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Yotsukura E, Torii H, Mori K, Ogawa M, Hanyuda A, Negishi K, Kurihara T, Tsubota K. Slowing of Greater Axial Length Elongation Stemming from the Coronavirus Disease 2019 Pandemic with Increasing Time Outdoors: The Tokyo Myopia Study. OPHTHALMOLOGY SCIENCE 2024; 4:100491. [PMID: 38827490 PMCID: PMC11141272 DOI: 10.1016/j.xops.2024.100491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 01/25/2024] [Accepted: 02/06/2024] [Indexed: 06/04/2024]
Abstract
Purpose To investigate the changes in axial length (AL) elongation and other ocular parameters before and during the coronavirus disease 2019 pandemic. Design A longitudinal school-based study. Participants Public elementary schoolchildren in Tokyo (grades 1-6; age, 6-12 years) participated in this study from 2018 to 2021. Methods All participants underwent eye examinations and provided written consent to measurements of the noncycloplegic refraction and ocular biometry including AL, among others. The students' parents also completed a questionnaire about the students' lifestyles. We included the right eye in our analysis and compared the changes in the ocular parameters among the periods using a linear mixed-effects model for repeated measures and examined the univariate and step-wise multiple regression analyses to evaluate the associations between myopia and other covariates. Main Outcome Measures Changes in AL elongation and other ocular parameters from 2018 to 2019 (prepandemic), that of 2019 to 2020 (immediately after the pandemic onset), and that of 2020 to 2021 (during the pandemic). Results A total of 578 students before the pandemic period, 432 immediately after the pandemic onset, and 457 during the pandemic period were evaluated. The changes in the ALs and spherical equivalents (SEs) a year before, immediately after onset, and during the pandemic were 0.31 mm/-0.20 diopter, 0.38 mm/-0.27 diopter, and 0.28 mm/-0.47 diopter, respectively (ALs, P < 0.001; SEs, P = 0.014). The results of the questionnaire showed that time spent outdoors daily had changed during the 3 years to 79, 63, and 77 minutes/day, respectively (P < 0.001). Time spent using smartphones or tablets increased year by year to 41, 52, and 62 minutes/day (P < 0.001). The greatest AL elongation occurred during the period when the shortest amount of time was spent outdoors during the 3 years. Conclusions These results suggested that the school closures and decreasing time spent outdoors might have caused greater AL elongation among schoolchildren in Tokyo; however, it is possible that, although the time spent in near work still increased, the return to the time spent outdoors to the prepandemic levels may have affected the slowing of AL elongation after lockdown. Financial Disclosures Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
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Affiliation(s)
- Erisa Yotsukura
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
- JINS Endowed Research Laboratory for Myopia, Keio University School of Medicine, Shinjuku, Tokyo, Japan
- Laboratory of Photobiology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Hidemasa Torii
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
- Laboratory of Photobiology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Kiwako Mori
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
- Laboratory of Photobiology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Mamoru Ogawa
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
- JINS Endowed Research Laboratory for Myopia, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Akiko Hanyuda
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Toshihide Kurihara
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
- Laboratory of Photobiology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
- Tsubota Laboratory, Inc., Shinjuku, Tokyo, Japan
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Liu P, Zhu B, Fu J, Sun Y, Liu X, Li L, Wang S, Qin X. A clearer vision: unveiling the importance of cycloplegic refraction and the pseudomyopia prevalence in Chinese preschoolers. BMC Ophthalmol 2024; 24:338. [PMID: 39134974 PMCID: PMC11320859 DOI: 10.1186/s12886-024-03551-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 07/01/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND This study aimed to investigate the difference between cycloplegic and noncycloplegic refraction and evaluate the pseudomyopia prevalence in Chinese preschool children during the outbreak of COVID-19. METHODS A cross-sectional study was conducted in the Tongzhou District of Beijing, China. Refractive error was measured under both noncycloplegic and cycloplegic conditions with autorefraction. The difference between noncycloplegic and cycloplegic spherical equivalent refraction (SER) and pseudomyopia prevalence were analyzed. Pseudomyopia was defined as SER ≤-0.50D in precycloplegic assessments and >-0.50D in post-cycloplegic assessments. RESULTS Out of the 1487 participants who were enrolled in the study, 1471 individuals (98.92%) between the ages of 3-6 years completed all required procedures. A statistically significant difference in refraction was observed between noncycloplegic and cycloplegic measurements, the median of difference in spherical equivalent refraction (SER) of 0.88D (dioptre)(0.50,1.38). There was a high intraclass correlation (ICC) between these two methods for cylinders (ICC = 0.864; 95% CI, 0.850-0.877). The median DSE for myopia, emmetropia and hyperopia were 0.25D (0.00, 0.38),0.25D (0.06, 0.50) and 1.00D (0.62, 1.38), an hypermetropes showed considerably greater differences than myopes and emmetropes (Kruskal-Wallis test, H = 231.023, P = 0.000). Additionally, girls displayed a greater DSE than boys. Furthermore, when comparing against-the-rule (ATR) and oblique astigmatism, it was found that with-the-rule (WTR) astigmatism had the largest DSE. The study found varying prevalence rates of myopia, emmetropia, and hyperopia with and without cycloplegia, which were 1.90% vs. 10.06%, 11.49% vs. 50.31%, and 86.61% vs. 39.63%, respectively. Additionally, the overall prevalence of pseudomyopia was determined to be 8.29%. Participants with pseudomyopia had a significantly higher mean difference in SER (DSE) compared to non-pseudomyopic participants. CONCLUSIONS Cycloplegic refraction is more sensitive than a noncycloplegic one for measuring refractive error in preschool children. Pseudomyopia is prevalent in preschool children during the COVID-19 outbreak period. Our study indicates the possibility that cycloplegic refraction should be performed in preschool children routinely.
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Affiliation(s)
- Peipei Liu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Bidan Zhu
- Tongzhou Maternal and Child Health Hospital of Beijing, Beijing, China
| | - Jing Fu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China.
| | - Yunyun Sun
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Xiangxiang Liu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Lei Li
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China
| | - Shana Wang
- Tongzhou Maternal and Child Health Hospital of Beijing, Beijing, China
| | - Xi Qin
- Tongzhou Maternal and Child Health Hospital of Beijing, Beijing, China
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Khalaf AM, Alhazimi AY, Almaymuni KK, Alsubaie NA. Prevalence of Myopia Among Schoolchildren and the Impact of Increased Screen Time: A Systematic Review. Cureus 2024; 16:e66815. [PMID: 39280371 PMCID: PMC11393148 DOI: 10.7759/cureus.66815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2024] [Indexed: 09/18/2024] Open
Abstract
Myopia is the most frequent kind of refractive error and affects hundreds of millions of people. Growing evidence suggests that extended exposure to digital screens may exacerbate nearsightedness in children and young people. The purpose of this review is to compile data on the link between too much time in front of a screen and nearsightedness in young people so far. The principles of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guided the methods used and the format of the resulting report. Articles published between January 1, 2000, and June 30, 2023, were found by searching Medline, PubMed, ScienceDirect, Google Scholar, CINAHL, the Cochrane Library, and Scopus. Studies reporting an association between myopia and time spent in front of screens in children and young adults were considered eligible. The initial search yielded a total of 1,251 studies. After eliminating duplicates and reviewing the titles and abstracts, 64 full-text articles were evaluated for eligibility. Ultimately, 15 of these studies were included in the final analysis. The 15 studies involved a total of 59,775 participants and were conducted in various countries, including China, Singapore, and the United States. Overall, the evidence did not support a significant association between screen time and myopia in school children and young adults. There is conflicting evidence on the link between screen time and myopia in children and adolescents. More research is needed to determine whether or not digital screen use is a risk factor for myopia. The complex association between screen time and myopia is not fully understood at this time because of the variability of the included studies. These results have significant public health implications since they may be used to guide recommendations for screen time use in children and the young population.
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Affiliation(s)
- Ahmed M Khalaf
- General Practice, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, SAU
| | - Amro Y Alhazimi
- Ophthalmology, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, SAU
| | | | - Noura A Alsubaie
- General Practice, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
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Tapasztó B, Flitcroft DI, Aclimandos WA, Jonas JB, De Faber JTHN, Nagy ZZ, Kestelyn PG, Januleviciene I, Grzybowski A, Vidinova CN, Guggenheim JA, Polling JR, Wolffsohn JS, Tideman JWL, Allen PM, Baraas RC, Saunders KJ, McCullough SJ, Gray LS, Wahl S, Smirnova IY, Formenti M, Radhakrishnan H, Resnikoff S, Németh J. Myopia management algorithm. Annexe to the article titled Update and guidance on management of myopia. European Society of Ophthalmology in cooperation with International Myopia Institute. Eur J Ophthalmol 2024; 34:952-966. [PMID: 38087768 PMCID: PMC11295429 DOI: 10.1177/11206721231219532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/23/2023] [Indexed: 02/06/2024]
Abstract
Myopia is becoming increasingly common in young generations all over the world, and it is predicted to become the most common cause of blindness and visual impairment in later life in the near future. Because myopia can cause serious complications and vision loss, it is critical to create and prescribe effective myopia treatment solutions that can help prevent or delay the onset and progression of myopia. The scientific understanding of myopia's causes, genetic background, environmental conditions, and various management techniques, including therapies to prevent or postpone its development and slow its progression, is rapidly expanding. However, some significant information gaps exist on this subject, making it difficult to develop an effective intervention plan. As with the creation of this present algorithm, a compromise is to work on best practices and reach consensus among a wide number of specialists. The quick rise in information regarding myopia management may be difficult for the busy eye care provider, but it necessitates a continuing need to evaluate new research and implement it into daily practice. To assist eye care providers in developing these strategies, an algorithm has been proposed that covers all aspects of myopia mitigation and management. The algorithm aims to provide practical assistance in choosing and developing an effective myopia management strategy tailored to the individual child. It incorporates the latest research findings and covers a wide range of modalities, from primary, secondary, and tertiary myopia prevention to interventions that reduce the progression of myopia.
