DOI: 10.3389/fmed.2022.992587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/06/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction Myopia is the most common visual disorder in school-aged children and adolescents worldwide. This study aimed to explore the ocular biometric characteristics of children aged 6–14 years from the Wenzhou optometry center and to determine the relationship between spherical equivalent refraction (SER) and macular pigment optical density (MPOD). Subjects and methods Participants underwent a full-scale ophthalmic examination anteriorly and posteriorly. Relevant parameters were documented, such as axial length (AL), anterior chamber depth (ACD), SER and lens thickness (LT), corneal curvature radius (CCR), and MPOD. Lens power (LP) was calculated using Bennett’s formula. Shapiro–Wilk tests and histograms were used to check the normality of the distribution of refractive and ocular biometric parameters. Scatter diagrams were adopted to analyze the relationships between refraction and parameters of ocular biometry. Multiple linear regression models were employed to fit the associated factors of AL, AL/CCR, and LP. Results A total of 902 mild hyperopia to mild myopia (+3.00 D ≤ SE ≤ −3.00 D) children aged 6–14 years were included. The mean age of participants was 10.03 ± 2.47 years, and the prevalence of mild hyperopia, emmetropia, and myopia was 5.65, 27.05, and 67.30%, respectively. The prevalence of mild myopia increased from 30.53% at 6 years of age to 93.62% at 14 years of age. Overall, AL, ACD, and AL/CCR increased, but LP declined from 6 to 14 years of age, whereas CCR and MPOD remained stable. An increase of 1 mm in AL was associated with −0.69 D of myopic change. A unit increase in AL/CCR was associated with −7.87 D in SER. As for the SER variance, AL explained 30.5% and AL/CCR explained 51.1%, whereas AL/CCR and LP accounted for 59.2%. Discussion In this work, we have studied the distributions of ocular biometric characteristics of mild hyperopia to mild myopia children from the perspective of an optometry center rather than a sampling survey. In addition, we found that children from the optometry center had a slower progression toward myopia than those from previous sampling surveys, which was an informative finding for future myopia prevention. In addition, we have made a correlation analysis between the macular pigment optical density and spherical equivalent refraction. Though, no correlation was found.
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Affiliation(s)
- Weiqin Liu
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Weishai Liu
- Department of Ophthalmology, Ankang Hospital of Traditional Chinese Medicine, Ankang, China
| | - Chenxiao Wang
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, China,*Correspondence: Chenxiao Wang,
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Bhandari KR, Ostrin LA. Objective measures of viewing behaviour in children during near tasks. Clin Exp Optom 2022; 105:746-753. [PMID: 34538208 PMCID: PMC8933286 DOI: 10.1080/08164622.2021.1971049] [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: 06/19/2021] [Revised: 08/04/2021] [Accepted: 08/16/2021] [Indexed: 10/20/2022] Open
Abstract
CLINICAL RELEVANCE Objective assessment of near viewing behaviours performed in a laboratory setting showed that children demonstrate differing viewing distances and angles based on the type of task. Findings will contribute to our understanding of how near work influences myopia. BACKGROUND Evidence suggests that near working distance and viewing breaks are associated with myopia. The purpose of this study was to use an objective, continuously measuring range finding device to examine these viewing behaviours in children. METHODS Viewing distance, number of breaks, and head and eye angles were assessed in 16 non-myopic and 19 myopic children (ages 13.38 ± 4.14 years) using the Clouclip, an objective rangefinder, during five 15-minute near tasks, including (a) passive reading and (b) active writing on printed material, (c) passive viewing and (d) active engagement on an iPad, and (e) active engagement on a cell phone. Height and Harmon distance were measured. Viewing behaviours were analysed by task, refractive error group, and gender. RESULTS Mean viewing distances significantly differed by task (P < 0.001) and were highly correlated with children's Harmon distance and height for all near tasks (P < 0.05), except for the active printed task (P > 0.05). Viewing distances did not differ by gender or refractive error group. During each task, mean number of viewing breaks was 2.6 ± 4.1 and did not vary between task (P = 0.92) or refractive error group (P = 0.65). Head declination and total viewing angle varied by type of near task (P < 0.001 for both). CONCLUSION Children demonstrated differing viewing distances and viewing angles based on the type of near task they were performing. Viewing behaviours did not vary between myopic and non-myopic children. Findings will contribute to a better understanding of how near viewing behaviours can be quantified objectively and relationships with myopia.
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Affiliation(s)
- Khob R Bhandari
- University of Houston College of Optometry, 4901 Calhoun Rd, Houston, TX, 77204 USA
| | - Lisa A Ostrin
- University of Houston College of Optometry, 4901 Calhoun Rd, Houston, TX, 77204 USA
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Singh H, Singh H, Latief U, Tung GK, Shahtaghi NR, Sahajpal NS, Kaur I, Jain SK. Myopia, its prevalence, current therapeutic strategy and recent developments: A Review. Indian J Ophthalmol 2022; 70:2788-2799. [PMID: 35918918 PMCID: PMC9672758 DOI: 10.4103/ijo.ijo_2415_21] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Myopia is a widespread and complex refractive error in which a person's ability to see distant objects clearly is impaired. Its prevalence rate is increasing worldwide, and as per WHO, it is projected to increase from 22% in 2000 to 52% by 2050. It is more prevalent in developed, industrial areas and affects individuals of all ages. There are a number of treatments available for the control of myopia, such as glasses, contact lenses, laser surgery, and pharmaceuticals agents. However, these treatments are less beneficial and have significant side effects. A novel molecule, 7-methylxanthine (7-MX), has been found to be a highly beneficial alternate in the treatment of myopia and excessive eye elongation. Many preclinical and clinical studies showed that 7-MX is effective for the treatment of myopia and is presently under phase II of clinical investigation. We have also investigated preclinical toxicity studies such as acute, sub-acute, sub-chronic, and chronic on rats. In these studies, 7-MX was found to be non-toxic as compared to other reported anti-myopic agents. Moreover, as an ideal drug, 7-MX is observed to have no or low toxicity, brain permeability, non-allergic, higher oral administration efficacy, and low treatment costs and thus qualifies for the long-term treatment of myopia. This review article on 7-MX as an alternative to myopia treatment will highlight recent findings from well-designed preclinical and clinical trials and propose a potential future therapy.
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Affiliation(s)
- Harjeet Singh
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, Punjab, India,Department of Pharmacy, Government Polytechnic College, Amritsar, Punjab, India
| | - Harmanpreet Singh
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, Punjab, India
| | - Uzma Latief
- Center for Basic and Translational Research in Health Science, Guru Nanak Dev University, Amritsar, Punjab, India
| | - Gurleen Kaur Tung
- Center for Basic and Translational Research in Health Science, Guru Nanak Dev University, Amritsar, Punjab, India
| | - Navid Reza Shahtaghi
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, Punjab, India
| | | | - Inderjit Kaur
- Department of Ophthalmology, Baba Farid University of Health Sciences, Faridkot, Punjab, India
| | - Subheet Kumar Jain
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, Punjab, India,Center for Basic and Translational Research in Health Science, Guru Nanak Dev University, Amritsar, Punjab, India,Correspondence to: Prof. Subheet Kumar Jain, Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, Punjab - 143 005, India. E-mail:
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Children in Tokyo Have a Long Sustained Axial Length from Age 3 Years: The Tokyo Myopia Study. J Clin Med 2022; 11:jcm11154413. [PMID: 35956029 PMCID: PMC9369597 DOI: 10.3390/jcm11154413] [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: 06/14/2022] [Revised: 07/14/2022] [Accepted: 07/27/2022] [Indexed: 02/01/2023] Open
Abstract
Background: myopia prevalence is high among Japanese schoolchildren, but the underlying causes are unclear. Objective: To examine the distributions of ocular biometry and refraction and their associations with lifestyle variables among Japanese schoolchildren. Methods: This cross-sectional school-based study included 2140 children aged 3−14 years in Tokyo, Japan, and evaluated the distributions under non-cycloplegic conditions and the associated environmental factors. Results: The prevalence of spherical equivalent (SE) ≤−0.75 diopter among preschoolers (aged 3−6 years), elementary school students (aged 6−11 years), and junior high school students (aged 12−14 years) was 49.7%, 72.4%, and 87.7%, respectively. Multiple linear regression analyses showed that the time spent using digital devices was associated positively with lens thickness (β = 0.010; p < 0.050) but not SE, axial length, or vitreous chamber depth. The time spent reading was associated negatively with lens thickness (β = −0.012; p < 0.050), SE (β = −0.152; p < 0.010), axial length (β = 0.110; p < 0.001), and vitreous chamber depth (β = 0.110; p < 0.001). Conclusions: The data indicated that almost half of preschoolers may be myopic. The association with the lens thickness differed depending on the type of near work performed.
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Gajjar S, Ostrin LA. A systematic review of near work and myopia: measurement, relationships, mechanisms and clinical corollaries. Acta Ophthalmol 2022; 100:376-387. [PMID: 34622560 DOI: 10.1111/aos.15043] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 09/02/2021] [Accepted: 09/22/2021] [Indexed: 12/17/2022]
Abstract
After decades of investigation, the role of near work in myopia remains unresolved, with some studies reporting no relationship and others finding the opposite. This systematic review is intended to summarize classic and recent literature investigating near work and the onset and progression of myopia, potential mechanisms and pertinent clinical recommendations. The impact of electronic device use is considered. PubMed and Medline were used to find peer-reviewed cross-sectional and longitudinal studies related to near work and myopia from 1980 to July 2020 using the PRISMA checklist. Studies were chosen using the Joanna Briggs Institute checklist, with a focus on studies with a sample size greater than 50. Studies were independently evaluated; conclusions were drawn per these evaluations. Numerous cross-sectional studies found increased odds ratio of myopia with increased near work. While early longitudinal studies failed to find this relationship, more recent longitudinal studies have found a relationship between myopia and near work. Rather than daily duration of near work, interest has increased regarding absolute working distance and duration of continuous near viewing. Several reports have found that shorter working distances (<30 cm) and continuous near-work activity (>30 min) are risk factors for myopia onset and progression. Novel objective continuously measuring rangefinding devices have been developed to better address these questions. The literature is conflicting, likely due to the subjective and variable nature in which near work has been quantified and a paucity of longitudinal studies. We conclude that more precise objective measures of near viewing behaviour are necessary to make definitive conclusions regarding the relationship between myopia and near work. Focus should shift to utilizing objective and continuously measuring instruments to quantify near-work behaviours in children, followed longitudinally, to understand the complex factors related to near work. A better understanding of the roles of absolute working distance, temporal properties, viewing breaks and electronic device use on myopia development and progression will aid in the development of evidence-based clinical recommendations for behavioural modifications to prevent and slow myopia.
