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Chakraborty R, Baranton K, Pic E, Didone J, Kim W, Lam K, Papandrea A, Kousa J, Bhasme T, Edmonds C, Trieu C, Chang E, Coleman A, Hussain A, Lacan P, Spiegel D, Barrau C. Axial length reduction and choroidal thickening with short-term exposure to cyan light in human subjects. Ophthalmic Physiol Opt 2024. [PMID: 39244703 DOI: 10.1111/opo.13390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Revised: 08/21/2024] [Accepted: 08/26/2024] [Indexed: 09/10/2024]
Abstract
PURPOSE Given the potential role of light and its wavelength on ocular growth, this study investigated the effect of short-term exposure to red, cyan and blue light on ocular biometry in humans. METHODS Forty-four young adults and 20 children, comprising emmetropes and myopes, underwent 2-h sessions of cyan (507 nm), red (638 nm) and broadband white light on three separate days via light-emitting glasses. Additionally, young adults were exposed to blue light (454 nm) on an additional day. Axial length (AL) and choroidal thickness (CT) were measured in the right eye before the light exposure (0 min), after 60 and 120 min of exposure and 30 min after light offset using an optical biometer and optical coherence tomographer, respectively. RESULTS Compared to broadband light, exposure to red light resulted in a significant increase in AL (mean difference between white and red light at 120 min, +0.007 mm [0.002]), but no significant change in CT, while cyan light caused a significant AL reduction (-0.010 mm [0.003]) and choroidal thickening (+0.008 mm [0.002]) in young adults (p < 0.05). Blue light caused a significant decrease of -0.007 mm (0.002) in young adult eyes at 60 min (p < 0.05). In children, cyan light led to a significant reduction in AL (-0.016 mm [0.004]) and strong sustained choroidal thickening (+0.014 mm [0.004]) compared to broadband light at 120 min (p < 0.05). The effects of cyan light on AL and CT were found to be stronger in myopic young adults and emmetropic children. The opposing effects of red and cyan light on ocular biometry were similar between the two age groups (p > 0.05). CONCLUSIONS Exposure to cyan light resulted in AL reduction and choroidal thickening in both young adults and children. Further research is needed to determine the application of these results in developing interventions for myopia control.
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Affiliation(s)
- Ranjay Chakraborty
- Myopia and Visual Development Lab, College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
| | - Konogan Baranton
- Essilor International, Centre of Innovation and Technologies Europe, Paris, France
| | - Eleonore Pic
- Essilor International, Centre of Innovation and Technologies Europe, Paris, France
| | - Julia Didone
- Myopia and Visual Development Lab, College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
| | - Wanki Kim
- Myopia and Visual Development Lab, College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
| | - Kevin Lam
- Myopia and Visual Development Lab, College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
| | - Alessandro Papandrea
- Myopia and Visual Development Lab, College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
| | - Jad Kousa
- Myopia and Visual Development Lab, College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
| | - Tiana Bhasme
- Myopia and Visual Development Lab, College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
| | - Chloe Edmonds
- Myopia and Visual Development Lab, College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
| | - Cindy Trieu
- Myopia and Visual Development Lab, College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
| | - Eunjong Chang
- Myopia and Visual Development Lab, College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
| | - Alexander Coleman
- Myopia and Visual Development Lab, College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
| | - Azfira Hussain
- Myopia and Visual Development Lab, College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
| | - Pascale Lacan
- Essilor International, Centre of Innovation and Technologies Europe, Paris, France
| | - Daniel Spiegel
- Essilor Asia Pacific Pte Ltd, Singapore City, Singapore, Singapore
| | - Coralie Barrau
- Essilor International, Centre of Innovation and Technologies Europe, Paris, France
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Demir P, Baskaran K, Ramos PL, Naduvilath T, Sankaridurg P, Macedo AF. Incidence of myopia in Swedish schoolchildren: A longitudinal study. Ophthalmic Physiol Opt 2024; 44:1301-1308. [PMID: 38953568 DOI: 10.1111/opo.13359] [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: 02/26/2024] [Revised: 06/17/2024] [Accepted: 06/18/2024] [Indexed: 07/04/2024]
Abstract
PURPOSE The prevalence of myopia in Scandinavia tends to be lower than in other parts of the world. This study aimed to investigate the incidence of myopia and its predictors in Swedish children to characterise this trend. METHODS A 2-year longitudinal study was conducted following a cohort of schoolchildren aged 8-16 years. Myopia was defined as a spherical equivalent refraction (SER) ≤ -0.50 D. The study enrolled 128 participants, 70 (55%) females with a mean age of 12.0 years (SD = 2.4). RESULTS The cumulative incidence of myopia during the follow-up period was 5.5%, and the incidence rate of myopia was 3.2 cases per 100 person-years. Participants with myopia at baseline exhibited a faster increase in refractive error during the follow-up period. Likewise, participants with two myopic parents exhibited a more marked change towards myopia, regardless of their initial refractive error. CONCLUSION In the current study, similar to prevalence, the incidence of myopia was low when compared with other parts of the world. These results lead us to formulate a new hypothesis that the normal emmetropisation process may be protected by low educational pressure practised in Sweden during early childhood. Further research is necessary to test this new hypothesis.
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Affiliation(s)
- Pelsin Demir
- Medicine and Optometry, Linnaeus University, Kalmar, Sweden
| | | | - Pedro Lima Ramos
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal
| | | | | | - Antonio Filipe Macedo
- Medicine and Optometry, Linnaeus University, Kalmar, Sweden
- Department and Centre of Physics-Optometry and Vision Science, University of Minho, Braga, Portugal
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Wang J, Qi Z, Feng Y, Chen J, Du L, Yang J, Xie H, Zhu J, Zou H, He X, Xu X. Normative value of hyperopia reserve and myopic shift in Chinese children and adolescents aged 3-16 years. Br J Ophthalmol 2024; 108:1024-1029. [PMID: 37709362 PMCID: PMC11228215 DOI: 10.1136/bjo-2023-323468] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 08/17/2023] [Indexed: 09/16/2023]
Abstract
BACKGROUND This research aims to generate normative values of hyperopia reserve and refractive progression as effective tools to estimate the risk of myopia. METHODS A 1-year follow-up study was conducted among Chinese children and adolescents aged 3-16 years selected from schools and kinder gardens using cluster sampling. All participants underwent examinations including visual acuity, axial length and cycloplegic autorefraction (1% cyclopentolate). Percentiles of spherical equivalent (SE) were calculated using Lambda-Mu-Sigma (LMS) method. Age-specific refractive progression and hyperopia reserve were determined by backward calculation. RESULTS Of 3118 participants, 1702 (54.6%) were boys with a mean baseline age of 7.30 years. The 50th percentile of SE estimated by LMS decreased from 1.04 D at 3 years to -2.04 D at 16 years in boys, while from 1.29 D to -2.81 D in girls. The 1-year refractive progression of myopes (0.81 D) was greater than that of non-myopes (0.51 D). The normative value of hyperopia reserve was 2.64 (range: 2.40 D-2.88 D) at 3 years and -0.35 (range: -0.50 to -0.17) D at 16 years, with the maximum progression of 0.35 D at the age of 6 years. CONCLUSION Age-specific normative values of hyperopia reserve and yearly myopic shift in children and adolescents aged 3-16 years were provided, helping identify and monitor myopia and giving prevention in advance.
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Affiliation(s)
- Jingjing Wang
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Ziyi Qi
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Yanqing Feng
- Department of Ophthalmology, Kong Jiang Hospital of Shanghai Yangpu District, Yangpu Eye Disease Prevention Center, Shanghai, China
| | - Jun Chen
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Linlin Du
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Jinliuxing Yang
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Hui Xie
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Jianfeng Zhu
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Haidong Zou
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Xiangui He
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Xun Xu
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Shanghai, China
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Hartmann A, Grabitz SD, Wagner FM, Wild PS, Müller-Nurasyid M, Lackner KJ, Beutel ME, Münzel T, Tüscher O, Schattenberg JM, Pfeiffer N, Schuster AKG. Bi-Gaussian analysis reveals distinct education-related alterations in spherical equivalent and axial length-results from the Gutenberg Health Study. Graefes Arch Clin Exp Ophthalmol 2024; 262:1819-1828. [PMID: 38446204 PMCID: PMC11106185 DOI: 10.1007/s00417-024-06395-z] [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: 09/25/2023] [Revised: 12/26/2023] [Accepted: 01/31/2024] [Indexed: 03/07/2024] Open
Abstract
PURPOSE The aim of this study is to investigate the distribution of spherical equivalent and axial length in the general population and to analyze the influence of education on spherical equivalent with a focus on ocular biometric parameters. METHODS The Gutenberg Health Study is a population-based cohort study in Mainz, Germany. Participants underwent comprehensive ophthalmologic examinations as part of the 5-year follow-up examination in 2012-2017 including genotyping. The spherical equivalent and axial length distributions were modeled with gaussian mixture models. Regression analysis (on person-individual level) was performed to analyze associations between biometric parameters and educational factors. Mendelian randomization analysis explored the causal effect between spherical equivalent, axial length, and education. Additionally, effect mediation analysis examined the link between spherical equivalent and education. RESULTS A total of 8532 study participants were included (median age: 57 years, 49% female). The distribution of spherical equivalent and axial length follows a bi-Gaussian function, partially explained by the length of education (i.e., < 11 years education vs. 11-20 years). Mendelian randomization indicated an effect of education on refractive error using a genetic risk score of education as an instrument variable (- 0.35 diopters per SD increase in the instrument, 95% CI, - 0.64-0.05, p = 0.02) and an effect of education on axial length (0.63 mm per SD increase in the instrument, 95% CI, 0.22-1.04, p = 0.003). Spherical equivalent, axial length and anterior chamber depth were associated with length of education in regression analyses. Mediation analysis revealed that the association between spherical equivalent and education is mainly driven (70%) by alteration in axial length. CONCLUSIONS The distribution of axial length and spherical equivalent is represented by subgroups of the population (bi-Gaussian). This distribution can be partially explained by length of education. The impact of education on spherical equivalent is mainly driven by alteration in axial length.
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Affiliation(s)
- Alica Hartmann
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
| | - Stephanie Desirée Grabitz
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Felix Mathias Wagner
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Philipp Sebastian Wild
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
- Preventive Cardiology and Preventive Medicine - Department of Cardiology, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
- Institute of Molecular Biology (IMB), Mainz, Germany
| | | | - Karl Johannes Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Manfred Elmar Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Thomas Münzel
- Center for Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Oliver Tüscher
- Institute of Molecular Biology (IMB), Mainz, Germany
- Clinic for Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
- Leibniz Institute for Resilience Research, Mainz, Germany
| | - Jörn Markus Schattenberg
- Metabolic Liver Research Center, I. Department of Medicine, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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Youssef MA, Shehata AR, Adly AM, Ahmed MR, Abo-Bakr HF, Fawzy RM, Gouda AT. Efficacy of Repeated Low-Level Red Light (RLRL) therapy on myopia outcomes in children: a systematic review and meta-analysis. BMC Ophthalmol 2024; 24:78. [PMID: 38378527 PMCID: PMC10877869 DOI: 10.1186/s12886-024-03337-5] [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: 04/17/2023] [Accepted: 02/01/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Myopia is the most prevalent form of refractive error that has a major negative impact on visual function and causes blurring of vision. We aimed to determine if Repeated Low-Level Red Light (RLRL) treatment is beneficial in treating childhood myopia in terms of axial length (AL), spherical equivalent refraction (SER), and sub foveal choroidal thickness (SFCT). METHODS This systematic review was performed on RLRL for treatment of myopia in children compared to single vision spectacles (SVS). We employed the search strategy with key terms myopia and low-level light therapy then we searched PubMed, Scopus, Cochrane, and Web of Science databases. The mean differences (MD) were used to evaluate the treatment effects. Heterogeneity was quantified using I2 statistics and explored by sensitivity analysis. RESULTS Five randomized controlled trials (RCTs) were included in our meta-analysis with a total of 833 patients, 407 in treatment group and 426 in control group. At a 3 month follow up period, pooled studies show a statistical difference in AL between RLRL and SVS group (MD = -0.16; 95% CI [-0.19, -0.12], SER (MD = 0.33; 95% CI [0.27, 0.38]), and SFCT (MD = 43.65; 95% CI [23.72, 45.58]). At a 6 month follow up period, pooled studies show a statistical difference in AL between RLRL and SVS group (MD = -0.21; 95% CI [-0.28, -0.15]), SER (MD = 0.46; 95% CI [0.26, 0.65]), and SFCT (MD = 25.07; 95% CI [18.18, 31.95]). At a 12 month follow up period, pooled studies show a statistical difference in AL between RLRL and SVS group (MD = -0.31; 95% CI [-0.42, -0.19]) and SER (MD = 0.63; 95% CI [0.52, 0.73]). CONCLUSION This is the first systematic review and meta-analysis investigating only RCTs evidence supporting the efficacy of 650 nm RLRL for myopia control in the short term of 3, 6, and 12 months follow up. The present review revealed the clinical significance of RLRL as a new alternative treatment for myopia control with good user acceptability and no documented functional or structural damage. However, the effect of long-term RLRL treatment and the rebound effect after cessation require further investigations.
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Affiliation(s)
| | | | - Ahmed Moataz Adly
- Faculty of Medicine, Beni Suef University, Beni Suef city, Beni Suef, Egypt
| | | | | | | | - Ahmed Taha Gouda
- Faculty of Medicine, Beni Suef University, Beni Suef city, Beni Suef, Egypt
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Dastamooz S, Yam JC, Tham CCY, Wong SHS, Farahani MHD, Xueting K, Sit CHP. The effects of physical activity on pediatric eyes: A systematic review and meta-analysis. Prev Med 2024; 179:107845. [PMID: 38185223 DOI: 10.1016/j.ypmed.2023.107845] [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: 11/06/2023] [Revised: 12/16/2023] [Accepted: 12/29/2023] [Indexed: 01/09/2024]
Abstract
INTRODUCTION Examining the retina represents a non-invasive method to evaluate abnormalities pertaining to the nervous and cardiovascular systems. Evidence indicates that physical activity is a non-pharmacological intervention to enhance the nervous and cardiovascular systems. However, little is unknown about its effects on ocular characteristics in children and adolescents. The purpose of this study was to examine the effects of physical activity interventions on ocular characteristics in children and adolescents. METHOD The electronic bases Web of Science, Embase, Cochrane Library, PubMed, SPORTDiscus, CINAHL, and ERIC were searched from inception to May 2023. Incorporated were randomized controlled trials or quasi-experimental designs that had implemented acute or chronic physical activity interventions among children and adolescents to evaluate various eye-related attributes via clinical examinations or surveys. Two authors independently performed the data extraction and risk of bias assessment, utilizing the Physiotherapy Evidence Database checklist. RESULTS A total of 474 articles were identified, of which eight articles underwent a systematic review, and six were chosen for meta-analysis. Chronic physical activity interventions positively impacted central retinal artery equivalent (CRAE) with a small to moderate effect (SMD = 0.21; 95% CI 0.04 to 0.39, p = 0.034, I2 = 0%) and central retinal venular equivalent (CRVE) with a small effect (SMD = 0.098; 95% CI 0.08 to 0.11; p = 0.008, I2 = 0%). Intraocular pressure, kinetic visual acuity, and eye strain also improved significantly after physical activity interventions. DISCUSSION Participating in chronic physical activity programs appear to impact children and adolescents' eye-related attributes positively.
