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Zhang J, Wang L, Guo L, Guo Y, Zhao F, Hu Y, Li Q, Du X, Deng X, Deng N, Yang X, Lu C. Effects of online family health education on myopia prevention in children by parental myopia: a randomized clinical trial. Clin Exp Optom 2024; 107:299-306. [PMID: 37263755 DOI: 10.1080/08164622.2023.2216840] [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: 11/13/2022] [Revised: 05/13/2023] [Accepted: 05/17/2023] [Indexed: 06/03/2023] Open
Abstract
CLINICAL RELEVANCE Online family health education may be effective for myopia prevention in children, and the effects may be different between children with myopic and non-myopic parents. BACKGROUND Myopia is a common cause of vision loss. The aims of this study were to evaluate the effects of online family health education on preventing the development of myopia in children, and to estimate whether the effects vary according to parental myopia. METHODS A cluster randomised trial including grade 1 and grade 2 children from 12 primary schools was conducted in Guangzhou, China. Weekly online family health education messages were sent to parents in the intervention group. Data collection included eye examinations of children and questionnaires completed by parents. RESULTS Among the 3123 children included at baseline (1703 boys [54.5%]; mean [SD] age, 6.83 [0.73] years), 2376 completed the follow-up after 3 years. The differences in the incidence of myopia and myopic shift between the study groups were not significant in total. However, the 3-year cumulative incidence rate of myopia in the intervention group (125 of 445 [28.1%]) was significantly lower than that in the control group (225 of 603 [37.3%]; difference, 9.2% [95% CI, -14.9% to -3.5%]; P = 0.001) among children with non-myopic parents. In parallel, among children with non-myopic parents, the mean myopic change in SER was less for the intervention group than for the control group (-1.10 D vs. -1.24 D; difference, 0.13 D [95% CI, 0.03 to 0.23 D]; P = 0.01). CONCLUSIONS Compared with children with myopic parents, online family health education was more effective in children with non-myopic parents. The incidence of myopia and myopic shift in refraction have been reduced in children with non-myopic parents. Further studies are needed to assess these differences by parental myopia.
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Affiliation(s)
- Jiayu Zhang
- Department of Medical Statistics and Epidemiology, Sun Yat-sen University, Guangzhou, China
| | - Lili Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, Sun Yat-sen University, Guangzhou, China
| | - Yangfeng Guo
- Department of Student Health Work, Health Promotion Center for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou, China
| | - Feng Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yin Hu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Qian Li
- Department of Medical Statistics and Epidemiology, Sun Yat-sen University, Guangzhou, China
| | - Xueying Du
- Department of Student Health Work, Health Promotion Center for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou, China
| | - Xueqing Deng
- Department of Medical Statistics and Epidemiology, Sun Yat-sen University, Guangzhou, China
| | - Nali Deng
- Department of Student Health Work, Health Promotion Center for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou, China
| | - Xiao Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, Sun Yat-sen University, Guangzhou, China
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Lin J, Vasudevan B, Gao TY, Zhou HJ, Ciuffreda KJ, Liang YB, Lin Z. Intraocular Pressure and Myopia Progression, Axial Length Elongation in Rural Chinese Children. Optom Vis Sci 2023; 100:708-714. [PMID: 37639709 DOI: 10.1097/opx.0000000000002065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Abstract
SIGNIFICANCE This study reported the relationship between intraocular pressure (IOP) and myopia progression, which helps to understand more comprehensively whether IOP can be an important reference factor to intervene in the progression of myopia. PURPOSE This study aimed to investigate the association between IOP and myopia progression as well as axial length elongation in rural Chinese children. METHODS A total of 598 (598 of 878 [68.1%]) children (6 to 17 years) from the baseline Handan Offspring Myopia Study who completed a 3.5-year follow-up vision examination were included. Ocular examinations at both visits included cycloplegic autorefraction, IOP, and axial length measurements. RESULTS Children with myopia had the highest baseline IOP of the three refractive groups (14.13 ± 1.31, 13.78 ± 1.71, and 13.59 ± 1.64 mmHg in myopes, emmetropes, and hyperopes, respectively, P = .002). However, IOPs showed no significant difference between eyes with or without newly developed myopia (13.63 ± 1.68 vs. 13.89 ± 1.68, P = .16), with or without faster myopia progression (13.75 ± 1.61 vs. 13.86 ± 1.63, P = .46), or with axial length elongation (13.80 ± 1.61 vs. 13.76 ± 1.64, P = .80). The multivariate regression analysis demonstrated that neither baseline refractive error ( β = -0.082, P = .13) nor baseline axial length ( β = -0.156, P = .08) was associated with baseline IOP. CONCLUSIONS Myopic eyes have slightly higher IOP compared with emmetropic and hyperopic eyes, although it was not clinically significant. However, IOP was not found to be associated with either myopia progression or axial length elongation in this cohort sample of rural Chinese children.
