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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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Martínez-Albert N, Bueno-Gimeno I, Gené-Sampedro A. Risk Factors for Myopia: A Review. J Clin Med 2023; 12:6062. [PMID: 37763002 PMCID: PMC10532298 DOI: 10.3390/jcm12186062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/15/2023] [Accepted: 09/17/2023] [Indexed: 09/29/2023] Open
Abstract
Due to the myopia prevalence increase worldwide, this study aims to establish the most relevant risk factors associated with its development and progression. A review search was carried out using PubMed, Web of Science, and Scopus databases to identify the main myopia risk factors. The inclusion criteria for the articles were those related to the topic, carried out in subjects from 5 to 30 years, published between January 2000 and May 2023, in English, and with the full text available. Myopia etiology has proven to be associated with both genetic and environmental factors as well as with gene-environment interaction. The risk of developing myopia increases in children with myopic parents (one parent ×2 times, two parents ×5 times). Regarding environmental factors, education is the main risk factor correlated with myopia prevalence increase. Further, several studies found that shorter distance (<30 cm) and longer time spent (>30 min) for near work increase the risk of myopia. Meanwhile, increased outdoor activity (>40 min/day) has been shown to be a key factor in reducing myopia incidence. In conclusion, the interventional strategy suggested so far to reduce myopia incidence is an increase in time outdoors and a reduction in the time spent performing near-work tasks.
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Affiliation(s)
| | - Inmaculada Bueno-Gimeno
- Department of Optics and Optometry and Vision Sciences, University of Valencia, 46100 Burjassot, Spain;
| | - Andrés Gené-Sampedro
- Department of Optics and Optometry and Vision Sciences, University of Valencia, 46100 Burjassot, Spain;
- Research Institute on Traffic and Road Safety (INTRAS), University of Valencia, 46022 Valencia, Spain
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3
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Liu Y, Meng D, Wang Y, Wang X, Xue C, Hao R, Zhang W. Ocular biological parameters and prevalence of myopia in vocational high school and general high school in China. Front Public Health 2023; 11:1100437. [PMID: 37020816 PMCID: PMC10067628 DOI: 10.3389/fpubh.2023.1100437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 03/03/2023] [Indexed: 03/22/2023] Open
Abstract
SignificanceHigher prevalence of myopia is possibly associated with more extended schooling schedules. Therefore, adjustments to high school curricula may aid in reducing the prevalence of myopia among adolescents.PurposeTo investigate the prevalence of myopia among 15- to 18-year-old adolescents in Tianjin, China, and to evaluate the impact of different educational schedules on the prevalence of myopia among high school students.MethodsThis is a school-based epidemiological study with a cross-sectional design. Ocular biological parameters and noncycloplegic photorefraction were examined using optical biometry devices and photoscreener devices. Each student’s spherical equivalent (SE) and ocular biometry were recorded, and the prevalence of myopia was calculated.ResultsA total of 2,867 participants (1,519 males and 1,348 females) were tested for non-cycloplegic refraction, axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD) and lens thickness (LT). In this research, the overall prevalence of myopia was 81.6%, with high myopia accounting for 11.8%. Myopia prevalence was substantially higher in general high schools than in vocational high schools, with 86.1 and 70.1%, respectively. There were no significant differences in the prevalence of myopia (p = 0.744) or high myopia (p = 0.851) across the three vocational school years. In the general high school, however, there was an increase of 4.6% (p < 0.05) in myopia prevalence between year 10 and year12.ConclusionComparing vocational and standard high school students, there are considerable disparities in prevalence of myopia, spherical equivalent, and ocular biological parameters. The prevalence of myopia and high myopia increased among standard high school students, but remained relatively consistent among students in vocational schools.
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Affiliation(s)
- Yang Liu
- Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Nankai University Affiliated Eye Hospital, Clinical College of Ophthalmology Tianjin Medical University, Tianjin, China
| | - Dexin Meng
- Department of Ophthalmology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yun Wang
- Tianjin Occupational Diseases Precaution and Therapeutic Hospital (Tianjin Workers’ Hospital), Tianjin, China
| | - Xuechun Wang
- Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Nankai University Affiliated Eye Hospital, Clinical College of Ophthalmology Tianjin Medical University, Tianjin, China
| | - Caihong Xue
- Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Nankai University Affiliated Eye Hospital, Clinical College of Ophthalmology Tianjin Medical University, Tianjin, China
| | - Rui Hao
- Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Nankai University Affiliated Eye Hospital, Clinical College of Ophthalmology Tianjin Medical University, Tianjin, China
- *Correspondence: Rui Hao,
| | - Wei Zhang
- Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Nankai University Affiliated Eye Hospital, Clinical College of Ophthalmology Tianjin Medical University, Tianjin, China
- Wei Zhang,
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Li M, Lanca C, Tan CS, Foo LL, Sun CH, Yap F, Najjar RP, Sabanayagam C, Saw SM. Association of time outdoors and patterns of light exposure with myopia in children. Br J Ophthalmol 2023; 107:133-139. [PMID: 33858839 DOI: 10.1136/bjophthalmol-2021-318918] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/06/2021] [Accepted: 03/28/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND/AIMS To evaluate the association of reported time outdoors and light exposure patterns with myopia among children aged 9 years from the Growing Up in Singapore Towards Healthy Outcomes birth cohort. METHODS We assessed reported time outdoors (min/day), light exposure patterns and outdoor activities of children aged 9 years (n=483) with a questionnaire, the FitSight watch and a 7-day activity diary. Light levels, the duration, timing and frequency of light exposure were assessed. Cycloplegic spherical equivalent (SE), myopia (SE≤-0.5 D) and axial length (AL) of paired eyes were analysed using generalised estimating equations. RESULTS In this study, 483 (966 eyes) multiethnic children (50.0% boys, 59.8% Chinese, 42.2% myopic) were included. Reported time outdoors (mean±SD) was 100±93 min/day, and average light levels were 458±228 lux. Of the total duration children spent at light levels of ≥1000 lux (37±19 min/day), 76% were spent below 5000 lux. Peak light exposure occurred at mid-day. Children had 1.7±1.0 light exposure episodes/day. Common outdoor activities were walks, neighbourhood play and swimming. Greater reported time outdoors was associated with lower odds of myopia (OR=0.82, 95% CI 0.70 to 0.95/hour increase daily; p=0.009). Light levels, timing and frequency of light exposures were not associated with myopia, SE or AL (p>0.05). CONCLUSION Reported time outdoors, light levels and number of light exposure episodes were low among Singaporean children aged 9 years. Reported time outdoors was protective against myopia but not light levels or specific light measures. A multipronged approach to increase time outdoors is recommended in the combat against the myopia epidemic.
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Affiliation(s)
- Mijie Li
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore.,Myopia Research Group, Singapore Eye Research Institute, Singapore
| | - Carla Lanca
- Myopia Research Group, Singapore Eye Research Institute, Singapore
| | - Chuen-Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Li-Lian Foo
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore
| | - Chen-Hsin Sun
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Fabian Yap
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore
| | - Raymond P Najjar
- Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore.,Visual Neuroscience Research Group, Singapore Eye Research Institute, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore
| | - Seang-Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore .,Myopia Research Group, Singapore Eye Research Institute, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore
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Weighted Zernike defocus coefficient of treatment zone is a meaningful indicator for myopia control efficacy of Ortho-K lenses. EYE AND VISION 2022; 9:24. [PMID: 35773712 PMCID: PMC9248179 DOI: 10.1186/s40662-022-00296-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 06/06/2022] [Indexed: 12/04/2022]
Abstract
Background The goal of this study was to reproduce a three-dimensional representation of corneal defocus characteristics after orthokeratology (Ortho-K) treatment via an indicator defined as the weighted Zernike defocus coefficient of the treatment zone (Cweighted defocus). This could be used to predict the effectiveness of Ortho-K treatment quantitatively in a timely manner after the one-month visit. Methods Seventy myopic children with axial length (AL) elongation after Ortho-K treatment (group A) and 63 myopic children with AL shortening after Ortho-K treatment (group B) were included in this one-year retrospective study. The proposed indicator was calculated by a customized MATLAB program. Multivariate binomial logistic regression and multivariate linear regression analyses were used to explore the association between AL change and the Cweighted defocus, age, sex, and other ocular biometric parameters. Results The 12-month AL change, age, pupil diameter, and vertical decentration of the Ortho-K lens were significantly different between the two groups. Multivariate logistic regression analysis showed that a larger Cweighted defocus (≥ 0.35 D/mm2) (OR: 0.224; 95% CI: 0.078–0.646; P = 0.006) was correlated with the emergence of AL shortening after orthokeratology treatment. A multivariate linear regression model showed that a greater Cweighted defocus was associated with slower 12-month AL elongation (β = − 0.51, P = 0.001). Conclusions The Cweighted defocus is an effective predictive indicator of myopia control, and a larger Cweighted defocus may lead to slower elongation of AL. This meaningful indicator may help in the evaluation and adjustment of Ortho-K lens parameters in a timely manner and minimize the cost of clinical trial and error.
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Singh H, Singh H, Latief U, Tung GK, Shahtaghi NR, Sahajpal NS, Kaur I, Jain SK. Myopia, its prevalence, current therapeutic strategy and recent developments: A Review. Indian J Ophthalmol 2022; 70:2788-2799. [PMID: 35918918 PMCID: PMC9672758 DOI: 10.4103/ijo.ijo_2415_21] [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] [Indexed: 11/05/2022] Open
Abstract
Myopia is a widespread and complex refractive error in which a person's ability to see distant objects clearly is impaired. Its prevalence rate is increasing worldwide, and as per WHO, it is projected to increase from 22% in 2000 to 52% by 2050. It is more prevalent in developed, industrial areas and affects individuals of all ages. There are a number of treatments available for the control of myopia, such as glasses, contact lenses, laser surgery, and pharmaceuticals agents. However, these treatments are less beneficial and have significant side effects. A novel molecule, 7-methylxanthine (7-MX), has been found to be a highly beneficial alternate in the treatment of myopia and excessive eye elongation. Many preclinical and clinical studies showed that 7-MX is effective for the treatment of myopia and is presently under phase II of clinical investigation. We have also investigated preclinical toxicity studies such as acute, sub-acute, sub-chronic, and chronic on rats. In these studies, 7-MX was found to be non-toxic as compared to other reported anti-myopic agents. Moreover, as an ideal drug, 7-MX is observed to have no or low toxicity, brain permeability, non-allergic, higher oral administration efficacy, and low treatment costs and thus qualifies for the long-term treatment of myopia. This review article on 7-MX as an alternative to myopia treatment will highlight recent findings from well-designed preclinical and clinical trials and propose a potential future therapy.
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Affiliation(s)
- Harjeet Singh
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, Punjab, India,Department of Pharmacy, Government Polytechnic College, Amritsar, Punjab, India
| | - Harmanpreet Singh
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, Punjab, India
| | - Uzma Latief
- Center for Basic and Translational Research in Health Science, Guru Nanak Dev University, Amritsar, Punjab, India
| | - Gurleen Kaur Tung
- Center for Basic and Translational Research in Health Science, Guru Nanak Dev University, Amritsar, Punjab, India
| | - Navid Reza Shahtaghi
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, Punjab, India
| | | | - Inderjit Kaur
- Department of Ophthalmology, Baba Farid University of Health Sciences, Faridkot, Punjab, India
| | - Subheet Kumar Jain
- Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, Punjab, India,Center for Basic and Translational Research in Health Science, Guru Nanak Dev University, Amritsar, Punjab, India,Correspondence to: Prof. Subheet Kumar Jain, Department of Pharmaceutical Sciences, Guru Nanak Dev University, Amritsar, Punjab - 143 005, India. E-mail:
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7
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Gan J, Wang N, Li S, Wang B, Kang M, Wei S, Guo J, Liu L, Li H. Effect of Age and Refractive Error on Local and Global Visual Perception in Chinese Children and Adolescents. Front Hum Neurosci 2022; 16:740003. [PMID: 35153705 PMCID: PMC8831691 DOI: 10.3389/fnhum.2022.740003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/05/2022] [Indexed: 11/24/2022] Open
Abstract
PURPOSE This study investigated the impact of age and myopia on visual form perception among Chinese school-age children. METHODS This cross-sectional study included 1,074 students with a mean age of 12.1 ± 4.7 (range = 7.3-18.9) years. The mean spherical equivalence refraction (SER) of the participants was -1.45 ± 2.07 D. All participants underwent distance visual acuity (VA), refraction measurement and local and global visual form perception test including orientation, parallelism, collinearity, holes and color discrimination tasks. RESULTS The reaction times of emmetropes were slower than those of myopic and high myopic groups on both local (orientation, parallelism, and collinearity) and global discrimination tasks (all p < 0.05). A reduction in reaction times was found with increasing age on both local and global discrimination tasks (all p < 0.05). Age was significantly associated with both local and global visual perception performance after adjusting for gender, visual acuity and SER (orientation, β = -0.54, p < 0.001; parallelism, β = -0.365, p < 0.001; collinearity, β = -0.28, p < 0.001; holes, β = -0.319, p < 0.001; color, β = -0.346, p < 0.001). CONCLUSIONS This study revealed that both local and global visual perception improve with age among Chinese children and that myopes seem to have better visual perception than emmetropes.