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Affiliation(s)
- Sima Dastamooz
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, China
| | - Jason C Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, China
| | - Clement C Y Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, China
| | - Stephen H S Wong
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, China
| | - Mohammad H D Farahani
- Department of Mechanical and Automation Engineering, The Chinese University of Hong Kong, China
| | - Ku Xueting
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, China
| | - Cindy H P Sit
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, China.
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Jawaid I, Saunders K, Hammond CJ, Dahlmann-Noor A, Bullimore MA. Low concentration atropine and myopia: a narrative review of the evidence for United Kingdom based practitioners. Eye (Lond) 2024; 38:434-441. [PMID: 37717107 PMCID: PMC10858250 DOI: 10.1038/s41433-023-02718-2] [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: 03/12/2023] [Revised: 07/05/2023] [Accepted: 08/25/2023] [Indexed: 09/18/2023] Open
Abstract
The prevalence of myopia is increasing across the world. Controlling myopia progression would be beneficial to reduce adverse outcomes such as retinal detachment and myopic maculopathy which are associated with increased axial length. Pharmacological control of myopia progression with atropine has been investigated since the 19th century and the benefits of slowing myopia progression are considered against the side-effects of near blur and photophobia. More recently, randomised trials have focused on determining the optimum concentration of atropine leading to low-concentration atropine being used to manage myopia progression by practitioners across the world. Currently, in the United Kingdom, there is no licensed pharmacological intervention for myopia management. The aim of this review is to interpret the available data to inform clinical practice. We conducted a narrative review of the literature and identified peer-reviewed randomised controlled trials using the search terms 'myopia' and 'atropine', limited to the English language. We identified two key studies, which were the Atropine in the Treatment Of Myopia (ATOM) and Low-concentration Atropine for Myopia Progression (LAMP). Further studies were identified using the above search terms and the references from the identified literature. Atropine 0.01% has a modest effect on controlling axial length progression. Atropine 0.05% appears to be superior to atropine 0.01% in managing myopia progression. There is a dose-dependent rebound effect when treatment is stopped. Atropine is a well-tolerated, safe, and effective intervention. Treatment would be needed for several years and into adolescence, until axial length progression is stable.
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Affiliation(s)
- Imran Jawaid
- Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, UK.
| | - Kathryn Saunders
- School of Biomedical Sciences, Ulster University, Northern Ireland, UK
| | - Christopher J Hammond
- Section of Academic Ophthalmology, School of Life Course Sciences, King's College London, London, UK
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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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Barraza-Bernal MJ, Ohlendorf A, Sanz Diez P, Feng X, Yang LH, Lu MX, Wahl S, Kratzer T. Prediction of refractive error and its progression: a machine learning-based algorithm. BMJ Open Ophthalmol 2023; 8:e001298. [PMID: 37793703 PMCID: PMC10551949 DOI: 10.1136/bmjophth-2023-001298] [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: 03/29/2023] [Accepted: 09/07/2023] [Indexed: 10/06/2023] Open
Abstract
OBJECTIVE Myopia is the refractive error that shows the highest prevalence for younger ages in Southeast Asia and its projection over the next decades indicates that this situation will worsen. Nowadays, several management solutions are being applied to help fight its onset and development, nonetheless, the applications of these techniques depend on a clear and reliable assessment of risk to develop myopia. METHODS AND ANALYSIS In this study, population-based data of Chinese children were used to develop a machine learning-based algorithm that enables the risk assessment of myopia's onset and development. Cross-sectional data of 12 780 kids together with longitudinal data of 226 kids containing age, gender, biometry and refractive parameters were used for the development of the models. RESULTS A combination of support vector regression and Gaussian process regression resulted in the best performing algorithm. The Pearson correlation coefficient between prediction and measured data was 0.77, whereas the bias was -0.05 D and the limits of agreement was 0.85 D (95% CI: -0.91 to 0.80D). DISCUSSION The developed algorithm uses accessible inputs to provide an estimate of refractive development and may serve as guide for the eye care professional to help determine the individual best strategy for management of myopia.
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Affiliation(s)
| | - Arne Ohlendorf
- Technology and Innovation, Carl Zeiss Vision International GmbH, Aalen, Germany
| | | | - Xiancai Feng
- Myopia Prevention and Management, Carl Zeiss Shanghai Co Ltd, Shanghai, China
| | - Li-Hua Yang
- Wuhan Center for Adolescent Poor Vision Prevention and Control, Wuhan, China
| | - Mei-Xia Lu
- Wuhan Commission of Experts for the Prevention and Control of Adolescent Poor Vision, Wuhan, China
| | | | - Timo Kratzer
- Technology and Innovation, Carl Zeiss Vision GmbH, Aalen, Germany
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10
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Martínez-Albert N, Bueno-Gimeno I, Gené-Sampedro A. Risk Factors for Myopia: A Review. J Clin Med 2023; 12:6062. [PMID: 37763002 PMCID: PMC10532298 DOI: 10.3390/jcm12186062] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/15/2023] [Accepted: 09/17/2023] [Indexed: 09/29/2023] Open
Abstract
Due to the myopia prevalence increase worldwide, this study aims to establish the most relevant risk factors associated with its development and progression. A review search was carried out using PubMed, Web of Science, and Scopus databases to identify the main myopia risk factors. The inclusion criteria for the articles were those related to the topic, carried out in subjects from 5 to 30 years, published between January 2000 and May 2023, in English, and with the full text available. Myopia etiology has proven to be associated with both genetic and environmental factors as well as with gene-environment interaction. The risk of developing myopia increases in children with myopic parents (one parent ×2 times, two parents ×5 times). Regarding environmental factors, education is the main risk factor correlated with myopia prevalence increase. Further, several studies found that shorter distance (<30 cm) and longer time spent (>30 min) for near work increase the risk of myopia. Meanwhile, increased outdoor activity (>40 min/day) has been shown to be a key factor in reducing myopia incidence. In conclusion, the interventional strategy suggested so far to reduce myopia incidence is an increase in time outdoors and a reduction in the time spent performing near-work tasks.
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Affiliation(s)
| | - Inmaculada Bueno-Gimeno
- Department of Optics and Optometry and Vision Sciences, University of Valencia, 46100 Burjassot, Spain;
| | - Andrés Gené-Sampedro
- Department of Optics and Optometry and Vision Sciences, University of Valencia, 46100 Burjassot, Spain;
- Research Institute on Traffic and Road Safety (INTRAS), University of Valencia, 46022 Valencia, Spain
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11
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Jonas JB, Jonas RA, Bikbov MM, Wang YX, Panda-Jonas S. Myopia: Histology, clinical features, and potential implications for the etiology of axial elongation. Prog Retin Eye Res 2023; 96:101156. [PMID: 36585290 DOI: 10.1016/j.preteyeres.2022.101156] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/27/2022] [Accepted: 12/14/2022] [Indexed: 12/29/2022]
Abstract
Myopic axial elongation is associated with various non-pathological changes. These include a decrease in photoreceptor cell and retinal pigment epithelium (RPE) cell density and retinal layer thickness, mainly in the retro-equatorial to equatorial regions; choroidal and scleral thinning pronounced at the posterior pole and least marked at the ora serrata; and a shift in Bruch's membrane opening (BMO) occurring in moderately myopic eyes and typically in the temporal/inferior direction. The BMO shift leads to an overhang of Bruch's membrane (BM) into the nasal intrapapillary compartment and BM absence in the temporal region (i.e., parapapillary gamma zone), optic disc ovalization due to shortening of the ophthalmoscopically visible horizontal disc diameter, fovea-optic disc distance elongation, reduction in angle kappa, and straightening/stretching of the papillomacular retinal blood vessels and retinal nerve fibers. Highly myopic eyes additionally show an enlargement of all layers of the optic nerve canal, elongation and thinning of the lamina cribrosa, peripapillary scleral flange (i.e., parapapillary delta zone) and peripapillary choroidal border tissue, and development of circular parapapillary beta, gamma, and delta zone. Pathological features of high myopia include development of macular linear RPE defects (lacquer cracks), which widen to round RPE defects (patchy atrophies) with central BM defects, macular neovascularization, myopic macular retinoschisis, and glaucomatous/glaucoma-like and non-glaucomatous optic neuropathy. BM thickness is unrelated to axial length. Including the change in eye shape from a sphere in emmetropia to a prolate (rotational) ellipsoid in myopia, the features may be explained by a primary BM enlargement in the retro-equatorial/equatorial region leading to axial elongation.
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Affiliation(s)
- Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karis-University, Mannheim, Germany; Institute for Clinical and Scientific Ophthalmology and Acupuncture Jonas & Panda, Heidelberg, Germany.
| | - Rahul A Jonas
- Department of Ophthalmology, University of Cologne, Cologne, Germany
| | | | - Ya Xing Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China
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12
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Naduvilath T, He X, Xu X, Sankaridurg P. Normative data for axial elongation in Asian children. Ophthalmic Physiol Opt 2023; 43:1160-1168. [PMID: 37132642 DOI: 10.1111/opo.13159] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 04/03/2023] [Accepted: 04/19/2023] [Indexed: 05/04/2023]
Abstract
AIM To determine the influence of refractive error (RE), age, gender and parental myopia on axial elongation in Chinese children and to develop normative data for this population. METHODS This is a retrospective analysis of eight longitudinal studies conducted in China between 2007 and 2017. Data of 4701 participants aged 6-16 years with spherical equivalent from +6 to -6D contributed to one, two or three annualised progression data resulting in a dataset of 11,262 eyes of 26.6%, 14.8% and 58.6% myopes, emmetropes and hyperopes, respectively. Longitudinal data included axial length and cycloplegic spherical equivalent RE. Axial elongation was log-transformed to develop an exponential model with generalised estimating equations including main effects and interactions. Model-based estimates and their confidence intervals (CIs) are reported. RESULTS Annual axial elongation decreased significantly with increasing age, with the rate of decrease specific to the RE group. Axial elongation in myopes was higher than in emmetropes and hyperopes but these differences reduced with age (0.58, 0.45 and 0.27 mm/year at 6 years and 0.13, 0.06 and 0.05 mm/year at 15 years for myopes, emmetropes and hyperopes, respectively). The rate of elongation in incident myopes was similar to that in myopes at baseline (0.33 vs. 0.34 mm/year at 10.5 years; p = 0.32), while it was significantly lower in non-myopes (0.20 mm/year at 10.5 years, p < 0.001). Axial elongation was greater in females than in males and in those with both parents myopic compared with one or no myopic parent, with larger differences in non-myopes than in myopes (p < 0.01). CONCLUSIONS Axial elongation varied with age, RE, gender and parental myopia. Estimated normative data with CIs could serve as a virtual control group.
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Affiliation(s)
- Thomas Naduvilath
- Brien Holden Vision Institute (BHVI), Sydney, New South Wales, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Xiangui He
- Shanghai Eye Disease Prevention and Treatment Centre, Shanghai Eye Hospital, Shanghai Vision Health Centre & Shanghai Children Myopia Institute, Shanghai, China
| | - Xun Xu
- Shanghai Eye Disease Prevention and Treatment Centre, Shanghai Eye Hospital, Shanghai Vision Health Centre & Shanghai Children Myopia Institute, Shanghai, China
| | - Padmaja Sankaridurg
- Brien Holden Vision Institute (BHVI), Sydney, New South Wales, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
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13
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Greenbaum E, Barayev E, Shpitzer S, Heller D, Nahum Y, Livny E, Gershoni A, Bahar I. Post-refractive surgery of Israeli Defense Forces recruits in 2005-2018-prevalence, combat unit drop-out rates and utilization of eye-care services. Eye (Lond) 2023; 37:1484-1488. [PMID: 35835990 PMCID: PMC10169835 DOI: 10.1038/s41433-022-02164-6] [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: 06/20/2021] [Revised: 05/26/2022] [Accepted: 06/20/2022] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To assess the number of recruits for military service in the Israeli Defense Force (IDF) who underwent refractive surgery prior to enlistment and examine whether the procedure affected their ability to accomplish combat training. SETTING Medical records of IDF recruits. DESIGN Retrospective analysis of medical records of recruits with ametropia who underwent or did not undergo refractive surgery prior to enlistment. METHODS Recruits were categorized into ametropes and recruits who underwent refractive surgery. Fitness and assignment to combat units and completion status of combat training were compared between the two groups. RESULTS The study included 334,688 (182,969 males, 151,719 females) ametropes of which 5231 (4753 males, 478 females) underwent refractive surgery prior to recruitment. Refractive surgery prevalence increased from 9/1000 ametropes in 2005 to 18.5/1000 ametropes in 2018 (r = 0.912, p < 0.001); 2643 of the operated recruits (50.5%) had their surgery at the age of 17-18. Dropout rates from combat training were significantly lower in the refractive surgery group during the study period (1.68% vs. 6.14%, respectively, p < 0.001). Soldiers in the operated group were more frequently referred to ophthalmologists than those in the ametropes group and less frequently referred to optometrists. CONCLUSIONS The prevalence of refractive surgery in IDF recruits has increased substantially during the last decade with more of them applying to combat units. Refractive surgery opened new possibilities for recruits who were unfit for combat duty prior to surgery and did not appear to impair the chances of successfully completing combat training.
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Affiliation(s)
- Eran Greenbaum
- Israel Defense Forces, Medical Corps, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel
| | - Edward Barayev
- Israel Defense Forces, Medical Corps, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel
| | - Sagi Shpitzer
- Israel Defense Forces, Medical Corps, Tel Aviv, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel
| | - Dan Heller
- Israel Defense Forces, Medical Corps, Tel Aviv, Israel
- Department of Ophthalmology, Edith Wolfson Medical Center, Holon, Israel
| | - Yoav Nahum
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel
- Assuta Optic Laser Center, Assuta Medical Center, Tel Aviv, Israel
| | - Eitan Livny
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel
- Assuta Optic Laser Center, Assuta Medical Center, Tel Aviv, Israel
| | - Assaf Gershoni
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel
| | - Irit Bahar
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
- Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel.
- Assuta Optic Laser Center, Assuta Medical Center, Tel Aviv, Israel.
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Wang W, Zhang F, Yu S, Ma N, Huang C, Wang M, Wei L, Zhang J, Fu A. Prevention of myopia shift and myopia onset using 0.01% atropine in premyopic children - a prospective, randomized, double-masked, and crossover trial. Eur J Pediatr 2023:10.1007/s00431-023-04921-5. [PMID: 36944782 DOI: 10.1007/s00431-023-04921-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 03/23/2023]
Abstract
This study aims to evaluate the efficacy of 0.01% atropine eye drops in preventing myopia shift and myopia onset in premyopic children. A prospective, randomized, double-masked, placebo-controlled, and crossover trial was conducted over 13 months. Sixty premyopic children aged 6-12 years with cycloplegic spherical equivalent refraction (SER) > - 0.75 D and ≤ + 0.50 D in both eyes were assigned in a 1:1 ratio to receive one drop of 0.01% atropine or placebo once nightly for 6 months (period 1), followed by a 1-month recovery period. Then, the 0.01% atropine group was crossed over to the placebo group, and the latter was crossed over to the 0.01% atropine group for another 6 months (period 2). The primary outcomes were changes in SER and axial length (AL), and the secondary outcomes were the proportion of myopia onset (SER ≤ - 0.75D) and fast myopic shift (change in SER ≤ - 0.25D) in the two periods. Generalized estimating equation (GEE) model performed a statistically significant treatment effect of 0.01% atropine compared with placebo (pSER = 0.02, pAL < 0.001), with a mean SER and AL difference of 0.20D (- 0.15 ± 0.26D vs. - 0.34 ± 0.34D) and 0.11 mm (0.17 ± 0.11 mm vs. 0.28 ± 0.14 mm) in period 1, and 0.17D (- 0.18 ± 0.24D vs. - 0.34 ± 0.31D) and 0.10 mm (0.15 ± 0.15 mm vs. 0.24 ± 0.11 mm) in period 2. The GEE model showed that the proportion of myopia onset (p = 0.004) and fast myopic shift (p = 0.009) was significantly lower in the 0.01% atropine group than that in the placebo group. The period effect was not statistically significant (all p > 0.05). A total of 0.01% atropine significantly prevented myopic shift, axial elongation, and myopia onset in premyopic schoolchildren in central Mainland China. CONCLUSION Within the limits of only two consecutive 6-month observation period, 0.01% atropine eye drops effectively prevented myopic shift, axial elongation, and myopia onset in premyopic children. TRIAL REGISTRATION This trial was registered in the Chinese Clinical Trial Registry (Registration number: ChiCTR2000034760). Registered 18 July 2020. WHAT IS KNOWN • Minimal studies on interventions for pre-myopia, despite the International Myopia Institute stating that preventing myopia is an "even more valuable target" for science and practice than reducing progression after onset. WHAT IS NEW • A total of 0.01% atropine eye drops may safely and effectively reduce the proportion of myopia onset and fast myopic shift in premyopic schoolchildren.
