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Ma F, Yang J, Yuan J, Du B, Li T, Wu Q, Yan J, Zhu Y, Meng X, Liu Y, Wei R, Huang G, Yan H. The Myopia Prevalence and Association With Physical Activity Among Primary School Students Aged 6-12 Years: A Cross-Sectional Study in Tianjin, China. Transl Vis Sci Technol 2024; 13:4. [PMID: 38864819 PMCID: PMC11174138 DOI: 10.1167/tvst.13.6.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/26/2024] [Indexed: 06/13/2024] Open
Abstract
Purpose This study aimed to investigate the prevalence of myopia and determine the association between physical activity and risk of myopia among primary school students in Tianjin, China. Methods A cross-sectional study was conducted among subjects from nine primary schools. All of the subjects underwent visual acuity and spherical equivalent (SE) with noncycloplegic autorefraction measurement. Myopia was defined as an SE refraction ≤-0.50D and an uncorrected visual acuity <5.0 in either eye. Physical activity was measured via the Physical Activity Questionnaire for Children. Data were analyzed using the Pearson χ2 test and binary logistic regression. Stratification analysis by sex was also performed. Results A total of 2976 participants (1408 boys and 1568 girls) aged six to 12 years (mean age 8.82 years) were included in this study. The overall prevalence of myopia was 52.92%. When stratified according to physical activity, myopia prevalence significantly decreased with increasing physical activity levels (χ2 trend test = 127.63, P < 0.001). In the binary logistic regression analysis, after adjusting for age, sex, and school region, the odds ratio for the association between physical activity and myopia was 0.762 (95% confidence interval, 0.675-0.862, P < 0.001). When stratified by sex, the significant statistical association between physical activity and myopia both can be found in two groups (P < 0.05). Conclusions Higher levels of physical activity were independently associated with decreased risk of myopia. The significant reverse statistical association between physical activity and myopia can be found in male or female groups. Translational Relevance Taking part in physical activities may be an effective way to reduce the prevalence of myopia.
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Affiliation(s)
- Fei Ma
- School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Ocular Trauma, Tianjin, China
| | - Jing Yang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Laboratory of Molecular Ophthalmology, Tianjin Medical University, Tianjin, China
| | - Jing Yuan
- School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Ocular Trauma, Tianjin, China
| | - Bei Du
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Tongtong Li
- School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Ocular Trauma, Tianjin, China
| | - Qi Wu
- School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Ocular Trauma, Tianjin, China
| | - Jing Yan
- School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Ocular Trauma, Tianjin, China
| | - Yun Zhu
- School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Ocular Trauma, Tianjin, China
| | - Xiangda Meng
- Tianjin Key Laboratory of Ocular Trauma, Tianjin, China
- Department of Ophthalmology, Tianjin Medical University General Hospital, Laboratory of Molecular Ophthalmology, Tianjin Medical University, Tianjin, China
- International Joint Laboratory of Ocular Diseases, Ministry of Education, Tianjin, China
| | - Yuanyuan Liu
- Tianjin Key Laboratory of Ocular Trauma, Tianjin, China
- Department of Ophthalmology, Tianjin Medical University General Hospital, Laboratory of Molecular Ophthalmology, Tianjin Medical University, Tianjin, China
- International Joint Laboratory of Ocular Diseases, Ministry of Education, Tianjin, China
| | - Ruihua Wei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Guowei Huang
- School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Ocular Trauma, Tianjin, China
| | - Hua Yan
- Tianjin Key Laboratory of Ocular Trauma, Tianjin, China
- Department of Ophthalmology, Tianjin Medical University General Hospital, Laboratory of Molecular Ophthalmology, Tianjin Medical University, Tianjin, China
- International Joint Laboratory of Ocular Diseases, Ministry of Education, Tianjin, China
- School of Medicine, Nankai University, Tianjin, China
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Li D, Min S, Li X. Is Spending More Time Outdoors Able to Prevent and Control Myopia in Children and Adolescents? A Meta-Analysis. Ophthalmic Res 2024; 67:393-404. [PMID: 38710180 DOI: 10.1159/000539229] [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: 06/24/2023] [Accepted: 04/29/2024] [Indexed: 05/08/2024]
Abstract
INTRODUCTION Spending more time outdoors was treated as a safe and cost-effective method to prevent and control myopia. While prior research has established an inverse association between outdoor time and the risk of myopia onset, the effect of increasing outdoor time in delaying the progression of myopia remains a subject of debate. The present meta-analysis aimed to assess the relationship between outdoor time and the myopia onset, and further examine whether there is a dose-response relationship between outdoor time and the risk of myopia onset. Meanwhile, perform whether the outdoor time is related to delaying the progression of myopia. METHODS Studies were retrieved from PubMed, Web of Science, Embase, Medline, and the Cochrane Database, spanning from their inception to February 2023. Three cohort studies and 5 prospective intervention studies were included, with a total of 12,922 participants aged 6-16 years. RESULTS Comparing the highest with the lowest exposure levels of time spent outdoors, the highest outdoor time was strongly associated with a reduced risk of myopia onset (odds ratio [OR]: 0.53; 95% confidence interval [CI]: 0.34, 0.82). A nonlinear dose-response relationship was found between outdoor time and myopia onset risk. Compared to 3.5 h of outdoor time per week, an increase to 7, 16.3, and 27 h per week corresponded with a respective reduction in the risk of myopia onset by 20%, 53%, and 69%. Among children and adolescents who were not myopic, spending more time outdoors significantly slowed down the speed of change in spherical equivalent refractive (weighted mean difference [WMD] = 0.10D, 95% CI: 0.07, 0.14) and axial length (WMD = -0.05 mm, 95% CI: -0.06, -0.03). Among children and adolescents who were already myopic, spending more time outdoors did not slow myopia progression. CONCLUSIONS Overall, spending more time outdoors can prevent the onset of myopia, but it does not seem to slow its progression. Further studies are needed to better understand these trends.
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Affiliation(s)
- Dan Li
- School of Physical Education, Hunan Normal University, Changsha, China
| | - Sicheng Min
- School of Physical Education, Hunan Normal University, Changsha, China
| | - Xianxiong Li
- School of Physical Education, Hunan Normal University, Changsha, China
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Liu Z, Herold F, Owen N, Huang Z, Kuang J, Kramer AF, Ng JL, Zou L. Associations of meeting 24-hour movement behavior guidelines with prescribed eyeglasses/contact lenses among children and adolescents. Complement Ther Clin Pract 2024; 55:101844. [PMID: 38521002 DOI: 10.1016/j.ctcp.2024.101844] [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: 01/10/2024] [Revised: 02/25/2024] [Accepted: 03/07/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Vision health is crucial for many aspects of life especially in developing populations such as children and adolescents. However, there is a high proportion of children and adolescents who suffer from visual impairments. Notably, accumulating evidence indicates that meeting the 24-hour movement behaviors (24-HMB) guidelines is associated with positive physical and mental health outcomes in children and adolescents. However, the relationship between being prescribed eyeglasses/contact lenses and meeting the 24-HMB guidelines has yet to be investigated. Thus, this study aimed to address this gap in the existing literature by using the 2021 National Survey of Children's Health (NSCH) dataset. METHODS In this cross-sectional study, data was retrieved from the 2021 NSCH. A total of 14,193 U.S. children and adolescents aged between 6 and 17 years were included for data analyses. We used items of the NSCH concerning the 24-HMB guidelines (i.e., physical activity, screen time, and sleep duration) and prescription of eyeglasses/contact lenses that were answered by the legal guardian of the children. Binary logistic regression was performed to investigate whether meeting the 24-HMB guidelines is associated with prescription eyeglasses/contact lenses and whether wearing eyeglasses/contact lenses predicts adherence to the 24-HMB guidelines among children and adolescents. RESULTS More than half of the participants (59.53%) wore eyeglasses/contact lenses and only 8.40% of them met all three of the 24-HMB guidelines. Compared to meeting none of the 24-HMB guidelines, meeting one (OR = 0.76, 95% CI = 0.62-0.93, p = 0.008), two (OR = 0.54, 95% CI = 0.43-0.67, p < 0.001), and all three 24-HMB guidelines (OR = 0.47, 95% CI = 0.34-0.64, p < 0.001) were associated with a lower risk of being prescribed eyeglasses/contact lenses among children and adolescents. CONCLUSIONS The findings of the current study provided evidence that the prevalence of U.S. children and adolescents aged between 6 and 17 years who wore eyeglasses/contact lenses was relatively high. Furthermore, meeting the 24-HMB guidelines was associated with a lower risk of being prescribed eyeglasses/contact lenses. Future studies focusing on the effects of 24-HMB interventions on vision health among children and adolescents are needed to better inform public health actions.
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Affiliation(s)
- Zijun Liu
- Body-Brain-Mind Laboratory, Shenzhen University, Shenzhen, 518060, China
| | - Fabian Herold
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
| | - Neville Owen
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, Australia; Physical Activity Laboratory, Baker Heart & Diabetes Institute, Melbourne, Victoria, Australia
| | - Zhenmin Huang
- Shenzhen Institute for Education and Science, Shenzhen, 518060, China
| | - Jin Kuang
- Body-Brain-Mind Laboratory, Shenzhen University, Shenzhen, 518060, China
| | - Arthur F Kramer
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, IL, USA; Center for Cognitive and Brain Health, Northeastern University, Boston, MA, USA; Department of Psychology, Northeastern University, Boston, MA, 02115, USA
| | - Jonathan Leo Ng
- School of Education, College of Design and Social Context, RMIT University, Victoria, Australia
| | - Liye Zou
- Body-Brain-Mind Laboratory, Shenzhen University, Shenzhen, 518060, China.
