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Zhao X, He Y, Zhang J, Lin S, Zou H, Ma Y. Effects of Insufficient Sleep on Myopia in Children: A Systematic Review and Meta-Analysis. Nat Sci Sleep 2024; 16:1387-1406. [PMID: 39308665 PMCID: PMC11416795 DOI: 10.2147/nss.s472748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 08/30/2024] [Indexed: 09/25/2024] Open
Abstract
Myopia is increasingly prevalent in children. Its association with insufficient sleep has been studied, yielding inconsistent findings. This review aims to assess the association of insufficient sleep with myopia and myopia-related refractive parameters in children. A total of 657 articles were identified, of which 40 were included in the systematic review and 33 were included in the meta-analysis. Results showed that insufficient sleep was significantly associated with an increased prevalence of myopia (odds ratio [OR] = 1.59; 95% confidence interval [CI] = 1.31, 1.95; I 2 = 99%), and an increased prevalence of high myopia (OR = 3.36; 95% CI = 1.26, 9.00; I 2 = 96%). Shorter sleep duration was significantly linked to faster changes in axial length (AL) (β = 0.05; 95% CI = 0.02, 0.08; I 2 = 0%). However, correlation between insufficient sleep and the incidence of myopia, spherical equivalent refraction, corneal curvature radius (CR) and AL/CR were insignificant. Moreover, the effect of insufficient sleep on premyopia and astigmatism was not well-studied. The results of this study suggest that insufficient sleep may be an important risk factor for the development of myopia in school-aged children. Therefore, in addition to ensuring sufficient outdoor activities and reducing near work, it is necessary to inform children and parents about the importance of adequate sleep to mitigate the risk of myopia.
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Affiliation(s)
- Xixuan Zhao
- Shanghai Eye Diseases Prevention & Treatment Center/ Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
- National Clinical Research Center for Eye Diseases, Shanghai, People’s Republic of China
- Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai, People’s Republic of China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Yining He
- Biostatistics Office of Clinical Research Unit, Shanghai Ninth People’s Hospital, Shanghai, People’s Republic of China
| | - Juzhao Zhang
- Shanghai Eye Diseases Prevention & Treatment Center/ Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
- National Clinical Research Center for Eye Diseases, Shanghai, People’s Republic of China
- Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai, People’s Republic of China
| | - Senlin Lin
- Shanghai Eye Diseases Prevention & Treatment Center/ Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
- National Clinical Research Center for Eye Diseases, Shanghai, People’s Republic of China
- Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai, People’s Republic of China
| | - Haidong Zou
- Shanghai Eye Diseases Prevention & Treatment Center/ Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
- National Clinical Research Center for Eye Diseases, Shanghai, People’s Republic of China
- Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai, People’s Republic of China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Yingyan Ma
- Shanghai Eye Diseases Prevention & Treatment Center/ Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai, People’s Republic of China
- National Clinical Research Center for Eye Diseases, Shanghai, People’s Republic of China
- Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai, People’s Republic of China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
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Shing E, Kam KW, Zaabaar E, Zhang XJ, Young AL, Pang CP, Tham CC, Yam JC, Chen LJ. Heritability and Genetic Factors of Astigmatism and Corneal Curvature: A Systematic Review and Meta-analysis. Am J Ophthalmol 2024; 269:161-171. [PMID: 39216595 DOI: 10.1016/j.ajo.2024.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 05/25/2024] [Accepted: 08/16/2024] [Indexed: 09/04/2024]
Abstract
PURPOSE To systematically review and meta-analyze all reported heritability studies of refractive astigmatism (RA), corneal astigmatism (CA) and corneal curvature (CC), and evaluate the existing genetic associations of RA, CA and CC. DESIGN Systematic review and meta-analysis (PROSPERO ID: CRD42023447370). METHODS Studies that reported the heritability and genetic associations of RA, CA and/or CC were identified from PubMed, Web of Science and EMBASE (from inception to October 1, 2023). Newcastle-Ottawa Scale criteria was used to assess the risk of bias. Meta-analyses of heritability were conducted using random-effects model for mean difference. All current genetic associations were catalogued according to level of statistical significance. RESULTS Pooled heritabilities were moderate for RA (h2 = 0.46, 95% CI: 0.27-0.65), CA (h2 = 0.48, 95% CI: 0.38-0.58) and CC (h2 = 0.64, 95% CI: 0.53-0.76). Subgroup analyses revealed significant differences between analysis methods (CA: P < .01; CC: P = .03) and populations (CA: P < .01; CC: P < .01) in both CA and CC, and between age groups in CA (P < .01). Totally 50 single-nucleotide polymorphisms (SNPs) in 10 genes have been reported with overlapping associations with RA, CA, and/or CC, with BMP3, FMNL2, HERC2, PROX1-AS1, and ZC3H11B associated with RA and CA, FBN1, NHSL1, and PDGFRA with CA and CC, TRAF3IP1 with RA and CC, and CASC15 with RA, CA, and CC. CONCLUSIONS This study confirms moderate heritabilities of RA, CA and CC. Through evaluating overlapping SNPs or genes between these three phenotypes, we prioritized 50 SNPs in 10 genes as candidate variants for further validation. These findings highlight the complex genetic architecture of astigmatism and indicate shared and distinct genetic markers for different astigmatism-related corneal parameters. Future studies in different populations and functional studies evaluating the roles of the involved genes in astigmatism are warranted.