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Affiliation(s)
- Shail Gajjar
- University of Houston College of Optometry Houston TX USA
| | - Lisa A. Ostrin
- University of Houston College of Optometry Houston TX USA
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Dayi O, Bulut E, Karadag M, Bulut H. Ocular biometry characteristics and its relationship with age, gender, spherical equivalent in Turkish children. Niger J Clin Pract 2022; 25:569-575. [PMID: 35593597 DOI: 10.4103/njcp.njcp_1277_21] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Studying ocular biometric parameters in different populations and determining the relationship with personal characteristics can provide valuable information about ocular growth and help provide a better understanding of refractive errors. Aims To describe distributions of ocular biometry and to evaluate its associations with age, gender, spheric equivalent in Turkish children. Patients and Methods In this prospective study 344 children aged 3-14 years were evaluated. Parameters studied included axial length (AL), anterior chamber depth (ACD), and mean corneal radius (CR) measured with optical biometry. Cycloplegic refraction values were obtained using autorefractometer. The change of biometric parameters according to age and gender were evaluated. The relationship between ocular biometry parameters with refraction and age was analyzed by linear regression. Results Mean spherical equivalent (SE), AL, ACD and AL/CR observed to be lowest in the preschooler group (P < 0.001). SE reduced with age, and a weak correlation observed between SE and age (r = -0.333). AL and ACD had moderate and weak positive correlations with age respectively (r = 0.511; r = 0.304). There were negative correlations between SE with AL, ACD and AL/CR (r = -0.826; r = -0.540; r = -0.886). The strongest correlation with SE among these parameters was identified for AL/CR. AL and ACD were higher in boys, while the CR was lower in girls (p < 0.001). Conclusion While AL in children in late schooler group is higher than European countries, it shows similar characteristics in early schooler group. In addition AL is lower in all age groups than Asian population sexcept preschooler group. With age AL increases, SE decreases and AL plays a key role in refractive development.
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Affiliation(s)
- O Dayi
- Department of Ophthalmology, Beylikduzu State Hospital, Istanbul, Turkey
| | - E Bulut
- Department of Opticianry, Vocational School of Health Services, Gelisim University, Istanbul, Turkey
| | - M Karadag
- Department of Biostatistics and Medical information, Hatay Mustafa Kemal University Faculty of Medicine Hatay, Turkey
| | - H Bulut
- Department of Child Development, Vocational School of Health Services, Gelisim University, Istanbul, Turkey
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Wang CY, Hsu NW, Yang YC, Chen YL, Shyong MP, Tsai DC. Premyopia at Preschool Age: Population-based Evidence of Prevalence and Risk Factors from A Serial Survey in Taiwan. Ophthalmology 2022; 129:880-889. [PMID: 35331752 DOI: 10.1016/j.ophtha.2022.03.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 03/16/2022] [Accepted: 03/16/2022] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Premyopia at a young age carries a great risk of developing early-onset myopia, especially in regions with the epidemic of myopia, such as the developed areas in East Asia. This study aims to report the prevalence of premyopia and its risk factors in a Taiwan preschool population and lifestyle changes among premyopic preschoolers before and during the coronavirus disease 2019 (COVID-19) pandemic. DESIGN Repeated countywide population-based, cross-sectional study in Yilan County, northeastern Taiwan. PARTICIPANTS From 2014 through 2020, a total of 23,930 kindergarteners aged 5-6 years were identified in the Yilan Myopia Prevention and Vision Improvement Program (YMVIP). Of those, 21,761 (11,335 [52.1%] boys; mean age, 5.15 ± 0.37 years) were included for final analysis. METHODS Annual kindergarten-based eye examinations and myopia prevention strategies have been conducted since the commencement of the YMVIP in 2014. Refractive error was determined by cycloplegic autorefraction. The data of potential risk factors for myopia were gathered by caregiver-administered questionnaires. MAIN OUTCOME MEASURES The prevalence of premyopia (spherical equivalent [SE] > -0.5 diopter [D] and ≤ +0.75 D in the eye with less SE value) RESULTS: The prevalence of myopia (SE ≤ -0.5 D), premyopia, and hyperopia (SE > +0.75) was 10.7% (95% confidence interval [CI], 10.3%-11.1%), 52.0% (95% CI, 51.3%-52.7%), and 37.3% (95% CI, 36.7%-37.9%), respectively. Multinomial logistic regression analysis showed that premyopia prevalence was significantly associated with male gender (odds ratio [OR], 1.25; 95% CI, 1.18-1.32), caregiver myopia (OR, 1.46; 95% CI, 1.37-1.56), screen time ≥ 1 hour per weekdays (OR, 1.10; 95% CI, 1.04-1.17), 2-year exposure to myopia prevention strategy (OR, 0.59; 95% CI, 0.54-0.65), and college or higher education level of caregiver (OR, 0.91; 95% CI, 0.85-0.96). Even without large-scale school closure in Taiwan, there was a slight upward trend of increased time spent on screen-based devices during the COVID-19 pandemic. CONCLUSIONS Our findings showed that premyopia was the most common refractive error in a Taiwan preschool population. Premyopia was also associated with both parental and environmental myopiogenic factors. Longitudinal studies are warranted to examine the lifestyle change and myopic shift of premyopic preschoolers in the post-pandemic era.
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Affiliation(s)
- Chiao-Yu Wang
- Department of Ophthalmology, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan
| | - Nai-Wei Hsu
- Public Health Bureau, Yilan County, Taiwan; Division of Cardiology, Department of Internal Medicine, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan; Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan; Community Medicine Research Center & Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yu-Chieh Yang
- Department of Ophthalmology, Show Chwan Memorial Hospital, Changhua, Taiwan
| | | | - Mong-Ping Shyong
- Department of Ophthalmology, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan; Department of Ophthalmology, Suao Branch, Taipei Veterans General Hospital, Yilan, Taiwan
| | - Der-Chong Tsai
- Department of Ophthalmology, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan; Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan; Community Medicine Research Center & Institute of Public Health, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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Shan M, Dong Y, Chen J, Su Q, Wang Y. Global Tendency and Frontiers of Research on Myopia From 1900 to 2020: A Bibliometrics Analysis. Front Public Health 2022; 10:846601. [PMID: 35359777 PMCID: PMC8960427 DOI: 10.3389/fpubh.2022.846601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 02/10/2022] [Indexed: 01/29/2023] Open
Abstract
Background:Myopia is one of the most common causes of vision impairment in children and adults and has become a public health priority with its growing prevalence worldwide. This study aims to identify and evaluate the global trends in myopia research of the past century and visualize the frontiers using bibliometric analysis.MethodsThe literature search was conducted on the Web of Science for myopia studies published between 1900 and 2020. Retrieved publications were analyzed in-depth by the annual publication number, prolific countries and institutions, core author and journal, and the number of citations through descriptive statistics. Collaboration networks and keywords burst were visualized by VOSviewer and CiteSpace. Myopia citation network was visualized using CitNetExplorer.ResultsIn total, 11,172 publications on myopia were retrieved from 1900 to 2020, with most published by the United States. Saw SM, from the National University of Singapore, contributed the most publications and citations. Investigative Ophthalmology & Visual Science was the journal with highest number of citations. Journal of Cataract and Refractive Surgery with the maximum number of publications. The top 10 cited papers mainly focused on the epidemiology of myopia. Previous research emphasized myopia-associated experimental animal models, while recent keywords include “SMILE” and “myopia control” with the stronger burst, indicating a shift of concern from etiology to therapy and coincided with the global increment of incidence. Document citation network was clustered into six groups: “prevalence and risk factors of myopia,” “surgical control of myopia,” “pathogenesis of myopia,” “optical interventions of myopia,” “myopia and glaucoma,” and “pathological myopia.”ConclusionsBibliometrics analysis in this study could help scholars comprehend global trends of myopia research frontiers better. Hundred years of myopia research were clustered into six groups, among which “prevalence and risk factors of myopia” and “surgical control of myopia” were the largest groups. With the increasing prevalence of myopia, interventions of myopia control are a potential research hotspot and pressing public health issue.
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Affiliation(s)
- Mengyuan Shan
- School of Medicine, Nankai University, Tianjin, China
| | - Yi Dong
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Nankai University Affiliated Eye Hospital, Tianjin, China
| | - Jingyi Chen
- School of Medicine, Nankai University, Tianjin, China
| | - Qing Su
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
| | - Yan Wang
- School of Medicine, Nankai University, Tianjin, China
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Nankai University Affiliated Eye Hospital, Tianjin, China
- *Correspondence: Yan Wang
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Morgan IG, Jan CL. China Turns to School Reform to Control the Myopia Epidemic: A Narrative Review. Asia Pac J Ophthalmol (Phila) 2022; 11:27-35. [PMID: 35044336 DOI: 10.1097/apo.0000000000000489] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Myopia is now a major public health issue in parts of East and Southeast Asia, including mainland China. In this region, around 80% of students completing 12 years of school education are now myopic, and from 10% to 20% have high myopia in excess of -6D. Interventions to prevent the onset of myopia based on increasing time outdoors have now been implemented at a system-wide scale in Chinese Taipei (Taiwan) and Singapore with some success, but the prevalence of myopia still remains high by international standards. In mainland China, until recently, myopia prevention was largely based on eye exercises, but these have not been sufficient to prevent an epidemic. Control of myopia progression with atropine eye drops has been widely practiced in Singapore and Taiwan, with recent practice concentrating on low-dose concentrations. Orthokeratology has also been widely used across the region. Recent research has produced both contact and spectacle lenses that slow myopia progression by imposing myopic defocus. The new approaches to myopia control are ready for systematic use, which may be facilitated by system-wide screening and referral. In recent years, renewed emphasis has been placed on the prevention of myopia in mainland China by China's President Xi Jinping. In addition to making use of all the measures outlined above, China now seems to be aiming for major reforms to schooling, reducing educational pressures, particularly in the early school years, freeing more time for outdoor play and learning. These new initiatives may be crucial to myopia prevention and control.
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Affiliation(s)
- Ian G Morgan
- Research School of Biology, Australian National University, Canberra, ACT, Australia
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Catherine L Jan
- Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- Lost Child's Vision Project, Sydney, Australia, Department of Ophthalmology and Surgery, Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, Melbourne, Australia
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Mu J, Zeng D, Fan J, Liu M, Zhong H, Shuai X, Zhang S. The accuracy of the axial length and axial length/corneal radius ratio for myopia assessment among Chinese children. Front Pediatr 2022; 10:859944. [PMID: 36147807 PMCID: PMC9488664 DOI: 10.3389/fped.2022.859944] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 07/29/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The aim of this study was to assess the association between axial length/corneal radius ratio (AL/CR ratio), AL, and refractive status and evaluate the accuracy of AL and AL/CR ratio for myopia assessment among Chinese children. METHODS A diagnostic trial was conducted in Shenzhen Eye Hospital from June 2020 to December 2020. Cycloplegic refraction and demographic characteristic survey were carried out, and AL and CR were measured. The Pearson correlation analysis between AL, AL/CR ratio, and spherical equivalent (SE) was carried out. The sensitivity, specificity, Youden index, positive predictive value, and negative predictive value of the AL/CR ratio and AL for myopia assessment were analyzed using cycloplegic refraction as the gold standard by drawing receiver operating characteristic (ROC) curves. RESULTS A total of 300 children aged 8-18 years participated in this study. The Pearson correlation coefficient between AL and SE was -0.667 (P < 0.05) and -0.754 (P < 0.05) between AL/CR ratio and SE. There were significant differences in SE, AL, and AL/CR ratio among different age groups (p < 0.05). SE decreased by 1.185 diopter (D) for every 1 mm increase in AL and decreased by 0.667 D for every 0.1 increase in the AL/CR ratio. Taking cycloplegic refraction SE ≤ -0.50 D as the gold standard for the diagnosis of myopia, the area under the ROC curve of AL for myopia assessment was 0.836 (95% confidence interval [CI]: 0.767-0.906), with specificity, sensitivity, and Youden index of 0.833, 0.767, and 0.600, respectively. The area under the ROC curve of AL/CR ratio for myopia assessment was 0.937 (95% CI: 0.878-0.996), with specificity, sensitivity, Youden index, positive predictive value, and negative predictive value of 0.703, 0.913, 0.622, 0.956, and 0.771, respectively. The area under the ROC curve of the combination of AL/CR ratio and parental myopia for myopia assessment was 0.976 (95% CI: 0.957-0.996). CONCLUSION The correlation between SE and AL/CR ratio was stronger than that between SE and AL in children. The AL/CR ratio may be an alternative indicator for myopia assessment in children, and the combination of demographic factors and AL/CR ratio can improve the accuracy of myopia assessment.