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Chen D, Du Y, Liu Y, Hong J, Yin X, Zhu Z, Wang J, Zhang J, Chen J, Zhang B, Du L, Yang J, He X, Xu X. Development and validation of a smartwatch algorithm for differentiating physical activity intensity in health monitoring. Sci Rep 2024; 14:9530. [PMID: 38664457 PMCID: PMC11045869 DOI: 10.1038/s41598-024-59602-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
To develop and validate a machine learning based algorithm to estimate physical activity (PA) intensity using the smartwatch with the capacity to record PA and determine outdoor state. Two groups of participants, including 24 adults (13 males) and 18 children (9 boys), completed a sequential activity trial. During each trial, participants wore a smartwatch, and energy expenditure was measured using indirect calorimetry as gold standard. The support vector machine algorithm and the least squares regression model were applied for the metabolic equivalent (MET) estimation using raw data derived from the smartwatch. Exercise intensity was categorized based on MET values into sedentary activity (SED), light activity (LPA), moderate activity (MPA), and vigorous activity (VPA). The classification accuracy was evaluated using area under the ROC curve (AUC). The METs estimation accuracy were assessed via the mean absolute error (MAE), the correlation coefficient, Bland-Altman plots, and intraclass correlation (ICC). A total of 24 adults aged 21-34 years and 18 children aged 9-13 years participated in the study, yielding 1790 and 1246 data points for adults and children respectively for model building and validation. For adults, the AUC for classifying SED, MVPA, and VPA were 0.96, 0.88, and 0.86, respectively. The MAE between true METs and estimated METs was 0.75 METs. The correlation coefficient and ICC were 0.87 (p < 0.001) and 0.89, respectively. For children, comparable levels of accuracy were demonstrated, with the AUC for SED, MVPA, and VPA being 0.98, 0.89, and 0.85, respectively. The MAE between true METs and estimated METs was 0.80 METs. The correlation coefficient and ICC were 0.79 (p < 0.001) and 0.84, respectively. The developed model successfully estimated PA intensity with high accuracy in both adults and children. The application of this model enables independent investigation of PA intensity, facilitating research in health monitoring and potentially in areas such as myopia prevention and control.
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Affiliation(s)
- Daixi Chen
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, 200080, China
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, National Clinical Research Center for Eye Diseases, Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai, 200030, China
| | - Yuchen Du
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, National Clinical Research Center for Eye Diseases, Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai, 200030, China
| | - Yuan Liu
- Key Laboratory of Adolescent Health Assessment and Exercise Intervention of the Ministry of Education, East China Normal University, Shanghai, 200241, China
| | - Jun Hong
- Key Laboratory of Adolescent Health Assessment and Exercise Intervention of the Ministry of Education, East China Normal University, Shanghai, 200241, China
| | - Xiaojian Yin
- College of Economics and Management, Shanghai Institute of Technology, Shanghai, 201418, China
| | - Zhuoting Zhu
- Centre for Eye Research Australia, Ophthalmology, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Jingjing Wang
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, National Clinical Research Center for Eye Diseases, Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai, 200030, China
| | - Junyao Zhang
- Centre for Eye Research Australia, Ophthalmology, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Jun Chen
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, National Clinical Research Center for Eye Diseases, Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai, 200030, China
| | - Bo Zhang
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, National Clinical Research Center for Eye Diseases, Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai, 200030, China
| | - Linlin Du
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, National Clinical Research Center for Eye Diseases, Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai, 200030, China
| | - Jinliuxing Yang
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, National Clinical Research Center for Eye Diseases, Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai, 200030, China
| | - Xiangui He
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, 200080, China.
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, National Clinical Research Center for Eye Diseases, Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai, 200030, China.
| | - Xun Xu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, 200080, China.
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, National Clinical Research Center for Eye Diseases, Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai, 200030, China.
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Luo L. 24-H movement behaviors and visual impairment among Chinese adolescents with and without obesity. Complement Ther Clin Pract 2024; 54:101823. [PMID: 38171052 DOI: 10.1016/j.ctcp.2023.101823] [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: 08/03/2023] [Revised: 12/06/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Previous studies have identified obesity, sleep patterns, screen time, and physical activity as independent risk factors for the visual health of adolescents. However, our understanding of how these factors interact and contribute to visual impairment remains limited. This study aimed to investigate the relationship between adherence to the 24-h movement guidelines (24-HMG) and visual impairment in adolescents with and without obesity. METHODS We analyzed data from the 2014-2015 China Education Panel Survey. Participants provided self-reported information on their screen time, sleep duration, and physical activity levels. The data on weight, height, and visual acuity were obtained from school health examination reports. Logistic regression analysis was conducted to assess the association between 24-h movement behaviors and visual impairment, reported as odds ratios (ORs) with a 95 % confidence interval (CI). RESULTS After controlling for covariates such as sex and age, it was found that adolescents with obesity who adhered to the sleep guidelines had a lower risk of visual impairment compared with adolescents without obesity who did not adhere to the 24-HMG (OR = 0.84, 95 % CI: 0.75-0.94, P = 0.003). Additionally, adolescents who adhered to both the physical activity and sleep guidelines had an even lower risk of visual impairment (OR = 0.58, 95 % CI: 0.42-0.79, P = 0.001). CONCLUSIONS Adhering to the Sleep and physical activity + Sleep recommendations in the 24-HMG could significantly reduce the risk of visual impairment in adolescents without obesity. No significant relationship was observed between adherence to 24-HMG and the risk of visual impairment in adolescents with obesity.
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Affiliation(s)
- Lin Luo
- School of Physical Education, Guizhou Normal University, Guiyang, 550001, China.
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Biswas S, El Kareh A, Qureshi M, Lee DMX, Sun CH, Lam JSH, Saw SM, Najjar RP. The influence of the environment and lifestyle on myopia. J Physiol Anthropol 2024; 43:7. [PMID: 38297353 PMCID: PMC10829372 DOI: 10.1186/s40101-024-00354-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 01/05/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Myopia, commonly known as near-sightedness, has emerged as a global epidemic, impacting almost one in three individuals across the world. The increasing prevalence of myopia during early childhood has heightened the risk of developing high myopia and related sight-threatening eye conditions in adulthood. This surge in myopia rates, occurring within a relatively stable genetic framework, underscores the profound influence of environmental and lifestyle factors on this condition. In this comprehensive narrative review, we shed light on both established and potential environmental and lifestyle contributors that affect the development and progression of myopia. MAIN BODY Epidemiological and interventional research has consistently revealed a compelling connection between increased outdoor time and a decreased risk of myopia in children. This protective effect may primarily be attributed to exposure to the characteristics of natural light (i.e., sunlight) and the release of retinal dopamine. Conversely, irrespective of outdoor time, excessive engagement in near work can further worsen the onset of myopia. While the exact mechanisms behind this exacerbation are not fully comprehended, it appears to involve shifts in relative peripheral refraction, the overstimulation of accommodation, or a complex interplay of these factors, leading to issues like retinal image defocus, blur, and chromatic aberration. Other potential factors like the spatial frequency of the visual environment, circadian rhythm, sleep, nutrition, smoking, socio-economic status, and education have debatable independent influences on myopia development. CONCLUSION The environment exerts a significant influence on the development and progression of myopia. Improving the modifiable key environmental predictors like time spent outdoors and engagement in near work can prevent or slow the progression of myopia. The intricate connections between lifestyle and environmental factors often obscure research findings, making it challenging to disentangle their individual effects. This complexity underscores the necessity for prospective studies that employ objective assessments, such as quantifying light exposure and near work, among others. These studies are crucial for gaining a more comprehensive understanding of how various environmental factors can be modified to prevent or slow the progression of myopia.
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Affiliation(s)
- Sayantan Biswas
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Antonio El Kareh
- Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon
| | - Mariyem Qureshi
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
| | | | - Chen-Hsin Sun
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Janice S H Lam
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - 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, Singapore, Singapore
| | - Raymond P Najjar
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Singapore Eye Research Institute, Singapore, Singapore.
- Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore.
- Department of Biomedical Engineering, College of Design and Engineering, National University of Singapore, Singapore, Singapore.
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Ying ZQ, Li DL, Zheng XY, Zhang XF, Pan CW. Risk factors for myopia among children and adolescents: an umbrella review of published meta-analyses and systematic reviews. Br J Ophthalmol 2024; 108:167-174. [PMID: 36754586 DOI: 10.1136/bjo-2022-322773] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 01/24/2023] [Indexed: 02/10/2023]
Abstract
AIMS To identify potential risk factors for myopia in children and adolescents and assess the credibility of each evidence, providing reference for the development of myopia prevention strategies. METHODS We searched PubMed, Web of Science and Embase databases from inception to April 2022 to find systematic reviews or meta-analyses investigating the relationship between potential risk factors and myopia, and conducted an umbrella review. We recalculated the pooled effect sizes and 95% CIs of each potential risk factor through random-effects model, and reported its 95% prediction interval and between-study heterogeneity. Small-study effect and excess of significance bias were assessed to reveal potential publication bias. RESULTS Twelve publications were included in this umbrella review, including eight meta-analyses and four qualitative systematic reviews. Twenty-two factors were identified, of which 16 were analysed quantitatively. Ten factors showed statistically significant association with myopia. Myopia in one or two parents and per additional hour of time spend outdoors per week were rated as highly suggestive evidence. Near work and gender were evaluated as suggestive evidence. The other five factors are weak evidence. CONCLUSIONS We found several risk factors for myopia with different levels of evidence, of which parental myopia presented the strongest association with myopia in children and adolescents. Our findings contribute to a better understanding of the association between potential risk factors and myopia among children and adolescents and are important for informing parenting, education, clinical practice guidelines and public health policy. PROSPERO TRIAL REGISTRATION NUMBER CRD42022333053.
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Affiliation(s)
- Zhi-Qi Ying
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Dan-Lin Li
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Xin-Yu Zheng
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Xiao-Feng Zhang
- Department of Ophthalmology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China
| | - Chen-Wei Pan
- School of Public Health, Medical College of Soochow University, Suzhou, China
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Sun W, Li J, Zhou J, Li S, Hou L, Xiao W, Luo Z, Shan S, Zhang R, Song P. Meeting the Canadian 24-Hour Movement Guidelines and physical-mental comorbidity among Chinese children and adolescents: Prevalence, associations, and the population impacts. J Psychosom Res 2024; 176:111544. [PMID: 37977093 DOI: 10.1016/j.jpsychores.2023.111544] [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: 07/30/2023] [Revised: 10/31/2023] [Accepted: 11/05/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVES To examine the association between meeting the Canadian 24-Hour Movement Guidelines and physical-mental comorbidity among children and adolescents in a cross-sectional study. METHODS A total of 21,061 students aged 11-17 years from Zhejiang Province, China was recruited in the study. We examined the coexistence of five specific physical illnesses - hypertension, high myopia, dental caries, scoliosis, and obesity - with mental illness, specifically depressive symptoms. Generalized linear mixed models were performed to assess the association between overall and specific combinations of movement guidelines and physical-mental comorbidity, presented by odds ratio (OR) and 95% confidence interval (CI). Population attributable fraction (PAF) was calculated to estimate the preventable proportion of comorbid cases via meeting all three movement recommendations. RESULTS Of the included participants, 19.3% had physical-mental comorbidity. There were 3.8% and 17.0% meeting all three and none of the recommendations, respectively. Meeting at least one recommendation, except for moderate-to-vigorous physical activity recommendation only, was associated with a lower risk of physical-mental comorbidity, with ORs (95% CIs) ranging from 0.72 (0.66-0.79) to 0.40 (0.31-0.51). Meeting more recommendations was associated with decreased comorbid risks, and the association was stronger in 4th-6th graders. The association between specific combinations of recommendations and comorbid risks showed differences by gender and grade. Of the comorbid cases, 42.1% were attributed to not adhering to all three recommendations, and the PAFs varied from 27.4% to 55.7% across different genders and grades. CONCLUSION Adherence to the 24-h movement guidelines was associated with lower risks of physical-mental comorbidity among children and adolescents.