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Affiliation(s)
- Weiqun Wang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Fengyan Zhang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Shiao Yu
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Nana Ma
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Congcong Huang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Ming Wang
- Beijing Aier Intech Eye Hospital, Beijing, 100021, China
| | - Li Wei
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China
| | - Junjie Zhang
- Henan Eye Institute, Henan Provincial People's Hospital, Zhengzhou, 450000, China
| | - Aicun Fu
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450000, China.
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15
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Esteves S, Martinez-Perez C, Alvarez-Peregrina C, Sánchez-Tena MÁ. Citation Network Analysis on the Influence of Vision on Academic Performance. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10030591. [PMID: 36980150 PMCID: PMC10047661 DOI: 10.3390/children10030591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 03/14/2023] [Accepted: 03/18/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND Proper vision is absolutely critical to children's academic performance, as vision problems can drastically affect learning ability. Currently, the existing literature in this field is somewhat inconsistent and carries several controversies about the influence of vision on academic performance. In this study, citation networks were utilized in order to analyze the relationship between publications and authors, the most-cited publication, and the different research areas. Additionally, the most commonly utilized publication sources along with the most common research areas were also pinpointed. METHODS The aforementioned search was executed in the Web of Science database, with a time range beginning in 1941 and ending in 2022. In order to scrutinize the publications, VOSviewer, CiteSpace software, and the Citation Network Explorer were utilized for analysis about the most-cited publication and the different research areas. RESULTS Overall, 1342 papers were found in all fields along with 2187 citation networks. Moreover, 2020 was the year with the most publications, including 127 publications and 4 citation networks. Bull et al., published in 2008, was the most-cited work, reaching a citation index of 975. The clustering function managed to identity four groups with the most engaging research topics from researchers: motor visual skills, visual memory, the influence of vision on the different learning styles, and abnormal development of the visual system. CONCLUSIONS In the end, the topic with the greatest interest was the influence of visual motor skills on academic performance. Ideally, this paper will assist fellow researchers in quickly noting which topics are of greatest interest and how research in this area has evolved.
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Affiliation(s)
- Sandrina Esteves
- ISEC LISBOA (Instituto Superior de Educação e Ciências), 1750-142 Lisbon, Portugal
| | - Clara Martinez-Perez
- ISEC LISBOA (Instituto Superior de Educação e Ciências), 1750-142 Lisbon, Portugal
| | - Cristina Alvarez-Peregrina
- Optometry and Vision Department, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain
| | - Miguel Ángel Sánchez-Tena
- ISEC LISBOA (Instituto Superior de Educação e Ciências), 1750-142 Lisbon, Portugal
- Optometry and Vision Department, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain
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16
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Orthokeratology in adults and effect on quality of life. Cont Lens Anterior Eye 2023; 46:101824. [PMID: 36898875 DOI: 10.1016/j.clae.2023.101824] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 02/19/2023] [Accepted: 02/20/2023] [Indexed: 03/12/2023]
Abstract
OBJECTIVE To determine changes in various ocular parameters of adults wearing orthokeratology (ortho-k) lenses and their levels of satisfaction and quality of life (QoL) after commencing treatment. METHODS Adults aged 18-38 years, with mild to moderate myopia and astigmatism < 1.50D, were wearing ortho-k lenses for one year. Data collection, which included history taking, refraction, axial length (AL), corneal topography, corneal biomechanics, and biomicroscopy examination, was performed at baseline and every 6 months during the study period. The level of satisfaction with the treatment and QoL was determined via questionnaires. RESULTS Forty-four subjects completed the study. AL was shortened significantly at the 12-month visit: AL -0.03 (-0.45 to 0.13) mm compared to baseline (p < 0.05). A significant number of subjects in both groups presented with overall and central corneal staining, but the majority were mild (Grade 1). Central endothelial cell density was reduced by 40/mm2 (loss rate 1.4 %) (p < 0.05). High scores were obtained in the satisfaction questionnaire, with no significant differences between visits. At the 12-month visit, NEI-RQL-42 total score, dependence on correction, activity limitation, appearance, and satisfaction with the treatment all significantly increased compared to baseline values. CONCLUSIONS Results suggest that ortho-k can be an effective and safe myopia correction technique for adults with low to moderate myopia, improving daytime vision without serious adverse events. Satisfaction with ortho-k lens wear was high, particularly those who were dependent on vision correction and found spectacles or contact lenses limiting specific activities or cosmetically undesirable.
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Lawrenson JG, Shah R, Huntjens B, Downie LE, Virgili G, Dhakal R, Verkicharla PK, Li D, Mavi S, Kernohan A, Li T, Walline JJ. Interventions for myopia control in children: a living systematic review and network meta-analysis. Cochrane Database Syst Rev 2023; 2:CD014758. [PMID: 36809645 PMCID: PMC9933422 DOI: 10.1002/14651858.cd014758.pub2] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
BACKGROUND Myopia is a common refractive error, where elongation of the eyeball causes distant objects to appear blurred. The increasing prevalence of myopia is a growing global public health problem, in terms of rates of uncorrected refractive error and significantly, an increased risk of visual impairment due to myopia-related ocular morbidity. Since myopia is usually detected in children before 10 years of age and can progress rapidly, interventions to slow its progression need to be delivered in childhood. OBJECTIVES To assess the comparative efficacy of optical, pharmacological and environmental interventions for slowing myopia progression in children using network meta-analysis (NMA). To generate a relative ranking of myopia control interventions according to their efficacy. To produce a brief economic commentary, summarising the economic evaluations assessing myopia control interventions in children. To maintain the currency of the evidence using a living systematic review approach. SEARCH METHODS: We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register), MEDLINE; Embase; and three trials registers. The search date was 26 February 2022. SELECTION CRITERIA: We included randomised controlled trials (RCTs) of optical, pharmacological and environmental interventions for slowing myopia progression in children aged 18 years or younger. Critical outcomes were progression of myopia (defined as the difference in the change in spherical equivalent refraction (SER, dioptres (D)) and axial length (mm) in the intervention and control groups at one year or longer) and difference in the change in SER and axial length following cessation of treatment ('rebound'). DATA COLLECTION AND ANALYSIS: We followed standard Cochrane methods. We assessed bias using RoB 2 for parallel RCTs. We rated the certainty of evidence using the GRADE approach for the outcomes: change in SER and axial length at one and two years. Most comparisons were with inactive controls. MAIN RESULTS We included 64 studies that randomised 11,617 children, aged 4 to 18 years. Studies were mostly conducted in China or other Asian countries (39 studies, 60.9%) and North America (13 studies, 20.3%). Fifty-seven studies (89%) compared myopia control interventions (multifocal spectacles, peripheral plus spectacles (PPSL), undercorrected single vision spectacles (SVLs), multifocal soft contact lenses (MFSCL), orthokeratology, rigid gas-permeable contact lenses (RGP); or pharmacological interventions (including high- (HDA), moderate- (MDA) and low-dose (LDA) atropine, pirenzipine or 7-methylxanthine) against an inactive control. Study duration was 12 to 36 months. The overall certainty of the evidence ranged from very low to moderate. Since the networks in the NMA were poorly connected, most estimates versus control were as, or more, imprecise than the corresponding direct estimates. Consequently, we mostly report estimates based on direct (pairwise) comparisons below. At one year, in 38 studies (6525 participants analysed), the median change in SER for controls was -0.65 D. The following interventions may reduce SER progression compared to controls: HDA (mean difference (MD) 0.90 D, 95% confidence interval (CI) 0.62 to 1.18), MDA (MD 0.65 D, 95% CI 0.27 to 1.03), LDA (MD 0.38 D, 95% CI 0.10 to 0.66), pirenzipine (MD 0.32 D, 95% CI 0.15 to 0.49), MFSCL (MD 0.26 D, 95% CI 0.17 to 0.35), PPSLs (MD 0.51 D, 95% CI 0.19 to 0.82), and multifocal spectacles (MD 0.14 D, 95% CI 0.08 to 0.21). By contrast, there was little or no evidence that RGP (MD 0.02 D, 95% CI -0.05 to 0.10), 7-methylxanthine (MD 0.07 D, 95% CI -0.09 to 0.24) or undercorrected SVLs (MD -0.15 D, 95% CI -0.29 to 0.00) reduce progression. At two years, in 26 studies (4949 participants), the median change in SER for controls was -1.02 D. The following interventions may reduce SER progression compared to controls: HDA (MD 1.26 D, 95% CI 1.17 to 1.36), MDA (MD 0.45 D, 95% CI 0.08 to 0.83), LDA (MD 0.24 D, 95% CI 0.17 to 0.31), pirenzipine (MD 0.41 D, 95% CI 0.13 to 0.69), MFSCL (MD 0.30 D, 95% CI 0.19 to 0.41), and multifocal spectacles (MD 0.19 D, 95% CI 0.08 to 0.30). PPSLs (MD 0.34 D, 95% CI -0.08 to 0.76) may also reduce progression, but the results were inconsistent. For RGP, one study found a benefit and another found no difference with control. We found no difference in SER change for undercorrected SVLs (MD 0.02 D, 95% CI -0.05 to 0.09). At one year, in 36 studies (6263 participants), the median change in axial length for controls was 0.31 mm. The following interventions may reduce axial elongation compared to controls: HDA (MD -0.33 mm, 95% CI -0.35 to 0.30), MDA (MD -0.28 mm, 95% CI -0.38 to -0.17), LDA (MD -0.13 mm, 95% CI -0.21 to -0.05), orthokeratology (MD -0.19 mm, 95% CI -0.23 to -0.15), MFSCL (MD -0.11 mm, 95% CI -0.13 to -0.09), pirenzipine (MD -0.10 mm, 95% CI -0.18 to -0.02), PPSLs (MD -0.13 mm, 95% CI -0.24 to -0.03), and multifocal spectacles (MD -0.06 mm, 95% CI -0.09 to -0.04). We found little or no evidence that RGP (MD 0.02 mm, 95% CI -0.05 to 0.10), 7-methylxanthine (MD 0.03 mm, 95% CI -0.10 to 0.03) or undercorrected SVLs (MD 0.05 mm, 95% CI -0.01 to 0.11) reduce axial length. At two years, in 21 studies (4169 participants), the median change in axial length for controls was 0.56 mm. The following interventions may reduce axial elongation compared to controls: HDA (MD -0.47mm, 95% CI -0.61 to -0.34), MDA (MD -0.33 mm, 95% CI -0.46 to -0.20), orthokeratology (MD -0.28 mm, (95% CI -0.38 to -0.19), LDA (MD -0.16 mm, 95% CI -0.20 to -0.12), MFSCL (MD -0.15 mm, 95% CI -0.19 to -0.12), and multifocal spectacles (MD -0.07 mm, 95% CI -0.12 to -0.03). PPSL may reduce progression (MD -0.20 mm, 95% CI -0.45 to 0.05) but results were inconsistent. We found little or no evidence that undercorrected SVLs (MD -0.01 mm, 95% CI -0.06 to 0.03) or RGP (MD 0.03 mm, 95% CI -0.05 to 0.12) reduce axial length. There was inconclusive evidence on whether treatment cessation increases myopia progression. Adverse events and treatment adherence were not consistently reported, and only one study reported quality of life. No studies reported environmental interventions reporting progression in children with myopia, and no economic evaluations assessed interventions for myopia control in children. AUTHORS' CONCLUSIONS Studies mostly compared pharmacological and optical treatments to slow the progression of myopia with an inactive comparator. Effects at one year provided evidence that these interventions may slow refractive change and reduce axial elongation, although results were often heterogeneous. A smaller body of evidence is available at two or three years, and uncertainty remains about the sustained effect of these interventions. Longer-term and better-quality studies comparing myopia control interventions used alone or in combination are needed, and improved methods for monitoring and reporting adverse effects.
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Affiliation(s)
- John G Lawrenson
- Centre for Applied Vision Research, School of Health & Psychological Sciences , City, University of London, London, UK
| | - Rakhee Shah
- Centre for Applied Vision Research, School of Health & Psychological Sciences , City, University of London, London, UK
| | - Byki Huntjens
- Centre for Applied Vision Research, School of Health & Psychological Sciences , City, University of London, London, UK
| | - Laura E Downie
- Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Australia
| | - Gianni Virgili
- Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Rohit Dhakal
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
| | - Pavan K Verkicharla
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India
| | - Dongfeng Li
- Centre for Public Health, Queen's University Belfast, Belfast, UK
- Department of Ophthalmology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Sonia Mavi
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Ashleigh Kernohan
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Tianjing Li
- Department of Ophthalmology, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA
| | - Jeffrey J Walline
- College of Optometry, The Ohio State University, Columbus, Ohio, USA
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18
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Zhu Z, Chen Y, Tan Z, Xiong R, McGuinness MB, Müller A. Interventions recommended for myopia prevention and control among children and adolescents in China: a systematic review. Br J Ophthalmol 2023; 107:160-166. [PMID: 34844916 DOI: 10.1136/bjophthalmol-2021-319306] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 11/09/2021] [Indexed: 01/25/2023]
Abstract
In 2018, a consortium of government bodies in China led by the Ministry of Education released the Comprehensive Plan to Prevent Nearsightedness among Children and Teenagers (CPPNCT), aiming to reduce the incidence of myopia and control myopic progression in China. Recommendations span from home-based to school-based interventions, including time outdoors, physical activity, light exposure, near-work activity, screen time, Chinese eye exercises, diet and sleep. To date, the levels of evidence for this suite of interventions have not been thoroughly investigated. This review has summarised the evidence of the interventions recommended by the CPPNCT in myopia prevention and control. Thus, the following statements are supposed by the evidence: (1) Increasing time outdoors and reducing near-work time are effective in lowering incident myopia in school-aged children. (2) All interventions have a limited effect on myopia progression. Ongoing research may lead to a better understanding of the underlying mechanisms of myopia development, the interaction of different interventions and recommendations, confounding variables and their true effect on myopia prevention, and the identification of those most likely to respond to specific interventions. This field may also benefit from longer-term studies of the various interventions or strategies covered within this review article, to better understand the persistence of treatment effects over time and explore more novel approaches to myopia control.