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Affiliation(s)
- Jingfeng Mu
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Dan Zeng
- Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Jingjie Fan
- Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Meizhou Liu
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Haoxi Zhong
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Xinyi Shuai
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Shaochong Zhang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
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Wen L, Cheng Q, Cao Y, Li X, Pan L, Li L, Zhu H, Mogran I, Lan W, Yang Z. The Clouclip, a wearable device for measuring near-work and outdoor time: validation and comparison of objective measures with questionnaire estimates. Acta Ophthalmol 2021; 99:e1222-e1235. [PMID: 33729708 DOI: 10.1111/aos.14785] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 10/26/2020] [Accepted: 01/12/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE To validate a novel wearable device that can measure both viewing distance and light exposure, Clouclip, and compare questionnaire estimates regarding near-work and outdoor time with the objective measures obtained using Clouclip. METHODS Fifteen Clouclips were selected to measure different distances and levels of illuminance. With each Clouclip, five measurements at different distances and light intensities were measured and recorded. Eighty participants wore Clouclips for a week and completed an activity questionnaire afterwards. RESULTS The intra- and inter-Clouclip coefficients were 1.00 and 0.99 for measuring distance and 1.00 and 1.00 for illuminance, respectively. Within the measurement limit, the maximum relative error was 2.07% for distance and 2.23% for illuminance. Assuming that <30 cm was the typical distance for near-work activities and >1000 Lux was the typical cut-off for outdoor environments, the questionnaire showed a trend of overestimation for both. The greatest overestimation of near-work occurred during the school period [Questionnaire: 4.73 hr (4.73, 5.07) versus Clouclip: 2.16 hr (1.74, 2.78); p < 0.01]. The greatest overestimation of outdoor activity also occurred during the school period [Questionnaire: 1.60 hr (1.33, 1.85) versus Clouclip: 1.21 hr (0.96, 1.50); p < 0.01]. Based on Clouclip, the total time spent outdoors was estimated to be 1.55 hr on school days, of which 0.34 hr occurred after school. For weekend days, however, the duration was only 0.17 hr. CONCLUSIONS Clouclip had excellent precision and accuracy. Although the agreement between the questionnaire and Clouclip was relatively poor, they were able to complement each other to provide a more logical and feasible assessment of exposure to near-work and outdoor activity. Indoor-oriented lifestyles were found to predominate in Chinese children.
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Affiliation(s)
- Longbo Wen
- Aier School of Ophthalmology Central South University Hunan China
| | - Qian Cheng
- State Key Laboratory of Software Development Environment Beihang University Beijing China
| | - Yingpin Cao
- Aier School of Ophthalmology Central South University Hunan China
| | - Xiaoning Li
- Aier School of Ophthalmology Central South University Hunan China
- Aier School of Optometry and Vision Science Hubei University of Science and Technology Hubei China
| | - Lun Pan
- Aier School of Ophthalmology Central South University Hunan China
- Aier School of Optometry and Vision Science Hubei University of Science and Technology Hubei China
| | - Lei Li
- State Key Laboratory of Software Development Environment Beihang University Beijing China
| | - Haogang Zhu
- Guangzhou Aier Eye Hospital Jinan University Guangdong China
| | - Ian Mogran
- Research School of Biology Australia National University Canberra ACT Australia
| | - Weizhong Lan
- Aier School of Ophthalmology Central South University Hunan China
- Aier School of Optometry and Vision Science Hubei University of Science and Technology Hubei China
- Guangzhou Aier Eye Hospital Jinan University Guangdong China
| | - Zhikuan Yang
- Aier School of Ophthalmology Central South University Hunan China
- Aier School of Optometry and Vision Science Hubei University of Science and Technology Hubei China
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Wearable Sensors for Measurement of Viewing Behavior, Light Exposure, and Sleep. SENSORS 2021; 21:s21217096. [PMID: 34770402 PMCID: PMC8587946 DOI: 10.3390/s21217096] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/29/2021] [Accepted: 10/21/2021] [Indexed: 11/25/2022]
Abstract
The purpose of this study was to compare two wearable sensors to each other and to a questionnaire in an adult population. For one week, participants aged 29.2 ± 5.5 years (n = 25) simultaneously wore a Clouclip, a spectacle-mounted device that records viewing distance and illuminance, and an Actiwatch, a wrist-worn device that measures illuminance and activity. Participants maintained a daily log of activities and completed an activity questionnaire. Objective measures of time outdoors, near (10–< 60 cm) and intermediate (60–100 cm) viewing, and sleep duration were assessed with respect to the daily log and questionnaire. Findings showed that time outdoors per day from the questionnaire (3.2 ± 0.3 h) was significantly greater than the Clouclip (0.9 ± 0.8 h) and Actiwatch (0.7 ± 0.1 h, p < 0.001 for both). Illuminance from the Actiwatch was systematically lower than the Clouclip. Daily near viewing duration was similar between the questionnaire (5.7 ± 0.6 h) and Clouclip (6.1 ± 0.4 h, p = 0.76), while duration of intermediate viewing was significantly different between methods (p < 0.001). In conclusion, self-reported time outdoors and viewing behaviors were different than objective measures. The Actiwatch and Clouclip are valuable tools for studying temporal patterns of behavioral factors such as near work, light exposure, and sleep.
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Choi KY, Chan SSH, Chan HHL. The effect of spatially-related environmental risk factors in visual scenes on myopia. Clin Exp Optom 2021; 105:353-361. [PMID: 34612803 DOI: 10.1080/08164622.2021.1983400] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Myopia, the most common refractive error, is estimated to affect over two billion people worldwide, especially children from East Asian regions. Children with early onset myopia have an increased risk of developing sight threatening complications in later life. In addition to the contribution of genetic factors, of which expression is controversially suggested to be subject to environmental regulation, various environmental factors, such as near-work, outdoor, and living environment, have also been determined to play significant roles in the development of refractive error, especially juvenile myopia. Cues from daily visual scenes, including lighting, spatial frequency, and optical defocus over the field of visual stimuli, are suggested to influence emmetropisation, thereby affecting myopia development and progression. These risk factors in visual scenes of the everyday life may explain the relationship between urbanicity and myopia prevalence. This review first summarises the previously reported associations between myopia development and everyday-life environments, including schooling, urban settings, and outdoors. Then, there is a discussion of the mechanisms hypothesised in the literature about the cues from different visual scenes of urbanicity in relation to myopia development.
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Affiliation(s)
- Kai Yip Choi
- The Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Sonia Seen-Hang Chan
- The Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Henry Ho-Lung Chan
- The Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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Wei S, Sun Y, Li SM, Hu JP, Cao K, An W, Guo JY, Li H, Wang N. Effect of body stature on refraction and ocular biometry in Chinese young adults: The Anyang University Students Eye Study. Clin Exp Optom 2021; 104:201-206. [PMID: 32869355 DOI: 10.1111/cxo.13137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
CLINICAL RELEVANCE Large-scale data on the association between body stature with biometry parameters and refraction in young adults facilitates an understanding of myopia development. Taller persons have eyes with more negative refractions, longer axial lengths, deeper anterior chambers, flatter corneas, and higher axial length-corneal radius ratio. BACKGROUND To determine the relationship between body stature with ocular biometry and refraction in young adults. METHODS This was a cross-sectional university-based study of 16- to 26-year-old students in China. Cycloplegic refraction and corneal curvature were measured using an autorefractor. Ocular parameters, including axial length, anterior chamber depth and lens thickness, were measured using a Lenstar LS900. Data on height and weight were acquired from an annual standardised physical examination and body mass index was calculated. RESULTS Of 7,971 participants examined in the school clinics, 5,657 (71.0 per cent) were available in the analysis. After adjusting for age, gender, parental myopia, time outdoors, near work and weight, each centimetre of height increase was associated with more negative refraction of -0.023-D, a 0.032-mm increase in axial length, a 0.003-mm increase in anterior chamber depth, a 0.008-mm increase in corneal curvature, and a 0.001 increase in axial length-corneal radius ratio. With regard to weight, a 1-kg heavier person was more likely to have less negative refraction of 0.011-D, a 0.001-mm increase in anterior chamber depth and a 0.002-mm increase in corneal curvature. A similar pattern of significant associations was also found in body mass index. CONCLUSION Taller, young adults tended to have longer eyes, deeper anterior chambers, flatter corneas, higher axial length-corneal radius ratio, and more negative refraction, adjusted for potential confounders. In contrast, heavier and higher body mass index persons are more hyperopic. The differences in stature may partially explain the variation in refraction and ocular biometric parameters.
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Affiliation(s)
- Shifei Wei
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Centre, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yunyun Sun
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Centre, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Shi-Ming Li
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Centre, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jian-Ping Hu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Centre, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Kai Cao
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Centre, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Wenzai An
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Centre, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | | | - He Li
- Anyang Eye Hospital, Anyang, China
| | - Ningli Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Centre, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Thakur S, Verkicharla PK. Greater axial elongation associated with low accommodative lag: new insights on accommodative lag theory for myopia. Ophthalmic Physiol Opt 2021; 41:1355-1362. [PMID: 34569632 DOI: 10.1111/opo.12893] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/19/2021] [Accepted: 08/19/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE We aimed to test the accommodative lag and mechanical tension theories for myopia by assessing the influence of the lag of accommodation on axial elongation by using three different near targets that are known to influence the accommodative response differently. METHODS Forty-two young adults were recruited for the study. Axial length was measured using a non-contact biometer, before and immediately after a 15 minute visual task, with one of the three near targets placed 20 cm from the eye: reading text from a paper, reading text from a smartphone and watching a video on a smartphone. The accommodative response was determined using an open-field autorefractor while the participants viewed the near target monocularly. RESULTS Lag of accommodation was significantly different for the three tasks: watching a video (mean ± standard error of the mean [SEM] 0.92 ± 0.10 D); reading text on the smartphone (0.59 ± 0.08 D); and reading text on paper (0.24 ± 0.09 D). There was a significant (p < 0.05) increase in axial length after reading text from a paper (10.5 ± 1.9 µm after 15-min) and reading text from a smartphone (5.2 ± 2.7 µm), but not after watching a video on a smartphone (-0.5 ± 1.7 µm, p = 0.47). Vitreous chamber depth increased significantly more with the reading tasks compared with watching a video (reading text from a paper and smartphone: 33.9 ± 4 µm and 31.7 ± 4 µm vs. watching a video on a smartphone: 14.6 ± 5 µm, p = 0.001). CONCLUSION Greater changes in axial length associated with the low lag of accommodation failed to support the theory that lag of accommodation during visual tasks could be the trigger for axial elongation. Reading on paper and smartphone at the closest reading distance may stimulate high accommodative demand and axial elongation as a consequence, possibly due to increased "ciliary muscle tension" during accommodation.