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Affiliation(s)
- Beáta Tapasztó
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
- Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
| | - Daniel Ian Flitcroft
- Temple Street Children's Hospital, Dublin, Ireland
- Centre for Eye Research Ireland (CERI) Technological University, Dublin, Ireland
| | | | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Zoltán Zsolt Nagy
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | | | | | - Andrzej Grzybowski
- Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznan, Poland
| | - Christina Nicolaeva Vidinova
- Department of Ophthalmology, Military Medical Academy, Sofia, Bulgaria
- Department of Optometry, Sofia University “St. Kliment Ohridski“, Sofia, Bulgaria
| | | | - Jan Roelof Polling
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Optometry and Orthoptics, University of Applied Science, Utrecht, The Netherlands
| | - James S Wolffsohn
- Optometry and Vision Science Research Group, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - J Willem L Tideman
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department Ophthalmology, Martini Hospital, Groningen, The Netherlands
| | - 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, Ulster University, Coleraine, UK
| | - Sara J McCullough
- Centre for Optometry and Vision Science, Ulster University, Coleraine, UK
| | | | - Siegfried Wahl
- Institute for Ophthalmic Research, University Tübingen, Tübingen, Germany
- Carl Zeiss Vision International GmbH, Tübingen, Germany
| | | | - Marino Formenti
- Department of Physics, School of Science, University of Padova, Padova, Italy
| | - Hema Radhakrishnan
- Division of Pharmacy and Optometry, University of Manchester, Manchester, UK
| | - Serge Resnikoff
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
- Brien Holden Vision Institute, Sydney, Australia
| | - János Németh
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
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Au Eong JTW, Chen KS, Teo BHK, Lee SSY, Au Eong KG. Impact of the coronavirus disease 2019 pandemic on the progression, prevalence, and incidence of myopia: A systematic review. Taiwan J Ophthalmol 2024; 14:159-171. [PMID: 39027071 PMCID: PMC11253998 DOI: 10.4103/tjo.tjo-d-24-00027] [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: 02/28/2024] [Accepted: 04/07/2024] [Indexed: 07/20/2024] Open
Abstract
We systematically reviewed the literature on the effects of the coronavirus disease 2019 (COVID-19) pandemic on the progression, prevalence, and incidence of myopia. A comprehensive literature search was performed on PubMed, Cochrane Central Register of Controlled Trials, and Scopus databases. Studies included in the review assessed myopia progression, prevalence, and/or incidence as the primary outcome. Of 523 articles yielded in the initial search, 23 studies (6 cross-sectional and 17 cohort) were eligible for inclusion. Sixteen of these were conducted in China and one each in Hong Kong, Turkey, Spain, Israel, India, Korea, and Tibet. Quality appraisals were conducted with the Joanna Briggs Institute Critical Appraisal Checklists. Of the included studies, a large majority reported a greater myopic shift and increase in myopia prevalence during the COVID-19 pandemic compared to the pre-COVID-19 years. All three studies on myopia incidence showed increased incidence during the COVID-19 pandemic. Myopia progression accelerated during the COVID-19 pandemic, even in individuals using low-concentration atropine eye drops in two studies but not in those using orthokeratology treatment in one study. Overall, the studies found that the COVID-19 pandemic and its associated home confinement measures generally increased myopia progression, prevalence, and incidence, even in individuals using low-concentration atropine eye drops.
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Affiliation(s)
| | - Krystal S. Chen
- International Eye Cataract Retina Centre, Mount Elizabeth Medical Centre and Farrer Park Medical Centre, Singapore
| | - Benjamin H. K. Teo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Samantha S. Y. Lee
- Centre for Ophthalmology and Visual Science (Incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia
| | - Kah-Guan Au Eong
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- International Eye Cataract Retina Centre, Mount Elizabeth Medical Centre and Farrer Park Medical Centre, Singapore
- Department of Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital, Singapore
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Lee SSY, Lingham G, Mackey DA. Impact of coronavirus disease 2019 restrictions on the efficacy of atropine 0.01% eyedrops for myopia control - Findings from the Western Australia Atropine for the Treatment of Myopia study. Taiwan J Ophthalmol 2024; 14:262-265. [PMID: 39027074 PMCID: PMC11254007 DOI: 10.4103/tjo.tjo-d-24-00025] [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: 02/21/2024] [Accepted: 04/07/2024] [Indexed: 07/20/2024] Open
Abstract
This study explored the impact of short-term coronavirus disease 2019 (COVID-19) restrictions on the efficacy of atropine 0.01% eyedrops on myopia control in a multiethnic cohort of Australian children. In the Western Australia Atropine for the Treatment of Myopia study, 104 and 49 children were randomized to receive atropine 0.01% eyedrops and a placebo, respectively. We compared the 1-year myopia progression and axial elongation following the 2-month lockdown in 2020 to the same months in 2019 and 2021, i.e., the 1-year myopia progression up to May 2019-October 2019 (non-COVID-19) versus the 1-year progression up to May 2020-October 2020 (COVID-19 period), and the 1-year progression up to May 2021-October 2021 (non-COVID-19) versus the 1-year progression up to the same months in 2020. After excluding participants who withdrew, completed their treatment phase prior May 2020, or those whose study visits did not fall between May 2020 and October 2020, 65 participants (mean age at baseline = 11.8 ± 2.5 years) were included in the final analysis (49 in the treatment group; 16 in the placebo group). After correcting for age, sex, and ethnicity, there was no significant main effect of the short-term lockdown on the rate of spherical equivalent or axial length change. However, there was a lockdown × treatment interaction effect on the rate of axial elongation (P = 0.007). This was such that in the treatment group, the 1-year axial elongation was faster during lockdown by 0.056 mm compared to the nonlockdown periods (P = 0.009), while the rate of axial elongation in those on the placebo eye drops was similar during lockdown and nonlockdown. Our findings suggest that there is a decreased efficacy of low-concentration atropine even with relatively lenient restrictions lasting for a few months.
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Affiliation(s)
- Samantha Sze-Yee Lee
- Centre for Ophthalmology and Visual Science (Incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
| | - Gareth Lingham
- Centre for Ophthalmology and Visual Science (Incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
- Centre for Eye Research Ireland, Environmental, Sustainability and Health Institute, Technological University Dublin, Dublin, Ireland
| | - David A. Mackey
- Centre for Ophthalmology and Visual Science (Incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Victoria
- School of Medicine, Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia
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Pan W, Lan W. The Current and Future Landscape of the Childhood Myopia Epidemic in China-A Review. Ophthalmol Ther 2024; 13:883-894. [PMID: 38300487 PMCID: PMC10912377 DOI: 10.1007/s40123-024-00887-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 01/11/2024] [Indexed: 02/02/2024] Open
Abstract
Over the last two decades, the prevalence of myopia has gradually increased in China. Numerous epidemiological studies suggest that education and inadequate time spent outdoors are the major causes of the current myopia epidemic. China is one of the few countries that has begun to address the myopia epidemic with a national-level strategy, implementing nationwide education reform, cost-reduction measurements, and dissemination of information on myopia prevention and control. These "natural experiments" will provide insights into areas that may face similar or potential myopia problems.
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Affiliation(s)
- Wei Pan
- Aier School of Ophthalmology, Central South University, AIER Mansion, No. 188 South Furong Road, Changsha, 410000, Hunan Province, China
| | - Weizhong Lan
- Aier School of Ophthalmology, Central South University, AIER Mansion, No. 188 South Furong Road, Changsha, 410000, Hunan Province, China.
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, China.
- Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, China.
- Aier School of Optometry and Vision Science, Hubei University of Science and Technology, Xianning, China.
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Domsa P, Bankó ÉM, Körtvélyes J, Meigen C, Széchey R, Lantos K, Nagy ZZ, Csutak A. Astigmatism and maternal myopia as important factors affecting success rate of DIMS lens treatment. BMJ Open Ophthalmol 2024; 9:e001499. [PMID: 38453262 PMCID: PMC10921505 DOI: 10.1136/bmjophth-2023-001499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 01/28/2024] [Indexed: 03/09/2024] Open
Abstract
OBJECTIVE To assess the efficacy of myopia control spectacle lenses (defocus incorporated multiple segments/DIMS) in slowing myopia progression among a diverse Central European paediatric population and investigate the contribution of baseline parameters on treatment outcomes. METHODS AND ANALYSIS This retrospective observational study included 62 individuals aged 4-17 years (mean±SD: 10.21±2.70) with progressing myopia but without ocular pathology with a range of -0.88 to -8.25 D spherical equivalent refraction (SER) (-3.73±1.56), coupled with astigmatism up to -3.25 D cylindrical. All participants were prescribed DIMS (Hoya MiyoSmart) spectacles. Key outcome variables were cycloplegic SER, measured for all participants and axial length (AL), assessed in a subset of patients, recorded at baseline, 6 months and 12 months. Quality of life assessments were conducted at baseline, at 2 weeks, and 3, 6, 9 and 12 months. Additionally, parental myopic dioptre was recorded when applicable. RESULTS At the 12-month mark, myopia progression in patients (mean±SE: -0.40±0.05) mirrored findings from prior European DIMS studies, but with 50% of patients showing no progression. A multivariate analysis of covariance model revealed that baseline astigmatism and younger age adversely affected therapy outcomes in both SER and AL, while severe maternal myopia led to greater SER progression. In contrast, only young age but not astigmatism was associated with AL increase in a comparable group of children with myopia, part of the LIFE Child Study, wearing single-vision spectacles. Patients reported consistent satisfaction with treatment, with minimal side effects, which diminished over the year. CONCLUSION In the European population, astigmatism, young age and severe maternal myopia are risk factors for suboptimal outcomes following DIMS therapy. Further research is necessary to elucidate the impact of astigmatism on myopic defocus therapy.
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Affiliation(s)
- Patricia Domsa
- Non Plus Ultra Vision Centre, Budapest, Hungary
- Department of Ophthalmology, University of Pécs Medical School, Pecs, Hungary
| | - Éva M Bankó
- HUN-REN Research Centre for Natural Sciences, Budapest, Hungary
| | - Judit Körtvélyes
- Non Plus Ultra Vision Centre, Budapest, Hungary
- Heim Pál National Pediatric Institute, Budapest, Hungary
| | - Christof Meigen
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
| | - Rita Széchey
- Non Plus Ultra Vision Centre, Budapest, Hungary
- Semmelweis University of Medicine, Budapest, Hungary
| | - Krisztina Lantos
- Department of Ophthalmology, University of Pécs Medical School, Pecs, Hungary
| | - Zoltán Zsolt Nagy
- Department of Ophthalmology, Semmelweis University of Medicine, Budapest, Hungary
| | - Adrienne Csutak
- Department of Ophthalmology, University of Pécs Medical School, Pecs, Hungary
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Wang J, Shen Y, Zhao J, Wang X, Chen Z, Han T, Huang Y, Wang Y, Zhao W, Wen W, Zhou X, Xu Y. Algorithmic and sensor-based research on Chinese children's and adolescents' screen use behavior and light environment. Front Public Health 2024; 12:1352759. [PMID: 38454995 PMCID: PMC10917963 DOI: 10.3389/fpubh.2024.1352759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 02/06/2024] [Indexed: 03/09/2024] Open
Abstract
Background Myopia poses a global health concern and is influenced by both genetic and environmental factors. The incidence of myopia tends to increase during infectious outbreaks, such as the COVID-19 pandemic. This study examined the screen-time behaviors among Chinese children and adolescents and investigated the efficacy of artificial intelligence (AI)-based alerts in modifying screen-time practices. Methods A cross-sectional analysis was performed using data from 6,716 children and adolescents with AI-enhanced tablets that monitored and recorded their behavior and environmental light during screen time. Results The median daily screen time of all participants was 58.82 min. Among all age groups, elementary-school students had the longest median daily screen time, which was 87.25 min and exceeded 4 h per week. Children younger than 2 years engaged with tablets for a median of 41.84 min per day. Learning accounted for 54.88% of participants' screen time, and 51.03% (3,390/6,643) of the participants used tablets for 1 h at an average distance <50 cm. The distance and posture alarms were triggered 807,355 and 509,199 times, respectively. In the study, 70.65% of the participants used the tablet under an illuminance of <300 lux during the day and 61.11% under an illuminance of <100 lux at night. The ambient light of 85.19% of the participants exceeded 4,000 K color temperature during night. Most incorrect viewing habits (65.49% in viewing distance; 86.48% in viewing posture) were rectified swiftly following AI notifications (all p < 0.05). Conclusion Young children are increasingly using digital screens, with school-age children and adolescents showing longer screen time than preschoolers. The study highlighted inadequate lighting conditions during screen use. AI alerts proved effective in prompting users to correct their screen-related behavior promptly.
