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Du Y, Meng J, He W, Qi J, Lu Y, Zhu X. Complications of high myopia: An update from clinical manifestations to underlying mechanisms. ADVANCES IN OPHTHALMOLOGY PRACTICE AND RESEARCH 2024; 4:156-163. [PMID: 39036706 PMCID: PMC11260019 DOI: 10.1016/j.aopr.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 06/15/2024] [Accepted: 06/20/2024] [Indexed: 07/23/2024]
Abstract
Background High myopia is one of the major causes of visual impairment and has an ever-increasing prevalence, especially in East Asia. It is characterized by excessive axial elongation, leading to various blinding complications that extend beyond mere refractive errors and persist immovably after refractive surgery, presenting substantial public health challenge. Main text High myopia-related complications include lens pathologies, atrophic and tractional maculopathy, choroidal neovascularization, peripheral retinal degenerations and retinal detachment, and glaucoma and heightened susceptibility to intraocular pressure (IOP) elevation. Pathological lens changes characteristic of high myopia include early cataractogenesis, overgrowth of lens, weakened zonules, and postoperative capsular contraction syndrome, possibly driven by inflammatory pathogenesis, etc. Dome-shaped macula and cilioretinal arteries are two newly identified protective factors for central vision of highly myopic patients. These patients also face risks of open-angle glaucoma and IOP spike following intraocular surgery. Morphologic alternations of optic nerve in high myopia can complicate early glaucoma detection, necessitating comprehensive examinations and close follow-up. Anatomically, thinner trabecular meshwork increases this risk; conversely lamina cribrosa defects may offer a fluid outlet, potentially mitigating the pressure. Notably, anxiety has emerged as the first recognized extra-ocular complication in high myopia, with an underlying inflammatory pathogenesis that connects visual stimulus, blood and brain. Conclusions High myopia induces multiple ocular and potential mental health complications, underscoring the need to develop more effective strategies to improve both physical and emotional well-being of these patients, among which anti-inflammation might possibly represent a promising new target.
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Affiliation(s)
- Yu Du
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia and Related Eye Diseases, Key Laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Jiaqi Meng
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia and Related Eye Diseases, Key Laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Wenwen He
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia and Related Eye Diseases, Key Laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Jiao Qi
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia and Related Eye Diseases, Key Laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Yi Lu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia and Related Eye Diseases, Key Laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Xiangjia Zhu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia and Related Eye Diseases, Key Laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
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Abebe MG, Alemayehu AM, Munaw MB, Tilahun MM, Alemayehu HB. Prevalence and associated factors of refractive error among adults in South Ethiopia, a community-based cross-sectional study. PLoS One 2024; 19:e0298960. [PMID: 38527026 PMCID: PMC10962790 DOI: 10.1371/journal.pone.0298960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 02/01/2024] [Indexed: 03/27/2024] Open
Abstract
INTRODUCTION The increasing prevalence of refractive error has become a serious health issue that needs serious attention. However, there are few studies regarding the prevalence and associated factors of refractive error at the community level in Ethiopia as well as in the study area. Therefore, providing updated data is crucial to reduce the burdens of refractive error in the community. OBJECTIVE To assess the prevalence and associated factors of refractive error among adults in Hawassa City, South Ethiopia, 2023. METHOD A community-based cross-sectional study was conducted on 951 adults using a multistage sampling technique from May 8 to June 8, 2023, in Hawassa City, South Ethiopia. A pretested, structured questionnaire combined with an ocular examination and a refraction procedure was used to collect data. The collected data from the Kobo Toolbox was exported to a statistical package for social sciences for analysis. Binary and multivariable logistic regression analyses were performed. A P-value of less than 0.05 was considered statistically significant in the multivariable analysis. RESULT A total of 894 study participants were involved in this study with a 94.1% response rate. The prevalence of refractive error was 12.3% (95% CI: 10.2, 14.5%). Regular use of electronic devices (adjusted odds ratio = 3.64, 95% CI: 2.25, 5.91), being diabetic (adjusted odds ratio = 4.02, 95% CI: 2.16, 7.48), positive family history of refractive error (adjusted odds ratio = 2.71, 95% CI 1.59, 4.61) and positive history of cataract surgery (adjusted odds ratio = 5.17, 95% CI 2.19, 12.4) were significantly associated with refractive error. CONCLUSION AND RECOMMENDATION The overall magnitude of refractive error in our study area was high. Regular use of electronic devices, being diabetic, positive family history of refractive error, and a positive history of cataract surgery were associated with refractive error.