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Affiliation(s)
- Zhuoting Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yanxian Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Zachary Tan
- Centre for Eye Research Australia, East Melbourne, Victoria, Australia
| | - Ruilin Xiong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Myra Beth McGuinness
- Centre for Eye Research Australia, East Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Andreas Müller
- Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
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19
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Swierkowska J, Vishweswaraiah S, Mrugacz M, Radhakrishna U, Gajecka M. Differential methylation of microRNA encoding genes may contribute to high myopia. Front Genet 2023; 13:1089784. [PMID: 36685896 PMCID: PMC9847511 DOI: 10.3389/fgene.2022.1089784] [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: 11/04/2022] [Accepted: 12/08/2022] [Indexed: 01/05/2023] Open
Abstract
Introduction: High myopia (HM), an eye disorder with a refractive error ≤-6.0 diopters, has multifactorial etiology with environmental and genetic factors involved. Recent studies confirm the impact of alterations in DNA methylation and microRNAs (miRNAs) on myopia. Here, we studied the combined aspects evaluating to the role of methylation of miRNA encoding genes in HM. Materials and Methods: From the genome-wide DNA methylation data of 18 Polish children with HM and 18 matched controls, we retrieved differentially methylated CG dinucleotides localized in miRNA encoding genes. Putative target genes of the highest-ranked miRNAs were obtained from the miRDB and included in overrepresentation analyses in the ConsensusPathDB. Expression of target genes was assessed using the RNA sequencing data of retinal ARPE-19 cell line. Results: We identified differential methylation of CG dinucleotides in promoter regions of MIR3621, MIR34C, MIR423 (increased methylation level), and MIR1178, MIRLET7A2, MIR885, MIR548I3, MIR6854, MIR675, MIRLET7C, MIR99A (decreased methylation level) genes. Several targets of these miRNAs, e.g. GNAS, TRAM1, CTNNB1, EIF4B, TENM3 and RUNX were previously associated with myopia/HM/refractive error in Europeans in genome-wide association studies. Overrepresentation analyses of miRNAs' targets revealed enrichment in pathways/processes related to eye structure/function, such as axon guidance, transcription, focal adhesion, and signaling pathways of TGF-β, insulin, MAPK and EGF-EGFR. Conclusion: Differential methylation of indicated miRNA encoding genes might influence their expression and contribute to HM pathogenesis via disrupted regulation of transcription of miRNAs' target genes. Methylation of genes encoding miRNAs may be a new direction in research on both the mechanisms determining HM and non-invasive indicators in diagnostics.
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Affiliation(s)
| | - Sangeetha Vishweswaraiah
- Department of Obstetrics and Gynecology, Oakland University William Beaumont School of Medicine, Royal Oak, MI, United States
| | - Malgorzata Mrugacz
- Department of Ophthalmology and Eye Rehabilitation, Medical University of Bialystok, Bialystok, Poland
| | - Uppala Radhakrishna
- Department of Obstetrics and Gynecology, Oakland University William Beaumont School of Medicine, Royal Oak, MI, United States
| | - Marzena Gajecka
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland,Chair and Department of Genetics and Pharmaceutical Microbiology, Poznan University of Medical Sciences, Poznan, Poland,*Correspondence: Marzena Gajecka,
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20
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Dutheil F, Oueslati T, Delamarre L, Castanon J, Maurin C, Chiambaretta F, Baker JS, Ugbolue UC, Zak M, Lakbar I, Pereira B, Navel V. Myopia and Near Work: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:875. [PMID: 36613196 PMCID: PMC9820324 DOI: 10.3390/ijerph20010875] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/23/2022] [Accepted: 12/29/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Myopia is a global public health problem affecting quality of life and work productivity. Data is scarce regarding the effects of near work on myopia. Providing a larger meta-analysis with life-long perspective, including adults and occupational exposure seemed needed. METHODS We searched PubMed, Cochrane Library, Embase and Science Direct for studies reporting myopia prevalence in near work. Myopia was defined as a mean spherical equivalent ≤ -0.50 diopter. We performed a meta-analysis using random-effects model on myopia prevalence, myopia progression per year, and odds ratio (OR) of myopia in near work, completed by subgroup analyses and meta-regressions on patients' characteristics, type of work in adults, geographic zones, time and characteristics of near work. RESULTS We included 78 studies, representing a total of 254,037 participants, aged from 6 to 39 years. The global prevalence of myopia in near work was 35% (95% CI: 30 to 41%), with a prevalence of 31% (95% CI: 26 to 37%) in children and 46% (95% CI: 30 to 62%) in adults. Myopia progression was -0.39 diopters per year (-0.53 to -0.24 D/year), ranging from -0.44 (-0.57 to -0.31) in children to -0.25 D/year (-0.56 to 0.06) in adults. The odds of myopia in workers exposed vs. non-exposed to near work were increased by 26% (18 to 34%), by 31% (21 to 42%) in children and 21% (6 to 35%) in adults. Prevalence of myopia was higher in adults compared to children (Coefficient 0.15, 95% CI: 0.03 to 0.27). CONCLUSIONS Near work conditions, including occupational exposure in adults, could be associated with myopia. Targeted prevention should be implemented in the workplace.
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Affiliation(s)
- Frédéric Dutheil
- Preventive and Occupational Medicine, University Hospital of Clermont-Ferrand, Physiological and Psychosocial Stress, CNRS, LaPSCo, Université Clermont Auvergne, WittyFit, 63001 Clermont-Ferrand, France
| | - Tharwa Oueslati
- Ophthalmology, University Hospital of Clermont-Ferrand (CHU), 63001 Clermont-Ferrand, France
| | - Louis Delamarre
- Preventive and Occupational Medicine, University Hospital of Clermont-Ferrand, Physiological and Psychosocial Stress, CNRS, LaPSCo, Université Clermont Auvergne, WittyFit, 63001 Clermont-Ferrand, France
- Department of Anesthesiology and Intensive Care, University Hospital of Marseille, Hopital Nord—Assistance Publique Hôpitaux de Marseille, 13015 Marseille, France
| | - Joris Castanon
- Ophthalmology, University Hospital of Clermont-Ferrand (CHU), 63001 Clermont-Ferrand, France
| | - Caroline Maurin
- Ophthalmology, University Hospital of Clermont-Ferrand (CHU), 63001 Clermont-Ferrand, France
| | - Frédéric Chiambaretta
- Ophthalmology, University Hospital of Clermont-Ferrand (CHU), 63001 Clermont-Ferrand, France
| | - Julien S. Baker
- Centre for Health and Exercise Science Research, Physical Education and Health, Kowloon Tong, Hong Kong Baptist University, Hong Kong
| | - Ukadike C. Ugbolue
- School of Health and Life Sciences, University of the West of Scotland, Glasgow G72 0LH, UK
| | - Marek Zak
- Faculty of Medicine and Health Sciences, Institute of Physiotherapy, The Jan Kochanowski University, 25-369 Kielce, Poland
| | - Ines Lakbar
- Department of Anesthesiology and Intensive Care, University Hospital of Marseille, Hopital Nord—Assistance Publique Hôpitaux de Marseille, 13015 Marseille, France
| | - Bruno Pereira
- Biostatitics, Clinical Research Direction, University Hospital of Clermont-Ferrand (CHU), 63001 Clermont-Ferrand, France
| | - Valentin Navel
- Ophthalmology, University Hospital of Clermont-Ferrand (CHU), 63001 Clermont-Ferrand, France
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21
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Kfir J, Wygnanski-Jaffe T, Farzavandi S, Wei Z, Yam JC, de Faber JT, Orge FH, Aznauryan I, Tsai CB, de Liano RG, Natarajan S, Dadeya SC, Agrawal S, Sato M, Shemesh R, Mezer E. The impact of the first peak of the COVID-19 pandemic on childhood myopia control practice patterns among ophthalmologists-an international pediatric ophthalmology and strabismus council global perspective. Graefes Arch Clin Exp Ophthalmol 2023; 261:233-240. [PMID: 36303062 PMCID: PMC9613446 DOI: 10.1007/s00417-022-05864-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 08/16/2022] [Accepted: 10/07/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The prevalence of myopia keeps increasing during the COVID-19 pandemic. We aimed to map the worldwide treatment preferences of ophthalmologists managing myopia control during the first wave of the pandemic. METHODS An online questionnaire inquiring about pharmacological and optical treatment patterns during the first half of 2020 was sent to pediatric ophthalmology as well as general ophthalmology memberships worldwide. The results among pediatric ophthalmologists were compared to a previous study we performed before the pandemic. RESULTS A total of 2269 respondents from 94 countries were included. Most respondents were pediatric ophthalmologists (64.6%), followed by ophthalmologists from other subspecialties (32.3%). The preferred modality for all geographical regions was a combination therapy of pharmacological and optical treatments. When evaluated independently, the pharmacological treatment was more popular than the optical treatment in most regions other than East Asia (P < 0.001). Compared to a pre-pandemic questionnaire, the participation of pediatric ophthalmologists affiliated with non-university hospitals increased. Additionally, the prevalence of respondents utilizing either any type of pharmacological treatment and those that using only evidence-based treatments increased globally. Although a decline in the use of optical treatment was evident worldwide, the use of evidence-based optical treatments increased. CONCLUSION Ophthalmologists around the world preferred a combination therapy of pharmacological and optical treatments. More pediatric ophthalmologists treated myopia progression and preferred a better evidence-based approach to control myopia. These trends reflect a positive response and more awareness of the rising prevalence of myopia due to the increased burden of myopia imposed by the COVID-19 pandemic.
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Affiliation(s)
- Jonathan Kfir
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel
| | - Tamara Wygnanski-Jaffe
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel
| | | | - Zhang Wei
- Tianjin Eye Hospital, Tianjin, People’s Republic of China
| | - Jason C. Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong
| | | | - Faruk H. Orge
- Department of Ophthalmology and Visual Sciences, University Hospitals Rainbow Babies and Children’s Hospital, Case Western Reserve University, Cleveland, OH USA
| | - Igor Aznauryan
- Scientific Education Center “Yasnyi Vzor”, Moscow, Russian Federation
| | - Chong-Bin Tsai
- Department of Ophthalmology, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi City, Taiwan
| | - Rosario Gomez de Liano
- Hospital Clínico/Instituto Castroviejo, Universidad Complutense de Madrid, Madrid, Spain
| | | | - Subhash C. Dadeya
- Guru Nanak Eye Centre &, Maulana Azad Medical College, New Delhi, India
| | | | - Miho Sato
- Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Rachel Shemesh
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel
| | - Eedy Mezer
- Department of Ophthalmology, Ruth Rappaport Children’s Hospital, Rambam Medical Center, Haifa, Israel
- Bruce and Ruth Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel
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22
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Cooper J, O’Connor B, Aller T, Dillehay SM, Weibel K, Benoit D. Reduction of Myopic Progression Using a Multifocal Soft Contact Lens: A Retrospective Cohort Study. Clin Ophthalmol 2022; 16:2145-2155. [PMID: 35814919 PMCID: PMC9270009 DOI: 10.2147/opth.s370041] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 06/15/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Jeffrey Cooper
- Cooper Eye Care, New York, NY, USA
- State University of New York College of Optometry, New York, NY, USA
| | | | - Thomas Aller
- Dr. Thomas Aller, Optometrist, Inc., San Bruno, CA, USA
- University of California, Berkeley School of Optometry, Berkeley, CA, USA
| | | | - Katherine Weibel
- The Ohio State University College of Medicine, Department of Ophthalmology, Columbus, OH, USA
| | - Douglas Benoit
- Visioneering Technologies, Inc., Alpharetta, GA, USA
- Correspondence: Douglas Benoit, Visioneering Technologies, Inc, Alpharetta, GA, 30009, USA, Email
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23
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Limwattanayingyong J, Amornpetchsathaporn A, Chainakul M, Grzybowski A, Ruamviboonsuk P. The Association Between Environmental and Social Factors and Myopia: A Review of Evidence From COVID-19 Pandemic. Front Public Health 2022; 10:918182. [PMID: 35844861 PMCID: PMC9276954 DOI: 10.3389/fpubh.2022.918182] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/06/2022] [Indexed: 01/20/2023] Open
Abstract
PurposeTo review the association between children's behavioral changes during the restriction due to the pandemic of Coronavirus disease (COVID-19) and the development and progression of myopia.DesignA literature review.MethodWe looked for relevant studies related to 1) children's behavioral changes from COVID-19 restriction and 2) children's myopia progression during COVID-19 restriction by using the following keywords. They were “Behavior,” “Activity,” “COVID-19,” “Lockdown,” “Restriction,” and “Children” for the former; “Myopia,” “COVID-19,” “Lockdown,” “Restriction” for the latter. Titles, abstracts and full texts from the retrieved studies were screened and all relevant data were summarized, analyzed, and discussed.ResultsChildren were less active and more sedentary during COVID-19 restriction. According to five studies from China and six studies, each from Hong Kong, Spain, Israel, South Korea, Turkey and Taiwan included in our review, all countries without myopia preventive intervention supported the association between the lockdown and myopia progression by means of negative SER change ranging from 0.05–0.6 D, more negative SER change (compared post- to pre-lockdown) ranging from 0.71–0.98 D and more negative rate of SER changes (compared post- to pre-lockdown) ranging from 0.05–0.1 D/month. The reported factor that accelerated myopia is an increase in total near work, while increased outdoor activity is a protective factor against myopia progression.ConclusionThe pandemic of COVID-19 provided an unwanted opportunity to assess the effect of the behavioral changes and myopia in the real world. There is sufficient evidence to support the association between an increase in near work from home confinement or a reduction of outdoor activities and worsening of myopia during the COVID-19 lockdown. The findings from this review of data from the real world may help better understanding of myopia development and progression, which may lead to adjustment of behaviors to prevent myopia and its progression in the future.
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Affiliation(s)
- Jirawut Limwattanayingyong
- Department of Ophthalmology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
| | - Anyarak Amornpetchsathaporn
- Department of Ophthalmology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
- *Correspondence: Anyarak Amornpetchsathaporn
| | - Methaphon Chainakul
- Department of Ophthalmology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
| | - Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland
- Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznan, Poland
| | - Paisan Ruamviboonsuk
- Department of Ophthalmology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
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24
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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: 29] [Impact Index Per Article: 14.5] [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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25
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Lanca C, Yam JC, Jiang W, Tham Y, Hassan Emamian M, Tan C, Guo Y, Liu H, Zhong H, Zhu D, Hu Y, Saxena R, Hashemi H, Chen L, Wong T, Cheng C, Pang C, Zhu H, Pan C, Liang YB, Fotouhi A, Bi H, Jonas JB, Saw S. Near work, screen time, outdoor time and myopia in schoolchildren in the Sunflower Myopia AEEC Consortium. Acta Ophthalmol 2022; 100:302-311. [PMID: 34142457 DOI: 10.1111/aos.14942] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 05/10/2021] [Accepted: 05/20/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE To examine the association between near work, screen time including TV and outdoor time with myopia in children from the Sunflower Myopia Asian Eye Epidemiology Consortium (AEEC). METHODS We analysed AEEC cross-sectional data (12 241 children) on risk factors (near work, screen time including TV and outdoor time) and myopia of six population-based studies (China, Hong Kong and Singapore). Cycloplegic refraction and axial length (AL) measurements were included. Risk factors were determined using questionnaires. Data were pooled from each study, and multivariable regression analysis was performed to evaluate the associations between risks factors and myopia, spherical equivalent (SE) and AL. RESULTS Among the included children, 52.1% were boys, 98.1% were Chinese and 69.7% lived in urban areas. Mean±standard deviation (SD) for age was 8.8 ± 2.9 years, for SE was -0.14 ± 1.8 D and for AL was 23.3 ± 1.1 mm. Myopia prevalence was 30.6%. In multivariate analysis, more reading and writing (OR = 1.17; 95% CI, 1.11-1.24), more total near work (OR = 1.05; 95% CI, 1.02-1.09) and less outdoor time (OR = 0.82, 95% CI, 0.75-0.88) were associated with myopia (p's < 0.05). These factors were similarly associated with SE and AL (p's < 0.05), except for total near work and AL (p = 0.15). Screen time including TV was not significantly associated with myopia (p = 0.49), SE (p = 0.49) or AL (p = 0.83). CONCLUSION In this study, increased reading and writing and decreased outdoor time were associated with myopia. Screen time may be a surrogate factor of near work or outdoor time, but further research is needed to assess its role as an independent risk factor for myopia.