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Affiliation(s)
- Weidi Sun
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Juanjuan Li
- Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, Zhejiang, China
| | - Jiali Zhou
- Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, Zhejiang, China; School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Shuting Li
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Leying Hou
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Wenhan Xiao
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Zeyu Luo
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Shiyi Shan
- School of Public Health, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Ronghua Zhang
- Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, Zhejiang, China.
| | - Peige Song
- School of Public Health and Women's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
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Zhao M, Zhang Y, Herold F, Chen J, Hou M, Zhang Z, Gao Y, Sun J, Hossain MM, Kramer AF, Müller NG, Zou L. Associations between meeting 24-hour movement guidelines and myopia among school-aged children: A cross-sectional study. Complement Ther Clin Pract 2023; 53:101792. [PMID: 37595358 DOI: 10.1016/j.ctcp.2023.101792] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/24/2023] [Accepted: 08/03/2023] [Indexed: 08/20/2023]
Abstract
BACKGROUND The Canadian 24-hour movement behavior (24-HMB) guidelines recommend an adequate level of physical activity (PA), a limited amount of screen time (ST), and a sufficient sleep duration (SLP) to promote the healthy development of children. Although the positive effects of adhering to the 24-HMB guidelines have been established for several health parameters, less is known about how adherence to the 24-HMB guidelines relates to the myopia risk (i.e., inability to see distant objects properly). Thus, this study investigated associations between meeting 24-HMB guidelines and myopia risk in school-aged children. METHOD Using a questionnaire survey, this cross-sectional study was conducted among parents of school-aged children (5-13 years) in China from 15th September to 15th October 2022, with a total of 1423 respondents with complete data for analysis. Parents reported their child's time spent in moderate-to-vigorous-intensity physical activity (MVPA), SLP, and ST. Multiple logistic regression analyses were performed to examine the associations between measures of PA, ST, and SLP alone and in combination, and the occurrence of myopia. RESULTS A relatively low percentage of the children being included in the current study (4.92%) met all 24-HMB guidelines, while 32.46% had myopia. Girls had a significantly higher risk of myopia compared to boys (OR = 1.3, 1.002 to 1.68, p = 0.049). Children of parents without myopia had a lower risk of myopia (OR = 0.45, 0.34-0.59, p < 0.001). Children who lived in urban areas (OR = 1.83, 95% CI 1.33 to 2.52, p < 0.001) or towns (OR = 1.60, 1.03 to 2.47, p = 0.04) had a significantly higher risk of myopia compared to those living in rural areas. Meeting SLP guidelines (OR = 0.50, 95% CI 0.31 to 0.82, p < 0.01), meeting ST + SLP guidelines (OR = 0.47, 95% CI 0.32-0.69, <0.001), and meeting all three guidelines were associated with significantly lower risk of myopia (OR = 0.40, 95% CI 0.20-0.82, p = 0.01). Meeting more 24-HMB guidelines was associated with a reduced risk of myopia. CONCLUSIONS Our data suggest that adhering to SLP, ST + SLP, and ST + SLP + PA guidelines is associated with the risk of myopia. Future research investigating dose-response associations, and potential mechanisms, is necessary to achieve a more nuanced understanding of the observed associations.
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Affiliation(s)
- Mengxian Zhao
- Body-Brain-Mind Laboratory, School of Physical Education, School of Psychology, Shenzhen University, Shenzhen, 518060, China
| | - Yanjie Zhang
- Physical Education Unit, Chinese University of Hong Kong, Shenzhen, China
| | - Fabian Herold
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
| | - Jianyu Chen
- Body-Brain-Mind Laboratory, School of Physical Education, School of Psychology, Shenzhen University, Shenzhen, 518060, China
| | - Meijun Hou
- Body-Brain-Mind Laboratory, School of Physical Education, School of Psychology, Shenzhen University, Shenzhen, 518060, China
| | - Zhihao Zhang
- Body-Brain-Mind Laboratory, School of Physical Education, School of Psychology, Shenzhen University, Shenzhen, 518060, China
| | - Yanping Gao
- Body-Brain-Mind Laboratory, School of Physical Education, School of Psychology, Shenzhen University, Shenzhen, 518060, China
| | - Jing Sun
- School of Medicine and Dentistry and Menzies Health Institute Queensland, Institute for Integrated Intelligence and Systems, Griffith University, Australia
| | - M Mahbub Hossain
- Department of Decision and Information Sciences, C.T. Bauer College of Business, University of Houston, TX, 77204, USA; Department of Health Systems and Population Health Sciences, Tilman J. Fertitta Family College of Medicine, University of Houston, TX, 77204, USA
| | - Arthur F Kramer
- Center for Cognitive and Brain Health, Northeastern University, Boston, 02115, MA, United States; Beckman Institute, University of Illinois at Urbana-Champaign, Champaign, 61820, IL, United States
| | - Notger G Müller
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
| | - Liye Zou
- Body-Brain-Mind Laboratory, School of Physical Education, School of Psychology, Shenzhen University, Shenzhen, 518060, China.
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Fulton JM, Flanagan SC, Sittlington JJ, Cobice D, Dobbin S, McCullough SJ, Orr G, Richardson P, Saunders KJ. A Cross-Sectional Study of Myopia and Morning Melatonin Status in Northern Irish Adolescent Children. J Ophthalmol 2023; 2023:7961623. [PMID: 37946723 PMCID: PMC10632006 DOI: 10.1155/2023/7961623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/13/2023] [Accepted: 10/16/2023] [Indexed: 11/12/2023] Open
Abstract
Purpose Previous studies have demonstrated an association between melatonin status and both refractive error and axial length in young adult myopes. This study aimed to determine if this relationship extends to a younger adolescent cohort. Methods Healthy children aged 12-15 years provided morning saliva samples before attending Ulster University (55°N) for cycloplegic autorefraction and axial length measures. Participants completed questionnaires describing recent sleep habits and physical activity. Salivary melatonin was quantified using high-performance liquid chromatography-tandem mass spectrometry. Data collection for all participants occurred over a 1-week period (April 2021). Results Seventy participants aged 14.3 (95% CI: 14.2-14.5) years were categorised by spherical equivalent refraction [SER] (range: -5.38DS to +1.88DS) into two groups; myopic SER ≤ -0.50DS (n = 22) or nonmyopic -0.50DS < SER ≤ +2.00DS (n = 48). Median morning salivary melatonin levels were 4.52 pg/ml (95% CI: 2.60-6.02) and 4.89 pg/ml (95% CI: 3.18-5.66) for myopic and nonmyopic subjects, respectively, and did not differ significantly between refractive groups (P = 0.91). Melatonin levels were not significantly correlated with SER, axial length, sleep, or activity scores (Spearman's rank, all P > 0.39). Higher levels of physical activity were associated with higher sleep quality (Spearman's rank, ρ = -0.28, P = 0.02). Conclusion The present study found no significant relationship between morning salivary melatonin levels and refractive error or axial length in young adolescents. This contrasts with outcomes from a previous study of adults with comparable methodology, season of data collection, and geographical location. Prospective studies are needed to understand the discrepancies between adult and childhood findings and evaluate whether melatonin levels in childhood are indicative of an increased risk for future onset of myopia and/or faster axial growth trajectories and myopia progression in established myopes. Future work should opt for a comprehensive dim-light melatonin onset protocol to determine circadian phase.
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Affiliation(s)
- Jane M. Fulton
- Centre for Optometry and Vision Science, Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Sarah C. Flanagan
- Centre for Optometry and Vision Science, Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Julie J. Sittlington
- Nutrition Innovation Centre for Food and Health (NICHE), Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Diego Cobice
- Mass Spectrometry Centre, Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Sara Dobbin
- Mass Spectrometry Centre, Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Sara J. McCullough
- Centre for Optometry and Vision Science, Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Gareth Orr
- Mass Spectrometry Centre, Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Patrick Richardson
- Centre for Optometry and Vision Science, Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Kathryn J. Saunders
- Centre for Optometry and Vision Science, Biomedical Science Research Institute, Ulster University, Coleraine, UK
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Harrington S, Kearney J, O'Dwyer V. Visual factors associated with physical activity in schoolchildren. Clin Exp Optom 2023; 106:645-655. [PMID: 35952361 DOI: 10.1080/08164622.2022.2106780] [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: 02/23/2022] [Revised: 07/11/2022] [Accepted: 07/22/2022] [Indexed: 10/15/2022] Open
Abstract
CLINICAL RELEVANCE Physical activity is an essential part of childhood physical and mental development. Recent research identified visual problems associated with a sedentary lifestyle in children in Ireland. BACKGROUND This study explored the association between visual function in children and their engagement with physical activities outside school. METHODS Participants were 1,626 schoolchildren (728 aged 6-7-years, 898 aged 12-13-years) in randomly selected schools in Ireland. Before data collection, parents/legal guardians of participants completed a standardised questionnaire reporting physical activity as no activity (mostly on screens), light activity (occasional walking/cycling), moderate activity (<3 hrs/week engaged in sports), or regular activity (>3hrs/week engaged in sports). Measurements included logMAR monocular visual acuities (with spectacles and pinhole), in the distance (3 m) and near (40 cm), stereoacuity (TNO stereo-test), cover test, and cycloplegic autorefraction (1% cyclopentolate). RESULTS Controlling for confounders (socioeconomic disadvantage and non-White ethnicity), linear regression analysis revealed presenting distance visual acuity, near visual acuity, and stereoacuity were significantly better amongst participants who reported regular physical activity rather than moderate, light or no activity in both 6-7-year-old and 12-13-year-old participants. Absence of clinically-significant refractive error (>-0.50D < 2.00D) was associated with regular physical activity. Participants presenting with visual impairment (better-eye vision <6/12) (odds ratio = 5.78 (2.72-12.29)), amblyopia (pinhole acuity ≤6/12 plus an amblyogenic factor) (odds ratio = 5.66 (2.33-13.76)), and participants at school without their spectacles (odds ratio = 2.20 (1.33-3.63)), were more likely to report no activity. CONCLUSIONS Children regularly engaged in physical activities, including sports; had better visual and stereoacuity; and were less likely to need spectacles. Visual impairment, amblyopia, and refractive error were associated with no physical activity. Spectacle wear compliance was associated with regular physical activity. Regular physical activity is an essential factor in childhood vision and addressing visual impairment in children is vital to increasing participation in sports and exercise. Socioeconomically disadvantaged and non-White communities would benefit most from these measures.