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Affiliation(s)
- Jiahe Gan
- Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ningli Wang
- Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Shiming Li
- Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Bo Wang
- State Key Laboratory of Brain and Cognitive Science, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
| | - Mengtian Kang
- Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Shifei Wei
- Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | | | | | - He Li
- Anyang Eye Hospital, Anyang, China
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Jiang J, Xu J, Wang Y, Zheng J, Xu D. Correlation Analysis of Dominant Eye and Refractive Error Between Monozygotic Twins. Int J Gen Med 2021; 14:2631-2635. [PMID: 34168489 PMCID: PMC8216723 DOI: 10.2147/ijgm.s307602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 05/21/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE This study aims to investigate the correlation of dominant eye and refractive error between monozygotic twins. METHODS The data of dominant eye and refractive error of 13 pairs of monozygotic twins who were treated at the Optometry Clinic were collected. The paired chi-square test and Kappa consistency test were used to analyze the data of dominant eye between monozygotic twins, while the paired t test and Pearson correlation analysis were adopted to analyze the refractive error data. SPSS version 22.0 software was used to analyze the above statistics. RESULTS In the Kappa consistency test of dominant eye between monozygotic twins, Kappa value = 0.451, p = 0.052, p>0.05, and in the paired chi-square test, p = 0.250. In the spherical equivalent paired t test for the right eye of monozygotic twins, t = 1.491 and p = 0.162, while in the spherical equivalent paired t test for the left eye, t = 0.753 and p = 0.466. In the spherical equivalent correlation analysis of monozygotic twins, for the spherical equivalent refraction of the right eye, the Pearson correlation results were r = 0.901 and p = 0.00, and for the spherical equivalent refraction of the left eye, the Pearson correlation results were r = 0.971 and p = 0.00. CONCLUSION The difference in the chi-square test of dominant eye is not statistically significant between monozygotic twins, but dominant eye and refractive error are correlated to some extent. It is suggested that heredity may be the main determinant of the dominant eye. There is no difference in refractive error between identical twins which are highly correlated, however.
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Affiliation(s)
- Jian Jiang
- Clinical Optometry Center, Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, 325027, People’s Republic of China
| | - Jingjing Xu
- Clinical Optometry Center, Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, 325027, People’s Republic of China
| | - Yuwen Wang
- Clinical Optometry Center, Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, 325027, People’s Republic of China
| | - Jingwei Zheng
- Clinical Research Center, Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, 325027, People’s Republic of China
| | - Dan Xu
- School of Ophthalmology & Optometry, Wenzhou Medical University, Wenzhou, Zhejiang Province, 325027, People’s Republic of China
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Németh J, Tapasztó B, Aclimandos WA, Kestelyn P, Jonas JB, De Faber JTHN, Januleviciene I, Grzybowski A, Nagy ZZ, Pärssinen O, Guggenheim JA, Allen PM, Baraas RC, Saunders KJ, Flitcroft DI, Gray LS, Polling JR, Haarman AEG, Tideman JWL, Wolffsohn JS, Wahl S, Mulder JA, Smirnova IY, Formenti M, Radhakrishnan H, Resnikoff S. Update and guidance on management of myopia. European Society of Ophthalmology in cooperation with International Myopia Institute. Eur J Ophthalmol 2021; 31:853-883. [PMID: 33673740 PMCID: PMC8369912 DOI: 10.1177/1120672121998960] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/04/2021] [Indexed: 12/13/2022]
Abstract
The prevalence of myopia is increasing extensively worldwide. The number of people with myopia in 2020 is predicted to be 2.6 billion globally, which is expected to rise up to 4.9 billion by 2050, unless preventive actions and interventions are taken. The number of individuals with high myopia is also increasing substantially and pathological myopia is predicted to become the most common cause of irreversible vision impairment and blindness worldwide and also in Europe. These prevalence estimates indicate the importance of reducing the burden of myopia by means of myopia control interventions to prevent myopia onset and to slow down myopia progression. Due to the urgency of the situation, the European Society of Ophthalmology decided to publish this update of the current information and guidance on management of myopia. The pathogenesis and genetics of myopia are also summarized and epidemiology, risk factors, preventive and treatment options are discussed in details.
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Affiliation(s)
- János Németh
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Beáta Tapasztó
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
- Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
| | | | | | - Jost B Jonas
- Department of Ophthalmology, Heidelberg University, Mannheim, Germany
| | | | | | - Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland
- Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznan, Poland
| | - Zoltán Zsolt Nagy
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Olavi Pärssinen
- Gerontology Research Centre and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | | | - Peter M Allen
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Rigmor C Baraas
- National Centre for Optics, Vision and Eye Care, University of South-Eastern Norway, Kongsberg, Norway
| | - Kathryn J Saunders
- Centre for Optometry and Vision Science research, Ulster University, Coleraine, UK
| | - Daniel Ian Flitcroft
- Temple Street Children’s Hospital, Dublin, Ireland
- Centre for Eye Research Ireland (CERI) Technological University Dublin, Ireland
| | | | - Jan Roelof Polling
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Optometry and Orthoptics, Hogeschool Utrecht, University of Applied Science, Utrecht, The Netherlands
| | - Annechien EG Haarman
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - J Willem L Tideman
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - James Stuart Wolffsohn
- Optometry and Vision Science, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Siegfried Wahl
- Institute for Ophthalmic Research, University Tübingen, Tübingen, Germany
- Carl Zeiss Vision International GmbH, Tübingen, Germany
| | - Jeroen A Mulder
- Department of Optometry and Orthoptics, Hogeschool Utrecht, University of Applied Science, Utrecht, The Netherlands
| | | | - Marino Formenti
- Department of Physics, School of Science, University of Padova, Padova, Italy
| | | | - Serge Resnikoff
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
- Brien Holden Vision Institute, Sydney, Australia
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10
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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: 138] [Impact Index Per Article: 46.0] [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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11
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Hopkins S, Narayanasamy S, Vincent SJ, Sampson GP, Wood JM. Do reduced visual acuity and refractive error affect classroom performance? Clin Exp Optom 2021; 103:278-289. [DOI: 10.1111/cxo.12953] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 07/03/2019] [Accepted: 07/08/2019] [Indexed: 12/18/2022] Open
Affiliation(s)
- Shelley Hopkins
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia,
| | - Sumithira Narayanasamy
- Programme of Optometry & Vision Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia,
| | - Stephen J Vincent
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia,
| | - Geoff P Sampson
- School of Medicine (Optometry), Faculty of Health, Deakin University, Geelong, Australia,
| | - Joanne M Wood
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia,
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12
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Yotsukura E, Torii H, Ozawa H, Hida RY, Shiraishi T, Corso Teixeira I, Rautha YVBL, Moraes do Nascimento CF, Mori K, Uchino M, Kurihara T, Negishi K, Tsubota K. Axial Length and Prevalence of Myopia among Schoolchildren in the Equatorial Region of Brazil. J Clin Med 2020; 10:jcm10010115. [PMID: 33396242 PMCID: PMC7794886 DOI: 10.3390/jcm10010115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 12/26/2020] [Accepted: 12/27/2020] [Indexed: 12/14/2022] Open
Abstract
The prevalence of myopia is increasing globally, and the outdoor light environment is considered as a possible factor that can retard myopia. The aim of this study was to evaluate the prevalence of myopia and the light environment in Aracati, equatorial Brazil. We surveyed 421 children (421 right eyes; mean age, 10.6 years) and performed ocular examinations that included non-cycloplegic refraction and axial length (AL). Multiple regression analyses were performed to identify factors affecting myopia such as time spent outdoors and in near work. We measured illuminance and violet light irradiance in Aracati. The mean spherical equivalent (SE) and AL were −0.44 ± 1.38 diopters (D) and 22.98 ± 0.87 mm, respectively. The prevalence of myopia (SE ≤ −0.75 D) and high myopia (SE ≤ −6.0 D/AL ≥ 26.0 mm) was 20.4 and 1.4/0.48%, respectively. Multiple regression analyses showed that myopia was not associated with lifestyle factors. The average illuminance in Aracati was about 100,000 lux from morning to evening. The current results reflect the ALs and the prevalence of myopia among Brazilian schoolchildren. There is a possibility that the light environment in addition to other confounding factors including racial differences affects the ALs and refractive errors.
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Affiliation(s)
- Erisa Yotsukura
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (E.Y.); (H.T.); (H.O.); (R.Y.H.); (K.M.); (M.U.)
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Hidemasa Torii
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (E.Y.); (H.T.); (H.O.); (R.Y.H.); (K.M.); (M.U.)
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Hiroko Ozawa
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (E.Y.); (H.T.); (H.O.); (R.Y.H.); (K.M.); (M.U.)
| | - Richard Yudi Hida
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (E.Y.); (H.T.); (H.O.); (R.Y.H.); (K.M.); (M.U.)
- Department of Ophthalmology, Universidade de Sao Paulo, Av. Dr. Enéas Carvalho de Aguiar, 255-Cerqueira César, São Paulo SP 05402-000, Brazil;
- Department of Ophthalmology, Universidade Federal de Sao Paulo, R. Botucatu, 822-Vila Clementino, São Paulo SP 04039-032, Brazil
| | - Tetsuro Shiraishi
- Department of Obstetrics and Gynecology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan;
| | - Ivan Corso Teixeira
- Department of Ophthalmology, Santa Casa de Sao Paulo, Rua Dr. Cesario Mota Junior, 112-Vila Buarque, São Paulo SP 01221-010, Brazil; (I.C.T.); (C.F.M.d.N.)
| | | | - Caio Felipe Moraes do Nascimento
- Department of Ophthalmology, Santa Casa de Sao Paulo, Rua Dr. Cesario Mota Junior, 112-Vila Buarque, São Paulo SP 01221-010, Brazil; (I.C.T.); (C.F.M.d.N.)
| | - Kiwako Mori
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (E.Y.); (H.T.); (H.O.); (R.Y.H.); (K.M.); (M.U.)
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Miki Uchino
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (E.Y.); (H.T.); (H.O.); (R.Y.H.); (K.M.); (M.U.)
| | - Toshihide Kurihara
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (E.Y.); (H.T.); (H.O.); (R.Y.H.); (K.M.); (M.U.)
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Correspondence: (T.K.); (K.N.); (K.T.); Tel.: +81-3-5363-3204 (T.K.); +81-3-3353-1211 (K.N.); +81-3-3353-1211 (K.T.)
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (E.Y.); (H.T.); (H.O.); (R.Y.H.); (K.M.); (M.U.)
- Correspondence: (T.K.); (K.N.); (K.T.); Tel.: +81-3-5363-3204 (T.K.); +81-3-3353-1211 (K.N.); +81-3-3353-1211 (K.T.)
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (E.Y.); (H.T.); (H.O.); (R.Y.H.); (K.M.); (M.U.)
- Tsubota Laboratory, Inc., 304 Toshin Shinanomachi-Ekimae Bldg., 34 Shinanomachi Shinjuku-ku, Tokyo 160-0016, Japan
- Correspondence: (T.K.); (K.N.); (K.T.); Tel.: +81-3-5363-3204 (T.K.); +81-3-3353-1211 (K.N.); +81-3-3353-1211 (K.T.)