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Affiliation(s)
- Erica Shing
- From the Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong (E.S., K.W.K., E.Z., X.J.Z., A.L.Y., C.P.P., C.C.T., J.C.Y., L.J.C.), Hong Kong, China
| | - Ka Wai Kam
- From the Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong (E.S., K.W.K., E.Z., X.J.Z., A.L.Y., C.P.P., C.C.T., J.C.Y., L.J.C.), Hong Kong, China; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital (K.W.K., A.L.Y., C.P.P., C.C.T., J.C.Y., L.J.C.), Hong Kong, China
| | - Ebenezer Zaabaar
- From the Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong (E.S., K.W.K., E.Z., X.J.Z., A.L.Y., C.P.P., C.C.T., J.C.Y., L.J.C.), Hong Kong, China
| | - Xiu Juan Zhang
- From the Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong (E.S., K.W.K., E.Z., X.J.Z., A.L.Y., C.P.P., C.C.T., J.C.Y., L.J.C.), Hong Kong, China
| | - Alvin L Young
- From the Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong (E.S., K.W.K., E.Z., X.J.Z., A.L.Y., C.P.P., C.C.T., J.C.Y., L.J.C.), Hong Kong, China; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital (K.W.K., A.L.Y., C.P.P., C.C.T., J.C.Y., L.J.C.), Hong Kong, China
| | - Chi Pui Pang
- From the Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong (E.S., K.W.K., E.Z., X.J.Z., A.L.Y., C.P.P., C.C.T., J.C.Y., L.J.C.), Hong Kong, China; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital (K.W.K., A.L.Y., C.P.P., C.C.T., J.C.Y., L.J.C.), Hong Kong, China
| | - Clement C Tham
- From the Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong (E.S., K.W.K., E.Z., X.J.Z., A.L.Y., C.P.P., C.C.T., J.C.Y., L.J.C.), Hong Kong, China; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital (K.W.K., A.L.Y., C.P.P., C.C.T., J.C.Y., L.J.C.), Hong Kong, China; Hong Kong Eye Hospital (C.C.T., J.C.Y., L.J.C.), Hong Kong, China
| | - Jason C Yam
- From the Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong (E.S., K.W.K., E.Z., X.J.Z., A.L.Y., C.P.P., C.C.T., J.C.Y., L.J.C.), Hong Kong, China; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital (K.W.K., A.L.Y., C.P.P., C.C.T., J.C.Y., L.J.C.), Hong Kong, China; Hong Kong Eye Hospital (C.C.T., J.C.Y., L.J.C.), Hong Kong, China.
| | - Li Jia Chen
- From the Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong (E.S., K.W.K., E.Z., X.J.Z., A.L.Y., C.P.P., C.C.T., J.C.Y., L.J.C.), Hong Kong, China; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital (K.W.K., A.L.Y., C.P.P., C.C.T., J.C.Y., L.J.C.), Hong Kong, China; Hong Kong Eye Hospital (C.C.T., J.C.Y., L.J.C.), Hong Kong, China.
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Wei D, Wang H, Huang L, Hou M, Liang HG, Shi X, Wei X, Li J, Gan L, Lv B, Deng J, Qing L. A Mendelian randomization study on the causal relationship between smoking, alcohol consumption, and the development of myopia and astigmatism. Sci Rep 2024; 14:1868. [PMID: 38253641 PMCID: PMC10803726 DOI: 10.1038/s41598-024-52316-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 01/17/2024] [Indexed: 01/24/2024] Open
Abstract
The influence of environmental factors like smoking and alcohol on myopia and astigmatism is controversial. However, due to ethical concerns, alternative study designs are urgently needed to assess causal inference, as mandatory exposure to cigarettes and alcohol is unethical. Following comprehensive screenings, 326 single nucleotide polymorphisms (SNPs) related to myopia and astigmatism were included in the dataset. To validate the causal association between exposures such as cigarette smoking, alcohol consumption, and coffee intake, and outcomes namely astigmatism and myopia, five regression models were employed. These models encompassed MR-Egger regression, random-effects inverse-variance weighted (IVW), weighted median estimator (WME), weighted model, and simple model. The instrumental variables utilized in these analyses were the aforementioned SNPs. Apply Cochran's Q test to determine heterogeneity of SNPs; if heterogeneity exists, focus on IVW model results. The IVW model showed a 1.379-fold increase in the risk of astigmatism (OR = 1.379, 95%CI 0.822~2.313, P = 0.224) and a 0.963-fold increase in the risk of myopia (OR = 0.963, 95%CI 0.666~1.393, P = 0.841) for each unit increase in smoking. For each unit increase in coffee intake, the risk of astigmatism increased 1.610-fold (OR = 1.610, 95%CI 0.444~5.835, P = 0.469) and the risk of myopia increased 0.788-fold (OR = 0.788, 95%CI 0.340~1.824, P = 0.578). For each additional unit of alcohol consumption, the risk of astigmatism increased by 0.763-fold (OR = 0.763, 95%CI 0.380~1.530, P = 0.446), and none of the differences were statistically significant. However, for each unit of alcohol consumption, the risk of myopia increased by 1.597 times, and the difference was statistically significant (OR = 1.597, 95%CI 1.023~2.493, P = 0.039). The findings indicate that alcohol consumption is a risk factor for myopia but smoking and coffee intake do not affect its development. Additionally, there is no association between smoking, alcohol consumption, coffee intake, and the risk of astigmatism.