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Affiliation(s)
- Swapnil Thakur
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, 500034, India
| | - Pavan K Verkicharla
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, 500034, India
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Wang J, Liu J, Ma W, Zhang Q, Li R, He X, Liu L. Prevalence of myopia in 3-14-year-old Chinese children: a school-based cross-sectional study in Chengdu. BMC Ophthalmol 2021; 21:318. [PMID: 34470605 PMCID: PMC8411514 DOI: 10.1186/s12886-021-02071-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 08/14/2021] [Indexed: 02/08/2023] Open
Abstract
Background The prevalence of myopia among children in Chengdu is unknown. The aim of this study was to determine the prevalence of myopia in 3- to 14-year-old Chinese children in Chengdu. Methods This study was a school-based cross-sectional study in children aged 3–14 years. Visual acuity (VA), spherical equivalent error (SER) with noncycloplegic autorefraction, axial length (AL) and corneal radius (CR) were measured. Results A total of 19,455 children were recruited for this study. The prevalence of myopia was 38.1 %; the prevalence of low myopia was 26.6 %, that of moderate myopia was 9.8 %, and that of high myopia was 1.7 %. The prevalence of myopia and SER increased with age from 6 years old. The prevalence of myopia was higher, and the SER indicated more severe myopia in the girls than in the boys (40.1 % vs. 36.2 %, χ2 = 30.67, df = 1, P < 0.001; -0.93 D ± 1.75 D vs. -0.84 D ± 1.74 D, t = 3.613, df=19,453, P < 0.001). The girls had a higher prevalence of myopia and myopic SER than did the boys aged 9 years and older (P < 0.05). Among the myopic children, the rates of uncorrected, undercorrected and fully corrected myopia were 54.8 %, 31.1 and 14.1 %, respectively. AL and AL/CR increased with age from 6 years old, but CR remained stable after 4 years old. The AL was longer, and the CR was flatter in the boys than in the girls aged 3 to 14 years old (P < 0.05). Conclusions The prevalence of myopia, AL and AL/CR increased, and the SER became more myopic with age from 6 years old. The girls had a higher prevalence of myopia and myopic SER than did the boys, but the boys had a longer AL, flatter CR and higher AL/CR ratio than did the girls. The rate of uncorrected myopia was very high in the myopic children. More actions need to be taken to decrease the prevalence of myopia, especially uncorrected myopia in children.
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Affiliation(s)
- Jianglan Wang
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, 37 Guoxue Xiang, Sichuan Province, Chengdu, China
| | - Jinnan Liu
- EyeSee Medical Science & Technology Chengdu Co, Ltd. 49 Dongfu street, Jinjiang District, Chengdu, Sichuan Province, China
| | - Wei Ma
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, 37 Guoxue Xiang, Sichuan Province, Chengdu, China
| | - Qi Zhang
- EyeSee Medical Science & Technology Chengdu Co, Ltd. 49 Dongfu street, Jinjiang District, Chengdu, Sichuan Province, China
| | - Rong Li
- EyeSee Medical Science & Technology Chengdu Co, Ltd. 49 Dongfu street, Jinjiang District, Chengdu, Sichuan Province, China
| | - Xiao He
- West China Clinical Skills Training Center, West China School of Medicine/West China Hospital, Sichuan University, 37 Guoxue Xiang, Sichuan Province, 610041, Chengdu, China
| | - Longqian Liu
- Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, 37 Guoxue Xiang, Sichuan Province, Chengdu, China.
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Amblyopia risk factors among pediatric patients in a hospital-based setting using photoscreening. PLoS One 2021; 16:e0254831. [PMID: 34324539 PMCID: PMC8320995 DOI: 10.1371/journal.pone.0254831] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 07/04/2021] [Indexed: 11/19/2022] Open
Abstract
PURPOSE The aim of our study was to determine the prevalence of amblyopia risk factors in children visiting the American University of Beirut Medical Center (AUBMC) using automated vision screening. METHODS This was a hospital-based screening of 1102 children aged between 2 and 6 years. Vision screening was performed using PlusoptiX S12 over 2 years (2018-2020). The need for referral to a pediatric ophthalmologist was based on the amblyopia risk factors set forth by the American Association for Pediatric Ophthalmology and Strabismus. Referred patients underwent a comprehensive eye examination. RESULTS A total of 1102 children were screened, 63 were referred for amblyopia risk factors (5.7%); 37/63 (59%) underwent comprehensive eye examination and 73% were prescribed glasses. Of the non-referred group of children, 6.35% had astigmatism, 6.25% were hyperopic and 3.27% were myopic. The refractive errors observed among the examined patients were distributed as follows: 41% astigmatism, 51% hyperopia, and 8% myopia; amblyopia was not detected. Refractive amblyopia risk factors were associated with the presence of systemic disorders. Bland-Altman plots showed most of the differences to be within limits of agreement. CONCLUSION Using an automated vision screener in a hospital-based cohort of children aged 2 to 6 years, the rate of refractive amblyopia risk factors was 5.7%. Hyperopia was the most commonly encountered refractive error and children with systemic disorders were at higher risk.
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Liu L, Li R, Huang D, Lin X, Zhu H, Wang Y, Zhao X, Zhang X, Liu H. Prediction of premyopia and myopia in Chinese preschool children: a longitudinal cohort. BMC Ophthalmol 2021; 21:283. [PMID: 34289821 PMCID: PMC8296532 DOI: 10.1186/s12886-021-02045-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 07/12/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUNDS Myopia has become a global public health problem. Children with early onset of myopia are at particular risk of complications associated with myopia. Younger children and children with greater initial myopic refractive errors are at a greater risk of myopia progression. Therefore, it is essential to identify subjects at high risk of developing myopia to facilitate myopia prevention in the early stage, especially during the preschool period. The purpose of this study was to determine whether premyopia and myopia in preschool children can be predicted by easily obtainable parameters. METHODS Data was collected in a population-based cohort. Comprehensive examinations included height, weight, refraction, axial length (AL), and corneal radius of curvature (CR), with a follow-up of 2 years. Parental myopia history was obtained from a questionnaire. Myopia was defined as spherical equivalent (SE) ≤ - 0.50 D. Premyopia was defined as - 0.50 D < SE ≤ + 0.75 D. Multivariate linear regression models were fitted to determine the associations between these parameters at baseline and future SE. To predict premyopia and myopia, Cox proportional hazard regression analysis coupled with a nomogram was used. RESULTS A total of 830 children (433 boys and 397 girls) were included (40.83 ± 3.43 months old at baseline). A significantly negative relationship was observed in the multivariate analysis between baseline AL, AL/CR, two myopic parents, and the future SE after adjusting for age and gender (coefficient = - 0.291, coefficient = - 5.791, coefficient = - 0.273, respectively, both p < 0.001). Higher baseline AL, AL/CR (hazard ratio (HR) = 4.916, HR = 2.979, respectively, comparing the top quartile with the bottom quartile, both p < 0.001) and two myopic parents (HR = 1.756, compared to no myopic parents, p = 0.001) were associated with a higher risk of future onset of premyopia. From the nomogram, AL/CR was found to have the most enormous effect on survival. Different baseline AL and AL/CR values (both Log Rank p < 0.001) had different survival curves. CONCLUSIONS AL and AL/CR could be used as obtainable indicators for identifying subjects at high risk of developing premyopia and myopia in young preschool children.
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Affiliation(s)
- Lei Liu
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Rui Li
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Dan Huang
- Department of Child Healthcare, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Xiao Lin
- University of Houston, College of Optometry, Houston, TX, USA
| | - Hui Zhu
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Yue Wang
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Xiaoyan Zhao
- Department of Ophthalmology, The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Xiaohan Zhang
- Department of Ophthalmology, Wuxi Children's Hospital, Wuxi, China
| | - Hu Liu
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
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Wang Y, Hou ZJ, Wang HZ, Hu M, Li YX, Zhang Z. Comparison of ocular axis and corneal diameter between entropion and non-entropion eyes in children with congenital glaucoma. World J Clin Cases 2021; 9:4637-4643. [PMID: 34222430 PMCID: PMC8223843 DOI: 10.12998/wjcc.v9.i18.4637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/07/2021] [Accepted: 05/18/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Children with congenital glaucoma are often accompanied by acquired epiblepharon in the lower eyelid, which causes entropion of the lower eyelid and damages the cornea.
AIM To infer the possible causes of lower eyelid entropion by comparing the difference of ocular axis and corneal diameter between inverted and non-inverted ciliary eyes in children with congenital glaucoma.
METHODS A total of 15 patients (11 males and 4 females) diagnosed with congenital glaucoma between July 2016 and January 2019 at Tongren Hospital were included. Five patients had bilateral glaucoma, and ten had unilateral glaucoma. Each patient had only one eye with lower eyelid entropion which is associated with congenital glaucoma. All the patients had no entropion in another eye. The clinical data were collected. Main outcome measures were the ocular axis and corneal diameter.
RESULTS The average age of the 15 patients was 1.85 ± 0.49 years. Paired t-test showed that the average ocular axis of congenital glaucoma eyes with lower eyelid entropion (24.86 ± 3.44 mm) was significantly longer than that of congenital glaucoma eyes without lower eyelid entropion (20.79 ± 1.34 mm; P < 0.001). The average corneal diameter of congenital glaucoma eyes with lower eyelid entropion (13.61 ± 0.88 mm) was also significantly greater than that of congenital glaucoma eyes without lower eyelid entropion (11.63 ± 0.48; P < 0.001).
CONCLUSION The rapid growth of the ocular axis and corneal diameter may be the main cause of congenital glaucoma with acquired lower eyelid entropion. Therefore, children with poor control of intraocular pressure and excessive growth of ocular axis and corneal diameter must be observed for the existence of acquired epiblepharon.
