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Kim H, Shahraki K, Suh DW. Myopia trends among children and adolescents: a nationwide study in South Korea. J AAPOS 2024; 28:103969. [PMID: 38997085 DOI: 10.1016/j.jaapos.2024.103969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 03/24/2024] [Accepted: 04/05/2024] [Indexed: 07/14/2024]
Abstract
PURPOSE To evaluate gender disparities in the progression of myopia among children and adolescents in South Korea. METHODS Nationwide cross-sectional data of 1,190 subjects aged 10-18 years was obtained for the years of 2011 (baseline) and 2021 using the Korea National Health and Nutrition Examination Surveys. The prevalence of myopia, as well as data regarding age, household income, height, weight, body mass index, and age of menarche, were evaluated. Myopia was defined as a spherical equivalent (SE) ≤ -0.5 D. RESULTS The prevalence of myopia among boys was stable in 2021 compared to 2011, with rates of 53.7% and 52.8%, respectively (P = 0.372). Among girls, however, there was a statistically significant increase in myopia prevalence in 2021 compared to 2011, with rates of 73.7% and 51.6% (P < 0.001), respectively. Over 10 years, the adjusted prevalence ratio for myopia in boys was 1.11 (95% CI, 0.77-1.61), whereas myopia prevalence in girls underwent a 1.87-fold increase over the same period (95% CI, 1.30-2.69), and menarche at 12 years of age or older was associated with less myopia in girls (PR = 0.84; 95% CI, 0.72-0.99). The spherical equivalent refraction in girls increased significantly over the same 10-year period, from -1.09 ± 0.13 D to -1.58 ± 0.17 D (P < 0.017), whereas in boys, there was no significant difference (P = 0.604). CONCLUSIONS In our study cohort, the prevalence of myopia increased significantly among girls compared with boys over the course of decade. Additionally, an association between early menarche in girls and the prevalence of myopia was observed.
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Affiliation(s)
- Hyojin Kim
- Department of Optometry, Graduate School of Christian Studies, Baekseok University, Seocho-ku, Seoul, Republic of Korea; Division of Health Science, Baekseok University, Cheonan-si, Republic of Korea
| | - Kourosh Shahraki
- Department of Ophthalmology, Gavin Herbert Eye Institute, University of California Irvine
| | - Donny W Suh
- Department of Ophthalmology, Gavin Herbert Eye Institute, University of California Irvine.
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Chawla O, Singh A, Kumawat D, Chowdhury N, Kumar B. Systematic Review of Sleep Duration and Development of Myopia. Cureus 2024; 16:e56216. [PMID: 38618360 PMCID: PMC11016326 DOI: 10.7759/cureus.56216] [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] [Accepted: 03/15/2024] [Indexed: 04/16/2024] Open
Abstract
There is a knowledge gap in the relationship between sleep duration and myopia. Since sleep duration is a modifiable risk factor, its association with the development and progression of myopia has implications for public health. This review was conducted in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The bibliographic databases of PubMed and Scopus were searched for published studies on the association between sleep duration and myopia. These databases were searched in December 2023 with no date or study design limits. The relevant literature was extracted and met the priori determined population (children, adolescents, and adults suffering from myopia with or without corrective glasses), intervention/exposure (sleep), and the outcome (various indicators of sleep especially sleep duration/bedtime/wake time and sleep quality). Data were gathered by gender, age, and refraction technique and standardized to the definition of myopia as refractive error ≥0.50 diopter. The relevant literature was extracted from these electronic databases using the keywords "sleep," "sleep duration," "bedtime," and "myopia." English language articles related to the topic were included. Articles that have discussed the role of risk factors for myopia but did not mention any relation to sleep were excluded. Sixteen studies were included after reviewing the relevant literature, and only six studies have shown a significant relationship between shorter duration of sleep and the development of myopia. This review suggests that apart from other environmental factors, sleep duration may have a role in developing myopia. Thus, increasing awareness about optimum sleep duration has a potential utility to reduce the development and progression of myopia.