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13
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Wang S, Hao X, Ma X, Yu Y, Wu L, Wang Y, Li Y. Associations between Poor Vision, Vision-Related Behaviors and Mathematics Achievement in Chinese Students from the CNAEQ-PEH 2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228561. [PMID: 33218140 PMCID: PMC7698834 DOI: 10.3390/ijerph17228561] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 11/16/2020] [Indexed: 11/20/2022]
Abstract
Purpose: Poor vision is prevalent in school-aged students, especially in East Asia. This can not only cause irreversibly physical health impairments like glaucoma and cataracts, but also the loss of individual education and employment opportunities and deterioration of the quality of life. The present study aims to investigate the associations between poor vision, vision-related risk behaviors, and mathematics achievement in youth from China. Methods: The present study included a total of 106,192 Grade 4 students and 70,236 Grade 8 students from the China National Assessment of Educational Quality-Physical Education & Health 2015 (CNAEQ-PEH 2015). We conducted a standard logarithmic visual acuity scale for vision screening, a self-reported questionnaire for vision-related risk behavior and a standardized mathematics assessment for mathematics performance. Poor vision is defined as the visual acuity below 5.0 by using the standard logarithmic visual acuity chart. Linear regression was conducted. Results: The prevalence rate of poor vision in China was 37.1% in Grade 4 and 66.2% in Grade 8 in 2015. Students who had poor vision were more likely to have better mathematics achievement than those with normal vision. Reading in bed, insufficient sleep, and screen time during weekdays and weekends were associated with higher odds of poor vision. Conclusions: Poor vision was positively associated with mathematics academic achievements, while vision-related risk behaviors such as screen time, homework time and reading in bed were associated with a high prevalence of poor vision in compulsory education cycle students.
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14
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Megreli J, Barak A, Bez M, Bez D, Levine H. Association of Myopia with cognitive function among one million adolescents. BMC Public Health 2020; 20:647. [PMID: 32384882 PMCID: PMC7206693 DOI: 10.1186/s12889-020-08765-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 04/23/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Myopia is a leading cause of visual impairment worldwide, and its increasing incidence is of public health concern. Cognitive function was associated with myopia among children, but evidence for adolescents is scarce. The purpose of this study was to determine whether myopia is associated with cognitive function, and which cognitive ability, verbal or non-verbal, is involved. METHODS We conducted a population-based cross-sectional study of 1,022,425 Israeli candidates for military service aged 16.5-18 years. Participants underwent a comprehensive battery of tests assessing verbal and non-verbal intelligence, which yields a summarized cognitive function score (CFS). In addition, subjective visual acuity examination followed by objective non-cycloplegic refraction was carried out for each participant. Association between myopia and cognitive function was evaluated by multivariable logistic regression models adjusted for gender, age, country of origin, socioeconomic status, years of education, body mass index, height and year of examination. RESULTS Compared to the intermediate CFS of the entire cohort, participants who had the highest CFS had 1.85-fold (95% CI, 1.81 to 1.89; P < .001) higher odds of having myopia and 2.73-fold (95% CI, 2.58 to 2.88; P < .001) higher odds of high myopia, while participants with the lowest CFS had 0.59-fold (95% CI, 0.57 to 0.61, P < .001) lower odds of having myopia. The verbal components of the cognitive function assessment had stronger associations with myopia than the non-verbal components (P < .001, for all). CONCLUSIONS Cognitive function, especially verbal intelligence, is strongly and consistently associated with myopia among adolescents.
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Affiliation(s)
- Jacob Megreli
- Medical Corps, Israel Defense Forces, Ramat-Gan, Israel.,Hebrew University-Hadassah Faculty of Medicine, Braun School of Public Health and Community Medicine, P.O Box 12272, 9112002, Jerusalem, Israel
| | - Adiel Barak
- Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Maxim Bez
- Medical Corps, Israel Defense Forces, Ramat-Gan, Israel
| | - Dana Bez
- Medical Corps, Israel Defense Forces, Ramat-Gan, Israel.,Hebrew University-Hadassah Faculty of Medicine, Braun School of Public Health and Community Medicine, P.O Box 12272, 9112002, Jerusalem, Israel
| | - Hagai Levine
- Hebrew University-Hadassah Faculty of Medicine, Braun School of Public Health and Community Medicine, P.O Box 12272, 9112002, Jerusalem, Israel.
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15
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Refractive error and biometrics of anterior segment of eyes of healthy young university students in Japan. Sci Rep 2019; 9:15337. [PMID: 31653953 PMCID: PMC6814799 DOI: 10.1038/s41598-019-51920-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 10/09/2019] [Indexed: 11/30/2022] Open
Abstract
To determine the parameters of the anterior segment of eyes that are significantly associated with the refractive error in healthy young Japanese university students. This was a cross-sectional observational study of 229 healthy Japanese university students (men: women,147:82) whose age ranged between 20 to 29 years. Univariate and multivariate linear regression analyses were performed to identify the factors that were significantly correlated with the refractive error. The independent variables included age, sex, axial length, anterior chamber depth, corneal diameter, curvature of anterior surface of cornea, and central corneal thickness. The mean refractive error (spherical equivalent) was −4.1 ± 2.7 diopters (D) with a range of −12.5 to +0.5 D, and the mean axial length was 25.4 ± 1.3 mm with a range of 22.4 to 29.0 mm. Pearson univariate correlation analysis found that the refractive error was significantly and negatively correlated with the axial length (R = −0.82, P < 0.001), deeper anterior chamber (R = −0.30, P < 0.001), and larger corneal diameter (R = −0.21, P = 0.001). Multiple regression analysis showed that the refractive error was significantly associated with a longer axial length (P < 0.001), a deeper anterior chamber (P < 0.001), and a flatter corneal curvature (P < 0.001).The biometric values of the anterior segment of the eyes should make the eye more hyperopic which would reduce the myopia-inducing lengthening of the axial length.
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16
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Shapira Y, Mimouni M, Machluf Y, Chaiter Y, Saab H, Mezer E. The Increasing Burden of Myopia in Israel among Young Adults over a Generation: Analysis of Predisposing Factors. Ophthalmology 2019; 126:1617-1626. [PMID: 31474440 DOI: 10.1016/j.ophtha.2019.06.025] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 06/03/2019] [Accepted: 06/20/2019] [Indexed: 12/18/2022] Open
Abstract
PURPOSE To determine the trends in prevalence of myopia in Israeli young adults over approximately a generation, as well as associated factors and variation in the impact of these factors on myopia prevalence in this region over time. DESIGN Retrospective, cross-sectional study. PARTICIPANTS One hundred four thousand six hundred eighty-nine consecutive persons 16 to 19 years of age born between 1971 and 1994 who had not yet enlisted in the Israeli Army but had completed the medical profiling process. METHODS Using data collected at a north Israel recruitment center, the prevalence of myopia over time was estimated, and a polynomial regression analysis was performed to assess significance of nonlinear trends. Associations of demographic and socioeconomic factors with myopia were assessed, and trends over time were analyzed using a factorial logistic regression. MAIN OUTCOME MEASURES The primary outcome measure was factors associated with the prevalence of myopia over time. The secondary outcome measure was a description of the change in prevalence of myopia over time. RESULTS The prevalence of myopia increased 1.284-fold over 24 years from 20.4% among participants born between 1971 and 1982 to 26.2% among participants born between 1983 and 1994. A quite similar increase was observed among males (from 17.9% to 22.7%, respectively) and females (from 23.9% to 30.8%, respectively). The factors found to be associated with myopia were as follows: more recent date of birth, female gender, more years of education, being the eldest child, non-Israeli ethnic origin, and urban residence. However, there were significant trends over time in the effects of some of these factors, most notably an attenuation of the difference between participants of different religions in the recent birth-years period. Most of these associations and trends were observed in both males and females separately, with some gender-specific variations. Immigrants from Ethiopia who were raised in Israel were highly more likely to demonstrate myopia than those who arrived at an older age. CONCLUSIONS This study demonstrated an increase in the prevalence of myopia and the possible associations of urbanization- and higher education-related factors among several subpopulations and the risk for myopia developing.
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Affiliation(s)
- Yinon Shapira
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel
| | - Michael Mimouni
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel; Bruce and Ruth Rappaport Faculty of Medicine, Technion, Israel Institute of Technology.
| | - Yossy Machluf
- Israel Defense Forces, Medical Corps, Israel; Shamir Research Institute, University of Haifa, Kazerin, Israel
| | | | - Haitam Saab
- Israel Defense Forces, Medical Corps, Israel
| | - Eedy Mezer
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel; Bruce and Ruth Rappaport Faculty of Medicine, Technion, Israel Institute of Technology
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17
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Ding X, Hu Y, Guo X, Guo X, Morgan I, He M. Possible Causes of Discordance in Refraction in Monozygotic Twins: Nearwork, Time Outdoors and Stochastic Variation. Invest Ophthalmol Vis Sci 2019; 59:5349-5354. [PMID: 30398626 DOI: 10.1167/iovs.18-24526] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate the impact of differences in nearwork and time spent outdoors on difference in refraction in monozygotic (MZ) twins. Methods Data on MZ twins aged 7 to 18 years from the Guangzhou Twin Eye Study were used in this analysis. A standard questionnaire was administered by personal interview to estimate time spent on nearwork and time spent outdoors. Spherical equivalent (SE) was measured by autorefraction under cycloplegia. The interaction between age and nearwork or time spent outdoors was also estimated. Results A total of 490 MZ twin pairs (233 male and 257 female) were eligible in this analysis, the mean age was 13.14 ± 2.49. In the mixed-effects model, nearwork difference was a risk factor of discordance in myopic SE (β = -0.11 diopter (D)/h, P = 0.009), the overall association between time outdoors difference and SE discordance was not significant (β = -0.89 (D)/h, P = 0.120) although an interaction between time spent outdoors difference and age was detected (β = 0.07 (D)/h, P = 0.002). Furthermore, difference in nearwork and time outdoors explained about 1.8% and 2.5% of the variation in SE discordance, respectively. Conclusions Given the very marked genetic similarity of MZ twins, and the small effects of known risk factors on SE discordance, we suggest that the SE discordance across MZ twins largely results from stochastic variations at the genomic or epigenetic levels, or from uncollected environmental factors.
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Affiliation(s)
- Xiaohu Ding
- 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
| | - Xinxing Guo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.,Dana Center of Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States
| | - Xiaobo Guo
- Department of Statistics, School of Mathematics & Computational Science, Sun Yat-Sen University, Guangzhou, China
| | - Ian Morgan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.,Research School of Biology, College of Medicine, Biology and Environment, Australia National University, Canberra, Australia
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.,Centre for Eye Research Australia, Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia
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18
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Hill M, Hall A, Williams C, Emond AM. Impact of co-occurring hearing and visual difficulties in childhood on educational outcomes: a longitudinal cohort study. BMJ Paediatr Open 2019; 3:e000389. [PMID: 31206071 PMCID: PMC6542436 DOI: 10.1136/bmjpo-2018-000389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 01/30/2019] [Accepted: 02/06/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Mild hearing and visual difficulties are common in childhood, and both may have implications for educational achievement. However, the impact of co-occurring common hearing and visual difficulties in childhood is not known. OBJECTIVE To determine the prevalence and impact of co-occurring common hearing and visual difficulties of childhood on educational outcomes in primary and secondary school. METHODS The sample was drawn from the Avon Longitudinal Study of Parents and Children, a longitudinal birth cohort study in England. The exposures were hearing and visual difficulties at age 7 (defined as conductive hearing loss or otitis media with effusion, and amblyopia, strabismus or reduced visual acuity, respectively). The outcomes measured were achievement of level 4 or above at Key Stage 2 (KS2) in English, Maths and Science, respectively, at age 11, and attainment of five or more General Certificate of Secondary Education (GCSEs) at grades A*-C at age 16. Multiple logistic regression models assessed the relationship between hearing and visual difficulties and educational outcomes, adjusting for potential confounding factors. RESULTS 2909 children were included in the study; 261 had hearing difficulties, 189 had visual difficulties and 14 children had co-occurring hearing and visual difficulties. Children with co-occurring hearing and visual difficulties were less likely to achieve the national target at KS2 compared with children with normal hearing and vision, even after adjustment for confounding factors (OR 0.30, CI 0.15 to 0.61 for KS2 English). Differences in IQ, behaviour, attention and social cognition did not account for this relationship. The impact of co-occurring hearing and visual difficulties on GCSE results was explained largely by poor performance at KS2. CONCLUSIONS Co-occurring hearing and visual difficulties in childhood have an enduring negative impact on educational outcomes. Identification of affected children and early intervention in primary school is essential.