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Affiliation(s)
- Yue Wang
- Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing 100730, China
| | - Zhi-Jia Hou
- Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing 100730, China
| | - Huai-Zhou Wang
- Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing 100730, China
| | - Man Hu
- National Key Discipline of Pediatrics, Ministry of Education, Department of Ophthalmology, Beijing Children’s Hospital, Capital Medical University, Beijing 100045, China
| | - Yu-Xin Li
- Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing 100730, China
| | - Zheng Zhang
- Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing 100730, China
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Delshad S, Collins MJ, Read SA, Vincent SJ. Effects of brief periods of clear vision on the defocus-mediated changes in axial length and choroidal thickness of human eyes. Ophthalmic Physiol Opt 2021; 41:932-940. [PMID: 33973255 DOI: 10.1111/opo.12833] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 03/23/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To investigate the influence of brief, repeated periods of clear vision on the changes in axial length and choroidal thickness in response to short-term imposed defocus. METHODS The right eye of 16 young adults was exposed to 60 min episodes of continuous and interrupted defocus conditions (+3 DS and -3 DS) over five separate sessions, with the left eye optimally corrected for distance. For interrupted defocus, 2 min episodes of clear vision were imposed before each 15 min episode of myopic or hyperopic defocus (2/15 min). For hyperopic defocus, the effect of frequency of clear vision exposure was also assessed by imposing 1 min of clear vision before each 7.5 min of defocus (1/7.5 min). The right eye axial length and choroidal thickness were measured before, during and after each defocus condition. RESULTS After 60 min of continuous hyperopic defocus the eye elongated significantly by +9 ± 9 μm (p = 0.02). When exposed to interrupted (2/15 min) hyperopic defocus, axial elongation was significantly reduced by 77% compared to continuous hyperopic defocus (p = 0.03), with a final change of only +2 ± 10 μm relative to baseline. During interrupted (1/7.5 min) hyperopic defocus, axial elongation reduced slightly compared to continuous hyperopic defocus (+6 ± 8 μm relative to baseline, p = 0.12). For continuous myopic defocus, a reduction in axial length occurred but was not statistically significant (p > 0.05). A similar pattern of response was observed for choroidal thickness changes with continuous and interrupted (1/7.5 min) hyperopic defocus conditions. CONCLUSIONS Brief periods of clear vision can diminish axial elongation and choroidal thinning induced by hyperopic defocus exposure in human eyes. If hyperopic defocus contributes to myopia progression in humans, then interruption with brief periods of clear vision could reduce its myopiagenic effects.
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Affiliation(s)
- Samaneh Delshad
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Michael J Collins
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Scott A Read
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Stephen J Vincent
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
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Tao Z, Deng H, Zhong H, Yu Y, Zhao J, Chen S, Li S, Zhu M. A longitudinal study of the effect of ocular biometrics measures on myopia onset. Graefes Arch Clin Exp Ophthalmol 2021; 259:999-1008. [PMID: 33201354 DOI: 10.1007/s00417-020-05010-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 09/12/2020] [Accepted: 11/06/2020] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To investigate the relationship between ocular biometrics (OB) and myopia onset. METHODS OB data from students in 4 grades (aged from 6 to 14 years) in China were collected in a 1.5-year longitudinal study. Refractive error was assessed with cycloplegic autorefraction. RESULTS At baseline, 934 (56.33%) of the subjects (right eye) had myopia. The mean spherical equivalent (SE) and axial length to corneal radius (AL/CR) were - 2.14 ± 1.49 and 3.14 ± 0.11, respectively, in the subjects with myopia and - 0.09 ± 0.21 and 2.98 ± 0.07, respectively, in the subjects without myopia. The correlation between the SE and AL/CR was r = - 0.823 (P < 0.001). The slopes of the SE changing with the AL/CR (and R-squares) were - 0.28 to - 1.80 (0.01-0.14) in the no myopia group, - 3.40 to - 6.20 (0.20-0.48) in the low myopia group, and - 3.37 to - 11.34 (0.16-0.74) in the moderate and high myopia groups. The baseline AL/CR values in grades 1, 3, and 5 were higher in those who developed myopia within 1.5 years. The odds ratio of the AL/CR to myopia onset in 1.5 years was 1.096 (95% confidence interval (CI): 1.060-1.135). CONCLUSIONS Of the five indicators, the AL/CR showed the best correlation with the SE. The adjoint and linear relationship between the AL/CR and the SE tended to increase with SE progression. When myopia progressed beyond a certain range, the AL/CR was significantly different in those without initial myopia who developed it within 1.5 years compared with those who did not. After adjusting for age, sex, school, and grade, the interpretation capability of the current AL/CR to myopia onset in 1.5 years was limited.
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Affiliation(s)
- Zhengyang Tao
- Shenzhen Eye Hospital Affiliated to Jinan University, The Second Clinical Medical College of Jinan University, Shenzhen, 518000, Guangdong Province, China
| | - Hongwei Deng
- Shenzhen Eye Hospital Affiliated to Jinan University, The Second Clinical Medical College of Jinan University, Shenzhen, 518000, Guangdong Province, China.
| | - Huahong Zhong
- Shenzhen Eye Hospital Affiliated to Jinan University, The Second Clinical Medical College of Jinan University, Shenzhen, 518000, Guangdong Province, China
| | - Yang Yu
- Nanshan Educational Science Research Institute of ShenZhen, Shenzhen, 518000, Guangdong Province, China
| | - Jun Zhao
- Shenzhen Eye Hospital Affiliated to Jinan University, The Second Clinical Medical College of Jinan University, Shenzhen, 518000, Guangdong Province, China
| | - Shuiqiang Chen
- Shenzhen Aier Eye Hospital, Shenzhen, 518000, Guangdong Province, China
| | - Shan Li
- Nanshan Educational Science Research Institute of ShenZhen, Shenzhen, 518000, Guangdong Province, China
| | - Minjuan Zhu
- Shenzhen Eye Hospital Affiliated to Jinan University, The Second Clinical Medical College of Jinan University, Shenzhen, 518000, Guangdong Province, China
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Chen Y, Wang D, Chen L, Yan W, He M. Association of refraction and ocular biometry in highly myopic eyes. Clin Exp Optom 2021; 104:589-594. [PMID: 33689619 DOI: 10.1080/08164622.2021.1878819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Clinical relevance: Ocular biometry is key to understanding the determinants of ocular development and pathology changes, especially for the thriving myopic population in Asia. Investigating biometric data in highly myopic eyes within a wide age spectrum is therefore of high importance.Background: To report the magnitude of change in spherical equivalent for each unit of change in the ocular biometry parameters in a highly myopic population in China.Methods: Highly myopic patients aged 7 to 70 years were recruited from the Zhongshan Ophthalmic Center, China. Each patient had a cycloplegic refraction and a measurement of ocular biometry.Results: Data from 823 right eyes were available for analysis, with a mean age of 22.7 years and a median spherical equivalent of -8.88 D. Axial length and lens thickness increased with age, while anterior chamber depth (ACD) decreased in older subjects. There was a significant trend of increasing axial length, lens thickness, vitreous chamber depth (VCD) and decreasing ACD and calculated lens power over spherical equivalent quartiles (all p < 0.001). The univariate linear regression models showed that 1-D change in refraction equalled to a 0.33- to 0.34-mm increase of axial length, and a 0.32 to 0.33-mm increase of VCD in highly myopic eyes. Among the three components of axial length, lens thickness was associated with myopia shift in the groups of 7-18 years and 19-39 years (both p < 0.001), and VCD was significant in all groups (all p < 0.001), while ACD was not significant in any age group.Conclusion: The associations between refraction and axial length were consistent in children, young adults and the elderly with high myopia. Lens thickening with a higher degree of myopia appeared at a very early age, and vitreous chamber depth remained to be a prominent factor of refraction change in highly myopic eyes throughout seven to 70 years of age.
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Affiliation(s)
- Yanxian Chen
- Department of Ophthalmology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China.,State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Decai Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Linxing Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - William Yan
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Australia
| | - Mingguang He
- Department of Ophthalmology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China.,State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China.,Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Australia
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Effect of reading with a mobile phone and text on accommodation in young adults. Graefes Arch Clin Exp Ophthalmol 2021; 259:1281-1288. [PMID: 33464380 PMCID: PMC8102294 DOI: 10.1007/s00417-020-05054-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/29/2020] [Accepted: 12/15/2020] [Indexed: 02/08/2023] Open
Abstract
Purpose To investigate the effects of reading with mobile phone versus text on accommodation accuracy and near work-induced transient myopia (NITM) and its subsequent decay during near reading in young adults with mild to moderate myopia. Methods The refractions of 31 young adults were measured with an open-field autorefractor (WAM-5500, Grand Seiko) for two reading tasks with a mobile phone and text at 33 cm. The mean age of the young adults was 24.35 ± 1.80 years. The baseline refractive aspects were determined clinically with full distance refractive correction in place. The initial NITM and its decay time and accommodative lag were assessed objectively immediately after binocularly viewing a mobile phone or text for 40 min. Results The mean ± standard deviation (SD) initial NITM magnitude was greater for reading with text (0.23 ± 0.26 D) than for reading with mobile phone (0.12 ± 0.17 D), but there was no significant difference between the two reading tasks (p = 0.082). The decay time (median, first quartile, and third quartile) was 60 s (16, 154) and 70 s (32, 180) in the phone task and text task groups, respectively. There was also no significant difference in the decay time between the two reading types in general (p = 0.294). The accommodative lags of text tasks and mobile phones tasks were equivalent (1.27 ± 0.52 D vs 1.31 ± 0.64 D, p = 0.792). Conclusion There were no significant differences in accommodative lags and the initial NITM and its decay time between reading with a mobile phone and text in young adults.
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Lin Z, Vasudevan B, Gao T, Zhou H, Ciuffreda KJ, Liang Y. Refractive change and incidence of myopia among rural Chinese children: the Handan Offspring Myopia Study. Br J Ophthalmol 2021; 106:628-632. [PMID: 33441318 DOI: 10.1136/bjophthalmol-2020-317811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 12/03/2020] [Accepted: 12/07/2020] [Indexed: 11/04/2022]
Abstract
PURPOSE To assess the refractive change and incidence of myopia, as well as their risk factors, among Chinese rural children aged 6-17 years. METHODS Children who completed the baseline vision examination of the Handan Offspring Myopia Study were re-examined, including both cycloplegic and non-cyloplegic autorefraction, with a mean follow-up time of 42.4±1.47 months. RESULTS A total of 601 children (68.5%) who completed both baseline and the follow-up examinations were enrolled. The cumulative refractive change and axial length change were -0.53±1.03 diopter and 0.39±0.46 mm (-0.15 diopter/year and 0.11 mm/year), respectively. A hundred and five out of the 469 non-myopic children at baseline become myopic at the follow-up, yielding a cumulative myopia incidence of 22.4% (95% CI: 18.6% to 26.2%), or annual myopia incidence of 6.3%. After adjustment, younger age (β=0.08, p<0.001), more myopic baseline refraction (β=0.31, p<0.001), larger difference between cycloplegic and non-cycloplegic refraction (β=-0.20, p=0.007) and more myopic paternal refraction (β=0.09, p=0.007) were found to be associated with more rapid myopic refractive change. More myopic baseline refraction (relative risk (RR), 95% CI: 0.19, 0.13-0.28, p<0.001) and more myopic paternal refraction (RR, 95% CI: 0.92, 0.84-1.00, p=0.039) were also associated with myopia incidence. CONCLUSION Relatively low myopic refractive change and myopia incidence were found in this study cohort. Children's refraction and paternal refraction were associated with both myopic refractive change and myopia incidence. Such information will be helpful for further comparisons in other rural versus urban areas of China, and other countries.