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Affiliation(s)
- Jifang Wang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
- Department of Nursing, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Yang Shen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Jing Zhao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Xiaoying Wang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Zhi Chen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Tian Han
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Yangyi Huang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Yuliang Wang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Wuxiao Zhao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
- Center for Optometry and Visual Science, Guangxi Academy of Medical Sciences, Nanning, China
| | - Wen Wen
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
| | - Ye Xu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care, Shanghai, China
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Yang YC, Tsai DC, Wang CY, Chen YL, Shyong MP, Hsu NW. The prevalence of myopia remains stable under tighter COVID-19 social restriction in preschoolers receiving a school-based eyecare program. Acta Ophthalmol 2024; 102:e78-e85. [PMID: 37144676 DOI: 10.1111/aos.15680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 03/12/2023] [Accepted: 04/21/2023] [Indexed: 05/06/2023]
Abstract
PURPOSE This study investigated the impact of different levels of COVID-19 social restrictions (social distancing in 2020, large-scale home confinement in 2021) on myopia prevalence and behaviours in a preschool population with school-based eyecare programme. METHODS Repeated cross-sectional surveys were conducted between August and December in 2019, 2020 and 2021. Children aged 5-6 years received ocular examinations, and questionnaires were answered by caregivers before the day of the examination. The main outcome measures were the changes in after-school time spent on homework, screen-based devices and outdoors. Secondary outcome was the change in myopia prevalence (spherical equivalent [SE] ≤ -0.5 D in either eye after cycloplegia). RESULTS A total of 9997 preschoolers were included in the analysis. Under tighter restrictions, more preschoolers spent ≥1 h/day on screen-based devices (42.8% in 2019, 45.2% in 2020, 48.9% in 2021, p < 0.001), and fewer preschoolers spent ≥30 min/day on after-school outdoor activities (49.5% in 2019, 46.0% in 2020, 41.0% in 2021, p < 0.001) on weekdays. A similar trend was found on weekends. While more preschoolers spent ≥2 h/day on screen-based devices (35.3% in 2019, 38.5% in 2020, 43.0% in 2021, p < 0.001), fewer preschoolers spent ≥2 h/day on outdoor activities (41.7% in 2019, 41.7% in 2020, 34.0% in 2021, p < 0.001). The mean SE and myopia prevalence were stable (9.1% in 2019, 10.3% in 2020, 9.4% in 2021, p = 0.707). CONCLUSION Our study showed dose-dependent effect of social restrictions on near-work and outdoor behaviours at home. The prevalence of myopia did not increase significantly with short-term cessation of school-based eyecare programmes.
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Affiliation(s)
- Yu-Chieh Yang
- Department of Ophthalmology, Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Der-Chong Tsai
- Department of Ophthalmology, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan
- Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan
| | - Chiao-Yu Wang
- Department of Ophthalmology, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan
| | | | - Mong-Ping Shyong
- Department of Ophthalmology, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan
- Department of Ophthalmology, Suao Branch, Taipei Veterans General Hospital, Yilan, Taiwan
| | - Nai-Wei Hsu
- Faculty of Medicine, National Yang Ming Chiao Tung University School of Medicine, Taipei, Taiwan
- Public Health Bureau, Yilan County, Taiwan
- Division of Cardiology, Department of Internal Medicine, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan
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Shi Z, Yang L, Xu T, Jia J, Yang S, Yang B, Yang W, Yang C, Peng Y, Gu H, Liu C, Wei S. Development of a risk score for myopia: A cohort study conducted among school-aged children in China. Indian J Ophthalmol 2024; 72:S265-S272. [PMID: 38271422 DOI: 10.4103/ijo.ijo_2077_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 12/04/2023] [Indexed: 01/27/2024] Open
Abstract
PURPOSE To evaluate the myopia risk in school-aged children one year after lifting a pandemic-related lockdown and develop a tool to identify high-risk groups. METHODS In total, 38,079 children without myopia from 38 schools were included. The outcomes were myopia incidence and progression in 1 year after the COVID-19 lockdown was lifted, both obtained by the spherical equivalent refraction (SER). We separated the population into an exploratory (75%) and a validation sample (25%) to construct the risk score model. RESULTS In total, 9811 (29.57%) students became myopic, and the overall myopia progression was 0.22 ± 0.62 D. Even less myopia progression was noted in the pre-myopia group at baseline (All: P = 0.045, Boy: P = 0.005). The risk score model included seven predictors: gender, grade, SER at baseline, residence, parental myopia, eye discomfort symptoms, and online courses. The model had a score range of 0-46 and an optimal cutoff of 34. The area under the receiver operating curve of the model was 0.726 (0.719-0.732) for the exploratory sample and 0.731 (0.720-0.742) for the validation sample. CONCLUSIONS The risk score can serve as a practical tool for classifying the risk of myopia in school-aged children.
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Affiliation(s)
- Ziwei Shi
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Lihua Yang
- Wuhan Center for Adolescent Poor Vision Prevention and Control, Wuhan, Hubei, PR China
| | - Ting Xu
- Wuhan Center for Adolescent Poor Vision Prevention and Control, Wuhan, Hubei, PR China
| | - Jing Jia
- Wuhan Center for Adolescent Poor Vision Prevention and Control, Wuhan, Hubei, PR China
| | - Song Yang
- Wuhan Center for Adolescent Poor Vision Prevention and Control, Wuhan, Hubei, PR China
| | - Bo Yang
- Wuhan Center for Adolescent Poor Vision Prevention and Control, Wuhan, Hubei, PR China
| | - Wei Yang
- Wuhan Center for Adolescent Poor Vision Prevention and Control, Wuhan, Hubei, PR China
| | - Changchun Yang
- Wuhan Center for Adolescent Poor Vision Prevention and Control, Wuhan, Hubei, PR China
| | - Yan Peng
- Wuhan Center for Adolescent Poor Vision Prevention and Control, Wuhan, Hubei, PR China
| | - Hong Gu
- Wuhan Center for Adolescent Poor Vision Prevention and Control, Wuhan, Hubei, PR China
| | - Caiping Liu
- Wuhan Center for Adolescent Poor Vision Prevention and Control, Wuhan, Hubei, PR China
| | - Sheng Wei
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
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Tapia F, Peñaloza V, Silva-Olivares F, Sotomayor-Zárate R, Schmachtenberg O, Vielma AH. Glucagon Increases Retinal Rod Bipolar Cell Inhibition Through a D1 Dopamine Receptor-Dependent Pathway That Is Altered After Lens-Defocus Treatment in Mice. Invest Ophthalmol Vis Sci 2024; 65:46. [PMID: 38289613 PMCID: PMC10840015 DOI: 10.1167/iovs.65.1.46] [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: 10/03/2023] [Accepted: 01/05/2024] [Indexed: 02/01/2024] Open
Abstract
Purpose Members of the secretin/glucagon family have diverse roles in retinal physiological and pathological conditions. Out of them, glucagon has been associated with eye growth regulation and image defocus signaling in the eye, both processes central in myopia induction. On the other hand, dopamine is perhaps the most studied molecule in myopia and has been proposed as fundamental in myopia pathogenesis. However, glucagonergic activity in the mammalian retina and its possible link with dopaminergic signaling remain unknown. Methods To corroborate whether glucagon and dopamine participate together in the modulation of synaptic activity in the retina, inhibitory post-synaptic currents were measured in rod bipolar cells from retinal slices of wild type and negative lens-exposed mice, using whole cell patch-clamp recordings and selective pharmacology. Results Glucagon produced an increase of inhibitory post-synaptic current frequency in rod bipolar cells, which was also dependent on dopaminergic activity, as it was abolished by dopamine type 1 receptor antagonism and under scotopic conditions. The effect was also abolished after 3-week negative lens-exposure but could be recovered using dopamine type 1 receptor agonism. Conclusions Altogether, these results support a possible neuromodulatory role of glucagon in the retina of mammals as part of a dopaminergic activity-dependent synaptic pathway that is affected under myopia-inducing conditions.
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Affiliation(s)
- Felipe Tapia
- Centro Interdisciplinario de Neurociencia de Valparaíso (CINV), Universidad de Valparaíso, Valparaíso, Chile
- Programa de Doctorado en Ciencias, Universidad de Valparaíso, Valparaíso, Chile
| | - Valentín Peñaloza
- Centro Interdisciplinario de Neurociencia de Valparaíso (CINV), Universidad de Valparaíso, Valparaíso, Chile
| | - Francisco Silva-Olivares
- Laboratorio de Neuroquímica y Neurofarmacología, Centro de Neurobiología y Fisiopatología Integrativa (CENFI), Instituto de Fisiología, Universidad de Valparaíso, Valparaíso, Chile
| | - Ramón Sotomayor-Zárate
- Laboratorio de Neuroquímica y Neurofarmacología, Centro de Neurobiología y Fisiopatología Integrativa (CENFI), Instituto de Fisiología, Universidad de Valparaíso, Valparaíso, Chile
| | - Oliver Schmachtenberg
- Centro Interdisciplinario de Neurociencia de Valparaíso (CINV), Universidad de Valparaíso, Valparaíso, Chile
- Instituto de Biología, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso, Chile
| | - Alex H. Vielma
- Centro Interdisciplinario de Neurociencia de Valparaíso (CINV), Universidad de Valparaíso, Valparaíso, Chile
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Alvarez-Peregrina C, Ruiz-Pomeda A, Martinez-Perez C, Prieto-Garrido FL, Villa-Collar C, Gonzalez-Perez M, Gonzalez-Abad A, Sanchez-Tena MA. Subjective behavioral measures in myopic and pre-myopic children before and after the COVID lockdown. Front Med (Lausanne) 2023; 10:1308423. [PMID: 38155664 PMCID: PMC10753851 DOI: 10.3389/fmed.2023.1308423] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/28/2023] [Indexed: 12/30/2023] Open
Abstract
Background There are environmental factors that may contribute to the onset of myopia. This study aims to evaluate the children's lifestyle changes before and after the COVID-19 lockdown and how they can influence their vision. Methods The same questionnaire was administered to children aged between 5 and 7 in Spain every year in September before (2017-2019) and after the COVID-19 lockdown (2020-2021). All the children also passed a vision exam consisting of the measurement of visual acuity (VA) and determination of objective and subjective refraction. Children were classified as myopes, pre-myopes, or hyperopes. The cut-off points to define the refractive error were established according to the value of the spherical equivalent (SE): hyperopia (SE > +0,75D), myopia (SE ≤ -0,5D), or pre-myopia (-0.5D < SE ≥ +0.75D). Data analysis is performed with the SPSS 27.0 software (SPSS Inc., Chicago, Illinois). Results In the pre-COVID period, the pre-myopes were the ones who spent the longest time outdoors, and after the COVID lockdown, there were no differences between groups. There neither were any differences in the time spent doing near-work activities between the groups in both periods (p > 0.05). Regarding the spherical equivalent, in the pre-COVID period, the mean value was 0.75 ± 2.09D and after the COVID lockdown, it was 0.47 ± 1.88D (p < 0.001). Conclusion Pre-myopes spent more time outdoors than myopes in the pre-COVID period, while myopes spent more time using digital devices. All these differences do not exist after the COVID lockdown, with a general increase in the time spent outdoors and a decrease in the use of digital devices. Further studies are needed to know if these lifestyle changes remain and how they influence the onset of myopia.