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Affiliation(s)
- Diyao Wei
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China
| | - Huanyan Wang
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China.
| | - Ling Huang
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China
| | - Minghui Hou
- Department of Pediatrics, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510630, China
| | - Hong-Gang Liang
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China
| | - Xiang Shi
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China
| | - Xianghui Wei
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China
| | - Jingrong Li
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China
| | - Liuzhu Gan
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China
| | - Bi Lv
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China
| | - Jiabi Deng
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China
| | - Lulu Qing
- Department of Ophthalmology, Liuzhou Red Cross Hospital/ Eye Hospital of Liuzhou City, Liuzhou, 545001, China
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Zhang L, Zeng L, Ye Y, Zhang Z, Liu F, Xian Y, Shen Y, Sun L, Xu Y, Zheng K, Zhou X, Zhao J. Refractive and corneal astigmatism in Chinese 4-15 years old children: prevalence and risk factors. BMC Ophthalmol 2023; 23:449. [PMID: 37950161 PMCID: PMC10638796 DOI: 10.1186/s12886-023-03201-y] [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: 03/13/2023] [Accepted: 11/06/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND To investigate the prevalence and risk factors of refractive astigmatism (RA) and corneal astigmatism (CA) in preschool children and school-aged children in Shanghai, China. METHODS In this school-based, cross-sectional study, 4-15 years old children across three learning stages of kindergarten, primary school, and junior high school underwent noncycloplegic autorefraction and completed comprehensive questionnaires involving time spent on daily homework and outdoor activities. Data from the right eyes were analysed. RESULTS Overall, 7084 children (mean ± standard deviation (SD) of age: 8.08 ± 3.11 years) were included, and the prevalence rates of RA/CA ( ≤ - 1.0 D) in children were 15.8%/64% in kindergartens, 16.5%/65% in primary schools, and 32.8%/76.9% in junior high schools. The magnitude and prevalence of RA and CA all increased with age or with learning stage (all P < 0.001). The presence of RA was associated with more myopic spherical power (odds ratio (OR) 0.956, P = 0.021), junior high school (OR 1.973, P < 0.001), longer homework time on weekdays (OR 1.074, P = 0.029), and shorter outdoor activity time on weekends (odds ratio 0.929, P = 0.013). CONCLUSION In the wide age range of 4 to 15 years, the magnitude and prevalence of RA and CA increased with the learning stage, and these increases mainly began at the primary school stage. Factors, including longer homework time and shorter outdoor time were correlated with the presence of RA.
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Affiliation(s)
- Luoli Zhang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 200031, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), 200031, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, 200031, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, 200031, Shanghai, China
| | - Li Zeng
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 200031, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), 200031, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, 200031, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, 200031, Shanghai, China
| | - Yuhao Ye
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 200031, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), 200031, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, 200031, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, 200031, Shanghai, China
| | - Zhe Zhang
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 200031, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), 200031, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, 200031, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, 200031, Shanghai, China
| | - Fang Liu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 200031, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), 200031, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, 200031, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, 200031, Shanghai, China
| | - Yiyong Xian
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 200031, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), 200031, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, 200031, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, 200031, Shanghai, China
| | - Yang Shen
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 200031, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), 200031, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, 200031, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, 200031, Shanghai, China
| | - Ling Sun
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 200031, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), 200031, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, 200031, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, 200031, Shanghai, China
| | - Ye Xu
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 200031, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), 200031, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, 200031, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, 200031, Shanghai, China
| | - Ke Zheng
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 200031, Shanghai, China
- National Health Commission Key Lab of Myopia (Fudan University), 200031, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, 200031, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, 200031, Shanghai, China
| | - Xingtao Zhou
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 200031, Shanghai, China.
- National Health Commission Key Lab of Myopia (Fudan University), 200031, Shanghai, China.
- Shanghai Research Center of Ophthalmology and Optometry, 200031, Shanghai, China.
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, 200031, Shanghai, China.
| | - Jing Zhao
- Department of Ophthalmology, Eye and ENT Hospital of Fudan University, 200031, Shanghai, China.
- National Health Commission Key Lab of Myopia (Fudan University), 200031, Shanghai, China.
- Shanghai Research Center of Ophthalmology and Optometry, 200031, Shanghai, China.
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, 200031, Shanghai, China.