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Affiliation(s)
- Matilda Hill
- Centre for Child and Adolescent Health, University of Bristol, Bristol, UK
| | - Amanda Hall
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - Cathy Williams
- Centre for Child and Adolescent Health, University of Bristol, Bristol, UK
| | - Alan M Emond
- Centre for Child and Adolescent Health, University of Bristol, Bristol, UK
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19
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Hayes JF, Picot S, Osborn DPJ, Lewis G, Dalman C, Lundin A. Visual Acuity in Late Adolescence and Future Psychosis Risk in a Cohort of 1 Million Men. Schizophr Bull 2019; 45:571-578. [PMID: 29901774 PMCID: PMC6483575 DOI: 10.1093/schbul/sby084] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND We aimed to determine whether late adolescent visual impairment is associated with later psychosis. METHODS We conducted a longitudinal cohort study of Swedish male military conscripts aged 18 or 19 years from January 1, 1974, through December 31, 1997 (N = 1140710). At conscription, uncorrected and optometry-lens-corrected distance visual acuity was measured. Participants were then followed up to see if they received an inpatient diagnosis of non-affective psychotic disorder, including schizophrenia (N = 10769). Multivariable Cox modeling was used to estimate differences between groups. RESULTS After adjustment for confounders, those with severe impairment before optical correction in their best eye (decimal fraction <0.3) had an increased psychosis rate compared to those with normal uncorrected vision (decimal fraction 1.0) (hazard ratio [HR] 1.26, 95% CI 1.16-1.37). Larger interocular visual acuity difference was associated with an increased psychosis rate (adjusted HR 1.49, 95% CI 1.37-1.63 in those with differences >0.5 compared to those with no between eye acuity difference). Individuals with impaired vision that could not be corrected to normal with lenses had highest rates of psychosis (best eye adjusted HR 1.56; 95% CI 1.33-1.82), those with imperfect, but correctable vision also had elevated rates (best eye adjusted HR 1.21; 95% CI 1.15-1.28). Individuals with visual impairment had higher rates of psychosis than their full siblings with normal vision (adjusted HR 1.20, 95% CI 1.07-1.35). CONCLUSIONS Impaired visual acuity is associated with non-affective psychosis. Visual impairment as a phenotype in psychosis requires further consideration.
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Affiliation(s)
- Joseph F Hayes
- Division of Psychiatry, University College London, London, UK,To whom correspondence should be addressed; Division of Psychiatry, University College London, 6th Floor Maple House, 149 Tottenham Court Road, London W1T 7NF, UK; tel: 020-767-99736, e-mail:
| | - Suzanne Picot
- Division of Psychiatry, University College London, London, UK
| | | | - Glyn Lewis
- Division of Psychiatry, University College London, London, UK
| | - Christina Dalman
- Department of Public Health Sciences, Unit of Public Health Epidemiology, Karolinska Institute, Stockholm, Sweden
| | - Andreas Lundin
- Department of Public Health Sciences, Unit of Public Health Epidemiology, Karolinska Institute, Stockholm, Sweden
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20
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Huang L, Kawasaki H, Liu Y, Wang Z. The prevalence of myopia and the factors associated with it among university students in Nanjing: A cross-sectional study. Medicine (Baltimore) 2019; 98:e14777. [PMID: 30855486 PMCID: PMC6417623 DOI: 10.1097/md.0000000000014777] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Myopia, a common eye disease, is a global health burden that is increasing worldwide. Although the risk factors for myopia among children have been extensively investigated, those among university students have not. The aim of our study was to investigate the prevalence of myopia and the factors associated with it among university students in Nanjing.Subjects were selected from among the university students using a stratified random sampling method. A total of 1200 first-year university students were invited to participate in the study. A self-reported questionnaire was used to collect data on the students' demographic information, history of parental myopia, and behavioral factors, such as having bad postures while reading or writing, performing eye exercises, taking breaks after 30 minutes of continuous reading, using computers or smartphones, sleep, near-work, and outdoor activity. Univariate analyses were performed to find the associations between myopia and the various parameters. Factors that were statistically significant in univariate analyses were selected as candidate variates for multivariate analysis.The overall prevalence of myopia was 86.8%: 86.1% among males, and 88.0% among females (χ = 0.68, P = .411). Chi-squared tests showed that parental myopia, performing eye exercises, taking breaks after 30 minutes of continuous reading, and engaging in outdoor activity were significantly associated with myopia (P < .001, P = .034, P < .001, and P = .002, respectively). Having at least 1 parent with myopia was a risk factor for myopia (OR = 3.58, 95% CI = 1.96-6.54); whereas, taking breaks after 30 minutes of continuous reading and performing at least 2 hours of outdoor activity per day were protective against myopia in multivariate analysis (OR = 0.61, 95% CI = 0.41-0.93; and OR = 0.45, 95% CI = 0.2-0.99; respectively).The prevalence of myopia among university students was 86.8%. Parental myopia was a risk factor for myopia. Taking breaks after 30 minutes of continuous reading, and engaging in at least 2 hours of outdoor activity were associated with less myopia. In addition, performing eye exercises was associated with less myopia on univariate analysis.
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Affiliation(s)
- Luoming Huang
- Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiromi Kawasaki
- Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yiqun Liu
- School of Material Engineering, Jinling Institute of Technology, Nanjing
| | - Zhongliang Wang
- School of Economics & Management, Changsha University of Science & Technology, Changsha, China
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Nickels S, Hopf S, Pfeiffer N, Schuster AK. Myopia is associated with education: Results from NHANES 1999-2008. PLoS One 2019; 14:e0211196. [PMID: 30695049 PMCID: PMC6350963 DOI: 10.1371/journal.pone.0211196] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 01/09/2019] [Indexed: 11/20/2022] Open
Abstract
Purpose Myopia is increasing worldwide and possibly linked to education. In this study, we analyse the association of myopia and education in the U.S. and investigate its age-dependency. Methods We conducted a secondary data analysis using the public use files from the cross-sectional study National Health and Nutrition Examination Survey of the period from 1999 to 2008. 19,756 participants aged 20 to 85 years were included with data on education and ophthalmic parameters (distance visual acuity, objective refraction and keratometry). Spherical equivalent, astigmatism, corneal power and corneal astigmatism were evaluated for an association with education using linear regression analysis with adjustment of potential confounders. Results Analysis revealed an association between spherical equivalent and educational level in the univariate analysis (P < .001), and in the adjusted model (P < .001). Subjects who attend school to less than 9th grade had a mean spherical equivalent of 0.34 D, subjects with 9-11th grade -0.14 D, subjects that finished high school -0.33 D, subjects with partial college education -0.70 D, subjects that graduated from college or a higher formal education -1.22 D. Subjects that graduated from college or above were -1.47 D more myopic compared to subjects that completed less than 9th grade school in the adjusted analyses. Astigmatism and corneal curvature was not associated with education. Conclusions Myopia is associated with higher education in the U.S. Our analysis shows that corneal curvature does not contribute to this association, therefore axial elongation or lens power are likely to contribute to myopia.
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Affiliation(s)
- Stefan Nickels
- Center for Ophthalmic Epidemiology and Healthcare Research, Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Susanne Hopf
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Norbert Pfeiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Alexander K. Schuster
- Center for Ophthalmic Epidemiology and Healthcare Research, Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- * E-mail:
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22
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Jan C, Li SM, Kang MT, Liu L, Li H, Jin L, Qin X, Congdon N, Wang N. Association of visual acuity with educational outcomes: a prospective cohort study. Br J Ophthalmol 2019; 103:1666-1671. [PMID: 30658989 DOI: 10.1136/bjophthalmol-2018-313294] [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: 09/27/2018] [Revised: 11/29/2018] [Accepted: 12/15/2018] [Indexed: 11/03/2022]
Abstract
BACKGROUND/AIM To quantify the impact of baseline presenting visual acuity (VA), refractive error and spectacles wear on subsequent academic performance among Chinese middle school children. METHODS A prospective, longitudinal, school-based study on grade 7 Chinese children (age, mean±SD, 12.7±0.5 years, range=11.1-15.9) at four randomly selected middle schools in Anyang, China. Comprehensive eye examinations including cycloplegic autorefraction were performed at baseline, and information on demographic characteristics, known risk factors for myopia and spectacle wear was collected. Academic test scores for all subjects in the curriculum were obtained from the local Bureau of Education. Main outcome measure was total test scores for five subjects at the end of grade 9, adjusted for total scored at the beginning of grade 7. RESULTS Among 2363 eligible children, 73.1% (1728/2363) had seventh grade test scores available. 93.9% (1623/1728) completed eye examinations, and 98.5% (1599/1623) of these had ninth grade test scores. Adjusting only for baseline test score, the following were significantly associated with higher ninth grade scores: younger age, male sex, less time outdoors, better baseline presenting VA, higher parental education and income and parental myopia, but refractive error and spectacle wear were not. In the full multivariate model, baseline test score (p<0.001), presenting VA (p<0.01), age (p<0.001), quality of life (p<0.05) and parental education (p<0.001) and myopia (either: p<0.05; both: p<0.05) remained significantly associated with better ninth grade scores. CONCLUSIONS In this longitudinal study, better presenting VA, but not cycloplegic refractive error or spectacle wear, was significantly associated with subsequent academic performance.
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Affiliation(s)
- Catherine Jan
- The George Institute for Global Health, Faculty of Medicine, The University of New South Wale, Sydney, New South Wales, Australia.,Beijing Tongren Hospital, Beijing Ophthalmology Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University, Beijing Tongren Eye Center, Beijing, China.,School of Psychological and Cognitive Sciences, Peking University, Beijing, China
| | - Shi-Ming Li
- Beijing Tongren Hospital, Beijing Ophthalmology Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University, Beijing Tongren Eye Center, Beijing, China
| | - Meng-Tian Kang
- Beijing Tongren Hospital, Beijing Ophthalmology Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University, Beijing Tongren Eye Center, Beijing, China
| | | | - He Li
- Anyang Eye Hospital, Anyang, China
| | - Ling Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xuezheng Qin
- School of Economics, Peking University, Beijing, China
| | - Nathan Congdon
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.,ORBIS International, New York, New York City, USA.,TREE Centre, Centre for Public Health, Queen's University Belfast, Belfast, Northern Ireland
| | - Ningli Wang
- Beijing Tongren Hospital, Beijing Ophthalmology Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University, Beijing Tongren Eye Center, Beijing, China
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23
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Williams KM, Kraphol E, Yonova-Doing E, Hysi PG, Plomin R, Hammond CJ. Early life factors for myopia in the British Twins Early Development Study. Br J Ophthalmol 2018; 103:1078-1084. [PMID: 30401676 DOI: 10.1136/bjophthalmol-2018-312439] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 08/07/2018] [Accepted: 08/21/2018] [Indexed: 01/11/2023]
Abstract
PURPOSE Myopia is an increasingly prevalent condition globally. A greater understanding of contemporaneous, early life factors associated with myopia risk is urgently required, particularly in younger onset myopia as this correlates with higher severity and increased complications in adult life. METHODS Analysis of a subset of the longitudinal, UK-based Twins Early Development Study (n=1991) recruited at birth between 1994 and 1996. Subjective refraction was obtained from the twin's optometrists; mean age 16.3 years (SD 1.7). Myopia was defined as mean spherical equivalent ≤-0.75 dioptres. A life course epidemiology approach was used to appropriately weight candidate myopia risk factors during critical periods of eye growth. Adjusted ORs for myopia were estimated using multivariable logistic regression models at each life stage, together with variance explained (r2) and area under the receiver operator characteristic curve (AUROC) statistic of predictive models. RESULTS Factors significantly associated with myopia included level of maternal education (OR 1.33, 95% CI 1.11 to 1.59), fertility treatment (OR 0.63, 95% CI 0.43 to 0.92), summer birth (OR 1.93, 95% CI 1.28 to 2.90) and hours spent playing computer games (OR 1.03, 95% CI 1.01 to 1.06). The total variance explained by this model was 4.4 % (p<0.001) and the AUROC was 0.68 (95% CI 0.64 to 0.72). Consistent associations were observed with socioeconomic status, educational attainment, reading enjoyment and cognitive variables, particularly verbal cognition, at multiple points over the life course. CONCLUSIONS This study identifies known and novel associations with myopia during childhood development; associated factors identified in early life reflect sociological and lifestyle trends such as rates of maternal education, fertility treatment, early schooling and computer games.