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Affiliation(s)
- Cristina Alvarez-Peregrina
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Alicia Ruiz-Pomeda
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | | | - Francisco Luis Prieto-Garrido
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
- Fundación para la Investigación e Innovación Biomédica del Hospital Universitario del Henares (FIIB HHEN), Madrid, Spain
| | - Cesar Villa-Collar
- Faculty of Biomedical and Health Science, Universidad Europea de Madrid, Madrid, Spain
| | - Mariano Gonzalez-Perez
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
- Training and Development Department, Alain Afflelou Óptico, Madrid, Spain
| | - Ana Gonzalez-Abad
- Training and Development Department, Alain Afflelou Óptico, Madrid, Spain
| | - Miguel Angel Sanchez-Tena
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
- ISEC LISBOA-Instituto Superior de Educação e Ciências, Lisbon, Portugal
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Ehongo A. Understanding Posterior Staphyloma in Pathologic Myopia: Current Overview, New Input, and Perspectives. Clin Ophthalmol 2023; 17:3825-3853. [PMID: 38105912 PMCID: PMC10725704 DOI: 10.2147/opth.s405202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 12/01/2023] [Indexed: 12/19/2023] Open
Abstract
Posterior staphyloma (PS) is considered the hallmark of pathologic myopia and is defined as an outpouching of a circumscribed portion of the eyeball with a radius of curvature smaller than that of the adjacent zone. Although more common in eyes with high myopia, it can affect those without it. The presence of PS is associated with a structurally and functionally worse course of high myopia that can lead to visual disability. Unfortunately, the pathogenesis of PS is unclear so far. Thus, due to the increasing prevalence of myopia which has been further exacerbated by the advent of COVID-19 lockdown, researchers are eager to elucidate the pathogenesis of pathologic myopia and that of its complications, especially PS, which will allow the development of preventive strategies. The aim of this work was to review the morphological characteristics of PS with emphasis on similarities with peripapillary staphyloma and to discuss the pathogenesis of PS considering recent suggestions about that of peripapillary staphyloma.
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Affiliation(s)
- Adèle Ehongo
- Ophthalmology Department, Erasmus Hospital, Brussels, Belgium
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15
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Peng T, Jiang J. Efficiency and Related Factors of Multifocal Soft Contact Lenses in Controlling Myopia. Eye Contact Lens 2023; 49:535-541. [PMID: 37990441 DOI: 10.1097/icl.0000000000001043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVE To evaluate ocular changes in Chinese myopic children wearing multifocal soft contact lenses and explore their efficiency and related factors. METHOD This was a prospective, double-blind, randomized controlled study. A total of 36 myopic children aged 7 to 12 years were randomly divided into groups wearing multifocal soft contact lenses (MFCLs) or single-vision soft contact lenses (SVCLs) and followed up for 12 months. The spherical equivalent (SE), axial length (AL), choroidal thickness, and vascularity were measured before commencement and after 6 and 12 months of lens wear. Correlation between ocular changes and myopia progression was determined. RESULTS A total of 32 subjects (6 males and 26 females) completed the study and were included in the analysis. After 12 months of lens wear, both the AL elongation (0.25±0.22 vs. 0.43±0.16 mm, P=0.011) and the SE progression (-0.69±0.69 D vs. -1.45±0.56 D, P=0.002) of the MFCL group were significantly lower than those of the SVCL group. After 12 months, the progression of myopia was significantly correlated with changes of the choroid in the MFCL wearers, whereas no such correlation was observed in the SVCL group. CONCLUSION Multifocal soft contact lens can slow myopia progression, and this effect may be related to the changes of the choroid.
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Affiliation(s)
- Tianli Peng
- National Clinical Research Center for Ocular Diseases (T.P., J.J.), Eye Hospital, Wenzhou Medical University, Wenzhou, China; and State Key Laboratory of Ophthalmology (T.P., J.J.), Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
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Sanz Diez P, Ohlendorf A, Barraza-Bernal MJ, Kratzer T, Wahl S. Evaluating the impact of COVID-19 pandemic-related home confinement on the refractive error of school-aged children in Germany: a cross-sectional study based on data from 414 eye care professional centres. BMJ Open 2023; 13:e071833. [PMID: 37989374 PMCID: PMC10668271 DOI: 10.1136/bmjopen-2023-071833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 09/22/2023] [Indexed: 11/23/2023] Open
Abstract
OBJECTIVE This study aimed at evaluating refractive changes in German school-aged children before and after the COVID-19 pandemic. DESIGN Cross-sectional study. SETTING 414 eye care professional centres from Germany. PARTICIPANTS Refractive data from 59 926 German children aged 6-15 years were examined over a 7-year period (2015-2021). PRIMARY AND SECONDARY OUTCOME MEASURES Spherical equivalent refraction was assessed as a function of year, age and gender. The refractive values concerning 2020 and 2021 were compared with those assigned to prior years (2015-2019). RESULTS The refractive data associated with 2020 and 2021 showed a myopic refractive shift of approximately -0.20D compared with the 2015-2019 range. The refractive change was statistically considerable in the 6 to 11-year range (p<0.05), while from 12 to 15 years was negligible (p≥0.10). Percentage of myopes was also impacted in 2021 (p=0.002), but not in 2020 (p=0.25). From 6 to 11 years, the percentage of myopes in 2021 increased significantly by 6.02% compared with the 2015-2019 range (p≤0.04). The highest percentage increase occurred at 8 and 10 years of age, showing a rise of 7.42% (p=0.002) and 6.62% (p=0.005), respectively. From 12 to 15 years, there was no significant increase in the percentage of myopes in 2021 (p≥0.09). Percentage of myopes in 2020 was not influenced at any age (p≥0.06). CONCLUSION Disruption of normal lifestyle due to pandemic-related home confinement appears to lead to a myopic refractive shift in children aged 6-11 years in Germany. The greater effect observed at younger ages seems to emphasise the importance of refractive development in this age group.
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Affiliation(s)
- Pablo Sanz Diez
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Tuebingen, Germany
- Technology and Innovation, Carl Zeiss Vision International GmbH, Aalen, Germany
| | - Arne Ohlendorf
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Tuebingen, Germany
- Technology and Innovation, Carl Zeiss Vision International GmbH, Aalen, Germany
| | | | - Timo Kratzer
- Technology and Innovation, Carl Zeiss Vision GmbH, Aalen, Germany
| | - Siegfried Wahl
- Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Tuebingen, Germany
- Technology and Innovation, Carl Zeiss Vision International GmbH, Aalen, Germany
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Di Pierdomenico J, González-González R, Valiente-Soriano FJ, Galindo-Romero C, García-Ayuso D. Attitudes and knowledge of myopia management by Spanish optometrists. Int Ophthalmol 2023; 43:4247-4261. [PMID: 37596425 PMCID: PMC10520101 DOI: 10.1007/s10792-023-02835-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 07/27/2023] [Indexed: 08/20/2023]
Abstract
PURPOSE To investigate the knowledge, training and clinical practice of Spanish optometrists about preventing and controlling myopia progression. METHODS A web-based questionnaire was distributed to Spanish optometrists through social networks, optometric professional bodies and one of the major Spanish optometrists' associations to assess practitioner perception, understanding, and self-reported clinical practice behavior related to myopia diagnosis and management. RESULTS A total of 534 optometrists with a mean age of 40.8 ± 10.3 years completed the survey. Most respondents have been practicing optometry for more than 20 years (89.8%), report having actively treated childhood myopia (82.4%), and are very concerned about the increasing frequency of pediatric myopia in their daily practice (85.3%). Almost all of the respondents (97.3%) agreed that the efficacy of treatment is related to the age at which it is prescribed, and more than half (53.6%) considered a progression higher than - 0.50 and up to - 1.00D as the minimum necessary to consider a myopia management option. Respondents who reported actively managing childhood myopia considered orthokeratology, atropine and soft-defocus contact lenses the most effective myopia control interventions. However, the most frequently prescribed form of myopia correction by Spanish optometrists was single-vision spectacles, followed by orthokeratology and soft-defocus contact lenses. CONCLUSIONS Spanish optometrists are very active in the management of myopia, especially by fitting orthokeratology lenses or dual-focus soft contact lenses for myopia control, but there is still potential for improvement in the methodology they follow for both the diagnosis and management of myopia.
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Affiliation(s)
- Johnny Di Pierdomenico
- Facultad de Óptica y Optometría, Universidad de Murcia, Murcia, Spain
- Grupo de Investigación Oftalmología Experimental, Departamento de Oftalmología, Optometría, Otorrinolaringología y Anatomía Patológica, Facultad de Medicina, Universidad de Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB), Campus de Ciencias de la Salud, 30120, Murcia, España
| | | | - Francisco J Valiente-Soriano
- Facultad de Óptica y Optometría, Universidad de Murcia, Murcia, Spain
- Grupo de Investigación Oftalmología Experimental, Departamento de Oftalmología, Optometría, Otorrinolaringología y Anatomía Patológica, Facultad de Medicina, Universidad de Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB), Campus de Ciencias de la Salud, 30120, Murcia, España
| | - Caridad Galindo-Romero
- Facultad de Óptica y Optometría, Universidad de Murcia, Murcia, Spain
- Grupo de Investigación Oftalmología Experimental, Departamento de Oftalmología, Optometría, Otorrinolaringología y Anatomía Patológica, Facultad de Medicina, Universidad de Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB), Campus de Ciencias de la Salud, 30120, Murcia, España
| | - Diego García-Ayuso
- Facultad de Óptica y Optometría, Universidad de Murcia, Murcia, Spain.
- Grupo de Investigación Oftalmología Experimental, Departamento de Oftalmología, Optometría, Otorrinolaringología y Anatomía Patológica, Facultad de Medicina, Universidad de Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB), Campus de Ciencias de la Salud, 30120, Murcia, España.
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Li Q, Zhou W, Liao Y, Chen H, Sun Y, Wang M, Wang X, Wang W. Prevalence Trend of Myopia during the Post-COVID-19 Epidemic Period among Preschoolers: A Prospective School-based Study. Optom Vis Sci 2023; 100:727-734. [PMID: 37678562 DOI: 10.1097/opx.0000000000002069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023] Open
Abstract
SIGNIFICANCE Changes in behavior and lifestyle during the post-coronavirus disease 2019 (COVID-19) epidemic may have some impact on myopia rates in preschoolers, and exploring the changes in myopia rates in preschool children may inform the formulation of myopia prevention and control policies. PURPOSE This study aimed to investigate the prevalence of myopia in preschool children during the post-COVID-19 epidemic period in Xuzhou, China. METHODS A series of cross-sectional school-based studies was conducted. A total of 117,632 preschool children aged 3 to 6 years were subjected to annual vision screening from 2019 to 2021. Spot photo screening was used to record the spherical equivalent refraction for each child and to analyze the prevalence of myopia by age, sex, and region during the post-COVID-19 epidemic period. RESULTS A total of 113,979 preschool children were included in the analysis, of whom 60,784 (53.3%) were male and 53,195 (46.7%) were female. For all children, the mean ± standard deviation spherical equivalent refraction in 2019, 2020, and 2021 was +0.32 ± 0.50, +0.34 ± 0.55, and +0.34 ± 0.54 D, respectively (all P < .05), indicative of a very slight hyperopic shift. In all age groups, the change in mean spherical equivalent refraction and its distribution were relatively stable. From 2019 to 2021, the overall prevalence of myopia in preschool children was 3.1, 3.3, and 3.5%, respectively. The rise in myopia rates was minimal. The largest increase in the annual prevalence of myopia was seen among children aged 6 years, at 0.5%, followed by those aged 5 years (0.4%) and aged 3 years (0.4%). The prevalence was higher in boys than girls and in urban versus rural areas. CONCLUSIONS During the post-COVID-19 epidemic period, the refractive status of Xuzhou preschool children remained stable.