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Affiliation(s)
- Omna Chawla
- Department of Physiology, Government Doon Medical College, Dehradun, IND
| | - Anupam Singh
- Department of Ophthalmology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Devesh Kumawat
- Department of Ophthalmology, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Nilotpal Chowdhury
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Barun Kumar
- Department of Cardiology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
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Li Q, Zhou W, Liao Y, Chen H, Sun Y, Wang M, Wang X, Wang W. Prevalence Trend of Myopia during the Post-COVID-19 Epidemic Period among Preschoolers: A Prospective School-based Study. Optom Vis Sci 2023; 100:727-734. [PMID: 37678562 DOI: 10.1097/opx.0000000000002069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023] Open
Abstract
SIGNIFICANCE Changes in behavior and lifestyle during the post-coronavirus disease 2019 (COVID-19) epidemic may have some impact on myopia rates in preschoolers, and exploring the changes in myopia rates in preschool children may inform the formulation of myopia prevention and control policies. PURPOSE This study aimed to investigate the prevalence of myopia in preschool children during the post-COVID-19 epidemic period in Xuzhou, China. METHODS A series of cross-sectional school-based studies was conducted. A total of 117,632 preschool children aged 3 to 6 years were subjected to annual vision screening from 2019 to 2021. Spot photo screening was used to record the spherical equivalent refraction for each child and to analyze the prevalence of myopia by age, sex, and region during the post-COVID-19 epidemic period. RESULTS A total of 113,979 preschool children were included in the analysis, of whom 60,784 (53.3%) were male and 53,195 (46.7%) were female. For all children, the mean ± standard deviation spherical equivalent refraction in 2019, 2020, and 2021 was +0.32 ± 0.50, +0.34 ± 0.55, and +0.34 ± 0.54 D, respectively (all P < .05), indicative of a very slight hyperopic shift. In all age groups, the change in mean spherical equivalent refraction and its distribution were relatively stable. From 2019 to 2021, the overall prevalence of myopia in preschool children was 3.1, 3.3, and 3.5%, respectively. The rise in myopia rates was minimal. The largest increase in the annual prevalence of myopia was seen among children aged 6 years, at 0.5%, followed by those aged 5 years (0.4%) and aged 3 years (0.4%). The prevalence was higher in boys than girls and in urban versus rural areas. CONCLUSIONS During the post-COVID-19 epidemic period, the refractive status of Xuzhou preschool children remained stable.
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Affiliation(s)
- Qin Li
- Department of Ophthalmology, Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, China
| | - Wen Zhou
- Department of Ophthalmology, Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, China
| | - Ya Liao
- Department of Ophthalmology, Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, China
| | - Hongyan Chen
- Department of Ophthalmology, Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, China
| | - Yanmei Sun
- Department of Ophthalmology, Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, China
| | - Mei Wang
- Department of Ophthalmology, Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, China
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Khader Y, Wang C, Guo X, Xu H, Qin Z, Tao L. Effects of Greenness on Myopia Risk and School-Level Myopia Prevalence Among High School-Aged Adolescents: Cross-sectional Study. JMIR Public Health Surveill 2023; 9:e42694. [PMID: 36622746 PMCID: PMC9871879 DOI: 10.2196/42694] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 11/26/2022] [Accepted: 11/28/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Myopia is a serious public health issue. High school-aged adolescents in Beijing have an alarming prevalence of myopia. Therefore, determining myopia protective factors is essential. Green space has a certain association with myopia protective factors that can protect against myopia. OBJECTIVE This study aims to examine the effects of green space around schools on individual myopia risk in high school-aged adolescents and the school-level myopia prevalence. METHODS Green space was measured using the normalized difference vegetation index (NDVI). A total of 13,380 samples of 51 high schools were selected from a 2021 Beijing Municipal Health Commission survey. Adolescent myopia was defined as a spherical equivalent of ≤-1.00 diopters in the worse eye. Generalized linear mixed models with a binomial error structure were used to analyze the effects of the NDVI on personal myopia risk and adjust them by other factors, such as demographics, exposure time, and outdoor exercise. The effects of the NDVI on school-level myopia prevalence with adjusted demographics and the relative position factors of trees were analyzed through quasibinomial regression. RESULTS The overall prevalence of myopia was 80.61% (10,785/13,380, 95% CI 79.93%-81.27%). Although with a 0.1 increase in the 500 and 1000 m buffer NDVIs adjusted by demographic and other factors, the high school-aged personal myopia risk significantly dropped by 16% (odds ratio [OR] 0.84, 95% CI 0.73-0.97) and 12% (OR 0.88, 95% CI 0.79-0.99), respectively. However, only the adjusted 500 m buffer NDVI (by demographics and the position of trees) with a 0.1 increase significantly reduced the school-level myopia prevalence by 15% (OR 0.85, 95% CI 0.74-0.98). Subgroup analysis showed that the adjusted effects of the 500 m buffer NDVI are significant in schoolgirls (OR 0.82, 95% CI 0.72-0.93), juniors (OR 0.82, 95% CI 0.72-0.94), the Han nationality (OR 0.84, 95% CI 0.72-0.97), 1-year exposure (OR 0.84, 95% CI 0.71-0.99) and 3-year exposure (OR 0.78, 95% CI 0.65-0.94). CONCLUSIONS The greenness of a 500 m buffer around schools is associated with a lower personal myopia risk among adolescents and a lower prevalence of myopia in schools. With regard to prevention and control activities, green space within a 500 m buffer around schools is suggested as an independent protective factor for adolescent myopia.