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Kam KW, Chee ASH, Tang RCY, Zhang Y, Zhang XJ, Wang YM, Li SL, Chen LJ, Young AL, Tham CC, Pang CP, Yam JC. Differential compensatory role of internal astigmatism in school children and adults: The Hong Kong Children Eye Study. Eye (Lond) 2023; 37:1107-1113. [PMID: 35473966 PMCID: PMC10102244 DOI: 10.1038/s41433-022-02072-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 03/30/2022] [Accepted: 04/08/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND To compare the prevalence of refractive (RA), corneal (CA), and internal astigmatism (IA) in Hong Kong children and adults and evaluate the role of IA in compensating for total astigmatism and its relations to myopic traits. METHODS The Hong Kong Children Eye Study is a population-based cross-sectional study. Totally 3704 school children (mean age 7.5 ± 1.0 years) and 5577 adults (mean age 41.1 ± 7.5 years), who were their parents, were recruited. Cycloplegic and non-cycloplegic refractive cylinders were obtained from children and adults, respectively. Spearman correlation was applied to detect associations between astigmatism, ocular biometrics, refraction, and lens power. Astigmatism compensation factor (CF) was derived from the power vector analysis J0 and J45. RESULTS The prevalence of RA (≤-1.0 D), CA (≥+1.0 D) and IA (≥+1.0 D) was 21.9%, 63.9%, and 9.9% in children, and 30.9%, 39.5%, and 23.7% in adults respectively. The mean RA, CA and IA values in children and adults were -0.69 ± 0.66 D, +1.14 ± 0.61 D, +0.62 ± 0.32 D, and -0.80 ± 0.74 D, +0.97 ± 0.69 D, and +0.76 ± 0.43 D, respectively. In adults and children, IA was negatively correlated with axial length (p < 0.0001), but positively correlated with spherical values and equivalent (p < 0.0001), suggesting an association of astigmatism with myopic traits. A greater proportion of children exhibited compensation by IA than adults in J0 (86.6% vs. 66.0%, p < 0.0001) and J45 components (55.5% vs. 41.7%, p < 0.0001). CONCLUSIONS Chinese children in Hong Kong exhibit a higher prevalence of RA and CA than in other cities. Children displayed a greater compensation by IA than adults, suggesting an age-related attenuation of IA compensation. IA is associated with myopic traits.
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Affiliation(s)
- Ka Wai Kam
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
- Department of Ophthalmology & Visual Sciences, Prince of Wales Hospital, Hong Kong, China
| | - Arnold Shau Hei Chee
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
- Department of Ophthalmology & Visual Sciences, Prince of Wales Hospital, Hong Kong, China
| | - Rex Chin Yung Tang
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Yuzhou Zhang
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Xiu Juan Zhang
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Yu Meng Wang
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Sophia Ling Li
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
- Department of Ophthalmology & Visual Sciences, Prince of Wales Hospital, Hong Kong, China
| | - Li Jia Chen
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
- Department of Ophthalmology & Visual Sciences, Prince of Wales Hospital, Hong Kong, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, China
| | - Alvin L Young
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
- Department of Ophthalmology & Visual Sciences, Prince of Wales Hospital, Hong Kong, China
| | - Clement C Tham
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
- Department of Ophthalmology & Visual Sciences, Prince of Wales Hospital, Hong Kong, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Eye Hospital, Hong Kong, China
- Department of Ophthalmology, Hong Kong Children's Hospital, Hong Kong, China
| | - Chi Pui Pang
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, China
| | - Jason C Yam
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.
- Department of Ophthalmology & Visual Sciences, Prince of Wales Hospital, Hong Kong, China.
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong, China.
- Hong Kong Eye Hospital, Hong Kong, China.
- Department of Ophthalmology, Hong Kong Children's Hospital, Hong Kong, China.
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Karimi S, Nouri H, Mahmoudinejad-Azar S, Abtahi SH. Smoking and environmental tobacco smoke exposure: implications in ocular disorders. Cutan Ocul Toxicol 2023; 42:1-7. [PMID: 36369835 DOI: 10.1080/15569527.2022.2144874] [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] [Indexed: 11/14/2022]
Abstract
PURPOSE This article aims to gather and review the available knowledge on several implications of smoking and environmental tobacco smoke (ETS) exposure in ocular disorders and provides pathomechanistic insights where applicable. MATERIALS AND METHODS PubMed and Scopus databases were searched for relevant studies on the association of smoking and ETS exposure with various ocular disorders. Studies with different evidence levels, e.g., in-vivo, case-control, cohort, and meta-analysis, were included. RESULTS Smoking is an established, modifiable risk factor in several ocular diseases, including cataract, age-related macular degeneration, and Graves' ophthalmopathy; smokers are subject to more severe disease courses and less favorable treatment outcomes. Uveitis is twice as likely in smokers; smoking may also delay its resolution. Smoking and ETS exposure are major risk factors for diseases of other organs, with associated ocular complications as well, such as diabetes mellitus. ETS exposure is also associated with ocular surface pathologies, including dry eye syndrome. In children, early-life ETS exposure and maternal smoking during pregnancy are strongly associated with refractive errors and strabismus. Currently, available data on potential risks attributable to ETS exposure regarding ocular diseases are scarce and, in some instances, controversial. CONCLUSION In addition to smoking, ETS exposure is also a significant public health concern with possible links to several ocular diseases. However, the level of education of at-risk populations in this regard does not match the strength of the evidence.