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Affiliation(s)
- Síofra Harrington
- School of Physics and Clinical and Optometric Sciences, Technological University Dublin, Dublin, Ireland
| | - John Kearney
- Epidemiology, Biological and Health Sciences, Technological University Dublin, Dublin, Ireland
| | - Veronica O'Dwyer
- School of Physics and Clinical and Optometric Sciences, Technological University Dublin, Dublin, Ireland
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12
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Ali SG, Wang X, Li P, Jung Y, Bi L, Kim J, Chen Y, Feng DD, Magnenat Thalmann N, Wang J, Sheng B. A systematic review: Virtual-reality-based techniques for human exercises and health improvement. Front Public Health 2023; 11:1143947. [PMID: 37033028 PMCID: PMC10076722 DOI: 10.3389/fpubh.2023.1143947] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
Virtual Reality (VR) has emerged as a new safe and efficient tool for the rehabilitation of many childhood and adulthood illnesses. VR-based therapies have the potential to improve both motor and functional skills in a wide range of age groups through cortical reorganization and the activation of various neuronal connections. Recently, the potential for using serious VR-based games that combine perceptual learning and dichoptic stimulation has been explored for the rehabilitation of ophthalmological and neurological disorders. In ophthalmology, several clinical studies have demonstrated the ability to use VR training to enhance stereopsis, contrast sensitivity, and visual acuity. The use of VR technology provides a significant advantage in training each eye individually without requiring occlusion or penalty. In neurological disorders, the majority of patients undergo recurrent episodes (relapses) of neurological impairment, however, in a few cases (60-80%), the illness progresses over time and becomes chronic, consequential in cumulated motor disability and cognitive deficits. Current research on memory restoration has been spurred by theories about brain plasticity and findings concerning the nervous system's capacity to reconstruct cellular synapses as a result of interaction with enriched environments. Therefore, the use of VR training can play an important role in the improvement of cognitive function and motor disability. Although there are several reviews in the community employing relevant Artificial Intelligence in healthcare, VR has not yet been thoroughly examined in this regard. In this systematic review, we examine the key ideas of VR-based training for prevention and control measurements in ocular diseases such as Myopia, Amblyopia, Presbyopia, and Age-related Macular Degeneration (AMD), and neurological disorders such as Alzheimer, Multiple Sclerosis (MS) Epilepsy and Autism spectrum disorder. This review highlights the fundamentals of VR technologies regarding their clinical research in healthcare. Moreover, these findings will raise community awareness of using VR training and help researchers to learn new techniques to prevent and cure different diseases. We further discuss the current challenges of using VR devices, as well as the future prospects of human training.
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Affiliation(s)
- Saba Ghazanfar Ali
- Department of Computer Science and Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Xiangning Wang
- Department of Ophthalmology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ping Li
- Department of Computing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- School of Design, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Younhyun Jung
- School of Computing, Gachon University, Seongnam, Republic of Korea
| | - Lei Bi
- Biomedical and Multimedia Information Technology Research Group, School of Computer Science, The University of Sydney, Sydney, NSW, Australia
| | - Jinman Kim
- Biomedical and Multimedia Information Technology Research Group, School of Computer Science, The University of Sydney, Sydney, NSW, Australia
| | - Yuting Chen
- Department of Computer Science and Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - David Dagan Feng
- Biomedical and Multimedia Information Technology Research Group, School of Computer Science, The University of Sydney, Sydney, NSW, Australia
| | | | - Jihong Wang
- Shanghai University of Sport, Shanghai, China
| | - Bin Sheng
- Department of Computer Science and Engineering, Shanghai Jiao Tong University, Shanghai, China
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13
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Liu ZH, Zhao MF, Ma S, Li Y, Sun ZY, Gao L. Exercise is the dominant factor affecting the development of teenagers' eyesight-Based on the Bayesian model averaging. Front Public Health 2022; 10:1014227. [PMID: 36589959 PMCID: PMC9801519 DOI: 10.3389/fpubh.2022.1014227] [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: 08/08/2022] [Accepted: 11/28/2022] [Indexed: 12/15/2022] Open
Abstract
Objective The model uncertainty may result in inconsistency about the environmental factors of myopia among students, and the Bayesian model average (BMA) is an effective way to eliminate it. We aimed to explore the influencing factors of myopia in primary and middle school students by BMA. Methods The data came from the 2021 National Surveillance of Common Diseases and Health Influencing Factors of students. By stratified random cluster sampling, the physical and mental health status of students in Tianjin and the factors affecting their physical health, such as diet, exercise, mental stress, school bullying, sleep time, and internet use, were investigated. The sample consisted of 8,457 primary school students, 8,191 junior middle school students, and 5,901 senior middle school students. Besides the physical examination, we used computer optometry (non-ciliary paralysis) to screen myopia. And we used BMA to select the risk factors through the BMS package in R. Results The exercise was the only factor that affected the eyesight of junior and senior middle schoolers by BMA, with the posterior probability of 0.9736 and 0.9762, but not for the primary students. And we failed to select variables that affected eyesight in grades 4-6 of primary school. Conclusion The exercise was a strong influencing factor for the eyesight of students in Tianjin's junior and senior middle schools.
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Affiliation(s)
- Zhong-hui Liu
- Tianjin Center for Disease Control and Prevention, Tianjin, China
| | - Meng-fei Zhao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Shuai Ma
- Department of Maternal, Child & Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yin Li
- Department of Maternal, Child & Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Zhi-ying Sun
- Tianjin Center for Disease Control and Prevention, Tianjin, China
| | - Lei Gao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China,*Correspondence: Lei Gao
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14
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Zheng X, Shi L, Ou W, Xue Y, Xu Y, Xue B, Zhang J, Liang P, Huang W, Qin Z, Zhang C. Effects of physical activity and use of digital devices on visual acuity in children and adolescents during the COVID-19 pandemic: A cross-sectional study. Front Public Health 2022; 10:1017479. [PMID: 36568779 PMCID: PMC9772536 DOI: 10.3389/fpubh.2022.1017479] [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: 08/12/2022] [Accepted: 11/18/2022] [Indexed: 12/13/2022] Open
Abstract
Purpose To determine the association between poor visual acuity, the use of digital devices and physical activity (PA) during the COVID-19 pandemic. Methods A total of 327,646 Chinese children and adolescents were included in the analysis using a cluster random sampling method; this is a case-control study, of those 144,708 children and adolescents with poor visual acuity were included in the case group, while 182,938 who did not have poor visual acuity were included in the control group. A logistic regression model was used to assess the contribution of PA and the use of digital devices to poor visual acuity. Results A total of 144,708 children and adolescents experienced poor visual acuity during the COVID-19 pandemic; 54.8% were male, and 55.2% live in rural areas. Compared to controls, children and adolescents with poor visual acuity exhibited more time for the use of digital devices (4.51 ± 2.44 vs. 3.79 ± 2.34 for cases and controls, respectively; P < 0.001) and PA (3.07 ± 0.92 vs. 2.85 ± 1.00 for cases and controls, respectively; P < 0.001). During the COVID-19 pandemic, risk factors related to poor visual acuity among children and adolescents included the use of digital devices (OR 1.135; 95% CI 1.132-1.139), and PA (OR 1.269; 95%CI 1.259-1.278). The results of interaction analysis show that for children and adolescents aged 12 to 17, the positive association between the use of digital devices and poor visual acuity decreased. The interaction effect between PA and digital devices is 0.987. Conclusions Children and adolescents were at risk of poor visual acuity during the COVID-19 pandemic. Extended use of the digital devices increased the risk of poor visual acuity, especially for children aged 6-11 years. But the risk of poor visual acuity among children and adolescents decreases as the time spent on PA increases.
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Affiliation(s)
- Xiao Zheng
- Department of Health Management, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, China,School of Health Management, Southern Medical University, Guangzhou, China
| | - Lei Shi
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Weiyan Ou
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Yaqing Xue
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Ying Xu
- Division of Physical Education, Hygiene and Arts Education Department of Education of Guangdong Province, Guangzhou, China
| | - Benli Xue
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Jiachi Zhang
- School of Health Management, Southern Medical University, Guangzhou, China
| | - Pengyan Liang
- Health Publicity and Education Center of Guangdong Province, Guangzhou, China
| | - Wei Huang
- Health Publicity and Education Center of Guangdong Province, Guangzhou, China
| | - Zuguo Qin
- Health Publicity and Education Center of Guangdong Province, Guangzhou, China,Zuguo Qin
| | - Chichen Zhang
- Department of Health Management, Shunde Hospital, Southern Medical University (The First People's Hospital of Shunde, Foshan), Foshan, China,School of Health Management, Southern Medical University, Guangzhou, China,*Correspondence: Chichen Zhang
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15
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Xie J, Lu C, Zhu J. Screen time and myopia: A serial multiple mediator SEM analysis. Front Public Health 2022; 10:860098. [PMID: 36299744 PMCID: PMC9589147 DOI: 10.3389/fpubh.2022.860098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 07/29/2022] [Indexed: 01/21/2023] Open
Abstract
Background COVID-19 has influenced education systems worldwide, and significantly increased screen time for college students, posing a potential risk of myopia. In China, ninety percent of college students suffer from myopia. Excessive screen time changes college students' lifestyles, imposes potential health risks, and affects opportunities for employment. It is important to identify the potential correlation between screen time use and myopia among college students. Methods This paper conducted a nationwide experiment using Chinese college students and set a multiple-mediator SEM model to analyze the potential correlation between screen time and myopia. The two mediators were sedentary behavior and physical activity, respectively. Results We obtained three valuable conclusions as follows: First, there was no significant direct relationship between screen time and myopia among Chinese college students during the COVID-19 pandemic. Second, sedentary behavior and physical activity significantly predicted the increase/decrease of myopia among Chinese college students, respectively. Third, a serial multiple mediator that encompassed sedentary behavior and physical activity sequentially fully mediated the relationship between screen time and myopia. Conclusions Although there was no directly significant relationship between screen time and myopia, screen time can indirectly influence the risk of suffering myopia by influencing sedentary behavior and physical activity. Our study demonstrates the need to prevent the potential influence of overuse of electronic devices on myopia in college students, especially during the COVID-19 pandemic.