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Affiliation(s)
- Qin Li
- Department of Ophthalmology, Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, China
| | - Wen Zhou
- Department of Ophthalmology, Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, China
| | - Ya Liao
- Department of Ophthalmology, Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, China
| | - Hongyan Chen
- Department of Ophthalmology, Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, China
| | - Yanmei Sun
- Department of Ophthalmology, Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, China
| | - Mei Wang
- Department of Ophthalmology, Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu Province, China
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Kaur K, Muralikrishnan J, Hussaindeen JR, Deori N, Gurnani B. Impact of Covid-19 on Pediatric Ophthalmology Care: Lessons Learned. Pediatric Health Med Ther 2023; 14:309-321. [PMID: 37849985 PMCID: PMC10578174 DOI: 10.2147/phmt.s395349] [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: 06/27/2023] [Accepted: 10/04/2023] [Indexed: 10/19/2023] Open
Abstract
The COVID-19 pandemic came with many new challenges that forced personal and professional lifestyle modifications. Medical facilities were in scarcity against this new unknown enemy and were challenged with the overloaded patient flow, scarcity of healthcare staff, and evolving treatment modalities with a better understanding of the virus each day. Ophthalmology as a "branch of medicine" suffered challenges initially because of a lack of guidelines for patient management, close working distance during routine examinations, and halt of major surgeries, including cataracts. Pediatric ophthalmology had major implications, as reduced outpatient visits would mean deeper amblyopia, and changed lifestyles, including online classes and home refinement, predisposing children to myopia, digital eye strain, and worsening of strabismus. COVID-19 also unveiled underlying accommodation and convergence anomalies that predisposed pediatric and adolescent patients to an increased prevalence of headache and acute onset esotropia. Teleophthalmology and other innovative solutions, including the use of prism glasses, safe slit-lamp shields, alternative ways of school screening with the use of photoscreeners, performing retinoscopy only when needed, and using autorefractors were among the few guidelines or modifications adopted which helped in the efficient and safe management of pediatric patients. Many pediatric ophthalmologists also suffered in terms of financial constraints due to loss of salary or even closure of private practices. School screening and retinopathy of prematurity screening suffered a great setback and costed a lot of vision years, data of which remains under-reported. Important implications and learnings from the pandemic to mitigate future similar situations include using teleophthalmology and virtual platforms for the triage of patients, managing non-emergency conditions without physical consultations, and utilizing home-based vision assessment techniques customized for different age groups. Though this pandemic had a lot of negative implications, the innovations, modifications, and other important learnings helped pediatric ophthalmologists in navigating safely.
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Affiliation(s)
- Kirandeep Kaur
- Children Eye Care Center, Department of Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, India
| | - Janani Muralikrishnan
- Department of Pediatric Ophthalmology and Strabismus, Aravind Eye Hospital, Chennai, India
| | | | - Nilutparna Deori
- Department of Pediatric Ophthalmology and Strabismus, Sri Sankaradeva Nethralaya, Guwahati, Assam, India
| | - Bharat Gurnani
- Department of Cornea and Refractive Services, Sadguru Netra Chikitsalya, Shri Sadguru Seva Sangh Trust, Chitrakoot, Madhya Pradesh, India
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20
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Luo Z, Guo C, Yang X, Zhang M. Comparison of myopia progression among Chinese schoolchildren before and during COVID-19 pandemic: a meta-analysis. Int Ophthalmol 2023; 43:3911-3921. [PMID: 37389764 DOI: 10.1007/s10792-023-02777-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 06/22/2023] [Indexed: 07/01/2023]
Abstract
AIM To compare myopia progression in Chinese schoolchildren before and after the COVID-19 pandemic home confinement. METHODS This study was done through the data searched from PubMed, Embase, Cochrane Library, and Web of Science from January 2022 to March 2023 related to the COVID-19 pandemic home confinement and myopia progression among Chinese schoolchildren. Myopia progression was evaluated by the mean change of spherical equivalent refraction (SER) and axial length (AL) before and during the COVID-19 pandemic. Sex and regional differences in myopia progression among schoolchildren before and during the COVID-19 pandemic were also analyzed. RESULTS A total of eight eligible studies were included in this study. There was a significant difference in SER before and during home confinement during the COVID-19 pandemic (OR = 0.34; 95%CI = [0.23, 0.44]; Z = 6.39; P < 0.00001), but no significant difference in AL (OR = 0.16; 95%CI = [- 0.09, 0.41]; Z = 1.22, P = 0.22). There was a significant difference in SER between male and female groups during the COVID-19 home confinement (OR = 0.10; 95%CI = [0.00, 0.19]; Z = 1.98, P = 0.05). As for regional analysis, there was a significant difference in SER between urban and rural areas during the COVID-19 quarantine period (OR = -0.56; 95%CI = [- 0.88, - 0.25]; Z = 3.50, P = 0.0005). CONCLUSIONS Compared with the time before the COVID-19 home confinement, a higher rate of myopic progression among Chinese schoolchildren during the period of the COVID-19 pandemic was demonstrated.
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Affiliation(s)
- Zhengfen Luo
- Joint Shantou International Eye Center of Shantou University, The Chinese University of Hong Kong, North Dongxia Road, Shantou, 515041, Guangdong, China
- Shantou University Medical College, Shantou, Guangdong, China
| | - Chengyao Guo
- Joint Shantou International Eye Center of Shantou University, The Chinese University of Hong Kong, North Dongxia Road, Shantou, 515041, Guangdong, China
- Shantou University Medical College, Shantou, Guangdong, China
| | - Xiaoyuan Yang
- Joint Shantou International Eye Center of Shantou University, The Chinese University of Hong Kong, North Dongxia Road, Shantou, 515041, Guangdong, China
- Shantou University Medical College, Shantou, Guangdong, China
| | - Mingzhi Zhang
- Joint Shantou International Eye Center of Shantou University, The Chinese University of Hong Kong, North Dongxia Road, Shantou, 515041, Guangdong, China.
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21
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Du Y, Meng J, He W, Lu Y, Zhu X. Challenges of refractive cataract surgery in the era of myopia epidemic: a mini-review. Front Med (Lausanne) 2023; 10:1128818. [PMID: 37795415 PMCID: PMC10546203 DOI: 10.3389/fmed.2023.1128818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 09/04/2023] [Indexed: 10/06/2023] Open
Abstract
Myopia is the leading cause of visual impairment in the world. With ever-increasing prevalence in these years, it creates an alarming global epidemic. In addition to the difficulty in seeing distant objects, myopia also increases the risk of cataract and advances its onset, greatly affecting the productivity of myopes of working age. Cataract management in myopic eyes, especially highly myopic eyes is originally more complicated than that in normal eyes, whereas the growing population of cataract with myopia, increasing popularity of corneal and lens based refractive surgery, and rising demand for spectacle independence after cataract surgery all further pose unprecedented challenges to ophthalmologists. Previous history of corneal refractive surgery and existence of implantable collamer lens will both affect the accuracy of biometry including measurement of corneal curvature and axial length before cataract surgery, which may result in larger intraocular lens (IOL) power prediction errors and a compromise in the surgical outcome especially in a refractive cataract surgery. A prudent choice of formula for cataract patients with different characteristics is essential in improving this condition. Besides, the characteristics of myopic eyes might affect the long-term stability of IOL, which is important for the maintenance of visual outcomes especially after the implantation of premium IOLs, thus a proper selection of IOL accordingly is crucial. In this mini-review, we provide an overview of the impact of myopia epidemic on treatment for cataract and to discuss new challenges that surgeons may encounter in the foreseeable future when planning refractive cataract surgery for myopic patients.
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Affiliation(s)
- Yu Du
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Jiaqi Meng
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Wenwen He
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Yi Lu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Xiangjia Zhu
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia, Fudan University, Shanghai, China
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China
- State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
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22
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Zhu B, Sun Y, Wang S, Qin X, Li L, Du B, Fu J, Wei R. Refraction and ocular biometric parameters of preschool children in the Beijing whole childhood eye study: the first-year report. BMC Ophthalmol 2023; 23:366. [PMID: 37670238 PMCID: PMC10478261 DOI: 10.1186/s12886-023-03112-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 08/22/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND Prevention of myopia should begin before school age. However, few population-based cohort studies have investigated refractive status in preschool children with cycloplegia. This study aimed to investigate the post-COVID-19 refraction and ocular biometric parameters of preschool children in Beijing Tongzhou District. METHODS A population-based cohort study of kindergarten children in Tongzhou District, Beijing, commenced in November 2021. The present study reports data from the first year of the aforementioned population-based study. We selected children aged 3-6 years from nine kindergartens. Biometric parameters, including axial length (AL), anterior chamber depth (ACD), and corneal radius of curvature (CR), were collected before cycloplegia. Cycloplegic refraction was also measured. The spherical equivalent (SE), lens power (LP), and AL-to-CR ratio were calculated. Multiple linear regression analysis was used to analyse the correlation between refraction and ocular biometric parameters. RESULTS A total of 1,505 children completed the examination, and a mean SE of 1.24 ± 0.91 D was found. The overall prevalence of myopia was 1.93%. The mean AL, ACD, CR, LP, and AL-to-CR ratio were 22.24 ± 0.70 mm, 3.28 ± 0.26 mm, 7.77 ± 0.26 mm, 26.01 ± 1.56 D, and 2.86 ± 0.07, respectively. Longer AL, deeper ACD, larger AL-to-CR ratio, and lower LP were associated with older age; the CR was not significantly different among different ages. In the multiple linear regression analysis, after adjusting for sex and age, the model that included AL, CR, and LP explained 87% of the SE variation. No differences were observed in the prevalence of myopia or the SE in this particular age range. CONCLUSION The findings of this study suggest that a large proportion of preschool children in Beijing are mildly hyperopic, with a considerably low prevalence of myopia. In preschool children, refractive development was found to present mild hyperopia rather than emmetropia or myopia, a phenomenon that is characteristic of this age range.
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Affiliation(s)
- Bidan Zhu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 300392, Tianjin, China
- Tongzhou Maternal and Child Health Hospital of Beijing, 101101, Beijing, China
| | - Yunyun Sun
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory , 100730, Beijing, China
| | - Shana Wang
- Tongzhou Maternal and Child Health Hospital of Beijing, 101101, Beijing, China
| | - Xi Qin
- Tongzhou Maternal and Child Health Hospital of Beijing, 101101, Beijing, China
| | - Lei Li
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory , 100730, Beijing, China
| | - Bei Du
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 300392, Tianjin, China
| | - Jing Fu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory , 100730, Beijing, China.
| | - Ruihua Wei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, 300392, Tianjin, China.