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Affiliation(s)
- Saeed Karimi
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Ophthalmology, Torfe Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Clinical Research Development Unit of Torfe Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hosein Nouri
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
- Network of Immunity in Infection, Malignancy, and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Isfahan, Iran
| | - Sahar Mahmoudinejad-Azar
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Clinical Research Development Unit of Torfe Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed-Hossein Abtahi
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Ophthalmology, Torfe Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Clinical Research Development Unit of Torfe Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Kam KW, Chee ASH, Zhang Y, Tang RCY, Chan JTC, Zhang XJ, Wang YM, Chan RCF, Chu WK, Ip P, Young AL, Tham CC, Pang CP, Chen LJ, Yam JC. Association of Maternal and Paternal Astigmatism With Child Astigmatism in the Hong Kong Children Eye Study. JAMA Netw Open 2022; 5:e2247795. [PMID: 36542383 PMCID: PMC9856878 DOI: 10.1001/jamanetworkopen.2022.47795] [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] [Indexed: 12/24/2022] Open
Abstract
IMPORTANCE Parental astigmatism is a factor associated with risk for development of child astigmatism; however, the magnitude of the association has not been determined. OBJECTIVE To determine the association between parental and child astigmatism. DESIGN, SETTING, AND PARTICIPANTS This population-based, cross-sectional study included participants from familial trios, each comprising a child aged 6 to 8 years and both parents, recruited from the Hong Kong Children Eye Study. No restriction criteria were set on the children in terms of refractive status. Data were analyzed from February to June 2022. EXPOSURES Cycloplegic autorefraction and autokeratometry were conducted on the children, whereas noncycloplegic autorefraction and autokeratometry were conducted on their parents. The children were categorized into 6 groups on the basis of the severity of astigmatism of both parents. Information on parental education, family income, and children's outdoor and near work time were obtained by questionnaires. MAIN OUTCOMES AND MEASURES The primary outcome was the odds of child astigmatism among the 6 categories of children. Associations of factors with child astigmatism were evaluated by logistic regression analyses. RESULTS A total of 17 124 participants from 5708 trios (2964 boys and 2754 girls) at a mean (SD) age of 7.32 (0.87) years, and 11 416 parents were examined. Astigmatism of 1.0 D or greater in both parents was associated with greater odds of refractive astigmatism (RA) (odds ratio [OR], 1.62; 95% CI, 1.15-2.26) and corneal astigmatism (CA) (OR, 1.94; 95% CI, 1.50-2.50) in the child. The respective ORs increased to 3.10 (95% CI, 1.34-7.21) and 4.31 (95% CI, 1.76-10.55) when both parents had astigmatism 2.0 D or greater. Higher parental astigmatism conferred higher risks for both RA and CA in children (P for trend <.001). Parental astigmatism was significantly associated with greater odds of corresponding child astigmatism (maternal RA: OR, 0.76; 95% CI, 0.68-0.84; paternal RA: OR, 0.82; 95% CI, 0.74-0.91; maternal CA: OR, 1.70; 95% CI, 1.51-1.93; paternal CA: OR, 1.33; 95% CI, 1.19-1.49). CONCLUSIONS AND RELEVANCE The findings of this cross-sectional study suggest that parental astigmatism may confer an independent and dose-dependent association with child astigmatism. Children with parents with astigmatism should have early eye examinations for timely detection of astigmatism to facilitate age-appropriate vision correction and visual development.
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Affiliation(s)
- Ka Wai Kam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China
| | - Arnold S. H. Chee
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China
| | - Yuzhou Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Hong Kong SAR, China
| | - Rex C. Y. Tang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Hong Kong SAR, China
| | - Jason T. C. Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Hong Kong SAR, China
| | - Xiu Juan Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Hong Kong SAR, China
| | - Yu Meng Wang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Hong Kong SAR, China
| | - Ryan C. F. Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Hong Kong SAR, China
| | - Wai Kit Chu
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Hong Kong SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Alvin L. Young
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China
| | - Clement C. Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Eye Hospital, Kowloon, Hong Kong SAR, China
- Department of Ophthalmology, Hong Kong Children’s Hospital, Hong Kong SAR, China
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Hong Kong SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Li Jia Chen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jason C. Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Eye Hospital, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong SAR, China
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Eye Hospital, Kowloon, Hong Kong SAR, China
- Department of Ophthalmology, Hong Kong Children’s Hospital, Hong Kong SAR, China
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8
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Yu Y, Zhou Y, Tian M, Zhou Y, Tan Y, Wu L, Zheng H, Yang Y. Automatic identification of meibomian gland dysfunction with meibography images using deep learning. Int Ophthalmol 2022; 42:3275-3284. [PMID: 36121534 DOI: 10.1007/s10792-022-02262-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/12/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND Artificial intelligence is developing rapidly, bringing increasing numbers of intelligent products into daily life. However, it has little progress in dry eye, which is a common disease and associated with meibomian gland dysfunction (MGD). Noninvasive infrared meibography, known as an effective diagnostic tool of MGD, allows for objective observation of meibomian glands. Thus, we discuss a deep learning method to measure and assess meibomian glands of meibography. METHODS We used Mask R-CNN deep learning (DL) framework. A total of 1878 meibography images were collected and manually annotated by two licensed eyelid specialists with two classes: conjunctiva and meibomian glands. The annotated pictures were used to establish a DL model. An independent test dataset that contained 58 images was used to compare the accuracy and efficiency of the deep learning model with specialists. RESULTS The DL model calculated the ratio of meibomian gland loss with precise values by achieving high accuracy in the identification of conjunctiva (validation loss < 0.35, mAP > 0.976) and meibomian glands (validation loss < 1.0, mAP > 0.92). The comparison between specialists' annotation and the DL model evaluation showed that there is little difference between the gold standard and the model. Each image takes 480 ms for the model to evaluate, almost 21 times faster than specialists. CONCLUSIONS The DL model can improve the accuracy of meibography image evaluation, help specialists to grade the meibomian glands and save their time to some extent.