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Affiliation(s)
- Jinchen Xie
- Department of Sociology, Xi'an Jiaotong University, Xi'an, China
| | - Chuntian Lu
- Department of Sociology, Xi'an Jiaotong University, Xi'an, China
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Does Physical Activity Moderate the Relationship between Myopia and Functional Status in Children 9-11 Years of Age? J Clin Med 2022; 11:jcm11195672. [PMID: 36233536 PMCID: PMC9572250 DOI: 10.3390/jcm11195672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/15/2022] [Accepted: 09/21/2022] [Indexed: 11/17/2022] Open
Abstract
Although previous studies have reported an association between physical activity (PA) and myopia in school-aged children, little is known about the link between myopia and children’s functional status. The purpose of this study was to investigate dynamic balance control in relation to the daily PA levels of myopic schoolchildren aged 9−11 years (n = 52) versus a non-myopic control group (n = 53). A single leg stance test performed on the instability platform of the Biodex Balance System was used to assess balance control. The overall stability index (OSI), anterior-posterior stability index (APSI) and medial-lateral stability index (MLSI) were analyzed. PA levels were calculated using the World Health Organization European Childhood Obesity Surveillance Initiative family record form. Myopes and non-myopes were separated into three subgroups based on PA level (low, moderate and high). Myopia significantly affected OSI (F = 40.46, p < 0.001), APSI (F = 33.93, p < 0.001) and MLSI (F = 49.51, p < 0.001). There were significant differences (p < 0.001) between myopic and non-myopic children with low and moderate levels of PA, whilst there were no differences between compared children with high levels of PA. High PA levels had a positive impact on balance control in myopes. Our results showed that PA levels moderate the relationship between myopia and children’s functional status.
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Bhandari KR, Ostrin LA. Objective measures of viewing behaviour in children during near tasks. Clin Exp Optom 2022; 105:746-753. [PMID: 34538208 PMCID: PMC8933286 DOI: 10.1080/08164622.2021.1971049] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 08/04/2021] [Accepted: 08/16/2021] [Indexed: 10/20/2022] Open
Abstract
CLINICAL RELEVANCE Objective assessment of near viewing behaviours performed in a laboratory setting showed that children demonstrate differing viewing distances and angles based on the type of task. Findings will contribute to our understanding of how near work influences myopia. BACKGROUND Evidence suggests that near working distance and viewing breaks are associated with myopia. The purpose of this study was to use an objective, continuously measuring range finding device to examine these viewing behaviours in children. METHODS Viewing distance, number of breaks, and head and eye angles were assessed in 16 non-myopic and 19 myopic children (ages 13.38 ± 4.14 years) using the Clouclip, an objective rangefinder, during five 15-minute near tasks, including (a) passive reading and (b) active writing on printed material, (c) passive viewing and (d) active engagement on an iPad, and (e) active engagement on a cell phone. Height and Harmon distance were measured. Viewing behaviours were analysed by task, refractive error group, and gender. RESULTS Mean viewing distances significantly differed by task (P < 0.001) and were highly correlated with children's Harmon distance and height for all near tasks (P < 0.05), except for the active printed task (P > 0.05). Viewing distances did not differ by gender or refractive error group. During each task, mean number of viewing breaks was 2.6 ± 4.1 and did not vary between task (P = 0.92) or refractive error group (P = 0.65). Head declination and total viewing angle varied by type of near task (P < 0.001 for both). CONCLUSION Children demonstrated differing viewing distances and viewing angles based on the type of near task they were performing. Viewing behaviours did not vary between myopic and non-myopic children. Findings will contribute to a better understanding of how near viewing behaviours can be quantified objectively and relationships with myopia.
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Affiliation(s)
- Khob R Bhandari
- University of Houston College of Optometry, 4901 Calhoun Rd, Houston, TX, 77204 USA
| | - Lisa A Ostrin
- University of Houston College of Optometry, 4901 Calhoun Rd, Houston, TX, 77204 USA
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18
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Myopia: Mechanisms and Strategies to Slow Down Its Progression. J Ophthalmol 2022; 2022:1004977. [PMID: 35747583 PMCID: PMC9213207 DOI: 10.1155/2022/1004977] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 05/29/2022] [Indexed: 12/15/2022] Open
Abstract
This topical review aimed to update and clarify the behavioral, pharmacological, surgical, and optical strategies that are currently available to prevent and reduce myopia progression. Myopia is the commonest ocular abnormality; reinstated interest is associated with high and increasing prevalence, especially but not, in the Asian population and progressive nature in children. The growing global prevalence seems to be associated with both genetic and environmental factors such as spending more time indoor and using digital devices, particularly during the coronavirus disease 2019 pandemic. Various options have been assessed to prevent or reduce myopia progression in children. In this review, we assess the effects of several types of measures, including spending more time outdoor, optical interventions such as the bifocal/progressive spectacle lenses, soft bifocal/multifocal/extended depth of focus/orthokeratology contact lenses, refractive surgery, and pharmacological treatments. All these options for controlling myopia progression in children have various degrees of efficacy. Atropine, orthokeratology/peripheral defocus contact and spectacle lenses, bifocal or progressive addition spectacles, and increased outdoor activities have been associated with the highest, moderate, and lower efficacies, respectively.
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Prousali E, Haidich AB, Dastiridou A, Tzamalis A, Ziakas N, Mataftsi A. Part-time Versus Full-time Spectacles for Myopia Control (ParMA Study): A Randomized Clinical Trial. Cureus 2022; 14:e25995. [PMID: 35720776 PMCID: PMC9202340 DOI: 10.7759/cureus.25995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2022] [Indexed: 11/05/2022] Open
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Dhakal R, Shah R, Huntjens B, Verkicharla PK, Lawrenson J. Time spent outdoors as an intervention for myopia prevention and control in children: an overview of systematic reviews. Ophthalmic Physiol Opt 2022; 42:545-558. [PMID: 35072278 PMCID: PMC9305934 DOI: 10.1111/opo.12945] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 12/02/2021] [Accepted: 12/04/2021] [Indexed: 12/22/2022]
Abstract
PURPOSE Outdoor light exposure is considered a safe and effective strategy to reduce myopia development and aligns with existing public health initiatives to promote healthier lifestyles in children. However, it is unclear whether this strategy reduces myopia progression in eyes that are already myopic. This study aims to conduct an overview of systematic reviews (SRs) reporting time spent outdoors as a strategy to prevent myopia or slow its progression in children. METHODS We searched the Cochrane Library, EMBASE, MEDLINE and CINAHL from inception to 1 November 2020 to identify SRs that evaluated the association between outdoor light exposure and myopia development or progression in children. Outcomes included incident myopia, prevalent myopia and change in spherical equivalent refraction (SER) and axial length (AL) to evaluate annual rates of myopia progression. The methodological quality and risk of bias of included SRs were assessed using the AMSTAR-2 and ROBIS tools, respectively. RESULTS Seven SRs were identified, which included data from 47 primary studies with 63,920 participants. Pooled estimates (risk or odds ratios) consistently demonstrated that time outdoors was associated with a reduction in prevalence and incidence of myopia. In terms of slowing progression in eyes that were already myopic, the reported annual reductions in SER and AL from baseline were small (0.13-0.17 D) and regarded as clinically insignificant. Methodological quality assessment using AMSTAR-2 found that all reviews had one or more critical flaws and the ROBIS tool identified a low risk of bias in only two of the included SRs. CONCLUSION This overview found that increased exposure to outdoor light reduces myopia development. However, based on annual change in SER and AL, there is insufficient evidence for a clinically significant effect on myopia progression. The poor methodological quality and inconsistent reporting of the included systematic reviews reduce confidence in the estimates of effect.
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Affiliation(s)
- Rohit Dhakal
- Myopia Research LabProf. Brien Holden Eye Research CentreL V Prasad Eye InstituteHyderabadIndia
- Centre for Applied Vision ResearchSchool of Health Sciences, CityUniversity of LondonLondonUK
| | - Rakhee Shah
- Centre for Applied Vision ResearchSchool of Health Sciences, CityUniversity of LondonLondonUK
| | - Byki Huntjens
- Centre for Applied Vision ResearchSchool of Health Sciences, CityUniversity of LondonLondonUK
| | - Pavan K Verkicharla
- Myopia Research LabProf. Brien Holden Eye Research CentreL V Prasad Eye InstituteHyderabadIndia
| | - John G Lawrenson
- Centre for Applied Vision ResearchSchool of Health Sciences, CityUniversity of LondonLondonUK
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21
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Karthikeyan SK, Ashwini DL, Priyanka M, Nayak A, Biswas S. Physical activity, time spent outdoors, and near work in relation to myopia prevalence, incidence, and progression: An overview of systematic reviews and meta-analyses. Indian J Ophthalmol 2022; 70:728-739. [PMID: 35225506 PMCID: PMC9114537 DOI: 10.4103/ijo.ijo_1564_21] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/21/2021] [Accepted: 09/21/2021] [Indexed: 12/13/2022] Open
Abstract
Myopia has reached epidemic levels in recent years. Stopping the development and progression of myopia is critical, as high myopia is a major cause of blindness worldwide. This overview aims at finding the association of time spent outdoors (TSO), near work (NW), and physical activity (PA) with the incidence, prevalence, and progression of myopia in children. Literature search was conducted in PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature, Cochrane Database of Systematic Reviews, ProQuest, and Web of Science databases. Systematic reviews (SR) and meta-analyses (MA) on the TSO, NW, and PA in relation to myopia were reviewed. Methodological nature of qualified studies were evaluated utilizing the Risk of Bias in Systematic Review tool. We identified four SRs out of which three had MA, which included 62 unique studies, involving >1,00,000 children. This overview found a protective trend toward TSO with a pooled odds ratio (OR) of 0.982 (95% confidence interval (CI) 0.979-0.985, I2 = 93.5%, P < 0.001) per extra hour of TSO every week. A pooled OR 1.14 (95% CI 1.08-1.20) suggested NW to be related to risk of myopia. However, studies associating myopia with NW activities are not necessarily a causality as the effect of myopia might force children to indoor confinement with more NW and less TSO. PA presented no effect on myopia. Though the strength of evidence is less because of high heterogeneity and lack of clinical trials with clear definition, increased TSO and reduced NW are protective against myopia development among nonmyopes.
