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Abounoori M, Aghajani A, Chaibakhsh S, Babakhanian M, Pourazizi M, Peyman A. Paediatric myopia shift during the COVID-19 pandemic home quarantine: a systematic review and meta-analysis. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2022-001755. [PMID: 36645798 PMCID: PMC9805827 DOI: 10.1136/bmjpo-2022-001755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 12/14/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Outdoor activities were restricted during the COVID-19 outbreak, although digital learning grew. Concerns have been raised about the impact of these environmental changes on myopia status. This research aimed to examine myopia shift during the COVID-19 pandemic and offer the community evidence-based data. METHODS The literature search was undertaken in PubMed, SCOPUS, Science Direct, Web of Science and Google Scholar databases on published papers before 17 May 2022. The main outcome was mean spherical equivalent refraction (SER) before, at the onset and at the end of follow-up during the COVID-19 pandemic. RESULTS Among 518 articles, 10 studies were included in the meta-analysis. The mean SER differences during the COVID-19 pandemic follow-up (mean follow-up time was 10 months) compared with before the pandemic was 0.15 dioptre (D) (95% CI -0.39 to 0.69, p=0.58). After age adjustment using meta-regression, the mean SER differences during the COVID-19 follow-up compared with before the pandemic was - 0.46 D (95% CI -0.59 to -0.34, p<0.001). Over the mean follow-up time during the COVID-19 pandemic, the SER mean difference was -0.55 D (95% CI -0.78 to -0.32, p<0.001), showing that the mean SER had decreased significantly during the COVID-19 pandemic. The mean SER differences in myopic patients before COVID-19 compared with during the pandemic follow-up was -0.49 D (95% CI -0.53 to -0.45, p=0.00). So the prior pandemic myopic patients became more myopic during the pandemic follow-up time. CONCLUSION During home quarantine, the mean SRE shifting in paediatrics accelerated. This phenomenon should be given more attention by policymakers, eyecare experts, educators and parents.
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Affiliation(s)
- Mahdi Abounoori
- Isfahan Eye Research Center, Isfahan University of Medical Sciences, Isfahan, Iran (the Islamic Republic of)
| | - Ali Aghajani
- Department of Ophthalmology, Eye Research Center, Rassoul Akram Hospital, Eye Department, The Five Senses Health Institute, School of Medicine, Iran University of Medical Sciences, Isfahan, Iran (the Islamic Republic of)
| | - Samira Chaibakhsh
- Department of Ophthalmology, Eye Research Center, Rassoul Akram Hospital, Eye Department, The Five Senses Health Institute, School of Medicine, Iran University of Medical Sciences, Isfahan, Iran (the Islamic Republic of)
| | - Masoudeh Babakhanian
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran (the Islamic Republic of)
| | - Mohsen Pourazizi
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran (the Islamic Republic of)
| | - Alireza Peyman
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran (the Islamic Republic of)
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Dong Y, Jan C, Chen L, Ma T, Liu J, Zhang Y, Ma Q, Zhong P, Song Y, Ma J, Patton GC, Sawyer SM. The Cumulative Effect of Multilevel Factors on Myopia Prevalence, Incidence, and Progression Among Children and Adolescents in China During the COVID-19 Pandemic. Transl Vis Sci Technol 2022; 11:9. [PMID: 36515964 DOI: 10.1167/tvst.11.12.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Purpose To estimate the effects of school closures and associated lifestyle changes on myopia in Chinese children and adolescents during the coronavirus disease 2019 (COVID-19) pandemic. Methods Two cross-sectional surveys recruited 14,296 Chinese students aged 7 to 18 years in November 2019 and June 2020 from which an open cohort study (nested queue design) was derived and used to assess myopia prevalence, incidence, and progression rates (defined as students with progression in myopia severity at the second survey wave among those with myopia at baseline). The severity of myopia was determined by measurements of visual acuity (<5.0) and noncycloplegic refraction (spherical equivalent <-0.50 diopters). Twenty-three myopia-influencing factors were divided into three categories: eye-use habits, lifestyle, and family and subjective factors. Responses to each of these 23 factors were labeled as either positive or negative options and then combined to generate a comprehensive score. Results Boys and girls were equally represented (50%) and had the same average age (11.5 years) at each wave. The myopia prevalence increased from 48.2% to 60.0%, with 27.1% myopia incidence and 13.2% myopia progression rates for Chinese children and adolescents. Each of the 23 factors was associated with myopia prevalence but had no significant effect on myopia incidence or progression. However, these 23 factors had a cumulative effect on myopia risks; higher scores were associated with more positive factors and lower risk ratios of myopia and vice versa. Except for the progression rate, the myopia prevalence and incidence and risk ratios decreased with higher comprehensive scores. Conclusions School closures during the COVID-19 pandemic increased the risk of myopia in Chinese children and adolescents due to the accumulation of poor eyesight habits, unhealthy lifestyles, and excessive screen time. Translational Relevance Rather than focusing on single risk factors for myopia, future myopia prevention strategies should focus on integrating multiple comprehensive approaches across schools, families, and communities.
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Affiliation(s)
- Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Catherine Jan
- Centre for Eye Research Australia, Department of Ophthalmology, Royal Victorian Eye and Ear Hospital, East Melbourne, Melbourne, Australia.,School of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia.,Lost Child's Vision Project, Sydney, New South Wales, Australia
| | - Li Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Tao Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Jieyu Liu
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Yi Zhang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Qi Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Panliang Zhong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Yi Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - George C Patton
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Susan M Sawyer
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria, Australia
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Cai T, Zhao L, Kong L, Du X. Complex Interplay Between COVID-19 Lockdown and Myopic Progression. Front Med (Lausanne) 2022; 9:853293. [PMID: 35386915 PMCID: PMC8978626 DOI: 10.3389/fmed.2022.853293] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 02/14/2022] [Indexed: 01/23/2023] Open
Abstract
Purpose To compare the myopic progression before and during strict home confinement when coronavirus disease 2019 (COVID-19) outbreak and explore the potential influencing factors. Methods A cross-sectional study. One hundred and fifteen myopic children (115 right eyes) who replace their frame-glasses from December 2019 to January 2020 and with complete refractive records in our hospital since myopia were involved in the study. At the beginning of the strict home confinement and after a 3-month strict home confinement during the COVID-19 pandemic, they were invited to our hospital to examine the axial length and refractive errors. And visual functions, convergence insufficiency symptom survey (CISS) scale and questionnaires were also performed. Besides, the axial length and refractive errors before the COVID-19 were got from outpatient case files. The effect of strict home confinement on myopia was assessed by comparing monthly axial elongation before COVID-19 and during strict home confinement. Spearman correlation analysis was performed to explore the correlation between potential influencing factors and myopia progression. Results Axial length's monthly elongation during strict home confinement was 35% higher than normal periods (0.046 vs. 0.033 mm/month, P = 0.003). The proportion of severe asthenopia doubled (P = 0.020). For myopia progression, heredity, close indoor work time and electronic products were risk factors. Besides, the protective factors were age, rest time after continuous eye usage, sleep time and distance from eye to computer screen. Conclusions During COVID-19, the decline in outdoor activities and increase of exposure time to digital screens accelerated the progression of myopia by 1/3.
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Affiliation(s)
- Tao Cai
- Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China.,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China.,Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
| | - Lianghui Zhao
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China.,Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
| | - Ling Kong
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China.,Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
| | - Xianli Du
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China.,Qingdao Eye Hospital of Shandong First Medical University, Qingdao, China
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