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23
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Hadi DE, Moukhadder HM, Mansour H, Wehbi Z, Ghannam AB, Al-Haddad C. Effect of the COVID-19 Lockdown on Myopia Progression of School-aged Children: A Retrospective Chart Review. J Pediatr Ophthalmol Strabismus 2023; 60:353-358. [PMID: 36441129 DOI: 10.3928/01913913-20221010-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE To study the effect of the coronavirus disease 2019 (COVID-19)-related lockdown on myopia progression of school-aged children, comparing across the years and within different age groups. METHODS This was a retrospective chart review of school-aged children with myopia who presented to the pediatric ophthalmology clinic at the American University of Beirut between January 2020 and December 2021 (during COVID-19 lockdown). Annual myopia progression rate (back to January 2016) was computed by dividing the absolute value of the spherical equivalent (SE) difference of two consecutive visits by the duration (in years). Demographic data were retrieved. Patients were then divided into three age groups (3 to 10, 11 to 14, and 15 to 18 years) for analysis. RESULTS A total of 443 charts of myopic school-aged children were reviewed. Their average age was 11.81 ± 3.67 years with an average of 3.85 ± 1.67 visits across the years. The mean myopic SE increased over time: SE in 2021 was significantly higher than the mean SE in 2016, 2017, 2018, and 2019. Mean SE in 2020 was significantly higher than that in 2016 and 2017. There was no statistically significant difference in the mean annual progression (in diopters/year). For the 3 to 10 years group, the annual SE progression tended to be highest for 2020-2021 and 2019-2020 compared to previous years. CONCLUSIONS Children had more myopia in 2021 and 2020 (during lockdown) compared to previous years. The myopia annual progression tended to be highest in 2020-2021, especially for the younger age group, but the difference was not statistically significant. [J Pediatr Ophthalmol Strabismus. 2023;60(5):353-358.].
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Rodriguez NM, Acevedo A, Torres VP, Romero AF. Refractive Error Changes Due to COVID-19 Pandemic Confinement in Children from Puerto Rico: A Retrospective Study. Optom Vis Sci 2023; 100:638-644. [PMID: 37585748 DOI: 10.1097/opx.0000000000002055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023] Open
Abstract
SIGNIFICANCE The progression of myopia increased in children after the pandemic confinement. A myopic shift in the refractive error of the Hispanic population was found regardless of the refractive status of the school-aged children studied. PURPOSE This study aimed to evaluate the refractive error in Puerto Rican children before and after the COVID-19 pandemic. We were interested in whether there was a significant change in refractive error attributed to online learning during the pandemic lockdown. METHODS A retrospective record review of children aged 7 to 18 years who underwent a comprehensive visual evaluation between 2018 and 2021 at the Inter American Eye Institute in Puerto Rico was performed. The spherical equivalent pre- and post-lockdown was compared. The study excluded the best-corrected visual acuities worse than 20/40, any corneal or retinal disease, and amblyopia. RESULTS In total, 801 records were included in this study. The mean age was 12.7 ± 3.2 years, with 50.3% male and 49.7% female children. The mean spherical equivalent for the right and left eyes was similar ( r = 0.93, P ≤ .001). A significant difference in the mean spherical equivalent was found pre- and post- lockdown (0.22 ± 0.59 D, t800 = 10.44, P ≤ .001). A myopic shift post-lockdown was significant for all ages except those in the 7- (0.13 ± 0.79 D, t28 = 0.84, P = .40) and 8-year-old range (0.12 ± 0.65 D, t40 = 1.22, P = .23), respectively. No significant change was found between sexes before (0.16 ± 0.12 D; t799 = 1.38, P = .16) and after (0.15 ± 0.13 D; t799 = 1.19, P = .23) confinement. CONCLUSIONS The current study revealed a significant myopic shift in Hispanic school-aged children as a result of the pandemic confinement.
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Affiliation(s)
| | - Ariette Acevedo
- Inter American University of Puerto Rico School of Optometry, Bayamon, Puerto Rico
| | | | - Angel F Romero
- Inter American University of Puerto Rico School of Optometry, Bayamon, Puerto Rico
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25
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Xuan M, Zhu Z, Jiang Y, Wang W, Zhang J, Xiong R, Shi D, Bulloch G, Zeng J, He M. Longitudinal Changes in Choroidal Structure Following Repeated Low-Level Red-Light Therapy for Myopia Control: Secondary Analysis of a Randomized Controlled Trial. Asia Pac J Ophthalmol (Phila) 2023; 12:377-383. [PMID: 37523429 DOI: 10.1097/apo.0000000000000618] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 05/05/2023] [Indexed: 08/02/2023] Open
Abstract
PURPOSE Repeated low-level red-light (RLRL) therapy has been confirmed as a novel intervention for myopia control in children. This study aims to investigate longitudinal changes in choroidal structure in myopic children following 12-month RLRL treatment. MATERIALS AND METHODS The current study is a secondary analysis from a multicenter, randomized controlled trial (NCT04073238). Choroidal parameters were derived from baseline and follow-up swept-source optical coherence tomography scans taken at 1, 3, 6, and 12 months. These parameters included the luminal area (LA), stromal area (SA), total choroidal area (TCA; a combination of LA and SA), and choroidal vascularity index (CVI; ratio of LA to TCA), which were automatically measured by a validated custom choroidal structure assessment tool. RESULTS A total of 143 children (88.3% of all participants) with sufficient image quality were included in the analysis (n=67 in the RLRL and n=76 in the control groups). At the 12-month visit, all choroidal parameters increased in the RLRL group, with changes from baseline of 11.70×10 3 μm 2 (95% CI: 4.14-19.26×10 3 μm 2 ), 3.92×10 3 μm 2 (95% CI: 0.56-7.27×10 3 μm 2 ), 15.61×10 3 μm 2 (95% CI: 5.02-26.20×10 3 μm 2 ), and 0.21% (95% CI: -0.09% to 0.51%) for LA, SA, TCA, and CVI, respectively, whereas these parameters reduced in the control group. CONCLUSIONS Following RLRL therapy, the choroidal thickening was found to be accompanied by increases in both the vessel LA and SA, with the increase in LA being greater than that of SA. In the control group, with myopia progression, both the LA and SA decreased over time.
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Affiliation(s)
- Meng Xuan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong Province, China
| | - Zhuoting Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong Province, China
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
| | - Yu Jiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong Province, China
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong Province, China
| | - Jian Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong Province, China
| | - Ruilin Xiong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong Province, China
| | - Danli Shi
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong Province, China
| | - Gabriella Bulloch
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
- Faculty of Science, Medicine and Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Junwen Zeng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong Province, China
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, Guangdong Province, China
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Victoria, Australia
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
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Huang S, Shen F, Zhou F, Gong Q, Liu K, Feng W, Cen D. Myopia in elementary school students in Eastern China during the COVID-19 pandemic. Front Public Health 2023; 11:1167379. [PMID: 37415713 PMCID: PMC10320216 DOI: 10.3389/fpubh.2023.1167379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 05/30/2023] [Indexed: 07/08/2023] Open
Abstract
Background Myopia is an increasingly serious public concern, particularly among primary school students. The prevalence of myopia and its influencing factors in primary school pupils in Eastern China during the COVID-19 pandemic had not been explored. Methods A randomly clustered sampling method was performed, and selected pupils from grade 1 to grade 3 in 15 primary schools in the Fenghua District of Zhejiang Province were included and given myopia screening and uniform questionnaire survey 1 year later. Results A total of 4,213 students completed the myopia screening and questionnaire survey. Myopia was diagnosed in 1,356 pupils, with a myopia incidence of 32.19%. The spherical equivalent (SE) refraction of the included pupils decreased on average by 0.50 ± 2.15 D 1 year later. The myopia rate was positively correlated with the increase of grade, in which the myopia rate among grade 3 students was the highest at 39.69%. The myopia rate among female students was higher than that among male students. Students residing in urban areas had a higher myopia rate than in rural areas. Maintaining an near work distance ≥33 cm was a significant protective factor (OR = 0.84, 95% CI: 0.74-0.96). Students with two myopic parents had a higher risk of myopia (OR = 1.61, 95% CI: 1.34-1.92). Conclusion During the COVID-19 pandemic, the myopia rate among early primary school students in Eastern China was high. More attention and implementation of interventions from health and education departments, such as training the development of good eye behavior, should be considered to strengthen the intervention of myopia in primary school students.
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Affiliation(s)
| | - Fanhan Shen
- Fenghua District Center for Disease Control and Prevention, Ningbo, China
| | - Fujun Zhou
- Fenghua District Center for Disease Control and Prevention, Ningbo, China
| | - Qinghai Gong
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
| | - Kui Liu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Wei Feng
- Fenghua District Center for Disease Control and Prevention, Ningbo, China
| | - Dong Cen
- Ningbo Yinzhou No.2 Hospital, Ningbo, China
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27
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Zheng Y, Jia X, Li S, Xiao X, Zhang Q, Wang P. Non-Pharmaceutical Interventions against COVID-19 Causing a Lower Trend in Age of LHON Onset. Genes (Basel) 2023; 14:1253. [PMID: 37372433 DOI: 10.3390/genes14061253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/06/2023] [Accepted: 06/10/2023] [Indexed: 06/29/2023] Open
Abstract
Leber hereditary optic neuropathy (LHON) is a monogenic but multifactorial disease vulnerable to environmental triggers. Little is known about how LHON onset changed during the COVID-19 pandemic and how non-pharmaceutical interventions (NPHIs) against COVID-19 impact LHON onset. One hundred and forty-seven LHON patients with the m.11778G>A mutation complaining of vision loss were involved between January 2017 and July 2022. The onset time points, age of onset, and possible risk factors were evaluated. Analyses were conducted among 96 LHON patients in the Pre-COVID-19 group and 51 in the COVID-19 group. The median (IQR) age of onset decreased significantly from 16.65 (13.739, 23.02) in pre-COVID-19 to 14.17 (8.87, 20.29) during COVID-19. Compared with the Pre-COVID-19 group, the COVID-19 group exhibited bimodal distribution with an additional peak at six; the first quarter of 2020 also witnessed a relatively denser onset, with no subsequent second spike. NPHIs against COVID-19 significantly changed patients' lifestyles, including higher secondhand smoke exposure (p < 0.001), adherence to masks (p < 0.001), reduction in time spent outdoors for leisure (p = 0.001), and prolonged screen time (p = 0.007). Multivariate logistic regression revealed that secondhand smoke exposure and mask-wearing were independent risk factors of younger LHON onset. Lower age of onset of LHON appeared after the breakout of the COVID-19 pandemic, and novel risk factors were detected, including secondhand exposure and long mask-wearing. Carriers of LHON mtDNA mutations, especially teenagers or children, should be advised to avoid secondhand smoke exposure and there are possible adverse outcomes of longer mask-wearing.