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Affiliation(s)
| | - Cheng Wang
- Research Institute of Forestry, Chinese Academy of Forestry, Beijing, China
| | - Xin Guo
- Institute of School Health, Beijing Center for Disease Prevention and Control, Beijing, China.,School of Public Health, Capital Medical University, Beijing, China
| | - Huiyu Xu
- Institute of School Health, Beijing Center for Disease Prevention and Control, Beijing, China.,School of Public Health, Capital Medical University, Beijing, China
| | - Zihao Qin
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Liyuan Tao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China.,Medical Examination Centre, Peking University Third Hospital, Beijing, China
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Lyu IJ, Oh SY. Association between age at menarche and risk of myopia in the United States: NHANES 1999-2008. PLoS One 2023; 18:e0285359. [PMID: 37146094 PMCID: PMC10162551 DOI: 10.1371/journal.pone.0285359] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 04/22/2023] [Indexed: 05/07/2023] Open
Abstract
We evaluate the effect of menarche on myopia in women in the United States (US). A cross-sectional survey and examination were conducted using data from the 1999-2008 US National Health and Nutrition Examination Survey (NHANES), and 8,706 women aged ≥20 years (95% confidence interval [CI], 44.23 to 45.37) were enrolled. Characteristics were compared between nonmyopic and myopic participants. Univariable and multivariable logistic regression analysis was performed to evaluate the risk factors for myopia. A minimum p-value approach was used to estimate the cut-off point for age at menarche. The prevalence of myopia was 32.96%. Mean spherical equivalent (SE) were -0.81 diopters (95% CI, -0.89 to -0.73) and the mean age of menarche was 12.67 years (95% CI, 12.62 to 12.72). In the crude logistic regression model, age (odd ratio [OR] 0.98), height (OR, 1.02), astigmatism (OR, 1.57) (all p < 0.0001), age at menarche (OR, 0.95; p = 0.0005), white ethnicity, being born in the US, higher level of education, and higher annual household income (all p trend <0.0001) were significantly associated with myopia. 1-year increments in age at menarche was associated with a 4% decrease in the risk of myopia after adjusting for age, height, body mass index (BMI), ethnicity, and astigmatism (OR, 0.96; 95% CI, 0.93 to 0.99, p = 0.0288). The cut-off value for age at menarche was 15 years by the maximum chi-square test (p < 0.0001). Age at menarche may attribute to myopia progression, along with other environmental and individual risk factors.
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Affiliation(s)
- In Jeong Lyu
- Department of Ophthalmology, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea
| | - Sei Yeul Oh
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Myopia: Mechanisms and Strategies to Slow Down Its Progression. J Ophthalmol 2022; 2022:1004977. [PMID: 35747583 PMCID: PMC9213207 DOI: 10.1155/2022/1004977] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 05/29/2022] [Indexed: 12/15/2022] Open
Abstract
This topical review aimed to update and clarify the behavioral, pharmacological, surgical, and optical strategies that are currently available to prevent and reduce myopia progression. Myopia is the commonest ocular abnormality; reinstated interest is associated with high and increasing prevalence, especially but not, in the Asian population and progressive nature in children. The growing global prevalence seems to be associated with both genetic and environmental factors such as spending more time indoor and using digital devices, particularly during the coronavirus disease 2019 pandemic. Various options have been assessed to prevent or reduce myopia progression in children. In this review, we assess the effects of several types of measures, including spending more time outdoor, optical interventions such as the bifocal/progressive spectacle lenses, soft bifocal/multifocal/extended depth of focus/orthokeratology contact lenses, refractive surgery, and pharmacological treatments. All these options for controlling myopia progression in children have various degrees of efficacy. Atropine, orthokeratology/peripheral defocus contact and spectacle lenses, bifocal or progressive addition spectacles, and increased outdoor activities have been associated with the highest, moderate, and lower efficacies, respectively.