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Affiliation(s)
- Carla Lanca
- Singapore Eye Research Institute Singapore Singapore
- Comprehensive Health Research Centre Universidade NOVA de Lisboa Lisbon Portugal
| | - Jason C. Yam
- Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong SAR Hong Kong
| | - Wen‐Jun Jiang
- Eye Institute of Shandong University of Traditional Chinese Medicine Jinan China
| | - Yih‐Chung Tham
- Singapore Eye Research Institute Singapore Singapore
- Ophthalmology and Visual Science Academic Clinical Program Duke‐NUS Medical School Singapore Singapore
| | - Mohammad Hassan Emamian
- Ophthalmic Epidemiology Research Center Shahroud University of Medical Sciences Shahroud Iran
| | - Chuen‐Seng Tan
- Saw Swee Hock School of Public Health National University of Singapore and National University Health System Singapore Singapore
| | - Yin Guo
- Tongren Eye Care Center Beijing Tongren Hospital Capital Medical University Beijing China
| | - Hu Liu
- Department of Ophthalmology The First Affiliated Hospital with Nanjing Medical University Nanjing China
| | - Hua Zhong
- Department of Ophthalmology the First Affiliated Hospital of Kunming Medical University Kunming China
| | - Dan Zhu
- The Affiliated Hospital of Inner Mongolia Medical University Huhhot China
| | - Yuan‐Yuan Hu
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine Jinan China
| | - Rohit Saxena
- Pediatric Ophthalmology, Strabismus and Neuro‐Ophthalmology Section Dr. R P Centre for Ophthalmic Sciences All India Institute of Medical Sciences New Delhi India
| | - Hassan Hashemi
- Noor Ophthalmology Research Center Noor Eye Hospital Tehran Iran
| | - Li‐Jia Chen
- Comprehensive Health Research Centre Universidade NOVA de Lisboa Lisbon Portugal
| | - Tien‐Yin Wong
- Singapore Eye Research Institute Singapore Singapore
- Ophthalmology and Visual Science Academic Clinical Program Duke‐NUS Medical School Singapore Singapore
- Department of Ophthalmology Yong Loo Lin School of Medicine National University of Singapore Singapore Singapore
- Singapore National Eye Centre Singapore Singapore
| | - Ching‐Yu Cheng
- Singapore Eye Research Institute Singapore Singapore
- Ophthalmology and Visual Science Academic Clinical Program Duke‐NUS Medical School Singapore Singapore
- Department of Ophthalmology Yong Loo Lin School of Medicine National University of Singapore Singapore Singapore
| | - Chi‐Pui Pang
- Department of Ophthalmology and Visual Sciences The Chinese University of Hong Kong Hong Kong SAR Hong Kong
| | - Hui Zhu
- Department of Ophthalmology The First Affiliated Hospital with Nanjing Medical University Nanjing China
| | - Chen‐Wei Pan
- School of Public Health Medical College of Soochow University Suzhou China
| | - Yuan Bo Liang
- Eye Hospital School of Ophthalmology and Optometry Wenzhou Medical University Wenzhou China
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics School of Public Health Tehran University of Medical Sciences Tehran Iran
| | - Hong‐sheng Bi
- Eye Institute of Shandong University of Traditional Chinese Medicine Jinan China
| | - Jost B. Jonas
- Department of Ophthalmology Medical Faculty Mannheim University of Heidelberg Mannheim Germany
| | - Seang‐Mei Saw
- Singapore Eye Research Institute Singapore Singapore
- Ophthalmology and Visual Science Academic Clinical Program Duke‐NUS Medical School Singapore Singapore
- Saw Swee Hock School of Public Health National University of Singapore and National University Health System Singapore Singapore
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Self-Reported Computer Vision Syndrome among Thai University Students in Virtual Classrooms during the COVID-19 Pandemic: Prevalence and Associated Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073996. [PMID: 35409679 PMCID: PMC8997620 DOI: 10.3390/ijerph19073996] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/23/2022] [Accepted: 03/25/2022] [Indexed: 02/06/2023]
Abstract
During the COVID-19 pandemic, computer vision syndrome (CVS) related to online classrooms were unavoidable. This cross-sectional study aimed to explore the prevalence, characteristics and associated factors of CVS. A total of 527 students who were currently studying in a virtual classroom (70.40% female, mean (standard deviation; SD) age of 20.04 (2.17) years) were included. The prevalence of CVS assessed by an online CVS-Questionnaire was 81.0% (427/527). Comparing with those in the period before the online study, an increase in screen time (interquartile range) in students with and without CVS was 3 (0−3) and 2 (1−5) h, respectively. Overall, 516 students (97.9%) experienced at least one symptom. The most frequent symptom in CVS subjects was eye pain (96.5%). The most intense symptoms were the feeling of worsening eyesight (15.9%). The factors associated with CVS were female (p < 0.001), age (p = 0.010), atopic diseases (p = 0.020), prior ocular symptoms (p < 0.001), astigmatism (p = 0.033), distance from display <20 cm (p = 0.023), presence of glare or reflection on screen (p < 0.001), low screen brightness (p = 0.045), sleep duration (p = 0.030), inadequate break time between classes (p < 0.001) and increased screen time usage during online study (p < 0.001). Recommendations to prevent CVS based on the adjustable factors might reduce the burden of online study.
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Duan F, Yuan Z, Deng J, Yeo AC, Yang A, Drobe B, Wong YL, Chen X. Incidence of myopic shift and related factors in young Chinese adults. Clin Exp Optom 2022; 106:422-426. [PMID: 35254945 DOI: 10.1080/08164622.2022.2048172] [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: 10/18/2022] Open
Abstract
CLINICAL RELEVANCE Myopia is a leading cause of visual impairment worldwide, and myopia progression in young adulthood may worsen this public health issue. BACKGROUND The aim was to describe the changes in myopia and various ocular biometry parameters, and to determine the incidence and related factors of myopic shift among young adults in China. METHODS This 2-year prospective cohort study was conducted at the Zhongshan Ophthalmic Center, Sun Yet-san University, China. A total of 291 Chinese medical freshmen (314 enrolled at baseline) were followed over 2 years. The participants underwent detailed eye examinations at baseline and follow-up visits, including cycloplegic refraction, ocular biometry measurements, and swept-source optical coherence tomography. Visual fatigue was assessed with the Convergence Insufficiency Symptom Survey (CISS) using Rasch analysis. Questionnaire on eye care habits and physical activities was administered. RESULTS A total of 291 study participants (baseline mean [SD] age, 18.7 [0.9] years; 132 [45.4%] male) were analysed. Seventy eight (26.8%) developed a myopic shift (defined as negative change in spherical equivalent worse than or equal to -0.50 D) over a 2-year period. The magnitude of subfoveal choroidal thinning was greater in participants with myopic shift, compared to those without. Axial length increased significantly by 0.12 mm in the group with myopic shift, compared to 0.02 mm in those without the myopic shift (p < 0.001) over 2 years. After multivariable adjustment, visual fatigue (using CISS) was found to be associated with the myopic shift (p = 0.02). CONCLUSIONS Approximately one in four Chinese medical students had a clinically significant myopic shift. Choroidal thinning and axial elongation were observed in young adults with myopic shift. Greater visual fatigue score at baseline was associated with myopic shift after multivariable adjustment.
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Affiliation(s)
- Fang Duan
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhaohui Yuan
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Jiayu Deng
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Anna Ch Yeo
- Education & Professional Services, Essilor AMERA Pte Ltd, Singapore
| | | | | | | | - Xiang Chen
- Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou, Guangdong, China
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Pärssinen O, Kauppinen M. Associations of near work time, watching TV, outdoors time, and parents' myopia with myopia among school children based on 38-year-old historical data. Acta Ophthalmol 2022; 100:e430-e438. [PMID: 34291573 DOI: 10.1111/aos.14980] [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: 03/19/2021] [Accepted: 07/01/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE To study the prevalence and risk factors of myopia with data from a questionnaire study conducted in 1983 among Finnish school children. METHODS School children (n = 4 961) from the 1st, 5th and 8th grades of school (7-, 11- and 15-year-olds) in Central Finland were screened for vision followed by a questionnaire, which was returned by 4 352 (87.7%) participants. Myopia was categorized based on the questionnaire. Items concerned daily time spent on near work and outdoor activities, excluding time spent at school, watching TV and parental myopia and the associations of myopia with these factors were studied. RESULTS The prevalence of myopia was 3%, 15% and 27% among the 7-, 11- and 15-year-olds, and if daily near work at home was ≤1 hr, myopia prevalence was 0.5%, 3.3% and 17.6%, respectively. The adjusted risk of myopia for each daily near work hour was OR 1.476 (95% confidence interval 1.099-1.984, p = 0.010), OR 1.346 (1.170-1.584, p < 0.001) and OR 1.206 (1.076-1.352, p = 0.001), in the 3 age groups, respectively. The adjusted risk of myopia for each daily hour spent outdoors was OR 0.764 (0.648-0.900, p = 0.001) in the 11-year-olds and OR (0.840, 0.743-0.950, p = 0.005) in the 15-year-olds. Outdoors time prevented myopia at different levels of near work, although less at the highest levels, and near work increased risk of myopia with the level of outdoors time. If the ratio between near work and outdoors time was ≤0. 5 or >1.5, the prevalence of myopia was 1.4% versus 5.6%, 6.3% versus 24.7% and 15.9% versus 36.9%, among the 7-, 11- and 15-year-olds, respectively. The higher prevalence of myopia among the 11- and 15-year-old girls than boys was explained by more near work and less outdoor time among the girls. Having two myopic parents roughly doubled the risk of myopia compared to if one myopic parent in the 11- and 15-year-olds. CONCLUSIONS Myopic parents, greater near work time, less outdoors time, a higher near work/outdoors ratio, and being a girl increased the risk of myopia. Myopia was rare in the 7- and 11-year-olds if daily near work at home did not exceed one hour or if the near work/outdoors ratio was not higher than 0.5. Outdoors time was associated with the prevalence of myopia at all levels of near work, although the association was weaker at the highest level.
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Affiliation(s)
- Olavi Pärssinen
- Department of Ophthalmology Central Hospital of Central Finland Jyväskylä Finland
- Gerontology Research Center and Faculty of Sport and Health Sciences University of Jyvaskylä Jyväskylä Finland
| | - Markku Kauppinen
- Gerontology Research Center and Faculty of Sport and Health Sciences University of Jyvaskylä Jyväskylä Finland
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Ducloux A, Marillet S, Ingrand P, Bullimore MA, Bourne RRA, Leveziel N. Progression of myopia in teenagers and adults: a nationwide longitudinal study of a prevalent cohort. Br J Ophthalmol 2021; 107:644-649. [PMID: 34937695 PMCID: PMC10176358 DOI: 10.1136/bjophthalmol-2021-319568] [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: 04/28/2021] [Accepted: 11/12/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND The prevalence of myopia is increasing worldwide. The purpose of this study was to evaluate the progression of myopia in teenagers and adults in France. METHODS This nationwide prospective study followed 630 487 myopic adults and teenagers (mean age 43.4 years±18.2, 59.8% of women) between January 2013 and January 2019. Myopia and high myopia were defined as a spherical equivalent less than or equal to -0.50 and -6.00 diopters (D), respectively. Demographic data were collected at first visit and refractive characteristics were collected at each visit. Analysis of short-term progression (first 12 to 26 months postbaseline) was modelled using analysis of variance (ANOVA). Progression of myopia was stratified according to age, gender and spherical equivalent at first visit. RESULTS Higher proportions of progressors were observed in the youngest age groups: 14-15 (18.2 %) and 16-17 years old (13.9 %). In multivariate analysis, after adjustment for over age, spherical equivalent and gender, the mean short-term progression decreased from -0.36 D in the 14-15 years age group to -0.13 D in the 28-29 years age group. Young age and higher myopia at baseline together were strongly associated with the risk of developing high myopia, the 5-year cumulative risk being 76% for youngest teenager with higher myopia status at baseline. CONCLUSION In this large cohort of myopic teenagers and adults, myopia progression was reported in 18.2% and 13.9% of the 14-15 and 16-17 age groups, respectively. The risk to develop high myopia was higher for younger individuals with higher myopia at baseline examination.
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Affiliation(s)
| | - Simon Marillet
- Ophthalmology, CHU Poitiers, Poitiers, France.,Public Health Department, University of Poitiers, Poitiers, Nouvelle-Aquitaine, France
| | - Pierre Ingrand
- Public Health Department, University of Poitiers, Poitiers, Nouvelle-Aquitaine, France
| | - Mark A Bullimore
- Optometry, University of Houston College of Optometry, Houston, Texas, USA
| | - Rupert R A Bourne
- Postgraduate Medical Institute, Anglia Ruskin University Vision and Eye Research Institute, Cambridge, UK
| | - Nicolas Leveziel
- Ophthalmology, CHU Poitiers, Poitiers, France .,Postgraduate Medical Institute, Anglia Ruskin University Vision and Eye Research Institute, Cambridge, UK
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Yang Z, Jin G, Li Z, Liao Y, Gao X, Zhang Y, Lan Y. Global disease burden of uncorrected refractive error among adolescents from 1990 to 2019. BMC Public Health 2021; 21:1975. [PMID: 34724911 PMCID: PMC8559690 DOI: 10.1186/s12889-021-12055-2] [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: 04/24/2021] [Accepted: 10/19/2021] [Indexed: 12/04/2022] Open
Abstract
Background To estimate the global disease burden of uncorrected refractive error (URE) among adolescents and assess the contributions of various risk factors to disability-adjusted life-years (DALYs) due to URE. Methods Global, regional and country-level DALY numbers and rates due to URE among adolescents were acquired from the Global Burden of Disease Study 2019 database. Human Development Index (HDI), Socio-Demographic Index (SDI) and other country-level data were obtained from other open databases as potential indicators. Regression analysis was used to evaluate associations between DALY rates among adolescents and potential predictors. Results Global DALYs due to URE among adolescents rose by 8% between 1990 and 2019 but moderately decreased by 4.8% during this period after adjusting for population size. Female adolescents showed higher DALY rates. DALY rates sharply increased from 5 to 9 years of age, then rose more slowly, reaching a plateau before 20 years of age. Country-level DALY rates in 2019 were positively associated with HDI, SDI, and urbanization rates but negatively correlated with primary school dropout rates. Higher disease burden of adolescents visually impaired from URE was associated with lower primary school dropout rates (β = − 0.257, 95% CI − 0.376 to − 0.138, P < 0.001) and higher urbanization rates (β = 0.257, 95% CI 0.067 to 0.256, P = 0.001). Conclusions Higher socioeconomic status, urbanization rates and education levels are associated with a heavier disease burden of URE among adolescents. The findings of this study can provide a reference for policy making on resource allocation for URE prevention and control in teenagers.
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Affiliation(s)
- Zhenlan Yang
- Department of ophthalmology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China
| | - Guangming Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Zijing Li
- Department of ophthalmology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China
| | - Yunru Liao
- Department of ophthalmology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China
| | - Xiang Gao
- Department of ophthalmology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China
| | - Yichi Zhang
- Department of ophthalmology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China.
| | - Yuqing Lan
- Department of ophthalmology, Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510000, People's Republic of China.