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Affiliation(s)
- Yuxi Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, 54 Xianlie Road, Guangzhou 510060, China
| | - Xiaoyun Jia
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, 54 Xianlie Road, Guangzhou 510060, China
| | - Shiqiang Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, 54 Xianlie Road, Guangzhou 510060, China
| | - Xueshan Xiao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, 54 Xianlie Road, Guangzhou 510060, China
| | - Qingjiong Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, 54 Xianlie Road, Guangzhou 510060, China
| | - Panfeng Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, 54 Xianlie Road, Guangzhou 510060, China
- Gene Diagnostic Laboratory, Genetic Eye Clinic, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 Xianlie Road, Guangzhou 510060, China
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Bui MH, Lee DY, Park SJ, Park KH. Real-World Treatment Intensity and Patterns in Patients With Myopic Choroidal Neovascularization: Common Data Model in Ophthalmology. J Korean Med Sci 2023; 38:e174. [PMID: 37309694 DOI: 10.3346/jkms.2023.38.e174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 02/24/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND A paucity of data addressing real-world treatment of myopic choroidal neovascularization (mCNV) in the era of anti-vascular endothelial growth factor (VEGF) drugs led us to investigate real-world treatment intensity and treatment patterns in patients with mCNV. METHODS This is a retrospective, observational study using the Observational Medical Outcomes Partnership-Common Data Model database of treatment-naïve patients with mCNV over the 18-year study period (2003-2020). Outcomes were treatment intensity (time trends of total/average number of prescriptions, mean number of prescriptions in the first year and the second year after initiating treatment, proportion of patients with no treatment in the second year) and treatment patterns (subsequent patterns of treatment according to the initial treatment). RESULTS Our final cohort included 94 patients with at-least 1-year observation period. Overall, 96.8% of patients received anti-VEGF drugs as first-line treatment, with most of injections from bevacizumab. The number of anti-VEGF injections in each calendar year showed an increasing trend over time; however, there was a drop in the mean number of injections in the second year compared to the first year from 2.09 to 0.47. About 77% of patients did not receive any treatment in their second year of treatment regardless of drugs. Most of patients (86.2%) followed non-switching monotherapy only and bevacizumab was the most popular choice either in the first-line (68.1%) or in the second-line (53.8%) of treatment. Aflibercept was increasingly used as the first-line treatment for patients with mCNV. CONCLUSION Anti-VEGF drugs have become the treatment of choice and second-line treatment for mCNV over the past decade. Anti-VEGF drugs are effective for the treatment of mCNV as the non-switching monotherapy is the main treatment regimen in most cases and the number of treatments decreases significantly in the second year of treatment.
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Affiliation(s)
- Manh-Hung Bui
- Department of Ophthalmology, College of Medicine, Seoul National University, Seoul, Korea
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Da Yun Lee
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sang Jun Park
- Department of Ophthalmology, College of Medicine, Seoul National University, Seoul, Korea
- Department of Ophthalmology, Seoul National University Bundang Hospital, Seongnam, Korea.
| | - Kyu Hyung Park
- Department of Ophthalmology, College of Medicine, Seoul National University, Seoul, Korea
- Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.
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Zhou X, Liu T, Wu A, Cheng B, Chen M, Wang K. Prevalence of myopia among senior students in Fenghua, Eastern China, before and during the COVID-19 pandemic. Front Public Health 2023; 11:1180800. [PMID: 37346105 PMCID: PMC10279843 DOI: 10.3389/fpubh.2023.1180800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/19/2023] [Indexed: 06/23/2023] Open
Abstract
Background Myopia is a common cause of vision impairment worldwide. In China, the prevalence, the affected population, and the onset age of myopia are prominent issues. Prevention and intervention of myopia are great public health concerns. Methods This school-based retrospective study retrieved visual acuity and refractive data of senior students (grade 12th) from six high schools in Fenghua City, Zhejiang Province, eastern China, from 2016 and 2022. Noncycloplegic autorefraction was performed for refractive status. Students were divided into three subgroups by their school types. The overall myopia prevalence, as well as the prevalence of low myopia, moderate myopia, and high myopia, were calculated separately for each year. Statistical analyzes were performed using SPSS 25.0 and Graphpad Prism software. Results The mean myopia prevalence in Fenghua was 84.5% (95% CI: 84.0-85.0%), and a slightly downward trend was found in myopia prevalence after 2019, but the change was not statistically significant (p = 0.078). The overall prevalence of myopia was 79.6, 85.2, and 86.1% in vocational high schools, general high schools, and key high schools, respectively, with statistically significant differences (p < 0.001). The prevalence of myopia among senior students in the vocational high school was significantly lower than that in the other two high schools. There's no significant change in the overall prevalence of myopia (84.7% vs. 84.3%, p = 0.265) before and during the COVID-19 pandemic, and it remained statistically insignificant after stratifying by gender (male p = 0.207, female p = 0.918) or school types (vocational high school p = 0.112; general high school p = 0.299; key high school p = 0.393). Conclusion The prevalence of myopia among senior students in Fenghua is relatively high, and the COVID-19 pandemic has no significant impact on it. The prevalence of myopia among vocational high school students is lower than that of general high school and key high school. Attention should be paid to the effects of educational pressure on the prevalence of myopia among students.
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Affiliation(s)
- Xuewei Zhou
- Department of Ophthalmology, The People’s Hospital of Fenghua, Ningbo, Zhejiang, China
| | - Tong Liu
- Eye Center, The 2nd Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China
- Zhejiang Provincial Key Laboratory of Ophthalmology, Hangzhou, China
| | - Aimin Wu
- Department of Ophthalmology, The People’s Hospital of Fenghua, Ningbo, Zhejiang, China
| | - Bo Cheng
- Department of Ophthalmology, The People’s Hospital of Fenghua, Ningbo, Zhejiang, China
| | - Min Chen
- Eye Center, The 2nd Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China
- Zhejiang Provincial Key Laboratory of Ophthalmology, Hangzhou, China
| | - Kaijun Wang
- Eye Center, The 2nd Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China
- Zhejiang Provincial Key Laboratory of Ophthalmology, Hangzhou, China
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Tong HJ, Huang ZM, Li YL, Chen YM, Tian B, Ding LL, Zhu LL. Machine learning to analyze the factors influencing myopia in students of different school periods. Front Public Health 2023; 11:1169128. [PMID: 37333519 PMCID: PMC10270291 DOI: 10.3389/fpubh.2023.1169128] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 05/16/2023] [Indexed: 06/20/2023] Open
Abstract
Purpose We aim to develop myopia classification models based on machine learning algorithms for each schooling period, and further analyze the similarities and differences in the factors influencing myopia in each school period based on each model. Design Retrospective cross-sectional study. Participants We collected visual acuity, behavioral, environmental, and genetic data from 7,472 students in 21 primary and secondary schools (grades 1-12) in Jiamusi, Heilongjiang Province, using visual acuity screening and questionnaires. Methods Machine learning algorithms were used to construct myopia classification models for students at the whole schooling period, primary school, junior high school, and senior high school period, and to rank the importance of features in each model. Results The main influencing factors for students differ by school section, The optimal machine learning model for the whole schooling period was Random Forest (AUC = 0.752), with the top three influencing factors being age, myopic grade of the mother, and Whether myopia requires glasses. The optimal model for the primary school period was a Random Forest (AUC = 0.710), with the top three influences being the myopic grade of the mother, age, and extracurricular tutorials weekly. The Junior high school period was an Support Vector Machine (SVM; AUC = 0.672), and the top three influencing factors were gender, extracurricular tutorial subjects weekly, and whether can you do the "three ones" when reading and writing. The senior high school period was an XGboost (AUC = 0.722), and the top three influencing factors were the need for spectacles for myopia, average daily time spent outdoors, and the myopic grade of the mother. Conclusion Factors such as genetics and eye use behavior all play an essential role in students' myopia, but there are differences between school periods, with those in the lower levels focusing on genetics and those in the higher levels focusing on behavior, but both play an essential role in myopia.
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Affiliation(s)
- Hao-Jie Tong
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
| | - Ze-Min Huang
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
| | - Yu-Lan Li
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
| | - Yi-Ming Chen
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
| | - Ben Tian
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
| | - Ling-Ling Ding
- Clinical College of Anhui Medical University, Hefei, Anhui, China
| | - Li-Ling Zhu
- School of Public Health, Jiamusi University, Jiamusi, Heilongjiang, China
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March de Ribot F, Salgado-Borges J, Benitez Del Castillo J. Visual complaints during the COVID-19 pandemic in Spain and Portugal. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023:S2173-5794(23)00070-1. [PMID: 37178785 PMCID: PMC10174337 DOI: 10.1016/j.oftale.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 03/09/2023] [Indexed: 05/15/2023]
Abstract
PURPOSE This study reports visual health during the COVID-19 pandemic in 2021 in Spain and Portugal, focusing on eye complaints and population habits. MATERIAL AND METHODS Cross-sectional survey through an online email invitation to patients attending ophthalmology clinics in Spain and Portugal from September to November 2021. Around 3833 participants offered valid anonymous responses in a questionnaire. RESULTS Sixty percent of respondents identified significant discomfort related to dry eye symptoms for increased screen time and lens fogging using facemasks. 81.6% of the participants used digital devices for more than 3 h per day and 40% for more than 8 h. In addition, 44% of participants referred to worsening near vision. The most frequent ametropias were myopia (40.2%) and astigmatism (36.7%). Parents considered eyesight the most important aspect of their children (87.2%). CONCLUSIONS The results show the challenges for eye practices during the initial COVID-19 pandemic. Focusing on signs and symptoms that lead to ophthalmologic conditions is an essential concern, especially in our digital society highly dependent on vision. At the same time, the excessive use of digital devices during this pandemic has aggravated dry eye and myopia.
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Affiliation(s)
- F March de Ribot
- Departamento de Oftalmología, Hospital Universitario de Girona, Girona, Spain.
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Long X, Li XY, Jiang H, Shen LD, Zhang LF, Pu Z, Gao X, Li M. Impact of the COVID-19 kindergarten closure on overweight and obesity among 3- to 7-year-old children. World J Pediatr 2023; 19:469-477. [PMID: 36507980 PMCID: PMC9742663 DOI: 10.1007/s12519-022-00651-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 11/03/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Knowledge on the impact of the temporary kindergarten closure policy under COVID-19 in 2020 on childhood overweight and obesity is inadequate. We aimed to examine differences in rates of overweight and obesity from 2018 to 2021 among kindergarten children aged 3-7 years. METHODS Overweight was defined as body mass index (BMI) > 1 standard deviation (SD) for age and sex, and obesity was defined as BMI > 2 SD for age and sex. Generalized linear mixed modeling was used for analysis. RESULTS A total of 44,884 children and 71,216 growth data points from all 57 public kindergartens in Jiading District, Shanghai, China were analyzed. The rates of obesity from 2018 to 2021 were 6.9%, 6.6%, 9.5%, and 7.3% in boys and 2.8%, 2.8%, 4.5%, and 3.1% in girls, respectively. The rates of overweight from 2018 to 2021 were 14.3%, 14.3%, 18.2%, and 15.3% in boys and 10.6%, 10.9%, 13.9%, and 11.6% in girls. The rates of obesity and overweight among kindergarten children in 2020 were significantly higher than those in 2018, 2019, and 2021. Compared to 2020, the odds ratios of the obesity rate in 2018, 2019, and 2021 were 0.67 [95% confidence interval (CI) = 0.58-0.77, P < 0.001], 0.72 (95% CI = 0.64-0.80, P < 0.001) and 0.81 (95% CI = 0.72-0.92, P = 0.001), respectively. The odds ratios of the overweight rate in 2018, 2019, and 2021 were 0.75 (95% CI = 0.69-0.82, P < 0.001), 0.78 (95% CI = 0.72-0.84, P < 0.001), and 0.89 (95% CI = 0.81-0.97, P = 0.008), respectively, compared to 2020. CONCLUSIONS The rates of overweight and obesity significantly increased among kindergarten children in 2020 after the 5-month kindergarten closure. It was critical to provide guidance to caregivers on fostering a healthy lifestyle for children at home under public health emergencies.