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Affiliation(s)
| | - Yiwen Zhou
- Eye Center of Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China
| | - Miao Tian
- Eye Center of Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China
| | - Yabiao Zhou
- School of Resources and Environmental Sciences of Wuhan University, Wuhan, China
| | - Yuejiao Tan
- School of Resources and Environmental Sciences of Wuhan University, Wuhan, China
| | - Lianlian Wu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Hongmei Zheng
- Eye Center of Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China.
| | - Yanning Yang
- Eye Center of Renmin Hospital of Wuhan University, 99 Zhangzhidong Road, Wuhan, 430060, Hubei Province, China.
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Wang Z, Zuo X, Liu L, Chen X, Li R, Zhu H, Huang D, Tong H, Zhao X, Yan W, Shen S, Wang Y, Li X, Zhao A, Chen D, Ding R, Li S, Liu H. Corneal endothelial cell density and its correlation with birth weight, anthropometric parameters, and ocular biometric parameters in Chinese school children. BMC Ophthalmol 2022; 22:334. [PMID: 35933331 PMCID: PMC9356483 DOI: 10.1186/s12886-022-02561-1] [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: 01/13/2022] [Accepted: 07/28/2022] [Indexed: 11/20/2022] Open
Abstract
Background To describe the distribution of corneal endothelial cell density (ECD), and to explore its correlation with birth weight (BW), anthropometric parameters, and ocular biometric parameters in Chinese school children. Methods In the population-based cross-sectional Nanjing Eye Study, children were measured for anthropometric information, for ECD by the noncontact specular microscope and for ocular biometric parameters by the optic low-coherent reflectometer. Data from right eyes were analyzed to illustrate the distribution of ECD and for determining correlated factors with ECD using univariate and multiple linear regression analysis. Comparisons among three different BW groups were performed using a one-way ANOVA analysis followed by the Bonferroni correction for pairwise comparisons. Results Of 1171 children, the mean (± standard deviation) ECD was 2875.34 ± 195.00 cells/mm2. In the Multiple Linear Regression analysis, BW, gender and central corneal thickness were significantly associated with ECD. The ECD increased by 36.16 cells/mm2 with BW increasing by 1 kg (P = 0.001) and increased by 0.44 cells/mm2 for every additional 1 mm in central corneal thickness (P = 0.01). The ECD of girls was 54.41 cells/mm2 higher than boys (P < 0.001). Children born with low BW presented significantly lower ECD than those born with normal BW (P < 0.05) and high BW (P < 0.05). Age and axial length were not significantly associated with ECD (P = 0.06 and P = 0.21, respectively). Conclusions In Chinese school children aged 82 to 94 months, the ECD is positively correlated with BW and central corneal thickness, in which BW is a newly identified associated factor. It is like that gender plays an important role in ECD distribution while girls have relatively greater ECD than boys.
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Affiliation(s)
- Zijin Wang
- Department of Ophthalmology, The First Affiliated Hospital With Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Xiaoxia Zuo
- Department of Ophthalmology, The First Affiliated Hospital With Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Lei Liu
- Department of Ophthalmology, The First Affiliated Hospital With Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Xuejuan Chen
- 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
| | - Hui Zhu
- 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
| | - Haohai Tong
- Eye Center, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiaoyan Zhao
- Department of Ophthalmology, the Affiliated Changzhou No.2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Wen Yan
- Department of Ophthalmology, The Fourth Affiliated Hospital of Nantong University, Yancheng, China
| | - Shiya Shen
- Department of Ophthalmology, The First Affiliated Hospital With Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Yun Wang
- Department of Ophthalmology, The First Affiliated Hospital With Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Xiaoxiao Li
- Department of Ophthalmology, Children's Hospital of Soochow University, Suzhou, China
| | - Andi Zhao
- Department of Ophthalmology, The First Affiliated Hospital With Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Danni Chen
- Department of Ophthalmology, The First Affiliated Hospital With Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Ranran Ding
- The Fourth School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Shiding Li
- The Fourth School of Clinical Medicine, Nanjing Medical University, Nanjing, China
| | - Hu Liu
- Department of Ophthalmology, The First Affiliated Hospital With Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
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Association of Physical Activity and Sedentary Behaviors with the Risk of Refractive Error in Chinese Urban/Rural Boys and Girls. SUSTAINABILITY 2022. [DOI: 10.3390/su14095539] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Background: Research shows physical activity (PA) is negatively associated with refractive error, especially outdoor activity. Our study aimed to examine the association of PA levels and sedentary time (SED) with refractive error in boys and girls living in urban and rural areas. Methods: A total of 8506 urban/rural boys and girls (13.5 ± 2.8 years old) in Shaanxi Province, China participated in this study. Questions about PA, SED, outdoor exercises, and digital screen time were asked in the study survey. Non-cycloplegic refractive error was measured by an autorefractor. The differences between sex/area groups have been analyzed by one-way ANOVA. The association of PA/SED with spherical equivalent (SE) and cylinder power was analyzed by general linear regression. The association between PA/SED and the risk of refractive error was determined using the binary logistic regression model. Results: Of the 8506 participants, the prevalence of refractive error was significantly higher in girls and urban students (p < 0.05). Less SED and digital screen time, and more outdoor activity were significantly associated with SE (p < 0.05), respectively. More PA and less SED were significantly associated with lower cylinder power (p < 0.05), respectively. More PA and less SED were significantly associated with lower risks of myopia and astigmatism, respectively (p < 0.05). Conclusions: PA and SED were associated with the risk of refractive error. Maintaining a healthy lifestyle can help to reduce the risk of refractive error in boys and girls.