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Affiliation(s)
- Siddharth K Karthikeyan
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Department of Optometry, Netra Jyothi Institute of Allied Health Sciences, Udupi, Karnataka, India
| | - D L Ashwini
- Department of Optometry, Sankara College of Optometry, Sankara Eye Hospital, Bengaluru, Karnataka, India
| | - M Priyanka
- Department of Optometry, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Anush Nayak
- Department of Optometry, Netra Jyothi Institute of Allied Health Sciences, Udupi, Karnataka, India
- Faculty of Life and Allied Health Sciences, Ramaiah University of Applied Sciences, Bangalore, Karnataka, India
| | - Sayantan Biswas
- Visual Neurosciences Group, Singapore Eye Research Institute, Singapore
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22
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Zieliński G, Filipiak Z, Ginszt M, Matysik-Woźniak A, Rejdak R, Gawda P. The Organ of Vision and the Stomatognathic System-Review of Association Studies and Evidence-Based Discussion. Brain Sci 2021; 12:brainsci12010014. [PMID: 35053758 PMCID: PMC8773770 DOI: 10.3390/brainsci12010014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 12/14/2021] [Accepted: 12/21/2021] [Indexed: 11/16/2022] Open
Abstract
The stomatognathic system is a functional complex of tissues and organs located within the oral and craniofacial cavities. The craniofacial anatomical factors and the biomechanics of the temporomandibular joints affect many systems throughout the body, including the organ of vision. However, few scientific reports have shown a relationship between the organ of vision and the stomatognathic system. The purpose of this review is to provide an overview of connections along neural, muscle-fascial, and biochemical pathways between the organ of vision and the stomatognathic system. Based on the literature presented in this review, the connections between the organ of vision and the stomatognathic system seem undeniable. Understanding the anatomical, physiological, and biochemical interrelationships may allow to explain the interactions between the mentioned systems. According to the current knowledge, it is not possible to indicate the main linking pathway; presumably, it may be a combination of several presented pathways. The awareness of this relationship among dentists, ophthalmologists, physiotherapists, and optometrists should increase for the better diagnosis and treatment of patients.
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Affiliation(s)
- Grzegorz Zieliński
- Department of Sports Medicine, Medical University of Lublin, 20-093 Lublin, Poland;
- Correspondence:
| | - Zuzanna Filipiak
- Department of Nephrology, Dialysis and Internal Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Michał Ginszt
- Department of Rehabilitation and Physiotherapy, Medical University of Lublin, 20-093 Lublin, Poland;
| | - Anna Matysik-Woźniak
- Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-093 Lublin, Poland; (A.M.-W.); (R.R.)
| | - Robert Rejdak
- Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-093 Lublin, Poland; (A.M.-W.); (R.R.)
| | - Piotr Gawda
- Department of Sports Medicine, Medical University of Lublin, 20-093 Lublin, Poland;
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23
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Lee YS, Choi SE, Hahm J, Kim MJ, Bae HS, Yi K, Lim HT, Hyon JY. Digital Therapeutics: Exploring the Possibilities of Digital Intervention for Myopia. Front Digit Health 2021; 3:710644. [PMID: 34713181 PMCID: PMC8521975 DOI: 10.3389/fdgth.2021.710644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 08/03/2021] [Indexed: 11/23/2022] Open
Abstract
Pediatric myopia is increasing globally and has become a major public health issue. However, the mechanism of pediatric myopia is still poorly understood, and there is no effective treatment to prevent its progression. Based on results from animal and clinical studies, certain neuronal–humoral factors (NHFs), such as IGF-1, dopamine, and cortisol may be involved in the progression of pediatric myopia. Digital therapeutics uses evidence-based software as therapeutic interventions and it has the potential to offer innovative treatment strategies for pediatric myopia beyond conventional treatment methods. In this perspective article, we introduce digital therapeutics SAT-001, a software algorithm that modulates the level of NHFs to reduce the progression of pediatric myopia. The proposed mechanism is based on a theoretical hypothesis derived from scientific research and clinical studies and will be further confirmed by evidence generated from clinical studies involving pediatric myopia.
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Affiliation(s)
| | | | - Jarang Hahm
- S-Alpha Therapeutics, Inc., Seoul, South Korea
| | - Myoung Joon Kim
- S-Alpha Therapeutics, Inc., Seoul, South Korea.,Renew Seoul Eye Center, Seoul, South Korea
| | | | - Kayoung Yi
- Department of Ophthalmology, Hallym University Kangnam Sacred Heart Hospital, Seoul, South Korea
| | - Hyun Taek Lim
- Department of Ophthalmology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, South Korea
| | - Joon Young Hyon
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul University Bundang Hospital, Seongnam, South Korea
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24
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The Association Between Objectively Measured Vision Impairment and Self-Reported Physical Activity Among 34,129 Adults Aged ≥50 Years in Six Low- and Middle-Income Countries. J Aging Phys Act 2021; 30:316-322. [PMID: 34453019 DOI: 10.1123/japa.2021-0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/31/2021] [Accepted: 06/05/2021] [Indexed: 11/18/2022]
Abstract
The authors investigated the association between vision impairment and physical activity among older adults from low- and middle-income countries. Visual acuity was measured using the tumbling ElogMAR chart, and vision impairment was defined as visual acuity worse than 6/18 (0.48 logMAR) in the better seeing eye. Physical activity was assessed by the Global Physical Activity Questionnaire. Multivariable logistic regression and meta-analysis were conducted to assess associations. The sample included 34,129 individuals aged 50-114 years (mean [SD] age 62.4 [16.0] years; 47.9% male). After adjustment for confounders, near vision impairment was not significantly associated with low physical activity, but far vision impairment showed a significant association (odds ratio = 1.32; 95% confidence interval [1.17, 1.49], I2 = 0.0%). Far vision impairment was dose-dependently associated with low physical activity (e.g., severe [<6/10] vs. no [≥6/12] far vision impairment; odds ratio = 1.80; 95% confidence interval [1.03, 3.15]). Interventions to address low levels of physical activity in the visually impaired in low- and middle-income countries should target those with far vision impairment.
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25
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Morgan IG, Wu PC, Ostrin LA, Tideman JWL, Yam JC, Lan W, Baraas RC, He X, Sankaridurg P, Saw SM, French AN, Rose KA, Guggenheim JA. IMI Risk Factors for Myopia. Invest Ophthalmol Vis Sci 2021; 62:3. [PMID: 33909035 PMCID: PMC8083079 DOI: 10.1167/iovs.62.5.3] [Citation(s) in RCA: 147] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Risk factor analysis provides an important basis for developing interventions for any condition. In the case of myopia, evidence for a large number of risk factors has been presented, but they have not been systematically tested for confounding. To be useful for designing preventive interventions, risk factor analysis ideally needs to be carried through to demonstration of a causal connection, with a defined mechanism. Statistical analysis is often complicated by covariation of variables, and demonstration of a causal relationship between a factor and myopia using Mendelian randomization or in a randomized clinical trial should be aimed for. When strict analysis of this kind is applied, associations between various measures of educational pressure and myopia are consistently observed. However, associations between more nearwork and more myopia are generally weak and inconsistent, but have been supported by meta-analysis. Associations between time outdoors and less myopia are stronger and more consistently observed, including by meta-analysis. Measurement of nearwork and time outdoors has traditionally been performed with questionnaires, but is increasingly being pursued with wearable objective devices. A causal link between increased years of education and more myopia has been confirmed by Mendelian randomization, whereas the protective effect of increased time outdoors from the development of myopia has been confirmed in randomized clinical trials. Other proposed risk factors need to be tested to see if they modulate these variables. The evidence linking increased screen time to myopia is weak and inconsistent, although limitations on screen time are increasingly under consideration as interventions to control the epidemic of myopia.
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Affiliation(s)
- Ian G Morgan
- Research School of Biology, Australian National University, Canberra, ACT, Australia.,State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Pei-Chang Wu
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Lisa A Ostrin
- College of Optometry, University of Houston, Houston, Texas, United States
| | - J Willem L Tideman
- Department of Ophthalmology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.,The Generation R Study Group, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Jason C Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Hong Kong Eye Hospital, Hong Kong, China.,Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong, China
| | - Weizhong Lan
- Aier School of Ophthalmology, Central South University, Changsha, China.,Aier School of Optometry, Hubei University of Science and Technology, Xianning, China.,Aier Institute of Optometry and Vision Science, Aier Eye Hospital Group, Changsha, China.,Guangzhou Aier Eye Hospital, Jinan University, Guangzhou, China
| | - Rigmor C Baraas
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Xiangui He
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China.,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Ocular Fundus Diseases, National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Padmaja Sankaridurg
- Brien Holden Vision Institute Limited, Sydney, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Seang-Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore (NUS), Singapore.,Singapore Eye Research Institute, Singapore.,Duke-NUS Medical School, Singapore
| | - Amanda N French
- Discipline of Orthoptics, Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | - Kathryn A Rose
- Discipline of Orthoptics, Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | - Jeremy A Guggenheim
- School of Optometry & Vision Sciences, Cardiff University, Cardiff, United Kingdom
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26
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The Association between Childhood Myopia Prevalence and Environmental Factors in China: A Metaregression Analysis. J Ophthalmol 2020. [DOI: 10.1155/2020/8736314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background. Myopia prevalence varies across the country among schoolchildren in China. Recently, environmental factors have been shown to be important in myopia development and progression. Given China’s geographical diversity with variable environmental factors, we investigated whether environmental factors could explain the regional variations in myopia in mainland China. Methods. We searched PubMed, Web of Science, and Chinese Science Periodical Databases for studies with reports of myopia prevalence in schoolchildren in mainland China from the years 1979 to 2019. Data on environmental factors (annual sunshine hours, temperature, and population density) were obtained from past records. A random-effect univariate metaregression analysis was used to investigate the association between the environmental factors and myopia prevalence and to determine the proportion of variation in regional myopia prevalence that can be attributed to each factor. Results. Forty-nine eligible studies were identified that included 666,864 schoolchildren aged 6 to 20 years. The pooled estimate of myopia prevalence was 32.88% (95% confidence interval: 26.69–39.08%). Univariate metaregression analysis indicated that annual sunshine hours (27.97% of variance), annual temperature (24.66%), and population density (7.06%) significantly contributed to regional myopia prevalence variation (each
), while seasonal variation in sunshine hours (1.54%,
) was not a significant predictor of myopia prevalence. However, only annual sunshine hours was significantly associated with myopia prevalence in the multivariate metaregression model. Conclusion. Myopia prevalence in children was higher in regions with low sunshine hours, and annual sunshine hours was significantly associated with regional variation in myopia prevalence in mainland China.