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Affiliation(s)
- Zhong Lin
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | | | | | - Hongjia Zhou
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Kenneth J Ciuffreda
- Department of Biological and Vision Sciences, SUNY College of Optometry, New York, NY, USA, New York, NY, USA
| | - Yuanbo Liang
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China .,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
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Jiang D, Lin H, Li C, Liu L, Xiao H, Lin Y, Huang X, Chen Y. Longitudinal association between myopia and parental myopia and outdoor time among students in Wenzhou: a 2.5-year longitudinal cohort study. BMC Ophthalmol 2021; 21:11. [PMID: 33407251 PMCID: PMC7789164 DOI: 10.1186/s12886-020-01763-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 12/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate the impact of parental myopia and outdoor time on myopia among students in Wenzhou. METHODS We examined 1388 primary students from first grade to third grade in Wenzhou from September 2012 to March 2015. We performed noncycloplegic refractometry on each student every six months and axial length (AL) measurements every year. At the commencement of our study, children were asked to complete a questionnaire regarding near work activity and outdoor activity, whereas parents were asked to complete a self-administered questionnaire regarding their background circumstances and their history of myopia. RESULTS A total of 1294 students (93.2%) returned for follow-up examinations. Children with initial and final no myopia spent more time on outdoor activities than those with new onset myopia (1.92 vs. 1.81 h/d, p = 0.022), and elongation of AL in children with a high level (> 2.5 h/day) of outdoor time (0.22 ± 0.13 mm/Y) was less than those with a low level (≤ 1.5 h/day) of outdoor time (0.24 ± 0.14 mm/Y, p = 0.045). The proportion of rapid myopia progression (≤-0.5D/Y) was 16.7%, 20.2% and 31.5% among the children with no myopic parent, one myopic parent and two myopic parents, respectively (X2 = 28.076, p < 0.001), and the elongation of AL in children among different numbers of myopic parents was significantly different (p < 0.001). A high level of outdoor time was a protective factor for children with one myopic parent (HR 0.49, 95% CI 0.27-0.88; p = 0.018). CONCLUSIONS In this sample, parental myopia and outdoor time were associated with myopia in children. A high level of outdoor time was a protective factor for children with one myopic parent.
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Affiliation(s)
- Dandan Jiang
- The Eye Hospital of Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang, 325027, China
| | - Haishuang Lin
- The Eye Hospital of Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang, 325027, China
| | - Chunchun Li
- The Eye Hospital of Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang, 325027, China
| | - Linjie Liu
- School of Ophthalmology and Optometry, Wenzhou Medical University, 82 West Xueyuan Road, Wenzhou, Zhejiang, 325027, China
| | - Haishao Xiao
- School of Ophthalmology and Optometry, Wenzhou Medical University, 82 West Xueyuan Road, Wenzhou, Zhejiang, 325027, China
| | - Yaoyao Lin
- School of Ophthalmology and Optometry, Wenzhou Medical University, 82 West Xueyuan Road, Wenzhou, Zhejiang, 325027, China
| | - Xiaoqiong Huang
- The Eye Hospital of Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang, 325027, China
| | - Yanyan Chen
- The Eye Hospital of Wenzhou Medical University, 270 West Xueyuan Road, Wenzhou, Zhejiang, 325027, China.
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Abstract
Myopia, also known as short-sightedness or near-sightedness, is a very common condition that typically starts in childhood. Severe forms of myopia (pathologic myopia) are associated with a risk of other associated ophthalmic problems. This disorder affects all populations and is reaching epidemic proportions in East Asia, although there are differences in prevalence between countries. Myopia is caused by both environmental and genetic risk factors. A range of myopia management and control strategies are available that can treat this condition, but it is clear that understanding the factors involved in delaying myopia onset and slowing its progression will be key to reducing the rapid rise in its global prevalence. To achieve this goal, improved data collection using wearable technology, in combination with collection and assessment of data on demographic, genetic and environmental risk factors and with artificial intelligence are needed. Improved public health strategies focusing on early detection or prevention combined with additional effective therapeutic interventions to limit myopia progression are also needed.
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Spinazze PA, Kasteleyn MJ, Aardoom JJ, Car J, Chavannes NH. Cross-Sectional Analysis of University Students' Health Using a Digitised Health Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17093009. [PMID: 32357473 PMCID: PMC7246463 DOI: 10.3390/ijerph17093009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 04/21/2020] [Accepted: 04/23/2020] [Indexed: 11/25/2022]
Abstract
University student years are a particularly influential period, during which time students may adopt negative behaviours that set the precedent for health outcomes in later years. This study utilised a newly digitised health survey implemented during health screening at a university in Singapore to capture student health data. The aim of this study was to analyze the health status of this Asian university student population. A total of 535 students were included in the cohort, and a cross-sectional analysis of student health was completed. Areas of concern were highlighted in student’s body weight, visual acuity, and binge drinking. A large proportion of students were underweight (body mass index (BMI) < 18.5)—18.9% of females and 10.6% of males—and 7% of males were obese (BMI > 30). Although the overall prevalence of alcohol use was low in this study population, 9% of females and 8% of males who consumed alcohol had hazardous drinking habits. Around 16% of these students (male and female combined) typically drank 3–4 alcoholic drinks each occasion. The prevalence of mental health conditions reported was very low (<1%). This study evaluated the results from a digitised health survey implemented into student health screening to capture a comprehensive health history. The results reveal potential student health concerns and offer the opportunity to provide more targeted student health campaigns to address these.
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Affiliation(s)
- Pier A. Spinazze
- Department of Primary Care and Public Health, Global Digital Health Unit, School of Public Health, Imperial College London, London W6 8RP, UK;
- Centre for Population Health Sciences (CePHaS), Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
- Correspondence: ; Tel.: +65-8332-5290
| | - Marise J. Kasteleyn
- Department of Public Health and Primary Care, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (M.J.K.); (J.J.A.); (N.H.C.)
- National eHealth Living Lab, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Jiska J. Aardoom
- Department of Public Health and Primary Care, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (M.J.K.); (J.J.A.); (N.H.C.)
- National eHealth Living Lab, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
| | - Josip Car
- Department of Primary Care and Public Health, Global Digital Health Unit, School of Public Health, Imperial College London, London W6 8RP, UK;
- Centre for Population Health Sciences (CePHaS), Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
| | - Niels H. Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands; (M.J.K.); (J.J.A.); (N.H.C.)
- National eHealth Living Lab, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
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Sarfare S, Yang J, Nickla DL. The effects of brief high intensity light on ocular growth in chicks developing myopia vary with time of day. Exp Eye Res 2020; 195:108039. [PMID: 32339518 DOI: 10.1016/j.exer.2020.108039] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 03/04/2020] [Accepted: 04/02/2020] [Indexed: 12/31/2022]
Abstract
Evidence suggests that the relevant variable in the anti-myopigenic effect of increased time spent outdoors is the increase in light intensity. Because light is the strongest Zeitgeber, it is plausible that the effects of bright light exposure depend on time of day, and may impact circadian rhythms. In these studies, we asked whether the effects on eye growth rates and ocular rhythms of brief daily exposures to bright light differed depending on time of day in eyes developing myopia in response to form deprivation (FD) or negative lens-induced hyperopic defocus (LENS). We also studied the effects of concurrent exposures to brief hyperopic defocus and bright light. Exp. 1: Starting at 12d, chicks wearing monocular diffusers or -10 D lenses were exposed to 3 daily hours (h) of bright light (30K lux) in the morning (FD: n = 12; LENS: n = 7) or evening (FD: n = 21; LENS: n = 7) for a total of 6 exposures. Controls wore diffusers or lenses but weren't exposed to bright light ("not bright" FD: n = 14; LENS: n = 9). Exp. 2: Untreated chicks were exposed to 3 h bright light in the morning (n = 12) or evening (n = 14) for a total of 6 exposures. Controls were not exposed to bright light (n = 11). Exp. 3: Chicks were exposed to 2 h simultaneous monocular hyperopic defocus and bright light in the morning (n = 11), mid-day (n = 7) or evening (n = 8) for 5 exposures. "Not bright" lens-wearing controls were data from published work (Nickla et al., 2017). High frequency A-scan ultrasonography was done at the start and end to measure growth rates. The FD group in Exp. 1 and the morning and evening groups in Exp. 3 were measured at 6-h intervals over the final 24 h to determine parameters for the rhythms in axial length and choroidal thickness. 1. Brief bright light in the evening inhibited eye growth in eyes wearing diffusers or lenses relative to "not bright" controls(interocular differences: FD: 316 vs 468 μm, p = 0.026; LENS: 233 vs 438 μm, p = 0.03); morning bright light had no effect. There was no differential effect of time of day of exposure on the rhythm in axial length; for choroid thickness, "time" accounted for the variance between groups (2-way ANOVA interaction p = 0.027). 2. In binocularly untreated chicks, bright light in the morning had a small but significant growth stimulatory effect relative to evening exposures (803 vs 679 μm/7d; post-hoc p = 0.048). 3. Eyes exposed to simultaneous hyperopic defocus and bright light were significantly more inhibited relative to "not bright" controls for morning exposures (interocular differences: -207 vs 69 μm; p < 0.01). In conclusion, the effects of brief periods of bright light on the growth controller depended on the time of day of exposure and on the contemporaneous state ofocular growth .
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Affiliation(s)
- Shanta Sarfare
- The New England College of Optometry, 424 Beacon St, Boston, MA, USA
| | - Jane Yang
- The New England College of Optometry, 424 Beacon St, Boston, MA, USA
| | - Debora L Nickla
- The New England College of Optometry, 424 Beacon St, Boston, MA, USA.
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Kim H, Seo JS, Yoo WS, Kim GN, Kim RB, Chae JE, Chung I, Seo SW, Kim SJ. Factors associated with myopia in Korean children: Korea National Health and nutrition examination survey 2016-2017 (KNHANES VII). BMC Ophthalmol 2020; 20:31. [PMID: 31959143 PMCID: PMC6971942 DOI: 10.1186/s12886-020-1316-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 01/14/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND To evaluate the prevalence and risk factors associated with myopia and high myopia in children in South Korea. METHODS A total of 983 children 5-18 years of age who participated in the Korean National Health and Nutrition Examination Survey 2016-2017 (KNHANES VII), a nationwide population-based cross-sectional study, were evaluated. Myopia and high myopia were defined as a spherical equivalent (SE) ≤ - 0.5 diopters (D) and SE ≤ --6.0 D. The association between refractive errors and potential risk factors for myopia was analyzed. RESULTS The prevalence of myopia and high myopia was 65.4 and 6.9%, respectively. Older age and parental myopia were significantly associated with both myopia and high myopia, while higher body mass index (BMI) was associated with high myopia only. Although the proportion of subjects who spent more time on near work activities (≥4 h/day) was sequentially increased with increased refractive error, this tendency was not statistically significant by multivariable logistic regression. CONCLUSIONS Korean children had a high prevalence of myopia and high myopia. In this age group, the risk of myopia increased with aging and parental myopia. Higher BMI may be associated with high myopia.