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Affiliation(s)
- Jue Lin
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou, Zhejiang, China
| | | | | | - Hong Jia Zhou
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou, Zhejiang, China
| | - Kenneth J Ciuffreda
- Department of Biological and Vision Sciences, SUNY College of Optometry, New York, New York
| | - Yuan Bo Liang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou, Zhejiang, China
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Luo F, Hao J, Li L, Liu J, Chen W, Fu J, Congdon N. Baseline Refractive Error, Habitual Accommodative Tone, and Its Association With Myopia in Children: The Lhasa Childhood Eye Study. Invest Ophthalmol Vis Sci 2023; 64:4. [PMID: 37535008 PMCID: PMC10408770 DOI: 10.1167/iovs.64.11.4] [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: 09/05/2022] [Accepted: 07/13/2023] [Indexed: 08/04/2023] Open
Abstract
PURPOSE The purpose of this study was to describe the baseline refractive error, habitual accommodative tone (HAT) in Tibetan children and its longitudinal association with incident myopia and myopia progression. METHODS This was a prospective cohort study. From 7 elementary schools, 1440 children with mean age of 6.83 ± 0.46 years were included with full noncycloplegic and cycloplegic refraction data at baseline, 1-year and 2-year follow-up in the Lhasa Childhood Eye Study. Noncycloplegic and cycloplegic automated refraction were performed at baseline and annually over the next 2 years. HAT was measured as the difference in spherical equivalent (DSE) between noncycloplegic and cycloplegic refraction. RESULTS The mean HAT decreased from a baseline value of 0.92 ± 0.82 diopters (D) to 0.55 ± 0.65 D, P < 0.0001 at 2 years. In multivariable logistic regression models, only baseline spherical equivalent (SE; P < 0.0001) was significantly (negatively) associated with 1- and 2-year incident myopia. Among 1386 children without myopia at baseline, 271 developed myopia over 2 years. For hyperopic children, baseline HAT was significantly associated with the incidence of myopia over 2 years (odds ratio [OR] = 0.43, P < 0.001), and the incidence of myopia was significantly lower with baseline HAT ≥0.5 D, compared to children <0.5 D. For 54 (3.75%) children who were myopic at baseline, SE was significant positively associated with myopic progression in univariable (P = 0.03) and multivariable general mixed linear regression analysis (P = 0.03). CONCLUSIONS Baseline SE was an independent influencing factor for the incidence of myopia and its progression. The incidence of myopia was significantly higher with lower baseline HAT among hyperopic children, indicating that lower HAT was potentially associated with myopic development.
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Affiliation(s)
- Fei Luo
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, China
| | - Jie Hao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, China
| | - Lei Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, China
| | - Jiawen Liu
- Industrial Engineering and Operations Research, University of California, Berkeley, California, United States
| | - Weiwei Chen
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, China
| | - Jing Fu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing, China
| | - Nathan Congdon
- School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, United Kingdom
- Orbis International, New York, New York, United States
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Chen H, Liao Y, Zhou W, Dong L, Wang W, Wang X. The change of myopic prevalence in children and adolescents before and after COVID-19 pandemic in Suqian, China. PLoS One 2022; 17:e0262166. [PMID: 35312694 PMCID: PMC8937315 DOI: 10.1371/journal.pone.0262166] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 12/19/2021] [Indexed: 01/23/2023] Open
Abstract
Purpose The aim of this study was to investigate the change of myopic prevalence in students with different demographic characteristics before and after the COVID-19 pandemic in Suqian, China. Methods A retrospective, cross-sectional study was conducted. Student data from 52 schools in 2019 and 2020 were collected from the electronic medical records database through cluster sampling. Ophthalmic examinations were conducted on students from September to December in 2019 and 2020. Measurements of uncorrected visual acuity (UCVA) and noncycloplegic autorefraction were included to obtain the spherical equivalent refraction (SER) and prevalence of myopia. The difference in the rate of myopia and SER of students ages 6 to 18 with various demographic characteristics was compared between the two years. Results Records from 118,479 students in 2019 and the 121,881 students in 2020 were obtained. In 2019 and 2020, the prevalence of overall myopia increased from 43.1% to 48.9% (5.8 percentage point), and a substantial shift in myopic rate occurred in grades 4 to 6 (6.9 percentage point). The change in the prevalence of myopia in girls (5.9 percentage point) was approximately equal to that in boys (5.8 percentage point) and it was more common in rural students (5.9 percentage point) than in urban students (5.1 percentage point). The prevalence of low myopia increased more in children, and the prevalence of moderate myopia increased more in adolescents. The mean spherical equivalent refraction (SER) (-1.34±2.03 D) was lower in 2020 than in 2019 (-1.16±1.92 D), while SER decreased mainly at ages 7 to 15. The SER presented myopic status at the age of 9 (-0.55±1.26 D in 2019, -0.71±1.42 D in 2020), and attained moderate myopia at the age of 15 (-3.06±2.41 D in 2019, -3.22±2.40 D in 2020). Conclusions After the COVID-19 pandemic, myopia increased in this population with variable rates of increase in different demographic groups. The change of myopia in children was comparatively greater than that in adolescents. Therefore, we should take measures to prevent and control the development of myopia after the COVID-19 pandemic, especially for younger students.