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Yang Z, Lu Z, Shen Y, Chu T, Pan X, Wang C, Wang J. Prevalence of and factors associated with astigmatism in preschool children in Wuxi City, China. BMC Ophthalmol 2022; 22:146. [PMID: 35365119 PMCID: PMC8976382 DOI: 10.1186/s12886-022-02358-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 03/14/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE To investigate the status of astigmatism in preschool children in Wuxi City, and explore the risk factors related to astigmatism. The risk factors related to astigmatism development as predictors can help us identify preschool children who need vision screening at an early stage to ensure good visual quality. METHODS The cross-sectional study was conducted in 10 kindergartens randomly selected in five districts of Wuxi City in November 2018. All preschool children were measured by objective refractometry under non-cycloplegic refraction. The basic information of preschool children was collected. The relevant factors of astigmatism in the questionnaire were completed by parents. Spss 26. 0 software was used for univariate and multivariate correlation analysis. RESULTS A total of 889 preschool children participated in the study, 864 were finally included in the study. The prevalence of astigmatism was 36.0%. The risk of astigmatism in premature children was higher than that in non-premature children (adjusted odds ratio = 1.841). The prevalence of astigmatism with parents' astigmatism history was higher, compared with preschool children without parents' astigmatism history (adjusted odds ratio = 2.037). When maternal age at childbirth was older (≥ 35 years old), the risk of astigmatism increased in preschool children (adjusted odds ratio = 2.181). Compared with bottle feeding, the risk of astigmatism for mixed feeding and breastfeeding reduced in preschool children. Compared with preschool children exposed to electronic screen for less than 2 h every day, preschool children exposed to electronic screen for more than 2 h had an increased risk of astigmatism (P = 0.004). CONCLUSION The prevalence of astigmatism among preschool children in Wuxi City was high. Some risk factors such as premature birth, parents' astigmatism history, maternal age at childbirth, feeding pattern, and electronic screen exposure time were closely related to the occurrence of astigmatism among preschool children. For preschool children with significant risk factors, their eyesight should be checked regularly to ensure their visual quality.
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Affiliation(s)
- Zhihui Yang
- Ophthalmology Department, Affiliated Hospital of Jiangnan University, No. 1000, Hefeng Road, Binhu District, Wuxi, 214100, China
| | - Zijing Lu
- Ophthalmology Department, Affiliated Hospital of Jiangnan University, No. 1000, Hefeng Road, Binhu District, Wuxi, 214100, China
| | - Yihui Shen
- Nursing Department, Affiliated Hospital of Jiangnan University, No. 1000, Hefeng Road, Binhu District, Wuxi, 214100, China
| | - Ting Chu
- Ophthalmology Department, Affiliated Hospital of Jiangnan University, No. 1000, Hefeng Road, Binhu District, Wuxi, 214100, China
| | - Xubin Pan
- Ophthalmology Department, Affiliated Hospital of Jiangnan University, No. 1000, Hefeng Road, Binhu District, Wuxi, 214100, China
| | - Cun Wang
- Ophthalmology Department, Affiliated Hospital of Jiangnan University, No. 1000, Hefeng Road, Binhu District, Wuxi, 214100, China
| | - Jihong Wang
- Ophthalmology Department, Affiliated Hospital of Jiangnan University, No. 1000, Hefeng Road, Binhu District, Wuxi, 214100, China.