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Affiliation(s)
- Marshet Gete Abebe
- Department of Ophthalmology and Optometry, Hawassa University, Comprehensive Specialized Hospital, Hawassa, Ethiopia
| | - Abiy Maru Alemayehu
- Department of Optometry, School of Medicine, University of Gondar, Comprehensive Specialized Hospital, Gondar, Ethiopia
| | - Minychil Bantihun Munaw
- Department of Optometry, School of Medicine, University of Gondar, Comprehensive Specialized Hospital, Gondar, Ethiopia
| | - Mikias Mered Tilahun
- Department of Optometry, School of Medicine, University of Gondar, Comprehensive Specialized Hospital, Gondar, Ethiopia
| | - Henok Biruk Alemayehu
- Department of Ophthalmology and Optometry, Hawassa University, Comprehensive Specialized Hospital, Hawassa, Ethiopia
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Cao K, Hao J, Wang NL. Incidence and its risk factors of high myopia in Chinese rural adults: A population-based six-year cohort study. Eur J Ophthalmol 2023; 33:2139-2145. [PMID: 37038333 DOI: 10.1177/11206721231168317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
BACKGROUND To investigate the incidence rate of high myopia and its risk factors in adults. METHODS This was a population-based cohort study, 4582 adults aged ≥ 30 years from rural area of China were included. The follow-up duration was six years. Objective refraction (sphere, cylinder, and axis) was measured using an autorefractor. Multivariable Logistic regression was used to explore risk factors of high myopia, odds ratio (OR) with 95% confidence interval (CI) were reported. RESULTS During the six-year follow-up, 25 participants developed high myopia. The incidence rate was 0.55% (95%CI: 0.44% to 0.66%), and were 0.54% (11/2035) in males and 0.55% (14/2547) in females. The age-gender standardized annual incidence rate was 0.11%. The median changes in spherical equivalent (SE) of all participants was 0.25D (IQR: -0.125 to 0.625). For the baseline myopic adults and non-myopic adults, the median changes in SE were 0.125D (IQR: -0.375 to 0.5), and 0.25D (IQR: -0.125 to 0.625). The difference was significant (p < 0.001). Of the two subgroups, 1.52% (21/1383) and 0.13% (4/3199) developed high myopia during six years. The risk of developing high myopia in baseline myopic adults was 11.7 times higher than that of the baseline non-myopic adults (p < 0.001). Age (OR = 1.061, 95%CI: 1.022 to 1.103, p = 0.002), and baseline myopia (OR = 1.007, 95%CI: 1.001 to 1.012, p < 0.001) were risk factors for high myopia. CONCLUSION The age-gender standardized annual incidence rate of high myopia in Chinese rural adults is 0.11%. More than 30% of adults still have myopia progression. Myopia control is of great significance for high myopia prevention.