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Affiliation(s)
- Hyuna Kim
- Department of Ophthalmology, Gyeongsang National University School of medicine and Gyeongsang National University Hospital, Jinju, South Korea
| | - Jin Seok Seo
- Department of Ophthalmology, Gyeongsang National University School of medicine and Gyeongsang National University Hospital, Jinju, South Korea
| | - Woong-Sun Yoo
- Department of Ophthalmology, Gyeongsang National University School of medicine and Gyeongsang National University Hospital, Jinju, South Korea
| | - Gyu-Nam Kim
- Department of Ophthalmology, Gyeongsang National University School of medicine and Gyeongsang National University Hospital, Jinju, South Korea
| | - Rock Bum Kim
- Regional Cardiocerebrovascular Disease Center, Gyeongsang National University, Jinju, South Korea
| | - Jae Eun Chae
- Biomedical Research Institute, Gyeongsang National University, Jinju, South Korea
| | - Inyoung Chung
- Department of Ophthalmology, Gyeongsang National University School of medicine and Gyeongsang National University Hospital, Jinju, South Korea.,Gyeongsang Institute of Health Science, Gyeongsang National University, Jinju, South Korea
| | - Seong-Wook Seo
- Department of Ophthalmology, Gyeongsang National University School of medicine and Gyeongsang National University Hospital, Jinju, South Korea.,Gyeongsang Institute of Health Science, Gyeongsang National University, Jinju, South Korea
| | - Seong Jae Kim
- Department of Ophthalmology, Gyeongsang National University School of medicine and Gyeongsang National University Hospital, Jinju, South Korea. .,Gyeongsang Institute of Health Science, Gyeongsang National University, Jinju, South Korea.
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Generational Difference of Axial Length and Its Risk Factors in Urban and Rural China. J Ophthalmol 2019; 2019:1607064. [PMID: 31885881 PMCID: PMC6899268 DOI: 10.1155/2019/1607064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 09/26/2019] [Accepted: 10/15/2019] [Indexed: 11/17/2022] Open
Abstract
Purpose To compare the axial length difference (ALD) and the estimated generational axial length shift (ALS) from parents to their children and its risk factors in urban and rural China. Methods Participants were enrolled from two longitudinal cohort studies, the Beijing Myopia Progression Study (BMPS) and the Handan Offspring Myopia Study (HOMS). Ocular biometry was performed in both parents and their children. ALD was defined as the difference between the children's axial length and the corresponding parental axial length. Generational ALS was estimated according to a binominal prediction model at 18 years of age. Results 237 and 380 urban and rural Chinese children (6–17 years) and their parents from the BMPS and HOMS, respectively, were enrolled. Children's axial length was estimated to be closest to the parental axial length at 11 and 9 years of age in the urban and rural areas, respectively; the estimated generational ALS would be 1.53 and 0.57 mm, respectively. Multivariable regression analysis revealed that older children (urban β = 0.26, p < 0.001; rural β = 0.11, p < 0.001) and males had larger ALD (urban β = 0.55, p < 0.001; rural β = 0.52, p < 0.001) in both areas. Furthermore, urban children with more educated parents (fathers: β = −0.30, p=0.002; mothers: β = −0.29, p=0.004) and more outdoor activity (β = −0.23, p=0.006) had a less ALD. Conclusions The urban generational axial length shift was estimated to be approximately 1 mm longer than that of the rural area. These results suggest different environmental effects on the ocular development in these two populations of Chinese children.
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Thorn F, Chen J, Li C, Jiang D, Chen W, Lin Y, Chang X, Deng R, Chen Y. Refractive status and prevalence of myopia among Chinese primary school students. Clin Exp Optom 2019; 103:177-183. [PMID: 31674055 DOI: 10.1111/cxo.12980] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 09/09/2019] [Accepted: 09/10/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate the prevalence of myopia in key (university-oriented) and non-key elementary schools in China using a traditional and a new criterion for myopia diagnosis in an epidemiological study. METHODS This school-based, cross-sectional study examined students from four key schools and seven non-key schools. Non-cycloplegic autorefraction and visual acuity (VA) were performed on each student. Myopia was defined as a spherical equivalent (SE) refractive error not better than -1.00 D. A questionnaire was also administered. RESULTS Of the 13,220 students examined, 6,546 (49.5 per cent) had myopia using the criterion of SE not better than -1.00 D. However, 2,246 (34.3 per cent) of these myopes had VA ≥ 0 logMAR in both eyes, indicating they were not functioning as myopes. Thus, a second myopia criterion was adopted: SE refractive error not better than -1.00 D + uncorrected VA ≥ 0 logMAR in at least one eye. By this definition, only 32.5 per cent of the overall sample had myopia. Students in key schools had a higher prevalence of myopia than those in non-key schools (53.8 per cent versus 44.7 per cent) by the initial criterion. By the new criterion, the prevalence of myopia was 41.2 per cent versus 22.7 per cent. Myopia was equal in grade 1 of both school types, but accelerated faster in key schools, where there was a much higher prevalence of myopia by fourth grade, and continued up to 79.2 per cent prevalence by sixth grade based on SE refractive error not better than -1.00 D. CONCLUSION Students in more competitive university-oriented elementary schools developed myopia much faster than those in regular schools, although they started with the same level of myopia. Since one-third of the 'myopes' had VA ≥ 0 logMAR in both eyes, they would not be prescribed a correction, or be clinically treated as myopes. A new criterion of SE refractive error not better than -1.00 D + uncorrected VA ≥ 0 logMAR in at least one eye was tested. This criterion is more clinically appropriate and could be used in future epidemiological studies.
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Affiliation(s)
- Frank Thorn
- The Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Jie Chen
- The Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Chunchun Li
- The Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Dandan Jiang
- The Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Wuhe Chen
- The Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yaoyao Lin
- School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiao Chang
- School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ruzhi Deng
- The Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Yanyan Chen
- The Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
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Risk Factors for Incident Myopia among Teenaged Students of the Experimental Class of the Air Force in China. J Ophthalmol 2019; 2019:3096152. [PMID: 31485343 PMCID: PMC6710729 DOI: 10.1155/2019/3096152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 03/15/2019] [Accepted: 07/22/2019] [Indexed: 12/03/2022] Open
Abstract
Background In recent decades, the prevalence rate of myopia has markedly increased, especially among teenagers. Our purpose was to determine the incidence of myopia and identify the related risk factors among schoolchildren in the experimental classes of the Air Force in China. Methods In May 2015, this 3-year prospective cohort study enrolled 522 boys (age, 14–16 years) attending grade 10 in 16 high schools in 15 cities in China. Cycloplegic refraction was examined using retinoscopy in both eyes at the baseline and follow-up (3 years). A detailed questionnaire was completed by the students at the 3-year follow-up and included questions on parental myopia and on the total time spent doing near work and outdoor activities each week. Results The incidence of myopia at the 3-year follow-up was 27.01% (141/522, 95% confidence interval (CI): 23.38% to 30.98%). The refractive change was −0.46 D (95% CI: −0.49 to −0.42 D). More hyperopic or less myopic baseline refraction, outdoor activity time per week ≥14 h (odds ratio (OR) = 0.464, 95% CI: 0.227 to 0.950), and reading/writing distance ≥ 30 cm (OR = 0.505, 95% CI: 0.270 to 0.944) were significant protective factors against incident myopia. Near-work time ≥28 h per week was a significant risk factor (OR = 2.579, 95% CI: 1.314 to 5.061). Parental myopia, age at the start of primary school, continuous reading/writing for ≥1 h, sleep duration per week <49 h, and one or more dietary biases were not significant risk factors (P > 0.05). Conclusion A more hyperopic baseline refraction, more time spent outdoors, and longer writing/reading distance were protected against myopia onset, while more near-work time was a risk factor.
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Li FF, Yam JC. Low-Concentration Atropine Eye Drops for Myopia Progression. Asia Pac J Ophthalmol (Phila) 2019; 8:360-365. [PMID: 31478936 PMCID: PMC6784858 DOI: 10.1097/apo.0000000000000256] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 07/30/2019] [Indexed: 12/13/2022] Open
Abstract
PURPOSE Atropine eye drops is an emerging therapy for myopia control. This article reviews the recent clinical trials to provide a better understanding of the use of atropine eye drops on myopia progression. METHODS All randomized clinical trials of atropine eye drops for myopia progression in the literatures were reviewed. RESULTS Atropine eye drops 1% conferred the strongest efficacy on myopia control. However, its use was limited by the side effects of blurred near vision and photophobia. ATOM 2 study evaluated 0.5%, 0.1%, and 0.01% atropine on 400 myopic children, and suggested that 0.01% is the optimal concentration with good efficacy and minimal side effects. Since then, the use of atropine eye drops has been transitioned from high-concentration to low-concentration worldwide. Recent Low-concentration Atropine for Myopia Progression (LAMP) study evaluated 0.05%, 0.025%, 0.01% atropine eye drops and placebo group in 438 myopic children. The study firstly provided placebo-compared evidence of low-concentration atropine eye drops in myopia control. Furthermore, both efficacy and side effects followed a concentration-dependent response within 0.01% to 0.05% atropine. Among them, 0.05% atropine was the optimal concentration to achieve best efficacy and safety profile. CONCLUSIONS Low concentration atropine is effective in myopia control. The widespread use of low-concentration atropine, especially in East Asia, may help prevent the myopia progression for the high-risk children. Further investigations on the rebound phenomenon following drops cessation, and longer-term individualized treatment approach should be warranted.
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Affiliation(s)
- Fen Fen Li
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong
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Wolffsohn JS, Kollbaum PS, Berntsen DA, Atchison DA, Benavente A, Bradley A, Buckhurst H, Collins M, Fujikado T, Hiraoka T, Hirota M, Jones D, Logan NS, Lundström L, Torii H, Read SA, Naidoo K. IMI - Clinical Myopia Control Trials and Instrumentation Report. Invest Ophthalmol Vis Sci 2019; 60:M132-M160. [PMID: 30817830 DOI: 10.1167/iovs.18-25955] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The evidence-basis based on existing myopia control trials along with the supporting academic literature were reviewed; this informed recommendations on the outcomes suggested from clinical trials aimed at slowing myopia progression to show the effectiveness of treatments and the impact on patients. These outcomes were classified as primary (refractive error and/or axial length), secondary (patient reported outcomes and treatment compliance), and exploratory (peripheral refraction, accommodative changes, ocular alignment, pupil size, outdoor activity/lighting levels, anterior and posterior segment imaging, and tissue biomechanics). The currently available instrumentation, which the literature has shown to best achieve the primary and secondary outcomes, was reviewed and critiqued. Issues relating to study design and patient selection were also identified. These findings and consensus from the International Myopia Institute members led to final recommendations to inform future instrumentation development and to guide clinical trial protocols.