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Longitudinal change in components of astigmatism and its association with axial length-corneal radius ratio in Chinese young children: the Nanjing Eye Study. Graefes Arch Clin Exp Ophthalmol 2021; 260:335-343. [PMID: 34436647 DOI: 10.1007/s00417-021-05386-8] [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: 02/25/2021] [Revised: 06/30/2021] [Accepted: 08/13/2021] [Indexed: 10/20/2022] Open
Abstract
PURPOSE To assess the longitudinal change in components of astigmatism from age 4 to 7 years and its association with axial length-corneal radius ratio (AL/CR). METHODS Children born between September 2011 and August 2012 in Yuhuatai District of Nanjing were invited to participate in the Nanjing Eye Study for a comprehensive eye examination annually since 2015. The data presented in this paper were obtained in 2016, 2017, and 2019. At each study encounter, noncycloplegic autorefraction and ocular biometric parameters were measured. Changes of total astigmatism (TA), corneal astigmatism (CA), anterior corneal astigmatism (ACA), residual astigmatism (RA), and internal astigmatism (IA) were analyzed in clinical notation (Cyl) and vector notation (J0, J45). RESULTS Nine hundred fifty-four children (mean ± standard deviation of baseline age: 4.63 ± 0.29 years, 53.7% boys) had complete data and were included in this study. Mean slopes of longitudinal changes in Cyl notation were significantly negative for TA, CA, and ACA, but positive for IA. TA, CA, ACA, and RA of J0 notation had a shift toward increasing with-the-rule (WTR) astigmatism and/or decreasing against-the-rule (ATR) astigmatism. TA of J45 notation showed an increase in astigmatism at axis 135° and/or a decrease in astigmatism at axis 45°, while CA and ACA of J45 notation showed an opposite change. Longitudinal changes in ACA and IA were negatively correlated in J0 notation, but not in J45 notation. Based on compensation factor (CF, defined as the minus ratio of IA and ACA), the compensation proportions for J0 in varying degrees (CF: 0.1-2) in 2016, 2017, and 2019 were 91.3%, 93.5%, and 90.0%, respectively, while these for J45 were 74.9%, 76.5%, and 34.6%, respectively. Higher AL/CR increase was associated with less decrease or more increase in CA and ACA of Cyl notation, and a shift toward increasing WTR and/or decreasing ATR in these of J0 notation. CONCLUSIONS The compensatory role of IA was persistent and prominent from 4 to 7 years old for J0 notation in Chinese young children. The progression of AL/CR was correlated with astigmatism originated from the cornea.
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Tong H, Hao Q, Wang Z, Wang Y, Li R, Zhao X, Sun Q, Zhang X, Chen X, Zhu H, Huang D, Liu H. The biometric parameters of aniso-astigmatism and its risk factor in Chinese preschool children: the Nanjing eye study. BMC Ophthalmol 2021; 21:67. [PMID: 33535994 PMCID: PMC7860027 DOI: 10.1186/s12886-021-01808-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 01/07/2021] [Indexed: 11/15/2022] Open
Abstract
Backgrounds Aniso-astigmatism may hinder normal visual development in preschool children. Knowing its prevalence, biometric parameters and risk factors is fundamental to children eye care. The purpose of this study was to determine the biometric components of aniso-astigmatism and associated maternal risk factors in Chinese preschool children. Methods In the population-based, prospective cohort Nanjing Eye Study, children were measured for noncycloplegic refractive error using an autorefractor and for biometric parameters using an optical low-coherent reflectometry. The difference of total astigmatism (TA) between both eyes was calculated using cylinder power (non-vectorial aniso-TA was defined as ≥1.00 Dioptre Cylinder [DC] between both eyes) and by vector analysis (vectorial aniso-TA was defined as a difference of ≥0.5 in J0 or J45 between both eyes which is equivalent to 1.00 DC). The prevalence of aniso-TA was presented. Interocular biometric parameters were compared between with vs. without aniso-astigmatism group. In addition, risk factors were determined using multivariate logistic regression model. Results Of 1131 children (66.90 ± 3.38 months, 53.31% male), the prevalence of non-vectorial aniso-TA was 1.95% (95% Confidence Interval (CI) = 1.14–2.75%), while the prevalence of vectorial aniso-TA was twice as common as non-vectorial aniso-TA, neither varying with sex or age. With aniso-TA eyes were more asymmetric in axial length and corneal curvature radius than without aniso-TA eyes. In multivariate logistic regression model, 5-min Apgar score less than 7 was significantly associated with higher risk of aniso-TA (vectorial aniso-TA: Odds Ratio (OR) = 6.42, 95%CI = 2.63–15.69, P < 0.001; non-vectorial aniso-TA: OR = 4.99, 95%CI = 1.41–17.68, P = 0.01). Being twin or triple was significantly associated with higher risk of vectorial aniso-CA (OR = 2.43, 95%CI = 1.05–5.60, P = 0.04). Pre-term delivery (OR = 2.60, 95%CI = 1.09–6.15, P = 0.03) and post-term delivery (OR = 3.61, 95%CI = 1.31–9.96, P = 0.01) were significantly associated with higher risk of vectorial aniso-CA. Conclusions Both corneal curvature radius and axial length asymmetry were correlated with aniso-TA. Children with 5-min Apgar score < 7 were more likely to have aniso-TA, while twin or triple, pre-term or post-term delivery were more likely to have vectorial aniso-CA. Supplementary Information The online version contains supplementary material available at 10.1186/s12886-021-01808-7.
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Affiliation(s)
- Haohai Tong
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Qingfeng Hao
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Zijin Wang
- 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
| | - Rui Li
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Xiaoyan Zhao
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Qigang Sun
- Department of Ophthalmology, Maternal and Child Healthcare Hospital of Yuhuatai District, Nanjing, China
| | - Xiaohan Zhang
- Department of Ophthalmology, Wuxi Children's Hospital, Wuxi, China
| | - Xuejuan Chen
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China
| | - Hui Zhu
- 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
| | - Hu Liu
- Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
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