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Affiliation(s)
- Katie M Williams
- Section of Academic Ophthalmology, School of Life Course Sciences, FoLSM, King's College London, London, UK.,Department of Twin Research & Genetic Epidemiology, School of Life Course Sciences, FoLSM, King's College London, London, UK
| | - Eva Kraphol
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ekaterina Yonova-Doing
- Department of Twin Research & Genetic Epidemiology, School of Life Course Sciences, FoLSM, King's College London, London, UK
| | - Pirro G Hysi
- Section of Academic Ophthalmology, School of Life Course Sciences, FoLSM, King's College London, London, UK.,Department of Twin Research & Genetic Epidemiology, School of Life Course Sciences, FoLSM, King's College London, London, UK
| | - Robert Plomin
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Christopher J Hammond
- Section of Academic Ophthalmology, School of Life Course Sciences, FoLSM, King's College London, London, UK .,Department of Twin Research & Genetic Epidemiology, School of Life Course Sciences, FoLSM, King's College London, London, UK
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24
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Abstract
Myopia occurs in more than 50% of the population in many industrialized countries and is expected to increase; complications associated with axial elongation from myopia are the sixth leading cause of blindness. Thus, understanding its etiology, epidemiology, and the results of various treatment regiments may modify current care and result in a reduction in morbidity from progressive myopia. This rapid increase cannot be explained by genetics alone. Current animal and human research demonstrates that myopia development is a result of the interplay between genetic and the environmental factors. The prevalence of myopia is higher in individuals whose both parents are myopic, suggesting that genetic factors are clearly involved in myopia development. At the same time, population studies suggest that development of myopia is associated with education and the amount time spent doing near work; hence, activities increase the exposure to optical blur. Recently, there has been an increase in efforts to slow the progression of myopia because of its relationship to the development of serious pathological conditions such as macular degeneration, retinal detachments, glaucoma, and cataracts. We reviewed meta-analysis and other of current treatments that include: atropine, progressive addition spectacle lenses, orthokeratology, and multifocal contact lenses.
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25
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Mountjoy E, Davies NM, Plotnikov D, Smith GD, Rodriguez S, Williams CE, Guggenheim JA, Atan D. Education and myopia: assessing the direction of causality by mendelian randomisation. BMJ 2018; 361:k2022. [PMID: 29875094 PMCID: PMC5987847 DOI: 10.1136/bmj.k2022] [Citation(s) in RCA: 142] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES To determine whether more years spent in education is a causal risk factor for myopia, or whether myopia is a causal risk factor for more years in education. DESIGN Bidirectional, two sample mendelian randomisation study. SETTING Publically available genetic data from two consortiums applied to a large, independent population cohort. Genetic variants used as proxies for myopia and years of education were derived from two large genome wide association studies: 23andMe and Social Science Genetic Association Consortium (SSGAC), respectively. PARTICIPANTS 67 798 men and women from England, Scotland, and Wales in the UK Biobank cohort with available information for years of completed education and refractive error. MAIN OUTCOME MEASURES Mendelian randomisation analyses were performed in two directions: the first exposure was the genetic predisposition to myopia, measured with 44 genetic variants strongly associated with myopia in 23andMe, and the outcome was years in education; and the second exposure was the genetic predisposition to higher levels of education, measured with 69 genetic variants from SSGAC, and the outcome was refractive error. RESULTS Conventional regression analyses of the observational data suggested that every additional year of education was associated with a more myopic refractive error of -0.18 dioptres/y (95% confidence interval -0.19 to -0.17; P<2e-16). Mendelian randomisation analyses suggested the true causal effect was even stronger: -0.27 dioptres/y (-0.37 to -0.17; P=4e-8). By contrast, there was little evidence to suggest myopia affected education (years in education per dioptre of refractive error -0.008 y/dioptre, 95% confidence interval -0.041 to 0.025, P=0.6). Thus, the cumulative effect of more years in education on refractive error means that a university graduate from the United Kingdom with 17 years of education would, on average, be at least -1 dioptre more myopic than someone who left school at age 16 (with 12 years of education). Myopia of this magnitude would be sufficient to necessitate the use of glasses for driving. Sensitivity analyses showed minimal evidence for genetic confounding that could have biased the causal effect estimates. CONCLUSIONS This study shows that exposure to more years in education contributes to the rising prevalence of myopia. Increasing the length of time spent in education may inadvertently increase the prevalence of myopia and potential future visual disability.
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Affiliation(s)
- Edward Mountjoy
- MRC Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Neil M Davies
- MRC Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Denis Plotnikov
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Santiago Rodriguez
- MRC Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Cathy E Williams
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Denize Atan
- Translational Health Sciences, Bristol Medical School, University of Bristol, Biomedical Sciences Building, Bristol BS8 1TD, UK
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Read SA, Vincent SJ, Tan CS, Ngo C, Collins MJ, Saw SM. Patterns of Daily Outdoor Light Exposure in Australian and Singaporean Children. Transl Vis Sci Technol 2018; 7:8. [PMID: 29862140 PMCID: PMC5976264 DOI: 10.1167/tvst.7.3.8] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 04/12/2018] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Myopia is rising in prevalence in many locations, and there is evidence that outdoor light exposure is a major environmental factor playing a role in myopia development. This study examined the patterns of daily light exposure in similarly aged children from two geographic locations (Australia and Singapore) known to exhibit differences in myopia prevalence. METHODS Wearable light sensors were used to assess daily light exposure in 69 Singaporean children aged 8 to 12 years (mean, 9.2 ± 1.1) and 43 Australian children aged 10 to 12 years (mean, 11.3 ± 0.6). The mean daily time exposed to bright outdoor light (>1000 lux) and the number and duration of daily episodes of outdoor exposure were examined. RESULTS Patterns of daily outdoor light exposure differed substantially between Australia and Singapore. Australian children (105 ± 42 min/d) experienced significantly longer daily outdoor light exposure than Singaporean children (61 ± 40 min/d; P = 0.005), with the largest differences found on weekdays during school hours. Australian children (6.9 ± 1.5 episodes per day) had more frequent daily episodes of outdoor light exposure compared with Singaporean children (4.6 ± 1.5; P = 0.02); however, there was no significant difference in the mean duration of these episodes between countries (P = 0.54). CONCLUSIONS Children living in Singapore were exposed to significantly less daily outdoor light than Australian children, and these differences may be one of several factors contributing to the differences in myopia prevalence typically found between these populations. TRANSLATIONAL RELEVANCE Knowledge of these light exposure patterns may assist in the design of outdoor interventions, including school programs, to increase outdoor time in urban Asian populations.
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Affiliation(s)
- Scott A. Read
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Stephen J. Vincent
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Chuen-Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Cheryl Ngo
- Department of Ophthalmology, National University Hospital, Singapore
| | - Michael J. Collins
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Seang-Mei Saw
- Department of Ophthalmology, National University Hospital, Singapore
- Singapore Eye Research Institute, Singapore
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27
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Early Intervention and Nonpharmacological Therapy of Myopia in Young Adults. J Ophthalmol 2018; 2018:4680603. [PMID: 29576878 PMCID: PMC5822817 DOI: 10.1155/2018/4680603] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Accepted: 12/13/2017] [Indexed: 02/08/2023] Open
Abstract
Myopia is a condition of the eye where parallel rays focus in front of, instead of on, the retina, which results in excessive refractive power of the cornea or the lens or eyeball elongation. Studies carried out in recent years show that the etiology of myopia is complex with genetic and environmental factors playing a role. Refraction defects decrease the quality of vision, while progressing myopia can lead to partial loss of vision, which can be particularly dramatic in young adults. Therefore, it is so crucial to take appropriate actions aimed at preventing myopia progression. This is a review of nonpharmacological therapeutic possibilities of refraction defect prevention in young adults, with special regard to myofascial therapy, osteopathy, and massage of acupuncture points surrounding the eye.
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Ding BY, Shih YF, Lin LL, Hsiao CK, Wang IJ. Myopia among schoolchildren in East Asia and Singapore. Surv Ophthalmol 2017; 62:677-697. [DOI: 10.1016/j.survophthal.2017.03.006] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 03/16/2017] [Accepted: 03/16/2017] [Indexed: 11/30/2022]
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29
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Čiumbaraitė R, Liutkevičienė R. Refractive errors characteristic of the patients at the Children's Ophthalmology Outpatient Department of Kauno klinikos Hospital (Lithuanian University of Health Sciences) from 1 January 2012 to 31 December 2012. Acta Med Litu 2017; 24:83-92. [PMID: 28845125 PMCID: PMC5566946 DOI: 10.6001/actamedica.v24i2.3488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The purpose of our study was to assess the distribution and patterns of refractive errors in children for the proper planning of paediatric eye care at the centre. MATERIAL AND METHODS The study was conducted in the hospital of the Lithuanian University of Health Sciences in Kaunas, from 1 January 2012 to 31 December 2012. During this period, a total of 11,406 children, aged 0-18 years, were evaluated at the outpatient department of paediatric ophthalmology, Kauno klinikos, the Lithuanian University of Health Sciences. All the children underwent a complete ophthalmic examination with cycloplegic refraction. RESULTS Myopia increased from 1.5% (95% CI:1.2, 1.8) in the age group of 0-1 to 44.7% (95% CI:43.46, 45.94) in the age group of 14-18 (p < 0.001). Myopia was associated with older age, female gender (20.3%; 95% CI:19.3, 21.3; p < 0.001). Hypermetropia decreased from 84.6% (95% CI:83.7, 85.5) in the cohort of 0-1 to 11.4% (95% CI: 10.61, 12.19) in the 14-18 age group (p < 0.001). Hypermetropia was associated with younger age, male gender (43.4%; 95% CI:42.16, 44.64; p < 0.001), preterm birth (56.1%; 95% CI:54.86, 57.34; 43.4%; p < 0.001), low birth weight (61.8%; 95% CI:60.59, 63.01; p < 0.001), and birth by Caesarean section (57.1%; 95% CI: 55.87; 58.33) (p < 0.001). The prevalence of astigmatism was 25.5% (95% CI: 24.41; 26.59) (p < 0.001). Astigmatism was associated with female gender (20.1%; 95%. CI: 19.1; 21.1) and too big pregnancy weight (22.1%.; 95%. CI: 21.06; 23.14) (p < 0.001). CONCLUSIONS Of the 14-18 age group, 44.7% of the patients were myopic. Of the 0-1 age group, 84.6% were hypermetropic. Astigmatism was detected in about 25.5% of children. The prevalence of refractive errors was associated with age, gender, gestation age, gestation weight, and parental refractive error.
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Affiliation(s)
- Rasa Čiumbaraitė
- Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Rasa Liutkevičienė
- Department of Ophthalmology, Neuroscience Institute, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
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30
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Hashemi H, Nabovati P, Yekta A, Shokrollahzadeh F, Khabazkhoob M. The prevalence of refractive errors among adult rural populations in Iran. Clin Exp Optom 2017; 101:84-89. [PMID: 28702951 DOI: 10.1111/cxo.12565] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Revised: 03/21/2017] [Accepted: 03/24/2017] [Indexed: 12/01/2022] Open
Abstract
PURPOSE The aim was to determine the prevalence of myopia and hyperopia and related factors in underserved rural areas in Iran. METHODS Under random cluster sampling, two rural regions were randomly selected in the north and southwest of the country, and 3,061 persons over 15 years of age were invited into the study. After selecting samples, all participants had refraction, measurement of uncorrected vision and visual acuity and ocular health examination by slitlamp biomicroscopy. RESULTS Of the 3,061 invitees, 2,575 participated in the study (response rate: 84.1 per cent). After excluding those who met the exclusion criteria or had missing refractive data, eventually there were 2,518 subjects available for this analysis. The mean age of the participants was 44.3 ± 17.5 years (range: 16 to 93 years) and 1,460 of them (58.0 per cent) were female. The overall prevalence of myopia and hyperopia in this study was 25.2 per cent (95 per cent CI: 23.2 to 27.2) and 22.5 per cent (95 per cent CI: 20.6 to 24.4), respectively. The prevalence of myopia increased from 20.9 per cent in participants 16 to 20 years to 32.9 per cent in the 21 to 30 years age group, declined up to the age of 60 years and increased again afterwards. The lowest prevalence was 6.8 per cent observed in the 16 to 20 years age group and the highest was 45.8 per cent in 61- to 70-year-olds. In the final logistic regression model, myopia significantly associated with age, higher education levels and cataracts, while hyperopia associated with age, lower education levels and male gender. CONCLUSION In our study, the prevalence of myopia was lower and the prevalence of hyperopia was higher compared to most previous studies. The findings of this study imply that refractive errors vary by age.