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Affiliation(s)
- Kai Cao
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jie Hao
- Beijing Tongren Eye center, Beijing Tongren Hospital, Capital Medical University Correspondence to Ning-Li Wang, No.17. Hougou alley, Dongcheng District, Beijing, China
| | - Ning-Li Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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Rabiu MM, Taryam MO, AlBanna S, Albastaki B, Khan H, Alnakhi WK, Hussain HY, Rao P, Sinjab MM, Sharbek LT, Singh G, Pai S, Shang X, He M. Prevalence and Risk Factors of Refractive Errors and Effective Spectacle Coverage in Emiratis and Non-Emiratis Aged 40 Years or Older: the Dubai Eye Health Survey. Asia Pac J Ophthalmol (Phila) 2023; 12:29-37. [PMID: 36706332 DOI: 10.1097/apo.0000000000000568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/29/2022] [Indexed: 01/28/2023] Open
Abstract
PURPOSE The aim was to investigate the prevalence and risk factors of refractive errors (REs) and the effective spectacle coverage in Emiratis and non-Emiratis in Dubai. DESIGN The Dubai Eye Health Survey was a population-based cross-sectional study of participants aged 40 years or older. METHODS Distance and near visual acuity (VA), and noncycloplegic automated refraction were tested according to a standardized protocol. Distance VA was tested using the Early Treatment Diabetic Retinopathy Study (ETDRS) logMAR chart at 3 m and near VA was measured using the near vision logMAR chart at 40 cm under ambient lighting. Myopia was defined as spherical equivalent of refraction of less than -0.50 diopters (D), and hypermetropia as spherical equivalent of more than +0.50 D. Astigmatism was defined as cylinder power of 0.5 D or greater. Effective spectacle coverage for distance vision was computed as met need/(met need+unmet need+under-met need)×100%. Multivariable logistic regression models were used to examine associations between sociodemographic factors and RE. RESULTS The authors included 892 participants (446 Emiratis and 446 non-Emiratis) in the analysis. The prevalence of hypermetropia was 20.4% [95% confidence interval (CI): 16.8%-24.4%] in Emiratis and 20.6% (95% CI: 20.0%-24.7%) in non-Emiratis. The prevalence of myopia and high myopia was 27.4% (95% CI: 23.3%-31.7%) and 1.8% (95% CI: 0.8%-3.5%) in Emiratis, and 19.5% (95% CI: 15.9%-23.5%) and 0.9% (95% CI: 0.2%-2.3%) in non-Emiratis, respectively. High education (P=0.02) and not currently working (P=0.002) were risk factors of myopia in non-Emiratis only. The prevalence of astigmatism was 7.4% (95% CI: 5.1%-10.2%) in Emiratis and 1.6% (95% CI: 0.6%-3.2%) in non-Emiratis. This prevalence was higher in individuals aged over 60 years (P<0.001) and men (P=0.014) among Emiratis. The prevalence of anisometropia and uncorrected presbyopia was 11.4% (95% CI: 8.6%-14.8%) and 0.7% (95% CI: 0.1%-2.0%) in Emiratis, and 9.2% (95% CI: 6.7%-12.3%) and 0.4% (95% CI: 0.05%-1.6%) in non-Emiratis, respectively. The effective spectacle coverage was 62.3% (95% CI: 54.0%-70.6%) and 69% (95% CI: 60.5%-77.5%) in Emiratis and non-Emiratis, respectively. CONCLUSIONS A high proportion of Emiratis and non-Emiratis was affected by RE without optimal effective spectacle coverage, highlighting the imperativeness of intervention to alleviate the burden. The findings may help facilitate evidence-based policymaking concerning the delivery of eye care services and allocation of medical resources in Dubai.
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Affiliation(s)
| | - Manal O Taryam
- Noor Dubai Foundation, Dubai Health Authority, Dubai, United Arab Emirates
| | - Shurooq AlBanna
- Noor Dubai Foundation, Dubai Health Authority, Dubai, United Arab Emirates
| | | | - Hayat Khan
- Dubai Health Authority, Dubai, United Arab Emirates
| | - Wafa K Alnakhi
- Dubai Health Authority, Dubai, United Arab Emirates
- Mohammed Bin Rashid University of Medicine and Health Sciences, United Arab Emirates
| | | | - Prasan Rao
- Medcare Hospital and clinics, Dubai, United Arab Emirates
| | - Mazen M Sinjab
- Medcare Hospital and clinics, Dubai, United Arab Emirates
| | - Lama T Sharbek
- Medcare Hospital and clinics, Dubai, United Arab Emirates
| | | | | | - Xianwen Shang
- Centre for Eye Research Australia Ltd, University of Melbourne, Australia
| | - Mingguang He
- Centre for Eye Research Australia Ltd, University of Melbourne, Australia