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Mccrann S, Loughman J, Butler JS, Paudel N, Flitcroft DI. Smartphone use as a possible risk factor for myopia. Clin Exp Optom 2021; 104:35-41. [PMID: 32452059 DOI: 10.1111/cxo.13092] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
CLINICAL RELEVANCE This study demonstrates an association between myopia and smartphone data usage. Youths now spend more time participating in near tasks as a result of smartphone usage. This poses an additional risk factor for myopia development/progression and is an important research question in relation to potential myopia management strategies. BACKGROUND Children are now exposed to another possible environmental risk factor for myopia - smartphones. This study investigates the amount of time students spend on their smartphones and their patterns of smartphone usage from a myopia perspective. METHODS Primary, secondary and tertiary level students completed a questionnaire exploring patterns of smartphone usage and assessing their attitudes toward potential myopia risk factors. Device-recorded data usage over an extended period was quantified as the primary and objective indicator of phone use. Average daily time spent using a smartphone was also quantified by self-reported estimates. Refractive status was verified by an optometrist. RESULTS Smartphone ownership among the 418 students invited to participate was over 99-per cent. Average daily smartphone data and time usage was 800.37 ± 1,299.88-MB and 265.16 ± 168.02-minutes respectively. Myopic students used almost double the amount of smartphone data at 1,130.71 ± 1,748.14-MB per day compared to non-myopes at 613.63 ± 902.15-MB (p = 0.001). Smartphone time usage was not significantly different (p = 0.09, 12-per cent higher among myopes). Multinomial logistic regression revealed that myopic refractive error was statistically significantly associated with increasing daily smartphone data usage (odds ratio 1.08, 95% CI 1.03-1.14) as well as increasing age (odds ratio 1.09, 95% CI 1.02-1.17) and number of myopic parents (odds ratio 1.55, 95% CI 1.06-2.3). Seventy-three per cent of students believed that digital technology may adversely affect their eyes. CONCLUSION This study demonstrates an association between myopia and smartphone data usage. Given the serious nature of the ocular health risks associated with myopia, our findings indicate that this relationship merits more detailed investigation.
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Affiliation(s)
- Saoirse Mccrann
- Centre for Eye Research Ireland, School of Physics, Clinical and Optometric Sciences, Technological University Dublin , Dublin, Ireland
| | - James Loughman
- Centre for Eye Research Ireland, School of Physics, Clinical and Optometric Sciences, Technological University Dublin , Dublin, Ireland.,Department of Optometry, African Vision Research Institute, University of KwaZulu Natal , Durban, South Africa
| | - John S Butler
- School of Mathematical Sciences, Technological University Dublin , Dublin, Ireland
| | - Nabin Paudel
- Centre for Eye Research Ireland, School of Physics, Clinical and Optometric Sciences, Technological University Dublin , Dublin, Ireland
| | - Daniel Ian Flitcroft
- Centre for Eye Research Ireland, School of Physics, Clinical and Optometric Sciences, Technological University Dublin , Dublin, Ireland.,Department of Ophthalmology, Children's University Hospital , Dublin, Ireland
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GÜNGÖR KOBAT S, CEM GÜL F. COVID-19 PANDEMİ SÜRECİNDE ONLİNE EĞİTİMİN MİYOPİK ÇOCUKLARDA REFRAKSİYON DEĞERLERİ ÜZERİNE ETKİLERİNİN DEĞERLENDİRİLMESİ. KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2021. [DOI: 10.17517/ksutfd.974848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AMAÇ: Bu çalışmanın amacı Covid-19 pandemisi nedeniyle uzaktan eğitim alan çocuklarda refraksiyon değişimlerini değerelendirmektir.
GEREÇ VE YÖNTEM: Çalışmaya pandemi döneminde uzaktan eğitim alan ve en az 6 saat ekran maruziyeti olan ve gözlük reçete edilen 18 yaş altı 56 hasta dahil edildi. Snellen Eşeli ile görme keskinliklerine bakıldı. Hastanın tam gördüğü refraksiyon değerleri kaydedilip retrospektif olarak kayıtları tarandı. 2020’deki refraksiyon değerleri 2018 ve 2019’daki refraksiyon değerleri ile karşılaştırıldı. p
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Affiliation(s)
- Sabiha GÜNGÖR KOBAT
- UNIVERSITY OF HEALTH SCIENCES, ELAZIĞ HEALTH RESEARCH CENTER, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, DEPARTMENT OF OPHTHALMOLOGY
| | - Fatih CEM GÜL
- UNIVERSITY OF HEALTH SCIENCES, ELAZIĞ HEALTH RESEARCH CENTER, DEPARTMENT OF SURGICAL MEDICAL SCIENCES, DEPARTMENT OF OPHTHALMOLOGY
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Lingham G, Mackey DA, Zhu K, Lucas RM, Black LJ, Oddy WH, Holt P, Walsh JP, Sanfilippo PG, Chan She Ping‐Delfos W, Yazar S. Time spent outdoors through childhood and adolescence - assessed by 25-hydroxyvitamin D concentration - and risk of myopia at 20 years. Acta Ophthalmol 2021; 99:679-687. [PMID: 33423400 DOI: 10.1111/aos.14709] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 11/03/2020] [Accepted: 11/09/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE To investigate the relationship between time spent outdoors, at particular ages in childhood and adolescence, and myopia status in young adulthood using serum 25-hydroxyvitamin D [25(OH)D] concentration as a biomarker of time spent outdoors. METHODS Participants of the Raine Study Generation 2 cohort had 25(OH)D concentrations measured at the 6-, 14-, 17- and 20-year follow-ups. Participants underwent cycloplegic autorefraction at age 20 years, and myopia was defined as a mean spherical equivalent -0.50 dioptres or more myopic. Logistic regression was used to analyse the association between risk of myopia at age 20 years and age-specific 25(OH)D concentrations. Linear mixed-effects models were used to analyse trajectory of 25(OH)D concentrations from 6 to 20 years. RESULTS After adjusting for sex, race, parental myopia, body mass index and studying status, myopia at 20 years was associated with lower 25(OH)D concentration at 20 years (per 10 nmol/L decrease, odds ratio (aOR)=1.10, 95% CI: 1.02, 1.18) and a low vitamin D status [25(OH)D < 50 nmol/L] at 17 years (aOR = 1.71, 95% CI: 1.06, 2.76) and 20 years (aOR = 1.71, 95% CI: 1.14, 2.56), compared to those without low vitamin D status. There were no associations between 25(OH)D at younger ages and myopia. Individuals who were myopic at 20 years had a 25(OH)D concentration trajectory that declined, relative to non-myopic peers, with increasing age. Differences in 25(OH)D trajectory between individuals with and without myopia were greater among non-Caucasians compared to Caucasians. CONCLUSIONS Myopia in young adulthood was most strongly associated with recent 25(OH)D concentrations, a marker of time spent outdoors.
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Affiliation(s)
- Gareth Lingham
- Lions Eye Institute Centre for Ophthalmology and Visual Science University of Western Australia Perth Australia
| | - David A. Mackey
- Lions Eye Institute Centre for Ophthalmology and Visual Science University of Western Australia Perth Australia
| | - Kun Zhu
- Medical School University of Western Australia Perth Australia
- Department of Endocrinology and Diabetes Sir Charles Gairdner Hospital Perth Australia
| | - Robyn M. Lucas
- Lions Eye Institute Centre for Ophthalmology and Visual Science University of Western Australia Perth Australia
- National Centre for Epidemiology and Population Health Research School of Population Health Australian National University Canberra Australia
| | | | - Wendy H. Oddy
- Menzies Institute for Medical Research University of Tasmania Hobart Australia
| | | | - John P. Walsh
- Medical School University of Western Australia Perth Australia
- Department of Endocrinology and Diabetes Sir Charles Gairdner Hospital Perth Australia
| | - Paul G. Sanfilippo
- Centre for Eye Research Australia Royal Victorian Eye and Ear Hospital University of Melbourne Melbourne Australia
| | | | - Seyhan Yazar
- Lions Eye Institute Centre for Ophthalmology and Visual Science University of Western Australia Perth Australia
- Garvan Institute of Medical Research Sydney Australia
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Jones-Jordan LA, Sinnott LT, Chu RH, Cotter SA, Kleinstein RN, Manny RE, Mutti DO, Twelker JD, Zadnik K. Myopia Progression as a Function of Sex, Age, and Ethnicity. Invest Ophthalmol Vis Sci 2021; 62:36. [PMID: 34463720 PMCID: PMC8411866 DOI: 10.1167/iovs.62.10.36] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose To model juvenile-onset myopia progression as a function of race/ethnicity, age, sex, parental history of myopia, and time spent reading or in outdoor/sports activity. Methods Subjects were 594 children in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) Study with at least three study visits: one visit with a spherical equivalent (SPHEQ) less myopic/more hyperopic than −0.75 diopter (D), the first visit with a SPHEQ of −0.75 D or more myopia (onset visit), and another after myopia onset. Myopia progression from the time of onset was modeled using cubic models as a function of age, race/ethnicity, and other covariates. Results Younger children had faster progression of myopia; for example, the model-estimated 3-year progression in an Asian American child was −1.93 D when onset was at age 7 years compared with −1.43 D when onset was at age 10 years. Annual progression for girls was 0.093 D faster than for boys. Asian American children experienced statistically significantly faster myopia progression compared with Hispanic (estimated 3-year difference of −0.46 D), Black children (−0.88 D), and Native American children (−0.48 D), but with similar progression compared with White children (−0.19 D). Parental history of myopia, time spent reading, and time spent in outdoor/sports activity were not statistically significant factors in multivariate models. Conclusions Younger age, female sex, and racial/ethnic group were the factors associated with faster myopic progression. This multivariate model can facilitate the planning of clinical trials for myopia control interventions by informing the prediction of myopia progression rates.
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Affiliation(s)
- Lisa A Jones-Jordan
- The Ohio State University College of Optometry, Columbus, Ohio, United States
| | - Loraine T Sinnott
- The Ohio State University College of Optometry, Columbus, Ohio, United States
| | - Raymond H Chu
- Marshall B. Ketchum University, Southern California College of Optometry, Fullerton, California, United States
| | - Susan A Cotter
- Marshall B. Ketchum University, Southern California College of Optometry, Fullerton, California, United States
| | - Robert N Kleinstein
- University of Alabama at Birmingham School of Optometry, Birmingham, Alabama, United States
| | - Ruth E Manny
- University of Houston College of Optometry, Houston, Texas, United States
| | - Donald O Mutti
- The Ohio State University College of Optometry, Columbus, Ohio, United States
| | - J Daniel Twelker
- University of Arizona Department of Ophthalmology and Vision Science, Tucson, Arizona, United States
| | - Karla Zadnik
- The Ohio State University College of Optometry, Columbus, Ohio, United States
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Enthoven CA, Polling JR, Verzijden T, Tideman JWL, Al-Jaffar N, Jansen PW, Raat H, Metz L, Verhoeven VJM, Klaver CCW. Smartphone Use Associated with Refractive Error in Teenagers: The Myopia App Study. Ophthalmology 2021; 128:1681-1688. [PMID: 34245754 DOI: 10.1016/j.ophtha.2021.06.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 06/18/2021] [Accepted: 06/29/2021] [Indexed: 02/08/2023] Open
Abstract
PURPOSE To investigate the association between smartphone use and refractive error in teenagers using the Myopia app. DESIGN Cross-sectional population-based study. PARTICIPANTS A total of 525 teenagers 12 to 16 years of age from 6 secondary schools and from the birth cohort study Generation R participated. METHODS A smartphone application (Myopia app; Innovattic) was designed to measure smartphone use and face-to-screen distance objectively and to pose questions about outdoor exposure. Participants underwent cycloplegic refractive error and ocular biometry measurements. Mean daily smartphone use was calculated in hours per day and continuous use as the number of episodes of 20 minutes on screen without breaks. Linear mixed models were conducted with smartphone use, continuous use, and face-to-screen distance as determinants and spherical equivalent of refraction (SER) and axial length-to-corneal radius (AL:CR) ratio as outcome measures stratified by median outdoor exposure. MAIN OUTCOME MEASURES Spherical equivalent of refraction in diopters and AL:CR ratio. RESULTS The teenagers on average were 13.7 ± 0.85 years of age, and myopia prevalence was 18.9%. During school days, total smartphone use on average was 3.71 ± 1.70 hours/day and was associated only borderline significantly with AL:CR ratio (β = 0.008; 95% confidence interval [CI], -0.001 to 0.017) and not with SER. Continuous use on average was 6.42 ± 4.36 episodes of 20-minute use without breaks per day and was associated significantly with SER and AL:CR ratio (β = -0.07 [95% CI, -0.13 to -0.01] and β = 0.004 [95% CI, 0.001-0.008], respectively). When stratifying for outdoor exposure, continuous use remained significant only for teenagers with low exposure (β = -0.10 [95% CI, -0.20 to -0.01] and β = 0.007 [95% CI, 0.001-0.013] for SER and AL:CR ratio, respectively). Smartphone use during weekends was not associated significantly with SER and AL:CR ratio, nor was face-to-screen distance. CONCLUSIONS Dutch teenagers spent almost 4 hours per day on their smartphones. Episodes of 20 minutes of continuous use were associated with more myopic refractive errors, particularly in those with low outdoor exposure. This study suggested that frequent breaks should become a recommendation for smartphone use in teenagers. Future large longitudinal studies will allow more detailed information on safe screen use in youth.
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Affiliation(s)
- Clair A Enthoven
- Department of Ophthalmology and Epidemiology, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands; The Generation R Study Group, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
| | - Jan Roelof Polling
- Department of Ophthalmology and Epidemiology, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands; Orthoptics and Optometry, University of Applied Sciences, Utrecht, Utrecht, The Netherlands
| | - Timo Verzijden
- Department of Ophthalmology and Epidemiology, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
| | - J Willem L Tideman
- Department of Ophthalmology and Epidemiology, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
| | - Nora Al-Jaffar
- Department of Ophthalmology and Epidemiology, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
| | - Pauline W Jansen
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands; Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, Zuid-Holland, The Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands
| | | | - Virginie J M Verhoeven
- Department of Ophthalmology and Epidemiology, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands; Clinical Genetics, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
| | - Caroline C W Klaver
- Department of Ophthalmology and Epidemiology, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands; Department of Ophthalmology, Radboud University Medical Center, Nijmegen, Gelderland, The Netherlands; Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland.
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Németh J, Tapasztó B, Aclimandos WA, Kestelyn P, Jonas JB, De Faber JTHN, Januleviciene I, Grzybowski A, Nagy ZZ, Pärssinen O, Guggenheim JA, Allen PM, Baraas RC, Saunders KJ, Flitcroft DI, Gray LS, Polling JR, Haarman AEG, Tideman JWL, Wolffsohn JS, Wahl S, Mulder JA, Smirnova IY, Formenti M, Radhakrishnan H, Resnikoff S. Update and guidance on management of myopia. European Society of Ophthalmology in cooperation with International Myopia Institute. Eur J Ophthalmol 2021; 31:853-883. [PMID: 33673740 PMCID: PMC8369912 DOI: 10.1177/1120672121998960] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/04/2021] [Indexed: 12/13/2022]
Abstract
The prevalence of myopia is increasing extensively worldwide. The number of people with myopia in 2020 is predicted to be 2.6 billion globally, which is expected to rise up to 4.9 billion by 2050, unless preventive actions and interventions are taken. The number of individuals with high myopia is also increasing substantially and pathological myopia is predicted to become the most common cause of irreversible vision impairment and blindness worldwide and also in Europe. These prevalence estimates indicate the importance of reducing the burden of myopia by means of myopia control interventions to prevent myopia onset and to slow down myopia progression. Due to the urgency of the situation, the European Society of Ophthalmology decided to publish this update of the current information and guidance on management of myopia. The pathogenesis and genetics of myopia are also summarized and epidemiology, risk factors, preventive and treatment options are discussed in details.