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Affiliation(s)
- Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran.,Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
| | - Payam Nabovati
- Department of Optometry, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Abbasali Yekta
- Refractive Errors Research Center, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Mehdi Khabazkhoob
- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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31
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Williams KM, Hysi PG, Yonova-Doing E, Mahroo OA, Snieder H, Hammond CJ. Phenotypic and genotypic correlation between myopia and intelligence. Sci Rep 2017; 7:45977. [PMID: 28383074 PMCID: PMC5382686 DOI: 10.1038/srep45977] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 03/07/2017] [Indexed: 01/13/2023] Open
Abstract
Myopia, or near-sightedness, is our most common eye condition and the prevalence is increasing globally. Visual impairment will occur if uncorrected, whilst high myopia causes sight-threatening complications. Myopia is associated with higher intelligence. As both are heritable, we set out to examine whether there is a genetic correlation between myopia and intelligence in over 1,500 subjects (aged 14-18 years) from a twin birth cohort. The phenotypic correlation between refractive error and intelligence was -0.116 (p < 0.01) - the inverse correlation due to the fact that myopia is a negative refractive error. Bivariate twin modeling confirmed both traits were heritable (refractive error 85%, intelligence 47%) and the genetic correlation was -0.143 (95% CI -0.013 to -0.273). Of the small phenotypic correlation the majority (78%) was explained by genetic factors. Polygenic risk scores were constructed based on common genetic variants identified in previous genome-wide association studies of refractive error and intelligence. Genetic variants for intelligence and refractive error explain some of the reciprocal variance, suggesting genetic pleiotropy; in the best-fit model the polygenic score for intelligence explained 0.99% (p = 0.008) of refractive error variance. These novel findings indicate shared genetic factors contribute significantly to the covariance between myopia and intelligence.
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Affiliation(s)
- Katie M. Williams
- Department of Ophthalmology, King’s College London, 3rd Floor Block D South Wing, St Thomas’ Hospital, Westminster Bridge Road, London, SE1 7EH, UK
- Department of Twin Research & Genetic Epidemiology, King’s College London, 3rd Floor Block D South Wing, St Thomas’ Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Pirro G. Hysi
- Department of Twin Research & Genetic Epidemiology, King’s College London, 3rd Floor Block D South Wing, St Thomas’ Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Ekaterina Yonova-Doing
- Department of Twin Research & Genetic Epidemiology, King’s College London, 3rd Floor Block D South Wing, St Thomas’ Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Omar A. Mahroo
- Department of Ophthalmology, King’s College London, 3rd Floor Block D South Wing, St Thomas’ Hospital, Westminster Bridge Road, London, SE1 7EH, UK
| | - Harold Snieder
- Unit of Genetic Epidemiology & Bioinformatics, Department of Epidemiology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, The Netherlands
| | - Christopher J. Hammond
- Department of Ophthalmology, King’s College London, 3rd Floor Block D South Wing, St Thomas’ Hospital, Westminster Bridge Road, London, SE1 7EH, UK
- Department of Twin Research & Genetic Epidemiology, King’s College London, 3rd Floor Block D South Wing, St Thomas’ Hospital, Westminster Bridge Road, London, SE1 7EH, UK
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Sorjonen K, Farioli A, Hemmingsson T, Melin B. Refractive state, intelligence, education, and Lord's paradox. INTELLIGENCE 2017. [DOI: 10.1016/j.intell.2017.01.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Rose KA, French AN, Morgan IG. Environmental Factors and Myopia: Paradoxes and Prospects for Prevention. Asia Pac J Ophthalmol (Phila) 2017; 5:403-410. [PMID: 27898443 DOI: 10.1097/apo.0000000000000233] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
The prevalence of myopia in developed countries in East and Southeast Asia has increased to more than 80% in children completing schooling, whereas that of high myopia has increased to 10%-20%. This poses significant challenges for correction of refractive errors and the management of pathological high myopia. Prevention is therefore an important priority. Myopia is etiologically heterogeneous, with a low level of myopia of clearly genetic origins that appears without exposure to risk factors. The big increases have occurred in school myopia, driven by increasing educational pressures in combination with limited amounts of time spent outdoors. The rise in prevalence of high myopia has an unusual pattern of development, with increases in prevalence first appearing at approximately age 11. This pattern suggests that the increasing prevalence of high myopia is because of progression of myopia in children who became myopic at approximately age 6 or 7 because age-specific progression rates typical of East Asia will take these children to the threshold for high myopia in 5 to 6 years. This high myopia seems to be acquired, having an association with educational parameters, whereas high myopia in previous generations tended to be genetic in origin. Increased time outdoors can counter the effects of increased nearwork and reduce the impact of parental myopia, reducing the onset of myopia, and this approach has been validated in 3 randomized controlled trials. Other proposed risk factors need further work to demonstrate that they are independent and can be modified to reduce the onset of myopia.
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Affiliation(s)
- Kathryn Ailsa Rose
- From the *Discipline of Orthoptics, Graduate School of Health, University of Technology Sydney, Ultimo, New South Wales; †Research School of Biology, Australian National University, Canberra, Australian Capital Territory, Australia; and ‡State Key Laboratory of Ophthalmology and Division of Preventive Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
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Handa S, Chia A, Htoon HM, Lam PM, Yap F, Ling Y. Myopia in young patients with type 1 diabetes mellitus. Singapore Med J 2016; 56:450-4. [PMID: 26310273 DOI: 10.11622/smedj.2015122] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION This study aimed to evaluate the proportion of young patients with type 1 diabetes mellitus (T1DM) who have myopia, as well as the risk factors associated with myopia in this group. METHODS In this cross-sectional study, patients aged < 21 years with T1DM for ≥ 1 year underwent a comprehensive eye examination. Presence of parental myopia, and average hours of near-work and outdoor activity were estimated using a questionnaire. Annualised glycosylated haemoglobin (HbA1c), defined as the mean of the last three HbA1c readings taken over the last year, was calculated. Multivariate analysis using genetic, environmental and diabetes-related factors was done to evaluate risk factors associated with myopia. RESULTS Of the 146 patients (mean age 12.5 ± 3.6 years) recruited, 66.4% were Chinese and 57.5% were female. Myopia (i.e. spherical equivalent [SE] of -0.50 D or worse) was present in 96 (65.8%) patients. The proportion of patients with myopia increased from 25.0% and 53.6% in those aged < 7.0 years and 7.0-9.9 years, respectively, to 59.2% and 78.4% in those aged 10.0-11.9 years and ≥ 12.0 years, respectively. Higher levels of SE were associated with lower parental myopia (p = 0.024) and higher annualised HbA1c (p = 0.011). CONCLUSION Compared to the background population, the proportion of myopia in young patients with T1DM was higher in those aged < 10 years but similar in the older age group. Myopia was associated with a history of parental myopia. Environmental risk factors and poor glycaemic control were not related to higher myopia risk.
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Affiliation(s)
- Swati Handa
- Department of Ophthalmology, KK Women's and Children's Hospital, Singapore
| | - Audrey Chia
- Department of Ophthalmology, KK Women's and Children's Hospital, Singapore ; Singapore National Eye Centre, Singapore
| | | | - Pin Min Lam
- Department of Ophthalmology, KK Women's and Children's Hospital, Singapore
| | - Fabian Yap
- Department of Ophthalmology, KK Women's and Children's Hospital, Singapore
| | - Yvonne Ling
- Department of Ophthalmology, KK Women's and Children's Hospital, Singapore ; Singapore National Eye Centre, Singapore
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The influence of near work on myopic refractive change in urban students in Beijing: a three-year follow-up report. Graefes Arch Clin Exp Ophthalmol 2016; 254:2247-2255. [PMID: 27460281 DOI: 10.1007/s00417-016-3440-9] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 07/01/2016] [Accepted: 07/07/2016] [Indexed: 10/21/2022] Open
Abstract
PURPOSE To investigate the influence of daily activities on myopic refractive change and myopic onset in Chinese urban students. METHODS The Beijing Myopia Progression Study was a 3-year cohort study. Cycloplegic refraction and a daily activity questionnaire were assessed at baseline and at follow-up examinations. Refractive change was defined as the difference in cycloplegic spherical equivalent (SE) between the final follow-up and baseline. 386 students were initially enrolled in the baseline study. RESULTS At the final follow-up, 222 students (57.5 %) with completed refractive error and daily activity data were analyzed. These students spent 0.32 ± 2.33 h/day more on near work (p = 0.04), and 0.21 ± 1.31 h/day less on outdoor leisure (p = 0.02), than they did at baseline. In the multivariate analysis, the younger among the secondary students (β = 0.06, p < 0.001), and those with more near work hours at baseline (β = -0.028, p = 0.033), exhibited more myopic refractive change. However, myopic refractive change was not found to be significantly associated with near work hours in the primary students, or with time spent outdoors, in either school level. After stratifying the activity hours into quartile groups, students with a greater near work load at baseline (trend P = 0.03) exhibited a greater myopic refractive change and had a higher risk to develop myopia (hazard ratio, 95 % confidence interval: 5.19, 1.49-18.13), after adjusting for the confounders. However, no significant association was found related to outdoor activity. CONCLUSIONS In this cohort, children with a greater near work load at baseline exhibited more myopic refractive change and were also more likely to develop myopia. The protective effect of outdoor activity on myopic refractive change was not observed.
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Radhakrishnan H, Hartwig A, Charman WN, Llorente L. Accommodation response to Chinese and Latin characters in Chinese-illiterate young adults. Clin Exp Optom 2015; 98:527-34. [PMID: 26450168 DOI: 10.1111/cxo.12296] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 03/09/2015] [Accepted: 03/12/2015] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Differences in accommodation when reading Chinese, as compared to Latin, characters have been suggested to have a role in the higher prevalence of myopia in some Asian countries. Yeo and colleagues (Optom Vis Sci 2013; 90: 156-163) found that, in Chinese-literate children, accommodation was marginally more accurate (by less than 0.05 D), when reading Chinese text. This was attributed to the additional cognitive demand associated with interpreting the more complex Chinese symbols. The present study compared responses to single Chinese and Latin characters, while controlling for cognitive demand. METHODS The monocular accommodative response was measured in Chinese-illiterate adults (10 emmetropes, mean spherical equivalent: -0.07 ± 0.42 D, age: 29.9 ± 4.2 years; 11 myopes, mean spherical equivalent: -4.28 ± 2.84 D, age: 31.7 ± 4.6 years) with an open-field autorefractor. Four Chinese and three Latin characters (approximately 1.15 degrees subtense) were individually presented on a display screen one metre away from the subject, while their vergence was varied over the range zero to 5.00 D using spectacle trial lenses. The slope and the accommodative error index (AEI) were calculated from the accommodative stimulus/response curves (ASRC). RESULTS No statistically significant differences were found between refractive groups or among characters within the same refractive group in ARSC slopes (Latin: 0.87 ± 0.14 for myopes versus 0.81 ± 0.12 for emmetropes; Chinese: 0.84 ± 0.12 for myopes versus 0.85 ± 0.12 for emmetropes). No significant differences were found between characters in accommodative error index either (Latin, 0.78 ± 0.42 D for myopes versus 1.15 ± 0.72 D for emmetropes; Chinese, 0.74 ± 0.37 D for myopes versus 1.17 ± 0.83 D for emmetropes). However, accommodative error indices and accommodative errors were significantly higher for emmetropes. CONCLUSION Under controlled cognitive demand, Chinese and Latin characters elicited similar responses in both individual refractive groups. This study fails to support the hypothesis that development of myopia in some Asian populations is associated with larger lags of accommodation when reading or viewing Chinese characters.
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Affiliation(s)
- Hema Radhakrishnan
- Faculty of Life Sciences, University of Manchester, Manchester, United Kingdom
| | - Andreas Hartwig
- Faculty of Life Sciences, University of Manchester, Manchester, United Kingdom
| | - W Neil Charman
- Faculty of Life Sciences, University of Manchester, Manchester, United Kingdom
| | - Lourdes Llorente
- Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia. .,Faculty of Health, Deakin University, Waurn Ponds, Australia.