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Affiliation(s)
- Hongyan Chen
- Department of Ophthalmology, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical university, Xuzhou, Jiangsu Province, China
- Xuzhou Medical University, Xuzhou, Jiangsu Province, China
| | - Ya Liao
- Department of Ophthalmology, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical university, Xuzhou, Jiangsu Province, China
- Xuzhou Medical University, Xuzhou, Jiangsu Province, China
| | - Wen Zhou
- Department of Ophthalmology, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical university, Xuzhou, Jiangsu Province, China
- Xuzhou Medical University, Xuzhou, Jiangsu Province, China
| | - Lei Dong
- The Primary and Middle School Health Care Center in Suqian, Suqian, Jiangsu Province, China
| | - Wei Wang
- School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu Province, China
| | - Xiaojuan Wang
- Department of Ophthalmology, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical university, Xuzhou, Jiangsu Province, China
- Xuzhou Medical University, Xuzhou, Jiangsu Province, China
- * E-mail:
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Mu J, Zhong H, Liu M, Jiang M, Shuai X, Chen Y, Long W, Zhang S. Trends in Myopia Development Among Primary and Secondary School Students During the COVID-19 Pandemic: A Large-Scale Cross-Sectional Study. Front Public Health 2022; 10:859285. [PMID: 35392469 PMCID: PMC8980682 DOI: 10.3389/fpubh.2022.859285] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 02/21/2022] [Indexed: 12/28/2022] Open
Abstract
ObjectivesTo evaluate myopia development among primary and secondary school students during the coronavirus 2019 (COVID-19) pandemic.MethodsA cross-sectional study was conducted to evaluate the development of myopia among students in Shenzhen, China during the COVID-19 outbreak.ResultsThe study included 1,472,957 and 1,573,824 students in 2019 and 2020, respectively. The prevalence of myopia was 46.9 and 50.5% in 2019 and 2020, respectively. The prevalence of myopia among students in the former Shenzhen Special Economic Zone (SEZ) was higher than that in areas outside the former Shenzhen SEZ (2019: 47.0 vs. 43.7%; 2020: 50.5 vs. 47.3%). The prevalence of myopia among girls was higher than that among boys (2019: 50.4 vs. 44.0%; 2020: 54.0 vs. 47.6%). The 50th percentile (P50) of spherical equivalent refraction (SER) in the right eye among girls was lower than that in boys. The prevalence of myopia continued to increase as the grade increased, with the greatest annual increase observed in Grades 2–5 (3.4–3.9%). The P50 of SER in the right eye of students decreased as the grade increased.ConclusionsThe prevalence of myopia among students increased during the COVID-19 pandemic, especially in primary school Grades 2–5.
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Affiliation(s)
- Jingfeng Mu
- Shenzhen Eye Hospital, Shenzhen Eye Institute, Shenzhen Eye Hospital affiliated to Jinan University, Shenzhen, China
- School of Optometry, Shenzhen University, Shenzhen, China
| | - Haoxi Zhong
- Shenzhen Eye Hospital, Shenzhen Eye Institute, Shenzhen Eye Hospital affiliated to Jinan University, Shenzhen, China
- School of Optometry, Shenzhen University, Shenzhen, China
| | - Meizhou Liu
- Shenzhen Eye Hospital, Shenzhen Eye Institute, Shenzhen Eye Hospital affiliated to Jinan University, Shenzhen, China
- School of Optometry, Shenzhen University, Shenzhen, China
| | - Mingjie Jiang
- Shenzhen Eye Hospital, Shenzhen Eye Institute, Shenzhen Eye Hospital affiliated to Jinan University, Shenzhen, China
- School of Optometry, Shenzhen University, Shenzhen, China
| | - Xinyi Shuai
- Shenzhen Eye Hospital, Shenzhen Eye Institute, Shenzhen Eye Hospital affiliated to Jinan University, Shenzhen, China
- School of Optometry, Shenzhen University, Shenzhen, China
| | - Yanjie Chen
- Shenzhen Eye Hospital, Shenzhen Eye Institute, Shenzhen Eye Hospital affiliated to Jinan University, Shenzhen, China
- School of Optometry, Shenzhen University, Shenzhen, China
| | - Wen Long
- Shenzhen Eye Hospital, Shenzhen Eye Institute, Shenzhen Eye Hospital affiliated to Jinan University, Shenzhen, China
- School of Optometry, Shenzhen University, Shenzhen, China
| | - Shaochong Zhang
- Shenzhen Eye Hospital, Shenzhen Eye Institute, Shenzhen Eye Hospital affiliated to Jinan University, Shenzhen, China
- School of Optometry, Shenzhen University, Shenzhen, China
- *Correspondence: Shaochong Zhang
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