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27
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Li H, Li F, Zhou R, Gao K, Liang L, Zhang X. Aerobic Exercise Increases Tear Secretion and Decreases Inflammatory Cytokines in Healthy Subjects. Asia Pac J Ophthalmol (Phila) 2020; 9:404-411. [PMID: 32433250 DOI: 10.1097/apo.0000000000000281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
PURPOSE The aim of this study was to investigate the changes of tear secretion and inflammatory cytokines induced by aerobic exercise (AE) on healthy Chinese. DESIGN A prospective, cross-sectional study. METHODS A total of 73 eyes from 43 healthy participants were included in this study, which was composed of 2 parts. Thirty individuals were included to investigate the effect of AE on tear secretion. Tear samples from extra 13 healthy subjects were collected to explore the effect of AE on tear cytokines profiles. RESULTS In the first section, both areas of lower tear meniscus and volume of lower tear meniscus showed significant increase at 10 minutes after AE (P < 0.01). In the second section, a total of 15 tear cytokines including interferon-γ, tumor necrosis factor-α, interleukin (IL)-1β, IL-4, IL-5, IL-6, IL-10, IL-12P70, IL-13, IL-15, IL-17A, IL-21, and IL-27 were significantly lower at 20 minutes after AE than that of baseline (P < 0.01), whereas CCL/MIP-3α persisted to decrease at 60 minutes after exercise (P = 0.031). However, there was no significant difference of IL-2 concentration between baseline and any time point after exercise (P > 0.05). CONCLUSIONS AE could promote tear secretion and decrease inflammatory cytokines in healthy subjects.
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Affiliation(s)
- Hao Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
- Department of Ophthalmology, Guizhou Provincial People's Hospital, Guiyang, China
| | - Fei Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Rouxi Zhou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Kai Gao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Lingyi Liang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xiulan Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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28
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Foreman J, Crowston JG, Dirani M. Is physical activity protective against myopia? Br J Ophthalmol 2020; 104:1329-1330. [PMID: 32620685 DOI: 10.1136/bjophthalmol-2020-316173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 06/06/2020] [Indexed: 12/29/2022]
Affiliation(s)
- Joshua Foreman
- Ophthalmology, Department of Surgery, The University of Melbourne, Melbourne, Australia .,Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | - Jonathan G Crowston
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia.,Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - Mohamed Dirani
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia.,Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore
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29
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Hansen MH, Laigaard PP, Olsen EM, Skovgaard AM, Larsen M, Kessel L, Munch IC. Low physical activity and higher use of screen devices are associated with myopia at the age of 16-17 years in the CCC2000 Eye Study. Acta Ophthalmol 2020; 98:315-321. [PMID: 31502414 DOI: 10.1111/aos.14242] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 08/17/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE To determine the myopia prevalence in a Danish cohort aged 16-17 years and its relation to physical activity and use of screen-based electronic devices. METHODS The Copenhagen Child Cohort 2000 Eye Study is a prospective, population-based, observational study. Information about use of screen devices and physical activity was obtained using questionnaires. Myopia was defined as non-cycloplegic subjective spherical equivalent refraction ≤-0.50 D in right eye. RESULTS We included 1443 participants (45% boys) with a median age (±IQR) of 16.6 years (±0.3). The prevalence of myopia was 25% (CI95% 23-28, n = 360) with no differences between sexes (p = 0.10). The odds ratio (OR) for myopia was 0.57 (CI95% 0.42-0.76, p = 0.0002) in participants physically active 3-6 hr/week (n = 502) and 0.56 (CI95% 0.42-0.76, p = 0.0002) if active >6 hr/week (n = 506), both compared with participants physically active <3 hr/week (n = 396). The use of screen devices >6 hr/day was associated with increased OR for myopia compared with screen device use <2 hr/day in both weekdays (OR = 1.95, CI95% 1.16-3.30, p = 0.012) and weekends (OR = 2.10, CI95% 1.17-3.77, p = 0.013). CONCLUSION In this cohort of healthy 16-17-year olds, lower physical activity and more use of screen devices contributed significantly to the observed 25% prevalence of myopia with a roughly doubled risk of having myopia if physically active <3 hr/week or if using screen devices >6 hr/day. Our results support physical activity being a protective factor and near work a risk factor for myopia in adolescents.
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Affiliation(s)
- Mathias Hvidtfelt Hansen
- Department of Ophthalmology Rigshospitalet Glostrup Denmark
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
| | | | - Else Marie Olsen
- Institute of Public Health University of Copenhagen Copenhagen Denmark
- Centre for Clinical Research and Disease Prevention Capital Region Copenhagen Denmark
| | - Anne Mette Skovgaard
- Institute of Public Health University of Copenhagen Copenhagen Denmark
- National Institute of Public Health University of Southern Denmark Copenhagen Denmark
| | - Michael Larsen
- Department of Ophthalmology Rigshospitalet Glostrup Denmark
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
| | - Line Kessel
- Department of Ophthalmology Rigshospitalet Glostrup Denmark
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
| | - Inger Christine Munch
- Department of Clinical Medicine University of Copenhagen Copenhagen Denmark
- Department of Ophthalmology Zealand University Hospital Roskilde Denmark
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30
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Honda T, Nakagawa T, Watanabe Y, Hayashi T, Nakano T, Horie S, Tatemichi M. Association between Information and Communication Technology use and Ocular Axial Length Elongation among Middle-Aged Male Workers. Sci Rep 2019; 9:17489. [PMID: 31767931 PMCID: PMC6877562 DOI: 10.1038/s41598-019-53423-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 10/31/2019] [Indexed: 11/16/2022] Open
Abstract
The use of Information and Communication Technology devices (ICT) has spread globally; therefore, increasing exposure to these display devices is an important health issue in the workplace. The association between ocular axial length (AL) elongation and ICT use was investigated among 7334 middle-aged Japanese male workers. Detailed ICT use information was obtained using a self-administered questionnaire. The high AL group was defined as the group with AL above the 75th percentile for each 5-year age interval. Logistic analysis showed that the odds ratio (OR) for the high AL group of >8 hours/day, adjusted for potent confounding factors, was significantly elevated relative to <1 hour/day. Notably, there was a strong association in the older groups (OR = 6.60, 95% CI = 3.92–11.12), based on work-related uses: word processing, sending e-mails, preparation of presentation materials, and browsing websites. In addition, among workers with extended ICT use for these work-related purposes, a significant lateral difference was observed in AL. However, these associations were not observed for private use, such as playing games. The results of our prospective cross-sectional study show that increased time spent on work-related ICT uses was associated with AL elongation, particularly in older workers.
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Affiliation(s)
- Toru Honda
- Hitachi Health Care Center, Ibaraki, Japan.,Department of Health Policy and Management, University of Occupational and Environmental Health, Kitakyushu, Japan
| | | | | | | | - Tadashi Nakano
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan
| | - Seichi Horie
- Department of Health Policy and Management, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Masayuki Tatemichi
- Department of Preventive Medicine, Tokai University, School of Medicine, Kanagawa, Japan.
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31
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Abstract
Refractive errors are the product of a mismatch between the axial length of the eye and its optical power, creating blurred vision. Uncorrected refractive errors are the second leading cause of worldwide blindness. One refractive error currently attracting significant scientific interest is myopia, mostly owing to the recent rise in its prevalence worldwide and associated ocular disease burden. This increase in myopia prevalence has also been rapid, suggesting environmental influences in addition to any genetic influences on eye growth. This review defines refractive errors, describes their prevalence, and presents evidence for the influence of genetic and environmental factors related to refractive error development.
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Affiliation(s)
- Elise N. Harb
- School of Optometry, University of California, Berkeley, California 94720, USA;,
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32
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Ulaganathan S, Read SA, Collins MJ, Vincent SJ. Influence of seasons upon personal light exposure and longitudinal axial length changes in young adults. Acta Ophthalmol 2019; 97:e256-e265. [PMID: 30288926 DOI: 10.1111/aos.13904] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 07/29/2018] [Indexed: 12/11/2022]
Abstract
PURPOSE To investigate the association between objectively measured ambient light exposure and longitudinal axial length changes (and their seasonal variations) over a period of 12 months in young adults. METHODS This prospective longitudinal observational study included 43 healthy young adult university students (21 emmetropes and 22 myopes) aged between 18 and 30 years. Three axial length measurements were collected at 6-month intervals (i.e. at baseline, 6 and 12 months), in summer and winter to determine the axial eye growth. Personal ambient light exposure data were measured in winter and summer months with wearable sensors, from which the mean daily time exposed to bright (outdoor) light levels (>1000 lux) was derived. RESULTS Greater daily bright light exposure was associated with less axial eye growth (β = -0.002, p = 0.006) over 12 months. In summer, myopes exhibited significantly greater changes in axial length (mean change 0.04 ± 0.05 mm) compared to emmetropes (-0.01 ± 0.05 mm) (p = 0.001), but there was no significant difference between refractive groups in winter. Emmetropes also spent significantly greater time in outdoor light levels in summer compared to winter (p < 0.0001), while myopes spent similar time outdoors during both seasons (p = 0.12). Differences in light exposure between summer and winter were also associated with seasonal differences in axial eye growth (p = 0.026). CONCLUSION In young adults, greater time spent in bright light was associated with slower longitudinal axial eye growth. Seasonal light exposure and axial length changes were dependent on refractive error in this population and also exhibited an inverse relationship.
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Affiliation(s)
- Sekar Ulaganathan
- Contact Lens and Visual Optics Laboratory School of Optometry and Vision Science Queensland University of Technology Brisbane Queensland Australia
| | - Scott A. Read
- Contact Lens and Visual Optics Laboratory School of Optometry and Vision Science Queensland University of Technology Brisbane Queensland Australia
| | - Michael J. Collins
- Contact Lens and Visual Optics Laboratory School of Optometry and Vision Science Queensland University of Technology Brisbane Queensland Australia
| | - Stephen J. Vincent
- Contact Lens and Visual Optics Laboratory School of Optometry and Vision Science Queensland University of Technology Brisbane Queensland Australia
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Hwang HS, Park G, Heo JW, Kim MK, Baek S, Cho B. Estimating heritability of refractive error in Koreans: the Korea National Health and Nutrition Examination Survey. Acta Ophthalmol 2019; 97:e248-e255. [PMID: 30207075 DOI: 10.1111/aos.13915] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 08/09/2018] [Indexed: 01/11/2023]
Abstract
PURPOSE To estimate the familial correlation and heritability of refractive error in general Korean population. METHODS From the Korea National Health and Nutrition Examination Survey, 13 258 subjects of 7920 families, who were aged ≥19 years, were included in the study. Using variance components analysis, the additive genetic effect, or heritability, and the common and unique environmental effects on refractive error were examined, adopting common environments shared by cohabiting family or by siblings. RESULTS The proportions of hyperopia, myopia and high myopia in Koreans were 0.8%, 45.2% and 5.7% respectively. The correlation coefficients of spherical equivalent (SE) were 0.257 for parent-offspring pairs, 0.410 for sibling pairs and 0.112 for spouse pairs (p < 0.001 for all). Common environment shared by siblings affected the variation of SE significantly (p < 0.001), but that shared by cohabitants did not (p = 0.395). Adopting common environment shared by siblings, the heritability, common environmental effect and unique environmental effect of refractive error were 42.1 ± 3.3%, 11.8 ± 3.5% and 46.1 ± 3.9% respectively. Heritabilities of hyperopia, myopia and high myopia were 45.7%, 44.3% and 68.9% respectively. Adjusted odds ratios of myopia among offspring were 3.78 given one parent has myopia and 4.43 when both parents have myopia. CONCLUSION Refractive error is influenced by common environment shared by siblings. The heritability of refractive error is higher for high myopia than for myopia or hyperopia.