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Ramessur R, Williams KM, Hammond CJ. Risk factors for myopia in a discordant monozygotic twin study. Ophthalmic Physiol Opt 2015; 35:643-51. [PMID: 26376775 PMCID: PMC4832275 DOI: 10.1111/opo.12246] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Accepted: 08/03/2015] [Indexed: 01/01/2023]
Abstract
PURPOSE Monozygotic (MZ) twin pairs discordant for disease allow careful examination of environmental factors whilst controlling for genetic variation. The purpose of this study was to examine differences in environmental risk factors in MZ twins discordant for myopia. METHODS Sixty four MZ twin pairs discordant for refractive error were interviewed. Discordant twins were selected from 1326 MZ twin pairs from the TwinsUK adult twin registry with non-cycloplegic autorefraction. Discordancy was defined as ≥ 2 Dioptres (D) difference in spherical equivalent (SphE) and discordant for class of refractive error. In a 35-item telephone questionnaire twins were separately asked (and scored) about the risk factors urban/rural residence, occupational status and highest educational level. They responded with more (1), less (-1) or the same (0) as their twin on time spent outside, playing outdoor sport, and on close work aged <16 and 16-25 years. The lower SphE twin's score was subtracted from the higher SphE twin's score, and mean values of the difference calculated for each variable. RESULTS Sixty four twin pairs were included (mean age 56, range 30-79 years; mean difference in refraction 3.35 D, S.D. 1.55 D, median difference 2.78 D). Within discordant MZ twin pairs, the more myopic twin was associated with having a higher occupational status (mean score between 16 and 25 years -0.11; 95% CI -0.19 to -0.04; mean score aged >25 years -0.23, 95% CI -0.28 to -0.17), being resident in urban area (mean score -0.26; 95% CI -0.33 to -0.18) and performing more close work (mean score <16 years -0.11; 95% CI -0.18 to -0.05; mean score aged 16-25 years -0.17, 95% CI -0.24 to -0.10) than their twin. The twins who spent more time outdoors (mean score <16 years 0.09; 95% CI 0.03-0.15; mean score aged 16-25 years 0.28, 95% CI 0.15-0.41) or performed more outdoors sports (mean score <16 years 0.13; 95% CI 0.04-0.21; mean score aged 16-25 years 0.23, 95% CI 0.10-0.36) were less likely to be myopic than their twin. CONCLUSIONS This study has confirmed known environmental risk factors for myopia. These data will allow selection of discordant twins for epigenetic analysis to advance knowledge of mechanisms of refractive error development.
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Affiliation(s)
- Rishi Ramessur
- Department of Twin Research, Kings College London, London, UK.,Department of Medicine, University of Oxford, Oxford, UK
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Williams KM, Bertelsen G, Cumberland P, Wolfram C, Verhoeven VJM, Anastasopoulos E, Buitendijk GHS, Cougnard-Grégoire A, Creuzot-Garcher C, Erke MG, Hogg R, Höhn R, Hysi P, Khawaja AP, Korobelnik JF, Ried J, Vingerling JR, Bron A, Dartigues JF, Fletcher A, Hofman A, Kuijpers RWAM, Luben RN, Oxele K, Topouzis F, von Hanno T, Mirshahi A, Foster PJ, van Duijn CM, Pfeiffer N, Delcourt C, Klaver CCW, Rahi J, Hammond CJ. Increasing Prevalence of Myopia in Europe and the Impact of Education. Ophthalmology 2015; 122:1489-97. [PMID: 25983215 PMCID: PMC4504030 DOI: 10.1016/j.ophtha.2015.03.018] [Citation(s) in RCA: 265] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 03/13/2015] [Accepted: 03/13/2015] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate whether myopia is becoming more common across Europe and explore whether increasing education levels, an important environmental risk factor for myopia, might explain any temporal trend. Design Meta-analysis of population-based, cross-sectional studies from the European Eye Epidemiology (E3) Consortium. Participants The E3 Consortium is a collaborative network of epidemiological studies of common eye diseases in adults across Europe. Refractive data were available for 61 946 participants from 15 population-based studies performed between 1990 and 2013; participants had a range of median ages from 44 to 78 years. Methods Noncycloplegic refraction, year of birth, and highest educational level achieved were obtained for all participants. Myopia was defined as a mean spherical equivalent ≤−0.75 diopters. A random-effects meta-analysis of age-specific myopia prevalence was performed, with sequential analyses stratified by year of birth and highest level of educational attainment. Main Outcome Measures Variation in age-specific myopia prevalence for differing years of birth and educational level. Results There was a significant cohort effect for increasing myopia prevalence across more recent birth decades; age-standardized myopia prevalence increased from 17.8% (95% confidence interval [CI], 17.6–18.1) to 23.5% (95% CI, 23.2–23.7) in those born between 1910 and 1939 compared with 1940 and 1979 (P = 0.03). Education was significantly associated with myopia; for those completing primary, secondary, and higher education, the age-standardized prevalences were 25.4% (CI, 25.0–25.8), 29.1% (CI, 28.8–29.5), and 36.6% (CI, 36.1–37.2), respectively. Although more recent birth cohorts were more educated, this did not fully explain the cohort effect. Compared with the reference risk of participants born in the 1920s with only primary education, higher education or being born in the 1960s doubled the myopia prevalence ratio–2.43 (CI, 1.26–4.17) and 2.62 (CI, 1.31–5.00), respectively—whereas individuals born in the 1960s and completing higher education had approximately 4 times the reference risk: a prevalence ratio of 3.76 (CI, 2.21–6.57). Conclusions Myopia is becoming more common in Europe; although education levels have increased and are associated with myopia, higher education seems to be an additive rather than explanatory factor. Increasing levels of myopia carry significant clinical and economic implications, with more people at risk of the sight-threatening complications associated with high myopia.
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Affiliation(s)
- Katie M Williams
- Department of Ophthalmology, King's College London, St. Thomas' Hospital, London, United Kingdom; Department of Twin Research and Genetic Epidemiology, King's College London, St. Thomas' Hospital, London, United Kingdom
| | - Geir Bertelsen
- Department of Ophthalmology, University Hospital of North Norway, Tromsø, Norway; Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Phillippa Cumberland
- Life Course, Epidemiology and Biostatistics Section, UCL Institute of Child Health, London, United Kingdom
| | - Christian Wolfram
- University Medical Center, Department of Ophthalmology, Mainz, Germany
| | - Virginie J M Verhoeven
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Gabriëlle H S Buitendijk
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Audrey Cougnard-Grégoire
- University Bordeaux, Bordeaux, France; ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France
| | - Catherine Creuzot-Garcher
- Department of Ophthalmology, Eye and Nutrition Research Group UMR 1324 INRA, University Hospital Dijon, France
| | - Maja Gran Erke
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
| | - Ruth Hogg
- Centre for Experimental Medicine, Institute of Clinical Science, Queen's University Belfast, Belfast, United Kingdom
| | - René Höhn
- University Medical Center, Department of Ophthalmology, Mainz, Germany
| | - Pirro Hysi
- Department of Twin Research and Genetic Epidemiology, King's College London, St. Thomas' Hospital, London, United Kingdom
| | - Anthony P Khawaja
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Jean-François Korobelnik
- University Bordeaux, Bordeaux, France; ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France
| | - Janina Ried
- Institute of Genetic Epidemiology, Helmholtz Center Munich, German Research Center for Environmental Health, Neuherberg, Germany
| | - Johannes R Vingerling
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Alain Bron
- Department of Ophthalmology, Eye and Nutrition Research Group UMR 1324 INRA, University Hospital Dijon, France
| | - Jean-François Dartigues
- University Bordeaux, Bordeaux, France; ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France
| | - Astrid Fletcher
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Albert Hofman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Robert W A M Kuijpers
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Robert N Luben
- Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Konrad Oxele
- Institute of Human Genetics, Klinikum rechts der Isar, Technische Universität, Munich, Germany
| | - Fotis Topouzis
- Department of Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Therese von Hanno
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway; Department of Ophthalmology, Nordland Hospital, Norway, Bodø, Norway
| | - Alireza Mirshahi
- University Medical Center, Department of Ophthalmology, Mainz, Germany
| | - Paul J Foster
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom
| | | | - Norbert Pfeiffer
- University Medical Center, Department of Ophthalmology, Mainz, Germany
| | - Cécile Delcourt
- University Bordeaux, Bordeaux, France; ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France
| | - Caroline C W Klaver
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Jugnoo Rahi
- Life Course, Epidemiology and Biostatistics Section, UCL Institute of Child Health, London, United Kingdom; NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom
| | - Christopher J Hammond
- Department of Ophthalmology, King's College London, St. Thomas' Hospital, London, United Kingdom; Department of Twin Research and Genetic Epidemiology, King's College London, St. Thomas' Hospital, London, United Kingdom.
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Association of birth parameters with refractive status in a sample of caucasian children aged 4-17 years. J Ophthalmol 2015; 2015:635682. [PMID: 25949820 PMCID: PMC4407624 DOI: 10.1155/2015/635682] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 03/17/2015] [Accepted: 04/01/2015] [Indexed: 11/17/2022] Open
Abstract
Purpose. To investigate the association of birth parameters with refractive status in different age groups of Caucasian children. Materials and Methods. This cross-sectional study included 564 eyes of 282 children aged 4 to 17 years. All children underwent complete ophthalmologic examination. The children were divided into three groups according to their refractive status (emmetropia,myopia, and hyperopia), ages (4-7, 8-9, 10-12, and 13-17), and appropriateness for gestational age, respectively. Results. The mean age of the children was 9.2 ± 2.8 (age range 4-17 years). The mean spheric equivalent was +0.3 ± 1.7 (range: (-10.0)-(+10.0) diopters). The mean birth weight and gestational age were 2681.1 ± 930.8 grams (750-5000 grams) and 37.2 ± 3.7 weeks (25-42 weeks). According to multinominal logistic regression analysis, children with myopia were more likely to have higher birth weights than emmetropic children (OR: 1.0, 95% CI: 1.000-1.001, and P = 0.028). The hypermetropes were found to be significantly small for gestational age between 13 and 17 years of age. Conclusion. Birth weight and appropriateness for gestational age as birth parameters may have an impact on development of all types of refractive errors. The hypermetropic children tended to be small for gestational age.
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Rodríguez Uña I, Pérez Bartolomé F, Urriés Ortiz M, Arriola Villalobos P, Bermúdez Vallecilla M, Fernández-Vega Cueto L, Martín Villaescusa C, Marticorena Álvarez P. Study of the relationship between myopia and personality. ACTA ACUST UNITED AC 2015; 90:365-72. [PMID: 25817967 DOI: 10.1016/j.oftal.2015.01.005] [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: 07/02/2014] [Revised: 11/22/2014] [Accepted: 01/23/2015] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To study the correlation between the myopic refractive error and certain personality traits, and to determine whether there is a correlation between the degree of myopia and an increased frequency in personality disorders. METHODS Cross-sectional observational multicenter study conducted on 82 subjects (26 men, 56 women) age over 18 years with myopia (spherical defect ≤ -0.5 D), with 30 subjects having high myopia (<-6 D). DATA COLLECTED age and gender, academic level, result in the Neo PI-R personality test, autorefractometry, myopic pathology, and ophthalmological treatment. RESULTS Correlation (Spearman's) between the magnitude of the spherical defect and the 5 personality traits studied in the total sample was not statistically significant: neuroticism (-0.057; P=.610), extroversion (-0.020; P=.857), openness (-0.032; P=.774), kindness (-0.060; P=.592), and responsibility (-0.034; P=.765). By dividing them into subgroups of low and high significance (t-test), a significant (P=.002) upward trend of the myopic defect with increasing scores on extraversion was found. When comparing high myopic subjects to the non-high myopic ones, there were significant differences between the 2 groups in terms of the associated pathology (P=.001), received treatment (P=.001) and the level of studies (P=.013). There were no differences in the variables of personality: neuroticism (P=.852), extroversion (P=.199), openness (P=.560), kindness (P=.584), and responsibility (P=.722). CONCLUSIONS A low correlation was found between myopia and personality. There was no difference in the degree of myopia between the groups with different education levels. Subjects with more severe ocular pathology associated with myopia had higher scores in neuroticism, without finding any significant association.
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Affiliation(s)
- I Rodríguez Uña
- Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, España.
| | - F Pérez Bartolomé
- Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, España
| | - M Urriés Ortiz
- Servicio de Psicología Clínica, Hospital Clínico San Carlos, Madrid, España
| | - P Arriola Villalobos
- Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, España; Red Temática de Investigación Cooperativa en Oftalmología (RETICS), Instituto de Salud Carlos III, Madrid, España
| | - M Bermúdez Vallecilla
- Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, España
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Verma A, Verma A. A novel review of the evidence linking myopia and high intelligence. J Ophthalmol 2015; 2015:271746. [PMID: 25653868 PMCID: PMC4306218 DOI: 10.1155/2015/271746] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 12/21/2014] [Accepted: 12/21/2014] [Indexed: 11/23/2022] Open
Abstract
The association between myopia and high intelligence has been the subject of much vexed debate in academic circles, particularly over the last two decades. This debate has risen from the observation that, over recent centuries, the prevalence of myopia amongst most populations has coincided with a marked increase in the average level of intelligence in these populations. The relationship between myopia and intelligence and theories surrounding this association is examined by the authors. Additionally, the various factors that confound the myopia and high intelligence debate, such as genetics, educational levels, ethnicity, and environmental factors were also explored by the authors. Whilst most studies found a positive correlation reaching statistical significance between myopia and high intelligence compared to emmetropes and hyperopes, further research is required to determine whether this association is causal.