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Affiliation(s)
- János Németh
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Beáta Tapasztó
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
- Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
| | | | | | - Jost B Jonas
- Department of Ophthalmology, Heidelberg University, Mannheim, Germany
| | | | | | - Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland
- Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznan, Poland
| | - Zoltán Zsolt Nagy
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Olavi Pärssinen
- Gerontology Research Centre and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | | | - Peter M Allen
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Rigmor C Baraas
- National Centre for Optics, Vision and Eye Care, University of South-Eastern Norway, Kongsberg, Norway
| | - Kathryn J Saunders
- Centre for Optometry and Vision Science research, Ulster University, Coleraine, UK
| | - Daniel Ian Flitcroft
- Temple Street Children’s Hospital, Dublin, Ireland
- Centre for Eye Research Ireland (CERI) Technological University Dublin, Ireland
| | | | - Jan Roelof Polling
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Optometry and Orthoptics, Hogeschool Utrecht, University of Applied Science, Utrecht, The Netherlands
| | - Annechien EG Haarman
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - J Willem L Tideman
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - James Stuart Wolffsohn
- Optometry and Vision Science, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Siegfried Wahl
- Institute for Ophthalmic Research, University Tübingen, Tübingen, Germany
- Carl Zeiss Vision International GmbH, Tübingen, Germany
| | - Jeroen A Mulder
- Department of Optometry and Orthoptics, Hogeschool Utrecht, University of Applied Science, Utrecht, The Netherlands
| | | | - Marino Formenti
- Department of Physics, School of Science, University of Padova, Padova, Italy
| | | | - Serge Resnikoff
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
- Brien Holden Vision Institute, Sydney, Australia
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Wolffsohn JS, Jong M, Smith EL, Resnikoff SR, Jonas JB, Logan NS, Morgan I, Sankaridurg P, Ohno-Matsui K. IMI 2021 Reports and Digest - Reflections on the Implications for Clinical Practice. Invest Ophthalmol Vis Sci 2021; 62:1. [PMID: 33909037 PMCID: PMC8083124 DOI: 10.1167/iovs.62.5.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The International Myopia Institute's (IMI) mission is to advance research, education, and management of myopia to decrease future vision impairment and blindness associated with increasing myopia. Its approach is to bring together scientists, clinicians, policymakers, government members, and educators into the field of myopia to stimulate collaboration and sharing of knowledge. The latest reports are on pathologic myopia, the impact of myopia, risk factors for myopia, accommodation and binocular vision in myopia development and progression, and the prevention of myopia and its progression. Together with the digest updating the 2019 International Myopia Institute white papers using the research published in the last 18 months, these evidence-based consensus white papers help to clarify the imperative for myopia control and the role of environmental modification initiatives, informing an evidence-based clinical approach. This guidance includes who to treat and when to start or stop treatment, and the advantages and limitations of different management approaches.
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Affiliation(s)
| | - Monica Jong
- Brien Holden Vision Institute, Sydney, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, Australia.,Discipline of Optometry and Vision Science, University of Canberra, Canberra, Australia
| | - Earl L Smith
- Brien Holden Vision Institute, Sydney, Australia.,College of Optometry, University of Houston, Houston, Texas, United States
| | - Serge R Resnikoff
- Brien Holden Vision Institute, Sydney, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Nicola S Logan
- School of Optometry, Aston University, Birmingham, United Kingdom
| | - Ian Morgan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yatsen University, Guangzhou, China.,Research School of Biology, College of Medicine, Biology and Environment, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Padmaja Sankaridurg
- Brien Holden Vision Institute, Sydney, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
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Demir P, Baskaran K, Theagarayan B, Gierow P, Sankaridurg P, Macedo AF. Refractive error, axial length, environmental and hereditary factors associated with myopia in Swedish children. Clin Exp Optom 2021; 104:595-601. [PMID: 33689658 DOI: 10.1080/08164622.2021.1878833] [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] [Indexed: 10/22/2022] Open
Abstract
Clinical relevance: Investigation of refractive errors amongst Swedish schoolchildren will help identify risk factors associated with myopia development.Background: Genetic and hereditary aspects have been linked with the development of myopia. Nevertheless, in the case of 'school myopia' some authors suggest that environmental factors may affect gene expression, causing school myopia to soar. Additional understanding about which environmental factors play a relevant role can be gained by studying refractive errors in countries like Sweden, where prevalence of myopia is expected to be low.Methods: Swedish schoolchildren aged 8-16 years were invited to participate. Participants underwent an eye examination, including cycloplegic refraction and axial length (AL) measurements. Predictors such as time spent in near work, outdoor activities and parental myopia were obtained using a questionnaire. Myopia was defined as spherical equivalent refraction (SER) ≤ -0.50D and hyperopia as SER ≥ +0.75D.Results: A total of 128 children (70 females and 58 males) participated in this study with mean age of 12.0 years (SD = 2.4). Based on cycloplegic SER of the right eye, the distribution of refractive errors was: hyperopia 48.0% (CI95 = 38.8-56.7), emmetropia 42.0% (CI95 = 33.5-51.2) and myopia 10.0%. (CI95 = 4.4-14.9). The mean AL was 23.1 mm (SD = 0.86), there was a correlation between SER and AL, r = -0.65 (p < 0.001). Participants with two myopic parents had higher myopia and increased axial length than those with one or no myopic parents. The mean time spent in near work, outside of school, was 5.3 hours-per-day (SD = 3.1), and mean outdoor time reported was 2.6 hours-per-day (SD = 2.2) for all the participants. The time spent in near work and outdoor time were different for different refractive error categories.Conclusion: The prevalence of myopia amongst Swedish schoolchildren is low. Hereditary and environmental factors are associated with refractive error categories. Further studies with this sample are warranted to investigate how refractive errors and environmental factors interact over time.
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Affiliation(s)
- Pelsin Demir
- Medicine and Optometry, Linnaeus University, Kalmar, Sweden
| | | | | | - Peter Gierow
- Medicine and Optometry, Linnaeus University, Kalmar, Sweden
| | - Padmaja Sankaridurg
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Antonio Filipe Macedo
- Medicine and Optometry, Linnaeus University, Kalmar, Sweden.,Center of Physics - Optometry and Vision Science, University of Minho, Braga, Portugal
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Polling JR, Klaver C, Tideman JW. Myopia progression from wearing first glasses to adult age: the DREAM Study. Br J Ophthalmol 2021; 106:820-824. [PMID: 33495159 PMCID: PMC9132855 DOI: 10.1136/bjophthalmol-2020-316234] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 12/23/2020] [Accepted: 12/25/2020] [Indexed: 01/12/2023]
Abstract
Purpose Data on myopia progression during its entire course are scarce. The aim of this study is to investigate myopia progression in Europeans as a function of age and degree of myopia from first prescription to final refractive error. Methods The Drentse Refractive Error and Myopia Study assessed data from a branch of opticians in the Netherlands from 1985 onwards in a retrospective study. First pair of glasses prescribed was defined as a spherical equivalent of refraction (SER) ≤−0.5 D to ≥−3.0 D. Subjects with prescriptions at an interval of at least 1 year were included in the analysis. Results A total of 2555 persons (57.3% female) met the inclusion criteria. Those with first prescription before the age of 10 years showed the strongest progression (−0.50 D; IQR: −0.75 to −0.19) and a significantly (p<0.001) more negative median final SER (−4.48 D; IQR: −5.37 to −3.42). All children who developed SER ≤−3 D at 10 years were highly myopic (SER ≤−6D) as adults, children who had SER between −1.5 D and −3 D at 10 years had 46.0% risk of high myopia, and children with SER between −0.5 D and −1.5 D had 32.6% risk of high myopia. Myopia progression diminished with age; all refractive categories stabilised after age 15 years except for SER ≤−5 D who progressed up to −0.25 D annually until age 21 years. Conclusion Our trajectories of the natural course of myopia progression may serve as a guide for myopia management in European children. SER at 10 years is an important prognostic indicator and will help determine treatment intensity.
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Affiliation(s)
- Jan Roelof Polling
- Ophthalmology, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands .,Orthopics & Optometry, Hogeschool Utrecht, Utrecht, The Netherlands
| | - Caroline Klaver
- Ophthalmology and Epidemiology, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands.,Ophthalmology, Radboudumc, Nijmegen, Gelderland, The Netherlands
| | - Jan Willem Tideman
- Ophthalmology and Epidemiology, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands
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Jiang X, Tarczy-Hornoch K, Cotter SA, Matsumura S, Mitchell P, Rose KA, Katz J, Saw SM, Varma R. Association of Parental Myopia With Higher Risk of Myopia Among Multiethnic Children Before School Age. JAMA Ophthalmol 2021; 138:501-509. [PMID: 32191277 DOI: 10.1001/jamaophthalmol.2020.0412] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Importance Parental myopia is an important risk factor for preschool myopia in Asian children. Further investigation of the association between parental myopia and early-onset myopia risk in other racial/ethnic groups, such as African American and Hispanic white children, could improve understanding of the etiology and treatment of this condition. Objective To investigate the association of parental myopia with refractive error and ocular biometry in multiethnic children aged 6 to 72 months. Design, Setting, and Participants This cohort study pooled data from children in 3 population-based studies with comparable design from the US, Singapore, and Australia. Parental myopia was defined as the use of glasses or contact lenses for distance viewing by the child's biological parent(s). Multivariable regressions were conducted to assess the association of parental myopia. Data were collected from 2003 to 2011 and analyzed from 2017 to 2019. Main Outcomes and Measures Cycloplegic refraction and prevalence of myopia (spherical equivalent refractive error of≤-0.5 diopters [D]) in the more myopic eye. Results The analysis cohort included 9793 children, including 4003 Asian, 2201 African American, 1998 Hispanic white, and 1591 non-Hispanic white participants (5106 boys [52.1%]; mean [SD] age, 40.0 [18.9] months). Compared with children without parental myopia, the odds ratios for early-onset myopia were 1.42 (95% CI, 1.20-1.68) for children with 1 parent with myopia, 2.70 (95% CI, 2.19-3.33) for children with 2 parents with myopia, and 3.39 (95% CI, 1.99-5.78) for children with 2 parents with childhood-onset myopia. Even among children without myopia, parental myopia was associated with a greater ratio of axial length to corneal curvature radius (regression coefficient for myopia in both parents, 0.023; P < .001) and more myopic refractive error (regression coefficient for myopia in both parents, -0.20 D; P < .001). Effects of parental myopia were observed in all 4 racial/ethnic groups and across age groups except those younger than 1 year. However, parental myopia was not associated with the age-related trends of refractive error (regression coefficient for children without parental myopeia, 0.08; for children with 2 parents with myopia, 0.04; P = .31 for interaction) and ratio of axial length to corneal curvature radius (regression coefficient for children without parental myopeia, 0.031; for children with 2 parents with myopia, 0.032; P = .89 for interaction) beyond infancy. Conclusions and Relevance Parental myopia, especially childhood-onset parental myopia, was associated with a greater risk of early-onset myopia in Asian, Hispanic, non-Hispanic white, and African American children. The observed associations of parental myopia in children as early as 1 year of age and in children without myopia suggests that genetic susceptibility may play a more important role in early-onset myopia and that parental myopia may contribute to myopia in children by setting up a more myopic baseline before school age.
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Affiliation(s)
- Xuejuan Jiang
- USC Roski Eye Institute, Department of Ophthalmology, Keck School of Medicine, University of Southern California, Los Angeles.,Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles
| | - Kristina Tarczy-Hornoch
- Department of Ophthalmology, University of Washington, Seattle.,Department of Ophthalmology, Seattle Children's Hospital, Seattle, Washington
| | - Susan A Cotter
- Southern California College of Optometry, Marshall B. Ketchum University, Fullerton
| | | | - Paul Mitchell
- Centre for Vision Research, Westmead Institute, Sydney, Australia
| | - Kathryn A Rose
- Discipline of Orthoptics, Graduate School of Health, University of Technology Sydney, Ultimo, Australia
| | - Joanne Katz
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Seang-Mei Saw
- Singapore Eye Research Institute, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Rohit Varma
- Southern California Eye Institute, CHA Hollywood Presbyterian Medical Center, Los Angeles
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Modjtahedi BS, Abbott RL, Fong DS, Lum F, Tan D. Reducing the Global Burden of Myopia by Delaying the Onset of Myopia and Reducing Myopic Progression in Children: The Academy's Task Force on Myopia. Ophthalmology 2020; 128:816-826. [PMID: 33388160 DOI: 10.1016/j.ophtha.2020.10.040] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 10/27/2020] [Accepted: 10/29/2020] [Indexed: 01/08/2023] Open
Abstract
In 2019, the American Academy of Ophthalmology (AAO) created the Task Force on Myopia in recognition of the substantial global increases in myopia prevalence and its associated complications. The Task Force, led by Richard L. Abbott, MD, and Donald Tan, MD, comprised recognized experts in myopia prevention and treatment, public health experts from around the world, and organization representatives from the American Academy of Family Physicians, American Academy of Optometry, and American Academy of Pediatrics. The Academy's Board of Trustees believes that myopia is a high-priority cause of visual impairment, warranting a timely evaluation and synthesis of the scientific literature and formulation of an action plan to address the issue from different perspectives. This includes education of physicians and other health care providers, patients and their families, schools, and local and national public health agencies; defining health policies to ameliorate patients' access to appropriate therapy and to promote effective public health interventions; and fostering promising avenues of research.
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Affiliation(s)
- Bobeck S Modjtahedi
- Department of Ophthalmology, Southern California Kaiser Permanente, Baldwin Park, California; Department of Research and Evaluation, Southern California Permanente Medical Group, Pasadena, California
| | - Richard L Abbott
- Department of Ophthalmology, University of California, San Francisco, San Francisco, California
| | - Donald S Fong
- Department of Ophthalmology, Southern California Kaiser Permanente, Baldwin Park, California; Department of Research and Evaluation, Southern California Permanente Medical Group, Pasadena, California
| | - Flora Lum
- American Academy of Ophthalmology, San Francisco, California.
| | - Donald Tan
- Eye and Retina Surgeons, Singapore, Republic of Singapore
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Wang YX, Panda-Jonas S, Jonas JB. Optic nerve head anatomy in myopia and glaucoma, including parapapillary zones alpha, beta, gamma and delta: Histology and clinical features. Prog Retin Eye Res 2020; 83:100933. [PMID: 33309588 DOI: 10.1016/j.preteyeres.2020.100933] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 11/22/2020] [Accepted: 11/27/2020] [Indexed: 12/13/2022]
Abstract
The optic nerve head can morphologically be differentiated into the optic disc with the lamina cribrosa as its basis, and the parapapillary region with zones alpha (irregular pigmentation due to irregularities of the retinal pigment epithelium (RPE) and peripheral location), beta zone (complete RPE loss while Bruch's membrane (BM) is present), gamma zone (absence of BM), and delta zone (elongated and thinned peripapillary scleral flange) within gamma zone and located at the peripapillary ring. Alpha zone is present in almost all eyes. Beta zone is associated with glaucoma and may develop due to a IOP rise-dependent parapapillary up-piling of RPE. Gamma zone may develop due to a shift of the non-enlarged BM opening (BMO) in moderate myopia, while in highly myopic eyes, the BMO enlarges and a circular gamma zone and delta zone develop. The ophthalmoscopic shape and size of the optic disc is markedly influenced by a myopic shift of BMO, usually into the temporal direction, leading to a BM overhanging into the intrapapillary compartment at the nasal disc border, a secondary lack of BM in the temporal parapapillary region (leading to gamma zone in non-highly myopic eyes), and an ocular optic nerve canal running obliquely from centrally posteriorly to nasally anteriorly. In highly myopic eyes (cut-off for high myopia at approximately -8 diopters or an axial length of 26.5 mm), the optic disc area enlarges, the lamina cribrosa thus enlarges in area and decreases in thickness, and the BMO increases, leading to a circular gamma zone and delta zone in highly myopic eyes.