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Affiliation(s)
- Ho Sik Hwang
- Department of Ophthalmology Chuncheon Sacred Heart Hospital Hallym University College of Medicine Chuncheon Korea
| | - Gyeong‐Hun Park
- Department of Dermatology Dongtan Sacred Heart Hospital Hallym University College of Medicine Hwaseong Korea
| | - Jang Won Heo
- Department of Ophthalmology Seoul National University College of Medicine Seoul Korea
| | - Mee Kum Kim
- Department of Ophthalmology Seoul National University College of Medicine Seoul Korea
| | - Seung‐Hee Baek
- Department of Ophthalmology Kim's Eye Hospital Konyang University College of Medicine Seoul Korea
| | - Bum‐Joo Cho
- Department of Ophthalmology Chuncheon Sacred Heart Hospital Hallym University College of Medicine Chuncheon Korea
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Chen DZ, Koh V, Tan M, Tan CS, Nah G, Shen L, Bhargava M, Cheng CY, Zhao P, Wong TY, Saw SM. Peripheral retinal changes in highly myopic young Asian eyes. Acta Ophthalmol 2018; 96:e846-e851. [PMID: 29575821 DOI: 10.1111/aos.13752] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 02/08/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE To determine the type and prevalence of peripheral retinal changes and its relationship with axial length (AL) in a population of young Asian adult males. METHODS This was a cross-sectional study of male subjects aged between 19 and 25 years old. High myopes [spherical equivalent refraction, (SER) < -6.00 D] were recruited and underwent further ocular investigations including dilated retinal photography and binocular indirect ophthalmoscopy by two trained ophthalmologists. The frequency of peripheral retinal changes within high myopes was correlated with axial length and also compared with a group of emmetropes (SER between -0.50 D and +1.00 D). RESULTS A total of 593 high myopes and 156 emmetropes were recruited. White without pressure (WWOP; n = 458, 46.5%) and lattice degeneration (LD; n = 109, 14.6%) were the commonest findings, and their prevalence was significantly higher among high myopes (LD, 16.9% versus 5.8%; WWOP, 57.2% versus 5.8%; both p < 0.001). Among high myopes, temporal LD was more common (71%) and 35% had more than one area in the same eye. Increasing AL was associated with LD (odds ratio 1.28, p = 0.01) and retinal holes (odd's ratio 1.44, p = 0.02) on multivariate analysis. CONCLUSION White without pressure (WWOP) and LD were the commonest peripheral retinal changes. One-third of high myopes with LD had more than one area in the same eye. Increasing AL was associated with LD and retinal holes. Studies in older adults should be conducted to develop clinical guidelines for the management of high myopes.
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Affiliation(s)
- David Z. Chen
- Vision Performance Centre; Military Medicine Institute; Singapore Singapore
- Department of Ophthalmology; National University Health System; Singapore Singapore
| | - Victor Koh
- Vision Performance Centre; Military Medicine Institute; Singapore Singapore
- Department of Ophthalmology; National University Health System; Singapore Singapore
| | - Marcus Tan
- Vision Performance Centre; Military Medicine Institute; Singapore Singapore
| | - Colin S. Tan
- National Healthcare Group Eye Institute; Tan Tock Seng Hospital; Singapore Singapore
- Fundus Image Reading Center; National Healthcare Group Eye Institute; Singapore Singapore
| | - Gerard Nah
- Vision Performance Centre; Military Medicine Institute; Singapore Singapore
| | - Liang Shen
- Biostatistics Unit; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
| | - Mayuri Bhargava
- Vision Performance Centre; Military Medicine Institute; Singapore Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute; Singapore National Eye Centre; Singapore Singapore
| | - Paul Zhao
- Vision Performance Centre; Military Medicine Institute; Singapore Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute; Singapore National Eye Centre; Singapore Singapore
- Department of Ophthalmology; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
| | - Seang-Mei Saw
- Singapore Eye Research Institute; Singapore National Eye Centre; Singapore Singapore
- Department of Ophthalmology; Yong Loo Lin School of Medicine; National University of Singapore; Singapore Singapore
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Abstract
During development, the eye tunes its size to its optics so that distant objects are in focus, a state known as emmetropia. Although multiple factors contribute to this process, a strong influence appears to be exerted by the visual input signals entering the eye. Much research has been dedicated to the possible roles of specific features of the retinal image, such as the magnitude of blur. However, in humans and other species, the input to the retina is not an image, but a spatiotemporal flow of luminance. Small eye movements occur incessantly during natural fixation, continually transforming the spatial scene into temporal modulations on the retina. An emerging body of evidence suggests that this space-time reformatting is crucial to many aspects of visual processing, including sensitivity to fine spatial detail. The resulting temporal modulations depend not only on ocular dynamics, but also on the optics and shape of the eye, and the spatial statistics of the visual scene. Here we examine the characteristics of these signals and suggest that they may play a role in emmetropization. A direct consequence of this viewpoint is that abnormal oculomotor behavior may contribute to the development of myopia and hyperopia.
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Affiliation(s)
- Michele Rucci
- Department of Brain & Cognitive Sciences, University of Rochester, Rochester, NY, USA.,Center for Visual Science, University of Rochester, Rochester, NY, USA
| | - Jonathan D Victor
- Feil Family Brain and Mind Research Institute, Weill Cornell Medical College, New York, NY, USA.,Department of Neurology, Weill Cornell Medical College, New York, NY, USA
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Lundberg K, Vestergaard AH, Jacobsen N, Suhr Thykjaer A, Søgaard Hansen R, Goldschmidt E, Peto T, Halekoh U, Wedderkopp N, Grauslund J. Choroidal thickness and myopia in relation to physical activity - the CHAMPS Eye Study. Acta Ophthalmol 2018; 96:371-378. [PMID: 29338123 DOI: 10.1111/aos.13640] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 10/17/2017] [Indexed: 12/30/2022]
Abstract
PURPOSE To describe the relationship between choroidal thickness (CT) and myopia in relation to physical activity (PA) in a population-based child cohort. METHODS In a prospective study of 307 children from the CHAMPS Study Denmark, we used objective data from GT3X accelerometer worn at four periods between 2009 and 2015 to determine the amount and intensity of PA. Intensity was estimated as counts/minutes, and cut-off points were defined at four intensity levels. Eye examinations were performed in 2015 and included autorefraction in cycloplegia, axial length (AL) by biometric and fovea-centred enhanced depth imaging optical coherence tomography. By a semi-automated method, we measured the CT at 17 targets per eye representing anatomically different locations (subfoveal, 1 and 3 millimetre in each direction of fovea). RESULTS Mean age at the eye examination was 15.4 ± 0.7 years. The mean AL was 23.5 ± 0.9 mm, and the mean subfoveal CT was 369 ± 87 μm. Choroidal thickness (CT) was 331 ± 68 μm for the overall macula, 355 ± 78 μm for the 1-mm zone and 304 ± 60 μm for the 3-mm zone. All CT measurements were thinner in myopic eyes (p < 0.0001) and in boys (p < 0.05). We found no association between total PA and the CT by either mixed model analysis (p = 0.074) or linear regression by any intensity levels (p = 0.22, p = 0.15 and p = 0.43). CONCLUSION Among adolescents aged 14-17 years, there was no association between objective PA exposures and the CT, AL or refractive error.
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Affiliation(s)
- Kristian Lundberg
- Department of Ophthalmology; Odense University Hospital; Odense Denmark
- Department of Clinical Research; Faculty of Health Sciences; University of Southern Denmark; Odense Denmark
| | - Anders Højslet Vestergaard
- Department of Ophthalmology; Odense University Hospital; Odense Denmark
- Department of Clinical Research; Faculty of Health Sciences; University of Southern Denmark; Odense Denmark
| | - Nina Jacobsen
- Department of Ophthalmology; Rigshospitalet-Glostrup University Hospital; Copenhagen Denmark
| | - Anne Suhr Thykjaer
- Department of Ophthalmology; Odense University Hospital; Odense Denmark
- Department of Clinical Research; Faculty of Health Sciences; University of Southern Denmark; Odense Denmark
| | - Rasmus Søgaard Hansen
- Department of Ophthalmology; Odense University Hospital; Odense Denmark
- Department of Clinical Research; Faculty of Health Sciences; University of Southern Denmark; Odense Denmark
| | | | - Tunde Peto
- Department of Clinical Research; Faculty of Health Sciences; University of Southern Denmark; Odense Denmark
- Centre for Public Health; Queen's University Belfast; Belfast UK
| | - Ulrich Halekoh
- Epidemiology, Biostatistics and Biodemography; University of Southern Denmark; Odense Denmark
| | - Niels Wedderkopp
- Centre of Research in Childhood Health; Research Unit for Exercise Epidemiology; Department of Sports Science and Clinical Biomechanics; University of Southern Denmark; Odense Denmark
- Sport medicine Clinic; The Orthopedic Department; Hospital of Middelfart; Institute of Regional Health Services Research; University of Southern Denmark; Middelfart Denmark
| | - Jakob Grauslund
- Department of Ophthalmology; Odense University Hospital; Odense Denmark
- Department of Clinical Research; Faculty of Health Sciences; University of Southern Denmark; Odense Denmark
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Modjtahedi BS, Ferris FL, Hunter DG, Fong DS. Public Health Burden and Potential Interventions for Myopia. Ophthalmology 2018; 125:628-630. [DOI: 10.1016/j.ophtha.2018.01.033] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 01/21/2018] [Accepted: 01/24/2018] [Indexed: 11/28/2022] Open
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