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Affiliation(s)
- James S Wolffsohn
- Ophthalmic Research Group, Aston University, Birmingham, United Kingdom
| | - Pete S Kollbaum
- Indiana University, School of Optometry, Bloomington, Indiana, United States
| | - David A Berntsen
- The Ocular Surface Institute, College of Optometry, University of Houston, Houston, Texas, United States
| | - David A Atchison
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia
| | | | - Arthur Bradley
- Indiana University, School of Optometry, Bloomington, Indiana, United States
| | - Hetal Buckhurst
- School of Health Professions, Peninsula Allied Health Centre, Plymouth University, Plymouth, United Kingdom
| | - Michael Collins
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia
| | - Takashi Fujikado
- Department of Applied Visual Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takahiro Hiraoka
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Masakazu Hirota
- Department of Applied Visual Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Debbie Jones
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Nicola S Logan
- Ophthalmic Research Group, Aston University, Birmingham, United Kingdom
| | | | - Hidemasa Torii
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Scott A Read
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia
| | - Kovin Naidoo
- African Vision Research Institute, University of KwaZulu-Natal, Durban, South Africa
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Harrington SC, O'Dwyer V. Ocular biometry, refraction and time spent outdoors during daylight in Irish schoolchildren. Clin Exp Optom 2019; 103:167-176. [PMID: 31187504 DOI: 10.1111/cxo.12929] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Revised: 04/10/2019] [Accepted: 04/23/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Previous studies have investigated the relationship between ocular biometry and spherical equivalent refraction in children. This is the first such study in Ireland. The effect of time spent outdoors was also investigated. METHODS Examination included cycloplegic autorefraction and non-contact ocular biometric measures of axial length, corneal radius and anterior chamber depth from 1,626 children in two age groups: six to seven years and 12 to 13 years, from 37 schools. Parents/guardians completed a participant questionnaire detailing time spent outdoors during daylight in summer and winter. RESULTS Ocular biometric data were correlated with spherical equivalent refraction (axial length: r = -0.64, corneal radius: r = 0.07, anterior chamber depth: r = -0.33, axial length/corneal radius ratio: r = -0.79, all p < 0.0001). Participants aged 12-13 years had a longer axial length (6-7 years 22.53 mm, 12-13 years 23.50 mm), deeper anterior chamber (6-7 years 3.40 mm, 12-13 years 3.61 mm), longer corneal radius (6-7 years 7.81 mm, 12-13 years 7.87 mm) and a higher axial length/corneal radius ratio (6-7 years 2.89, 12-13 years 2.99), all p < 0.0001. Controlling for age: axial length was longer in boys (boys 23.32 mm, girls 22.77 mm), and non-White participants (non-White 23.21 mm, White 23.04 mm); corneal radius was longer in boys (boys 7.92 mm, girls 7.75 mm); anterior chamber was deeper in boys (boys 3.62 mm, girls 3.55 mm, p < 0.0001), and axial length/corneal radius ratios were higher in non-White participants (non-White 2.98, White 2.94, p < 0.0001). Controlling for age and ethnicity, more time outdoors in summer was associated with a less myopic refraction, shorter axial length, and lower axial length/corneal radius ratio. Non-White participants reported spending significantly less time outdoors than White participants (p < 0.0001). CONCLUSION Refractive error variance in schoolchildren in Ireland was best explained by variation in the axial length/corneal radius ratio with higher values associated with a more myopic refraction. Time spent outdoors during daylight in summer was associated with shorter axial lengths and a less myopic spherical equivalent refraction in White participants. Strategies to promote daylight exposure in wintertime is a study recommendation.
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Affiliation(s)
- Síofra C Harrington
- School of Physics and Clinical and Optometric Sciences, Technological University Dublin, Dublin, Ireland
| | - Veronica O'Dwyer
- School of Physics and Clinical and Optometric Sciences, Technological University Dublin, Dublin, Ireland
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Novel Method of Remotely Monitoring the Face-Device Distance and Face Illuminance Using Mobile Devices: A Pilot Study. J Ophthalmol 2019; 2019:1946073. [PMID: 31281665 PMCID: PMC6594255 DOI: 10.1155/2019/1946073] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/21/2019] [Accepted: 05/13/2019] [Indexed: 12/11/2022] Open
Abstract
Specially developed software (app) was written for handheld electronic devices that uses the device camera and light detector for real-time monitoring of near-work distance and environmental lighting. A pilot study of this novel app employed children using tablet computers in a classroom. Measurements of face-device distance and face illuminance were obtained from two schools where tablets were used regularly. Children were divided randomly into a control group (CG) and intervention group (IG). The app was calibrated in a lab and configured to store average values every 20 seconds in a remote database. In both groups, the app recorded data only when a child's face was present in the camera image. The app darkened the screen for the IG when the face-device distance was shorter than 40 cm. The total mean face-device distance was 36.8 ± 5.7 cm in CG and 47.2 ± 6.5 cm in IG. Children in IG had to accommodate approximately 0.6 D less when using their devices. The mean classroom face illuminance was 980 ± 350 lux in School #1 and 750 ± 400 lux in School #2. The novel method of remotely monitoring and controlling the face-device distance and illuminance can potentially open new paths for myopia prevention and myopia control.
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Liu S, Ye S, Xi W, Zhang X. Electronic devices and myopic refraction among children aged 6-14 years in urban areas of Tianjin, China. Ophthalmic Physiol Opt 2019; 39:282-293. [PMID: 31099434 DOI: 10.1111/opo.12620] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 04/08/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE To assess associations between different types of electronic devices, myopic refraction and ocular biometric parameters in children aged 6-14 years in urban areas of Tianjin, China. METHODS A school-based, cross-sectional study was performed on 566 children (302 boys and 264 girls). The children underwent a comprehensive eye examination, including cycloplegic autorefraction and ocular biometry. The children's parents completed a detailed questionnaire that included each child's demographics, the use of electronic devices and other related risk factors. RESULTS Myopia was not associated with time spent using various electronic devices. However, the mean spherical equivalent refraction (SER) decreased by 0.28 D (p = 0.042) and 0.33 D (p = 0.018) for each 1-h increase in the time spent using smart phones and computers, respectively. In the multiple linear regression analyses of factors associated with the SER, the standardised coefficient B for time spent reading and writing was approximately four to five times larger than the standardised coefficient for time spent using smart phones or computers. Time spent using tablets and watching television was not significantly associated with the SER. A longer axial length (AL) was associated with more time spent using smart phones (B = 0.23, p = 0.006) and computers (B = 0.26, p = 0.002) but not using tablets (p = 0.45) and watching television (p = 0.45). No significant association was found between other ocular biometric parameters and time spent using various electronic devices. CONCLUSIONS On average, a more myopic SER and longer AL were both associated with more time spent using smart phones and computers, but not with time spent using tablets and watching television. The magnitude of the association between SER and time spent reading and writing was a substantially larger than that for smart phone or computer use. Different types of electronic devices had differing levels of association with myopic refraction.
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Affiliation(s)
- Shengxin Liu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Sheng Ye
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wei Xi
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Xin Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
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Huang L, Kawasaki H, Liu Y, Wang Z. The prevalence of myopia and the factors associated with it among university students in Nanjing: A cross-sectional study. Medicine (Baltimore) 2019; 98:e14777. [PMID: 30855486 PMCID: PMC6417623 DOI: 10.1097/md.0000000000014777] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Myopia, a common eye disease, is a global health burden that is increasing worldwide. Although the risk factors for myopia among children have been extensively investigated, those among university students have not. The aim of our study was to investigate the prevalence of myopia and the factors associated with it among university students in Nanjing.Subjects were selected from among the university students using a stratified random sampling method. A total of 1200 first-year university students were invited to participate in the study. A self-reported questionnaire was used to collect data on the students' demographic information, history of parental myopia, and behavioral factors, such as having bad postures while reading or writing, performing eye exercises, taking breaks after 30 minutes of continuous reading, using computers or smartphones, sleep, near-work, and outdoor activity. Univariate analyses were performed to find the associations between myopia and the various parameters. Factors that were statistically significant in univariate analyses were selected as candidate variates for multivariate analysis.The overall prevalence of myopia was 86.8%: 86.1% among males, and 88.0% among females (χ = 0.68, P = .411). Chi-squared tests showed that parental myopia, performing eye exercises, taking breaks after 30 minutes of continuous reading, and engaging in outdoor activity were significantly associated with myopia (P < .001, P = .034, P < .001, and P = .002, respectively). Having at least 1 parent with myopia was a risk factor for myopia (OR = 3.58, 95% CI = 1.96-6.54); whereas, taking breaks after 30 minutes of continuous reading and performing at least 2 hours of outdoor activity per day were protective against myopia in multivariate analysis (OR = 0.61, 95% CI = 0.41-0.93; and OR = 0.45, 95% CI = 0.2-0.99; respectively).The prevalence of myopia among university students was 86.8%. Parental myopia was a risk factor for myopia. Taking breaks after 30 minutes of continuous reading, and engaging in at least 2 hours of outdoor activity were associated with less myopia. In addition, performing eye exercises was associated with less myopia on univariate analysis.
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Affiliation(s)
- Luoming Huang
- Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiromi Kawasaki
- Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yiqun Liu
- School of Material Engineering, Jinling Institute of Technology, Nanjing
| | - Zhongliang Wang
- School of Economics & Management, Changsha University of Science & Technology, Changsha, China
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Hwang HS, Park G, Heo JW, Kim MK, Baek S, Cho B. Estimating heritability of refractive error in Koreans: the Korea National Health and Nutrition Examination Survey. Acta Ophthalmol 2019; 97:e248-e255. [PMID: 30207075 DOI: 10.1111/aos.13915] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 08/09/2018] [Indexed: 01/11/2023]
Abstract
PURPOSE To estimate the familial correlation and heritability of refractive error in general Korean population. METHODS From the Korea National Health and Nutrition Examination Survey, 13 258 subjects of 7920 families, who were aged ≥19 years, were included in the study. Using variance components analysis, the additive genetic effect, or heritability, and the common and unique environmental effects on refractive error were examined, adopting common environments shared by cohabiting family or by siblings. RESULTS The proportions of hyperopia, myopia and high myopia in Koreans were 0.8%, 45.2% and 5.7% respectively. The correlation coefficients of spherical equivalent (SE) were 0.257 for parent-offspring pairs, 0.410 for sibling pairs and 0.112 for spouse pairs (p < 0.001 for all). Common environment shared by siblings affected the variation of SE significantly (p < 0.001), but that shared by cohabitants did not (p = 0.395). Adopting common environment shared by siblings, the heritability, common environmental effect and unique environmental effect of refractive error were 42.1 ± 3.3%, 11.8 ± 3.5% and 46.1 ± 3.9% respectively. Heritabilities of hyperopia, myopia and high myopia were 45.7%, 44.3% and 68.9% respectively. Adjusted odds ratios of myopia among offspring were 3.78 given one parent has myopia and 4.43 when both parents have myopia. CONCLUSION Refractive error is influenced by common environment shared by siblings. The heritability of refractive error is higher for high myopia than for myopia or hyperopia.
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Affiliation(s)
- Ho Sik Hwang
- Department of Ophthalmology Chuncheon Sacred Heart Hospital Hallym University College of Medicine Chuncheon Korea
| | - Gyeong‐Hun Park
- Department of Dermatology Dongtan Sacred Heart Hospital Hallym University College of Medicine Hwaseong Korea
| | - Jang Won Heo
- Department of Ophthalmology Seoul National University College of Medicine Seoul Korea
| | - Mee Kum Kim
- Department of Ophthalmology Seoul National University College of Medicine Seoul Korea
| | - Seung‐Hee Baek
- Department of Ophthalmology Kim's Eye Hospital Konyang University College of Medicine Seoul Korea
| | - Bum‐Joo Cho
- Department of Ophthalmology Chuncheon Sacred Heart Hospital Hallym University College of Medicine Chuncheon Korea
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Prevalence of Myopia and Associated Risk Factors in Schoolchildren in North India. Optom Vis Sci 2019; 96:200-205. [DOI: 10.1097/opx.0000000000001344] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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