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Hashemi H, Asharlous A, Yekta A, Aghamirsalim M, Nabovati P, Sadoughi MM, Khabazkhoob M. Astigmatism profile in the elderly population: Tehran Geriatric Eye Study. Jpn J Ophthalmol 2022; 66:461-473. [PMID: 35947225 DOI: 10.1007/s10384-022-00936-x] [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: 02/11/2022] [Accepted: 06/23/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE To determine the prevalence of astigmatism and its associated factors and examine astigmatism symmetry patterns in an elderly population. STUDY DESIGN Population based cross-sectional study. METHODS The present population-based cross-sectional study was conducted on an elderly population above 60 years of age in Tehran, Iran in 2019. The sampling was done using the stratified multistage random cluster sampling method. All study participants underwent a complete optometric examination and slit-lamp biomicroscopy. RESULTS The prevalence of astigmatism higher than -0.50, -1.00, and -2.00 D was 83% (95% CI: 81 -84), 52 % (95% CI: 50 -54), and 19% (95% CI: 17-20), respectively. These prevalence was 79%(95% CI: 77-81), 46(95% CI: 44-49) and 14(95% CI: 13-16) in subjects without a history of ocular surgery, respectively. Based on cylinder power worse than -1.00 D, 10% (95% CI: 9-12), 20% (95% CI: 18-22), and 21% (95% CI:19-23) of study participants had with the rule, against the rule, and oblique astigmatism, respectively. According to the results of the multiple regression model, male gender, older age, low education level, pure posterior subcapsular cataract, pseudophakia, and myopia were independent factors associated with astigmatism. The prevalence of anisorule astigmatism was 57 % (95% CI: 56-59), the most common anisorule astigmatism was against the rule-oblique type with a prevalence of 36% (95% CI: 34-38). CONCLUSION The prevalence of astigmatism was high in the elderly population of Tehran. More than half of the participants in this study had anisorule astigmatism, and against the rule-oblique combination was more prevalent than other types. A posterior subcapsular cataract, a history of cataract surgery, and myopia were the associated factors of astigmatism in this study.
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Affiliation(s)
- Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Amir Asharlous
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Abbasali Yekta
- Department of Optometry, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Payam Nabovati
- Rehabilitation Research Center, Department of Optometry, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mehdi Sadoughi
- Department of Ophthalmology, School of Medicine, Shahid Labbafinezhad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Zhang KY, Lyu HB, Yang JR, Qiu WQ. Efficacy of long-term orthokeratology treatment in children with anisometropic myopia. Int J Ophthalmol 2022; 15:113-118. [PMID: 35047365 DOI: 10.18240/ijo.2022.01.17] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 06/10/2021] [Indexed: 11/23/2022] Open
Abstract
AIM To explore the efficacy of the orthokeratology lens for anisometropic myopia progression. METHODS A retrospective study was performed. Cycloplegic refraction and axial length (AL) were collected from 50 children (10.52±1.72y) who visited Peking University Third Hospital from July 2015 to August 2020. These children's one eyes (Group A) received monocular orthokeratology lenses at first, after different durations (12.20±6.94mo), their contralateral eyes (Group B) developed myopia and receive orthokeratology as well. The data in 1-year of binocular period were recorded. AL growth rate (difference of follow-up and baseline per month) were compared between two groups by paired t test. Interocular differences of AL were compared by Wilcoxon test. RESULTS During monocular period, the AL growth rate of the Group A (0.008±0.022 mm/mo) was significantly slower than that of the Group B (0.038±0.018 mm/mo; P<0.0001). However, during binocular period, the AL growth rate of the Group A (0.026±0.014 mm/mo) was significantly faster than that of the Group B (0.016±0.015 mm/mo; P<0.0001). The AL difference between both eyes was 0.6 (0.46) mm, then significantly decreased to 0.22 (0.39) mm when started binocular treatment (P<0.0001). However, it was significantly increased to 0.30 (0.32) mm after a year (P<0.0001), but still significantly lower than baseline (P<0.0001). CONCLUSION The orthokeratology lens is efficient for control the AL elongation of monocular myopia eyes and reduce anisometropia. For the condition that the contralateral eyes develop myopia and receive orthokeratology lens later, there is no efficiency observed on control interocular difference of AL during binocular treatment.
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Affiliation(s)
- Kai-Yun Zhang
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China.,College of Optometry, Peking University Health Science Center, Beijing 100191, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing 100191, China
| | - Hui-Bin Lyu
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing 100191, China
| | - Jia-Rui Yang
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing 100191, China
| | - Wei-Qiang Qiu
- Department of Ophthalmology, Peking University Third Hospital, Beijing 100191, China.,Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Third Hospital, Beijing 100191, China
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