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Xu R, Zhong P, Jan C, Song Y, Xiong X, Luo D, Dong Y, Ma J, Stafford RS. Sex Disparity in Myopia Explained by Puberty Among Chinese Adolescents From 1995 to 2014: A Nationwide Cross-Sectional Study. Front Public Health 2022; 10:833960. [PMID: 35712300 PMCID: PMC9196902 DOI: 10.3389/fpubh.2022.833960] [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] [Received: 01/10/2022] [Accepted: 04/20/2022] [Indexed: 11/29/2022] Open
Abstract
Importance Girls in East Asia have a higher myopia prevalence than boys. Less research has been done on whether girls' earlier puberty could explain this sex difference. Objective The purpose of this study was to evaluate the association between myopia and puberty and the role of puberty in explaining the sex disparity in adolescent myopia prevalence. Design, Setting, and Participants In this nationwide cross-sectional study, data came from five consecutive national surveys from 1995 to 2014 in China. We included 338,896 boys aged 11–18 and 439,481 girls aged 9–18. Main Outcomes and Measures Myopia was defined according to unaided distance visual acuity and subjective refraction; puberty status was defined dichotomously as menarche or spermarche status. The association between myopia and puberty was evaluated by robust Poisson GEE regression. Mediation analyses were used to quantify how much of the sex disparity in myopia could be explained by puberty. Results Post-menarche girls and post-spermarche boys showed 29–41% and 8–19% higher risk of myopia than pre-menarche girls and pre-spermarche boys, respectively. The association remained significant in girls [prevalence ratio (PR) = 1.07, 95%CI:1.04–1.10] but disappeared in boys (p > 0.05) after adjusting for potential confounders. Girls had a 12–23% higher risk of myopia than boys. A total of 16.7% of the sex disparity in myopia could be explained by girls' earlier puberty, whereas 11.1% could be explained by behavioral factors. Conclusion and Relevance Puberty status is independently associated with myopia in girls but not in boys. A significant proportion of the sex disparity in adolescent myopia could be explained by girls' earlier puberty, suggesting the need to consider sex-differentiated strategies for myopia prevention and treatment.
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Affiliation(s)
- Rongbin Xu
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China.,School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Panliang Zhong
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China
| | - Catherine Jan
- Lost Child's Vision Project, Sydney, NSW, Australia.,Centre for Eye Research Australia, University of Melbourne, Melbourne, VIC, Australia.,Department of Ophthalmology and Surgery, Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Yi Song
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China
| | - Xiuqin Xiong
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Dongmei Luo
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China
| | - Yanhui Dong
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China
| | - Jun Ma
- School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China
| | - Randall S Stafford
- Department of Medicine, Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, United States
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Saxena R, Gupta V, Rakheja V, Dhiman R, Bhardawaj A, Vashist P. Lifestyle modification in school-going children before and after COVID-19 lockdown. Indian J Ophthalmol 2021; 69:3623-3629. [PMID: 34827007 PMCID: PMC8837368 DOI: 10.4103/ijo.ijo_2096_21] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose To evaluate the impact of COVID-19 lockdown restrictions on lifestyle of school-going children. Methods This was a questionnaire-based prospective study of 1237 school children aged 9-14 years enrolled from various private and government schools across Delhi in October-December 2020. These children were being followed-up over the previous 2 years (before pandemic) with details of their lifestyle like near/outdoor/reading activities using a questionnaire as a part of another study. The data during the COVID-19 lockdown was collected by telephonic interview. This was compared to similar information collected from this cohort in the pre-Covid period in 2019 when the students had a regular physical school curriculum. Results A significant decline was noted in time spent on outdoor activity (from 8.5 hours/week in pre-COVID-19 time to 1.6 hours/week during COVID-19 lockdown; P < 0.001) and doing homework offline (from 15.3 hour/week to 14 hours/week; P < 0.001). A significant increase was noted in screen time spent on digital devices (from 6.2 hours/week to 19.8 hours/week; P<0.001), and watching television (from 12.2 hours/week to 13.4 hours/week; P < 0.001). The rise in the digital on-screen time was significantly more in boys (P < 0.001) and in students from private schools (P < 0.001). The rise in the duration of watching television was significantly more in girls than boys (P < 0.05). Conclusion COVID-19 lockdown has markedly impacted the lifestyle of school children by significantly decreasing the outdoor activity and increasing the screen time, thereby pre-disposing them to ocular ill-health and myopia. This necessitates the adoption of guidelines for promoting healthy digital habits in children.
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Affiliation(s)
- Rohit Saxena
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Vivek Gupta
- Department of Community Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Vaishali Rakheja
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Rebika Dhiman
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Amit Bhardawaj
- Department of Community Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Praveen Vashist
- Department of Community Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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