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Affiliation(s)
- Ya Xing Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing, China.
| | - Songhomitra Panda-Jonas
- Institute for Clinical and Scientific Ophthalmology and Acupuncture Jonas & Panda, Heidelberg, Germany
| | - Jost B Jonas
- Institute for Clinical and Scientific Ophthalmology and Acupuncture Jonas & Panda, Heidelberg, Germany; Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karis-University, Mannheim, Germany
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Wang S, Hao X, Ma X, Yu Y, Wu L, Wang Y, Li Y. Associations between Poor Vision, Vision-Related Behaviors and Mathematics Achievement in Chinese Students from the CNAEQ-PEH 2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228561. [PMID: 33218140 PMCID: PMC7698834 DOI: 10.3390/ijerph17228561] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 11/16/2020] [Indexed: 11/20/2022]
Abstract
Purpose: Poor vision is prevalent in school-aged students, especially in East Asia. This can not only cause irreversibly physical health impairments like glaucoma and cataracts, but also the loss of individual education and employment opportunities and deterioration of the quality of life. The present study aims to investigate the associations between poor vision, vision-related risk behaviors, and mathematics achievement in youth from China. Methods: The present study included a total of 106,192 Grade 4 students and 70,236 Grade 8 students from the China National Assessment of Educational Quality-Physical Education & Health 2015 (CNAEQ-PEH 2015). We conducted a standard logarithmic visual acuity scale for vision screening, a self-reported questionnaire for vision-related risk behavior and a standardized mathematics assessment for mathematics performance. Poor vision is defined as the visual acuity below 5.0 by using the standard logarithmic visual acuity chart. Linear regression was conducted. Results: The prevalence rate of poor vision in China was 37.1% in Grade 4 and 66.2% in Grade 8 in 2015. Students who had poor vision were more likely to have better mathematics achievement than those with normal vision. Reading in bed, insufficient sleep, and screen time during weekdays and weekends were associated with higher odds of poor vision. Conclusions: Poor vision was positively associated with mathematics academic achievements, while vision-related risk behaviors such as screen time, homework time and reading in bed were associated with a high prevalence of poor vision in compulsory education cycle students.
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Liu G, Rong H, Pei R, Du B, Jin N, Wang D, Jin C, Wei R. Age distribution and associated factors of cornea biomechanical parameter stress-strain index in Chinese healthy population. BMC Ophthalmol 2020; 20:436. [PMID: 33143686 PMCID: PMC7607623 DOI: 10.1186/s12886-020-01704-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 10/23/2020] [Indexed: 12/15/2022] Open
Abstract
Background To investigate the new cornea biomechanical parameter stress-strain index (SSI) in Chinese healthy people and the factors associated with SSI. Methods A total of 175 eyes from 175 participants were included in this study. Axial length was measured with the Lenstar LS-900. Pentacam measured curvature of the cornea and anterior chamber volume (ACV). Cornea biomechanical properties assessments were performed by corneal visualization Scheimpflug technology (Corvis ST). Student’s t-test, one-way ANOVA, partial least square linear regression (PLSLR) and linear mixed effects (LME) model were used in the statistical analysis. Results The mean (±SD) SSI was 1.14 ± 0.22 (range, 0.66–1.78) in all subjects and affected by age significantly after age of 35 (P < 0.05). In LME models, SSI was significantly associated with age (β = 0.526, P < 0.001), axial length (AL) (β = − 0.541, P < 0.001), intraocular pressure (IOP) (β = 0.326, P < 0.001) and steepest radius of anterior corneal curvature (RsF) (β = 0.229, P < 0.001) but not with ACV, biomechanical corrected intraocular pressure (bIOP), flattest radius of anterior corneal curvature (RfF) or central corneal thickness (CCT) (P > 0.05 for each). Conclusions SSI increased with age after the age of 35. In addition to age, SSI was positively correlated with RsF and IOP, while negatively correlated with AL.
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Affiliation(s)
- Guihua Liu
- Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Postal address: 251 Fukang Road, Nankai District, Tianjin, China.,Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Postal address: 251 Fukang Road, Nankai District, Tianjin, China
| | - Hua Rong
- Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Postal address: 251 Fukang Road, Nankai District, Tianjin, China.,Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Postal address: 251 Fukang Road, Nankai District, Tianjin, China
| | - Ruxia Pei
- Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Postal address: 251 Fukang Road, Nankai District, Tianjin, China.,Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Postal address: 251 Fukang Road, Nankai District, Tianjin, China
| | - Bei Du
- Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Postal address: 251 Fukang Road, Nankai District, Tianjin, China.,Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Postal address: 251 Fukang Road, Nankai District, Tianjin, China
| | - Nan Jin
- Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Postal address: 251 Fukang Road, Nankai District, Tianjin, China.,Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Postal address: 251 Fukang Road, Nankai District, Tianjin, China
| | - Di Wang
- Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Postal address: 251 Fukang Road, Nankai District, Tianjin, China.,Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Postal address: 251 Fukang Road, Nankai District, Tianjin, China
| | - Chengcheng Jin
- Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Postal address: 251 Fukang Road, Nankai District, Tianjin, China.,Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Postal address: 251 Fukang Road, Nankai District, Tianjin, China
| | - Ruihua Wei
- Tianjin International Joint Research and Development Centre of Ophthalmology and Vision Science, Postal address: 251 Fukang Road, Nankai District, Tianjin, China. .,Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Postal address: 251 Fukang Road, Nankai District, Tianjin, China.
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Luong TQ, Shu YH, Modjtahedi BS, Fong DS, Choudry N, Tanaka Y, Nau CL. Racial and Ethnic Differences in Myopia Progression in a Large, Diverse Cohort of Pediatric Patients. Invest Ophthalmol Vis Sci 2020; 61:20. [PMID: 33186467 PMCID: PMC7671858 DOI: 10.1167/iovs.61.13.20] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 09/08/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to characterize the differences in myopic progression in children by race/ethnicity and age. Methods Patients enrolled in Kaiser Permanente Southern California between 2011 and 2016 and between the ages of 4 and 11 years old with a documented refraction between -6 and -1 diopters (Ds) were included in this retrospective cohort study. Patients with a history of amblyopia, strabismus, retinopathy of prematurity, or prior ocular surgery were excluded from analyses. Patients' race/ethnicity and language information were used to create the following groups for analysis: white, Black, Hispanic, South Asian, East/Southeast Asian, Other Asian, and other/unknown. A growth curve analysis using linear mixed-effects modeling was used to trace longitudinal progression of spherical equivalents over time, modeled by race/ethnicity. Analyses adjusted for potential confounders, including body mass index (BMI), screen time, and physical activity. Results There were 11,595 patients who met the inclusion criteria. Patients were 53% girls, 55% Latino, 15% white, 9% black, 9% East/Southeast Asian, and 2% South Asian. Mean age (standard deviation [SD]) at the time of initial refraction was 8.9 years (1.6 years). Patients had an average (SD) of 3.4 (1.5) refractions, including the baseline measurement, during the study period. A three-way interaction model that assessed the effects of age at baseline, time since baseline, and race/ethnicity found that children of East/Southeast Asian descent showed significantly faster myopia progression across time (P < 0.001). East/Southeast Asian patients who presented with myopia between 6 to < 8 years progressed similarly to white patients in the same age group and significantly faster compared with white patients in other age groups. Conclusions Myopia progression differed significantly between East/Southeast Asian and white patients depending on the patients' age.
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Affiliation(s)
- Tiffany Q. Luong
- Southern California Permanente Medical Group, Pasadena, California, United States
| | - Yu-Hsiang Shu
- Southern California Permanente Medical Group, Pasadena, California, United States
| | - Bobeck S. Modjtahedi
- Southern California Permanente Medical Group, Irwindale, California, United States
| | - Donald S. Fong
- Southern California Permanente Medical Group, Irwindale, California, United States
| | | | - Yoko Tanaka
- Santen Inc., Emeryville, California, United States
| | - Claudia L. Nau
- Southern California Permanente Medical Group, Pasadena, California, United States
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Alvarez-Peregrina C, Sánchez-Tena MÁ, Martinez-Perez C, Villa-Collar C. The Relationship Between Screen and Outdoor Time With Rates of Myopia in Spanish Children. Front Public Health 2020; 8:560378. [PMID: 33178659 PMCID: PMC7592393 DOI: 10.3389/fpubh.2020.560378] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 09/02/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Nowadays, digital devices have become usual in children's lives around the world. Five percent of the children between 5 and 7 years old have their own smartphone and forty-two percent of them have their own tablet. This fact has produced a change in their lifestyle that can imply some risks, threats and/or opportunities. The light emitted by digital devices' screens could involve, among others, possible risks to children's vision. Methods: This study shows a detailed analysis of the vision of 7,497 children between 5 and 7 years old carried out in the "Annual school campaign for children's visual health" in Spain during the years 2016, 2017, and 2019. The study connects the results in the visual screening with children's lifestyle, taking into account both, the number of hours per day that they use all digital devices and the daily time of outdoor exposure. Results: The study shows that children with myopia have more screen time use and shorter outdoor activity time when compared to those without myopia (p < 0.01). Conclusions: Myopia in children is a public health problem and requires healthy lifestyle interventions at individual as well as at community level.
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Yu B, Dai L, Chen J, Sun W, Chen J, Du L, Deng N, Chen D. Prenatal and neonatal factors for the development of childhood visual impairment in primary and middle school students: a cross-sectional survey in Guangzhou, China. BMJ Open 2020; 10:e032721. [PMID: 32912936 PMCID: PMC7482504 DOI: 10.1136/bmjopen-2019-032721] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES In this cross-sectional survey, we sought to determine the prevalence of and the influence of prenatal and neonatal factors on childhood visual impairment without correction (VIUC) in a paediatric population from Guangzhou, China. SETTING The health survey covered 11 administrative districts in Guangzhou, including 991 schools. PARTICIPANTS All of the primary and middle school students in Guangzhou were invited to complete an online questionnaire with the help of their parents. The results of physical examinations were reported by school medical departments. The results of the questionnaire were collected by the researchers. In total, 253 301 questionnaires were collected. PRIMARY OUTCOME MEASURES The students' uncorrected visual acuity (UCVA) was examined by trained optometrists by standard logarithmic visual acuity charts. VIUC was defined by UCVA (of the better eye) (UCVA <6/12) with three levels: light VIUC (UCVA ≥6/18 to <6/12), mild VIUC (UCVA ≥6/60 to <6/18) and severe VIUC (UCVA <6/60). RESULTS A total of 39 768 individuals (15.7%) had VIUC, and the rate was much higher among grade 10 to 12 students (51.4%) than among grade 1 to 6 students (6.71%). The following factors were significantly associated with an increased risk of VIUC: female gender, high birth weight, formula feeding, not having siblings, higher level of parents' education, parental myopia, much homework time and little outdoor activity. Delivery mode was not associated with the risk of VIUC. CONCLUSIONS This study validates known major prenatal/genetic, perinatal and postnatal factors for childhood VIUC. In conclusion, prenatal and perinatal factors can affect the onset of childhood VIUC, but parental myopia and postnatal factors are the main factors.
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Affiliation(s)
- Bolan Yu
- BioResource Research Center, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Lijuan Dai
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Juanjuan Chen
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wen Sun
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jingsi Chen
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Lili Du
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Nali Deng
- Health Promotion Centre for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou, China
| | - Dunjin Chen
- Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Obstetrics, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Theodossiadis G, Theodossiadis P, Chatziralli I. The impact of scleral buckling technique application in diminishing high myopia. Graefes Arch Clin Exp Ophthalmol 2020; 259:557-558. [PMID: 32447547 DOI: 10.1007/s00417-020-04746-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 04/14/2020] [Accepted: 05/08/2020] [Indexed: 11/29/2022] Open
Affiliation(s)
- George Theodossiadis
- 2nd Department of Ophthalmology, Attikon Hospital, National and Kapodistrian University of Athens, 1, Rimini street, 12462, Haidari, Athens, Greece.
| | - Panagiotis Theodossiadis
- 2nd Department of Ophthalmology, Attikon Hospital, National and Kapodistrian University of Athens, 1, Rimini street, 12462, Haidari, Athens, Greece
| | - Irini Chatziralli
- 2nd Department of Ophthalmology, Attikon Hospital, National and Kapodistrian University of Athens, 1, Rimini street, 12462, Haidari, Athens, Greece
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Pusti D, Benito A, Madrid-Valero JJ, Ordoñana JR, Artal P. Inheritance of Refractive Error in Millennials. Sci Rep 2020; 10:8173. [PMID: 32424231 PMCID: PMC7235039 DOI: 10.1038/s41598-020-65130-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 04/22/2020] [Indexed: 12/13/2022] Open
Abstract
Over the last decades, the prevalence of myopia has suddenly increased, and at this rate, half of the world's population will be myopic by the year 2050. Contemporary behavioural and lifestyle circumstances, along with emergent technology, are thought to be responsible for this increase. Twin studies mostly reported a high heritability of refractive error across ethnicities. However, heritability is a population statistic and could vary as a result of changing environmental conditions. We studied the variance of refractive error in millennials with 100 twin pairs of university students in southeast Spain. The study population presented a high prevalence of myopia (77%). Statistical analysis showed the variance of refractive error in this group of young twins was mainly driven by the shared environment and, to a lesser extent, by additive genetic factors. We found an increase in myopia prevalence accompanied by a decrease in heritability in this sample of millennials in contrast with results from a previous generation group from the same ethnic origin.
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Affiliation(s)
- Dibyendu Pusti
- Laboratorio de Óptica, Instituto Universitario de Investigación en Óptica y Nanofísica, Universidad de Murcia, Campus de Espinardo (Ed. 34), 30100, Murcia, Spain.
| | - Antonio Benito
- Laboratorio de Óptica, Instituto Universitario de Investigación en Óptica y Nanofísica, Universidad de Murcia, Campus de Espinardo (Ed. 34), 30100, Murcia, Spain
| | - Juan J Madrid-Valero
- Registro de Gemelos de Murcia, Departamento de Anatomía Humana y Psicobiología, Universidad de Murcia, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Universidad de Murcia, Murcia, Spain
| | - Juan R Ordoñana
- Registro de Gemelos de Murcia, Departamento de Anatomía Humana y Psicobiología, Universidad de Murcia, Murcia, Spain
- Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Universidad de Murcia, Murcia, Spain
| | - Pablo Artal
- Laboratorio de Óptica, Instituto Universitario de Investigación en Óptica y Nanofísica, Universidad de Murcia, Campus de Espinardo (Ed. 34), 30100, Murcia, Spain
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Bullimore MA, Richdale K. Myopia Control 2020: Where are we and where are we heading? Ophthalmic Physiol Opt 2020; 40:254-270. [DOI: 10.1111/opo.12686] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 03/20/2020] [Accepted: 03/24/2020] [Indexed: 12/16/2022]
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