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Affiliation(s)
- Ajai Verma
- St Vincent's Hospital, Melbourne, VIC 3065, Australia
| | - Abhishek Verma
- Healthscope Private Hospitals, Woy Woy, NSW 2256, Australia
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te Nijenhuis J, Jongeneel-Grimen B, Kirkegaard EO. Are Headstart gains on the g factor? A meta-analysis. INTELLIGENCE 2014. [DOI: 10.1016/j.intell.2014.07.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Hysi PG, Wojciechowski R, Rahi JS, Hammond CJ. Genome-wide association studies of refractive error and myopia, lessons learned, and implications for the future. Invest Ophthalmol Vis Sci 2014; 55:3344-51. [PMID: 24876304 DOI: 10.1167/iovs.14-14149] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The investigation of the genetic basis of refractive error and myopia entered a new stage with the introduction of genome-wide association studies (GWAS). Multiple GWAS on many ethnic groups have been published over the years, providing new insight into the genetic architecture and pathophysiology of refractive error. This is a review of the GWAS published to date, the main lessons learned, and future possible directions of genetic studies of myopia and refractive error.
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Affiliation(s)
- Pirro G Hysi
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom Centre for Paediatric Epidemiology and Biostatistics, University College London Institute of Child Health, London, United Kingdom
| | | | - Jugnoo S Rahi
- Centre for Paediatric Epidemiology and Biostatistics, University College London Institute of Child Health, London, United Kingdom
| | - Chris J Hammond
- Department of Twin Research and Genetic Epidemiology, King's College London, London, United Kingdom
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Abstract
PURPOSE The purpose of this study was to investigate the role of (hyperopic or myopic) spectacle correction in reading speed of 9- to 10-year-old children. METHODS Subjects were recruited at their schools. Initial selection was based on reduced distance acuity and/or a positive blur test. Final inclusion depended on cycloplegic refraction. Forty-three myopes were prescribed glasses. Sixty-five hyperopes were randomized to three groups: (1) no glasses, (2) +0.5DS for both eyes, and (3) full correction. Before and 4 to 6 months after prescription of glasses, reading speed was tested: One-Minute Test (reading speed of genuine words) and the Klepel (reading speed of nonwords). Data for this second reading test were obtained in 34 myopes and 48 hyperopes. RESULTS At baseline, myopes had about 11% higher One-Minute scores (p = 0.005) and about 9% higher Klepel scores (p = 0.066) than hyperopes. At follow-up, the hyperopia-full correction group improved its One-Minute score by about 13% more than both the no-glasses group (p = 0.012) and +0.5DS group (p = 0.019). Spectacles did not, or only slightly, improve reading scores of myopes (One-Minute scores, p = 0.068; Klepel scores, p = 0.021). CONCLUSIONS Correction of hyperopia may increase speed of reading (as reflected by the One-Minute score). The fact that reading speed of nonwords does not increase after correction suggests that hyperopia affects speed of recognition but not decoding per se.
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Muhamedagic L, Muhamedagic B, Halilovic EA, Halimic JA, Stankovic A, Muracevic B. Relation between near work and myopia progression in student population. Mater Sociomed 2014; 26:100-3. [PMID: 24944532 PMCID: PMC4035135 DOI: 10.5455/msm.2014.26.100-103] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Accepted: 04/02/2014] [Indexed: 11/03/2022] Open
Abstract
AIM To determine relation between near work and myopia progression in student population. Causes of myopia occurrence are not sufficiently explained. METHODS This retrospective-prospective, descriptive research included 100 students with verified myopia up to -3 Dsph. Ophthalmological examination and measurement diopter-hours variable (Dh) were done twice, in the period from January 2011 until January 2012. RESULTS A multivariate regression analysis of impact on the difference of distance visual acuity without correction to the right and left eye and difference of automatic computer refractometry in cycloplegia of both eyes indicates that, diopter-hours variable (Dh) had statistically significant impact on increase of distance visual acuity difference (right eye OR: I measurement-Dh 1.489, II measurement-Dh 1.544, p<0.05; left eye OR: I measurement-Dh 1.602, II measurement-Dh 1.538, p<0.05) and automatic computer refractometry in cycloplegia (right eye OR: I measurement 1.361, II measurement 1.493, p<0.05; left eye OR: I measurement 0.931, II measurement 1.019, p<0.05) during both measurements. CONCLUSION Near work cause the increase of myopia. This research opened a perspective for other researches on the impact of near work on myopia.
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Affiliation(s)
- Lejla Muhamedagic
- Institute for Occupational and Sports Medicine of the Zenica-Doboj Canton, Zenica, Bosnia and Herzegovina
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Aller TA. Clinical management of progressive myopia. Eye (Lond) 2014; 28:147-53. [PMID: 24357844 PMCID: PMC3930271 DOI: 10.1038/eye.2013.259] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 11/06/2013] [Indexed: 11/08/2022] Open
Abstract
Myopia has been increasing in prevalence throughout the world, reaching over 90% in some East Asian populations. There is increasing evidence that whereas genetics clearly have an important role, the type of visual environment to which one is exposed to likely influences the onset, progression, and cessation of myopia. Consequently, attempts to either modify the environment or to reduce the exposure of the eye to various environmental stimuli to eye growth through the use of various optical devices are well under way at research centers around the globe. The most promising of current treatments include low-percentage atropine, bifocal soft contact lenses, orthokeratology, and multifocal spectacles. These methods are discussed briefly and are then categorized in terms of their expected degree of myopia progression control. A clinical strategy is presented for selecting the most effective treatment for the appropriate type of patient at the optimal stage of refractive development to achieve the maximum control of myopia progression.
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Affiliation(s)
- T A Aller
- Private Practice, San Bruno, CA, USA
- Vision Cooperative Research Centre, Sydney, NSW, Australia
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Guggenheim JA, McMahon G, Northstone K, Mandel Y, Kaiserman I, Stone RA, Lin X, Saw SM, Forward H, Mackey DA, Yazar S, Young TL, Williams C. Birth order and myopia. Ophthalmic Epidemiol 2013; 20:375-84. [PMID: 24168726 PMCID: PMC3833053 DOI: 10.3109/09286586.2013.848457] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE An association between birth order and reduced unaided vision (a surrogate for myopia) has been observed previously. We examined the association between birth order and myopia directly in four subject groups. METHODS Subject groups were participants in (1) the Avon Longitudinal Study of Parents and Children (ALSPAC; UK; age 15 years; N = 4401), (2) the Singapore Cohort Study of Risk Factors for Myopia (SCORM; Singapore; age 13 years; N = 1959), (3) the Raine Eye Health Study (REHS; Australia; age 20 years; N = 1344), and (4) Israeli Defense Force Pre-recruitment Candidates (IDFC; Israel; age 16-22 years; N = 888,277). The main outcome was odds ratios (OR) for myopia in first-born versus non-first-born individuals after adjusting for potential risk factors. RESULTS The prevalence of myopia was numerically higher in first-born versus non-first-born individuals in all study groups, but the strength of evidence varied widely. Adjusted ORs (95% confidence intervals, CIs) were: ALSPAC, 1.31 (1.05-1.64); SCORM, 1.25 (0.89-1.77); REHS, 1.18 (0.90-1.55); and IDFC, 1.04 (1.03-1.06). In the large IDFC sample, the effect size was greater (a) for the first-born versus fourth- or higher-born comparison than for the first-born versus second/third-born comparison (p < 0.001) and (b) with increasing myopia severity (p < 0.001). CONCLUSIONS Across all studies, the increased risk of myopia in first-born individuals was low (OR < 1.3). Indeed, only the studies with >4000 participants provided strong statistical support for the association. The available evidence suggested the relationship was independent of established risk factors such as time outdoors/reading, and thus may arise through a different causal mechanism.
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Affiliation(s)
| | - George McMahon
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Kate Northstone
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Yossi Mandel
- IDF Medical Corps HQ, Israel, and The Mina & Everard Goodman Faculty of Life Sciences, Bar Ilan University, Israel
| | - Igor Kaiserman
- IDF Medical Corps HQ, Israel, and The Mina & Everard Goodman Faculty of Life Sciences, Bar Ilan University, Israel
- Barzilai Medical Center, Ashkelon, Israel
| | - Richard A. Stone
- Department of Ophthalmology, Scheie Eye Institute, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA
| | - Xiaoyu Lin
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Singapore Eye Research Institute, Singapore
| | - Seang Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Singapore Eye Research Institute, Singapore
| | - Hannah Forward
- Department of Genetics and Epidemiology, Centre for Ophthalmology and Visual Science, University of Western Australia, Lions Eye Institute, Perth, Australia
| | - David A. Mackey
- Department of Genetics and Epidemiology, Centre for Ophthalmology and Visual Science, University of Western Australia, Lions Eye Institute, Perth, Australia
| | - Seyhan Yazar
- Department of Genetics and Epidemiology, Centre for Ophthalmology and Visual Science, University of Western Australia, Lions Eye Institute, Perth, Australia
| | - Terri L. Young
- Center for Human Genetics, Duke University Medical Center. Durham, NC, USA
- Department of Ophthalmology, Duke University Eye Center. Durham, NC, USA
| | - Cathy Williams
- Centre for Child and Adolescent Health, University of Bristol, Bristol, UK
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Caca I, Cingu AK, Sahin A, Ari S, Dursun ME, Dag U, Balsak S, Alakus F, Yavuz A, Palanci Y. Amblyopia and refractive errors among school-aged children with low socioeconomic status in southeastern Turkey. J Pediatr Ophthalmol Strabismus 2013; 50:37-43. [PMID: 22966784 DOI: 10.3928/01913913-20120804-02] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Accepted: 07/10/2012] [Indexed: 11/20/2022]
Abstract
PURPOSE To investigate the prevalence of refractive errors and other eye diseases, incidence and types of amblyopia in school-aged children, and their relation to gender, age, parental education, and socioeconomic factors. METHODS A total of 21,062 children 6 to 14 years old were screened. The examination included visual acuity measurements and ocular motility evaluation. Autorefraction under cycloplegia and examination of the external eye, anterior segment, media, and fundus were performed. RESULTS There were 11,118 females and 9,944 males. The average age was 10.56 ± 3.59 years. When all of the children were evaluated, 3.2% had myopia and 5.9% had hyperopia. Astigmatism 0.50 D or greater was present in 14.3% of children. Myopia was associated with older age, female gender, and higher parental education. Hyperopia was inversely proportional with older age. Spectacles were needed in 4,476 (22.7%) children with refractive errors, and 10.6% of children were unaware of their spectacle needs. Amblyopia was detected in 2.6% of all children. The most common causes of amblyopia were anisometropia (1.2%) and strabismus (0.9%). CONCLUSION Visual impairment is a common disorder in school-aged children. Eye health screening programs are beneficial in early detection and proper treatment of refractive errors.
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Affiliation(s)
- Ihsan Caca
- Department of Ophthalmology, Dicle University Faculty of Medicine, Diyarbakir, Turkey.
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Abstract
PURPOSE To determine the prevalence of myopia and hyperopia and the associated risk factors in the presbyopic age group of the population in Shahroud, Iran. METHODS Through a multistage random cluster sampling approach, 6311 people of the 40- to 64-year-old population residing in Shahroud were invited to this study. The prevalence of a cycloplegic spherical equivalent (SE) ≥-0.5 diopter (D) and hyperopia >+0.50 D was determined by age and gender. RESULTS Of the invitees, 5190 (82.2%) participated in the study and data from 4864 people was used in the analyses. On the basis of cycloplegic refraction, the prevalence of myopia and hyperopia was 30.2% [95% confidence interval (CI): 28.9 to 31.5] and 35.6 (95% CI: 34.1 to 37.1), respectively. In the multiple logistic regression model, the odds of myopia significantly increased with higher education [odds ratio (OR) = 1.02, p < 0.001] and nuclear cataract (OR = 3.23, p < 0.001). After the age of 54 years, the odds of hyperopia significantly increased compared with the 40- to 44-year age group, whereas higher education and nuclear cataract had negative association with hyperopia. The prevalence of high myopia (SE >-6.0 D) and high hyperopia (SE > 4.0 D) was 1.9% (95% CI: 1.5 to 2.3) and 1.1% (95% CI: 0.8 to 1.4), respectively. Nuclear cataract significantly correlated with high myopia (OR = 6.44) and older age significantly correlated with high hyperopia (OR = 1.12). CONCLUSIONS The prevalence of myopia was unexpectedly higher than that found in other parts of the Middle East. The prevalence of hyperopia was lower than that previously reported in Iran. Education correlated directly with myopia and inversely with hyperopia; however, nuclear cataract was the most important risk factor for myopia. Adjusted for other variables, the prevalence of hyperopia still increased with age.
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