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Affiliation(s)
- Xiang Long
- Department of Woman and Child Health Care, Jiading Maternal and Child Health Care Hospital, 1216 Gaotai Road, Jiading District, Shanghai 201821, China
| | - Xing-Ying Li
- School of Public Health, Key Laboratory of Health Technology Assessment (National Health Commission of the People's Republic of China), Fudan University, Mailbox 175, 138 Yixueyuan Road, Xuhui District, Shanghai 200032, China
| | - Hong Jiang
- School of Public Health, Key Laboratory of Health Technology Assessment (National Health Commission of the People's Republic of China), Fudan University, Mailbox 175, 138 Yixueyuan Road, Xuhui District, Shanghai 200032, China.
| | - Lian-Di Shen
- Department of Administrative Office, Jiading Maternal and Child Health Care Hospital, 1216 Gaotai Road, Jiading District, Shanghai 201821, China.
| | - Li-Feng Zhang
- Department of Woman and Child Health Care, Jiading Maternal and Child Health Care Hospital, 1216 Gaotai Road, Jiading District, Shanghai 201821, China
| | - Zheng Pu
- Department of Woman and Child Health Care, Jiading Maternal and Child Health Care Hospital, 1216 Gaotai Road, Jiading District, Shanghai 201821, China
| | - Xia Gao
- Department of Woman and Child Health Care, Jiading Maternal and Child Health Care Hospital, 1216 Gaotai Road, Jiading District, Shanghai 201821, China
| | - Mu Li
- School of Public Health, The University of Sydney, Sydney, Australia
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Cui L, Zhou H, Lou X, Chen T, Guo Y, Li J, Hao Y, Li Z, Yang X, Wang X. Effects of behaviors and surrounding environment on myopia before and during the COVID-19 pandemic: a longitudinal analysis of children and adolescents in China. ZEITSCHRIFT FUR GESUNDHEITSWISSENSCHAFTEN = JOURNAL OF PUBLIC HEALTH 2023:1-13. [PMID: 37361266 PMCID: PMC10088736 DOI: 10.1007/s10389-023-01900-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 03/27/2023] [Indexed: 06/28/2023]
Abstract
Aim To investigate the relationship between related factors and visual acuity of Chinese school students before and during the COVID-19 pandemic. Subject and methods Chinese students from primary and secondary schools were included from the Chinese National Surveys on Students' Constitution and Health CNSSCH (2019). A total of 1496 participants completed follow-ups in June and December 2020, respectively. Generalized estimating equations were used to test the differences in visual environment. Logistic regression models were utilized to examine the roles of behaviors and surrounding environment changes associated with myopia before and during the pandemic. Results The prevalence of myopia was 47.7%, 55.6%, and 57.2% in baseline and two follow-ups, respectively. Significant differences existed for gender, learning level, and region (all P < 0.05). The proportion of new myopia and myopia torsion was the highest in the primary schools. Multivariate logistic regression analysis found that screen time ≥ 4h/d (OR = 2.717), poor eye habits (OR = 1.477), insufficient lighting for studying at night (OR = 1.779), desk or roof lamps only (OR = 1.388), and poor sleep quality (OR = 4.512) were the risk factors for myopia (all P < 0.05), and eye exercises (OR = 0.417), milk intake (OR = 0.758), and eggs intake (OR = 0.735) were the protective factors for myopia (all P < 0.05). Conclusion Prevalence of myopia increased among Chinese students before and during the COVID-19. It is necessary to pay more attention to the pupils' visual acuity, especially in primary school students, in the future. Supplementary Information The online version contains supplementary material available at 10.1007/s10389-023-01900-w.
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Affiliation(s)
- Lingling Cui
- College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou, 450001 Henan People’s Republic of China
| | - Huijun Zhou
- College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou, 450001 Henan People’s Republic of China
| | - Xiaomin Lou
- College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou, 450001 Henan People’s Republic of China
| | - Tingting Chen
- College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou, 450001 Henan People’s Republic of China
| | - Yingying Guo
- College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou, 450001 Henan People’s Republic of China
| | - Jiaxin Li
- College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou, 450001 Henan People’s Republic of China
| | - Yudan Hao
- College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou, 450001 Henan People’s Republic of China
| | - Zhiqian Li
- College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou, 450001 Henan People’s Republic of China
| | - Xiaoli Yang
- College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou, 450001 Henan People’s Republic of China
| | - Xian Wang
- College of Public Health, Zhengzhou University, No.100 Science Avenue, Zhengzhou, 450001 Henan People’s Republic of China
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Ma LU, Yu X, Gong L, Wei L, Peng Z, Wang K, Li Y, Zhou J, Zhao M. Evaluating the optimised font size and viewing time of online learning in young children: a multicentre cross-sectional study. BMJ Paediatr Open 2023; 7:10.1136/bmjpo-2022-001835. [PMID: 37185652 PMCID: PMC10151978 DOI: 10.1136/bmjpo-2022-001835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 03/14/2023] [Indexed: 05/17/2023] Open
Abstract
OBJECTIVES Near viewing distance (VD) and longer viewing times are associated with myopia. This study aimed to identify the font size and viewing time that guarantee the appropriate VD and pixels per degree (PPD) for children's online learning. DESIGN This cross-sectional study comprised two experiments. In experiment A, participants read text in five font sizes on three backlit displays (a personal computer, a smartphone and a tablet), an E-ink display and paper for 5 min per font size. In experiment B, participants watched videos for 30 min on three backlit displays. SETTING The Peking University People's Hospital in Beijing (China) and the School of Ophthalmology and Optometry, Wenzhou Medical University (Zhejiang Province, China). PARTICIPANTS Thirty-five participants completed experiment A. Ten of them participated in experiment B. PRIMARY AND SECONDARY OUTCOME MEASURES VDs were measured by Clouclip. The corresponding PPD was calculated. RESULTS In experiment A, font size and display type significantly affected VD (F(4840)=149.44, p<0.001, ES (Effect size)=0.77; F(4840), p<0.001, ES=0.37). VDs were >33 cm for all five font sizes on the PC, the tablet and paper and for 18-pt on the smartphone and 16-pt on E-ink. PPD for 16-pt on the PC, 14-pt on the tablet and all five font sizes on the phone were >60. In experiment B, VD increased over the four previous 5 min periods but decreased slightly on tablets and PCs in the fifth 5 min period. PPD was >60. CONCLUSION Children demonstrated different VDs and PPDs based on font size and display type. To ensure a 33 cm VD and 60 PPD, the minimum font size for online reading should be 18-pt on smartphones, 16-pt on PCs and E-ink, 10.5-pt on tablets and 9-pt on paper. More attention should be given to children's VD with continuous video viewing of more than 25 min. TRIAL REGISTRATION NUMBER ChiCTR2100049584.
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Affiliation(s)
- L U Ma
- Department of Ophthalmology & Clinical Centre of Optometry, Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
- Institute of Medical Technology, Peking University Health Science Centre, Beijing, China
| | - Xi Yu
- School of Ophthalmology and Optometry, Affiliated Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ling Gong
- School of Ophthalmology and Optometry, Affiliated Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Lili Wei
- School of Ophthalmology and Optometry, Affiliated Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zisu Peng
- Department of Ophthalmology & Clinical Centre of Optometry, Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
- Institute of Medical Technology, Peking University Health Science Centre, Beijing, China
| | - Kai Wang
- Department of Ophthalmology & Clinical Centre of Optometry, Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
- Institute of Medical Technology, Peking University Health Science Centre, Beijing, China
| | - Yan Li
- Department of Ophthalmology & Clinical Centre of Optometry, Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Jiawei Zhou
- School of Ophthalmology and Optometry, Affiliated Eye Hospital, State Key Laboratory of Ophthalmology, Optometry and Vision Science, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Mingwei Zhao
- Department of Ophthalmology & Clinical Centre of Optometry, Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
- Institute of Medical Technology, Peking University Health Science Centre, Beijing, China
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Dong WH, Gu TM, Zhu BQ, Shen Y, He XY, Bai GN, Shao J. Comparison of anthropometric parameters and laboratory test results before and after the COVID-19 outbreak among Chinese children aged 3–18 years. Front Public Health 2023; 11:1048087. [PMID: 36998284 PMCID: PMC10043305 DOI: 10.3389/fpubh.2023.1048087] [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: 09/19/2022] [Accepted: 02/20/2023] [Indexed: 03/18/2023] Open
Abstract
ObjectiveTo compare the physiological health of Chinese children around the COVID-19 lockdown.MethodsWe extracted data on children's anthropometric and laboratory parameters from May to November in both 2019 and 2020 from the Health Checkup Center, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China. Overall, 2162 children aged 3~18 years without comorbidities in 2019 and 2646 in 2020 were assessed. Mann Whitney U tests were used to compare differences between the above health indicators before and after COVID-19 outbreak. Quantile regression analyses adjusted for age, sex and body mass index (BMI) were also used in analysis. Chi-square tests and Fisher's exact tests were used for comparing differences of categorical variables.ResultsCompared with children examined in 2019 before the outbreak, children in 2020 had a higher median z score of BMI for age (−0.16 vs. −0.31), total cholesterol (TC, 4.34 vs. 4.16 mmol/L), low density lipoprotein cholesterol (LDL-C, 2.48 vs. 2.15 mmol/L), high density lipoprotein cholesterol (HDL-C, 1.45 vs. 1.43 mmol/L) and serum uric acid (290 vs. 282 μmol/L), and a lower hemoglobin (Hb, 134 vs. 133 g/L), triglycerides (TG, 0.70 vs. 0.78 mmol/L) and 25(OH)D (45.8 vs. 52.2 nmol/L), all P < 0.05. No differences were identified for waist height ratio, blood pressure and fasting glucose (both P > 0.05). However, in regression models after adjusting, BMI, TC, LDL-C, blood glucose and sUA were positively correlated with year; while Hb, TG and 25(OH)D were negatively correlated with year (all P < 0.05). Accordingly, children in 2020 had a higher prevalence of overweight/obesity (20.6 vs. 16.7%, P < 0.001), hypercholesterol (16.2%vs. 10.2%, P < 0.001), high LDL-C (10 vs. 2.9%, P < 0.001), hyperuricemia (18.9 vs.15.1%, P = 0.002), vitamin D deficiency (22.6 vs. 8.1%, P < 0.001) and a lower prevalence of high TG (4.3 vs. 2.8%, P = 0.018) compared with children in 2019.ConclusionIn this real-world study, we found that long-term lockdown due to COVID-19 outbreak might cause adverse impact on children's metabolic health, which might increase their future risk of cardiovascular diseases. Thus, parents, health professionals, educationists, and caregivers should pay more attention to children's dietary pattern and lifestyle, especially in this new normal against COVID-19.
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Kneepkens SCM, de Vlieger J, Tideman JWL, Enthoven CA, Polling JR, Klaver CCW. Myopia risk behaviour related to the COVID-19 lockdown in Europe: The generation R study. Ophthalmic Physiol Opt 2023; 43:402-409. [PMID: 36772877 DOI: 10.1111/opo.13100] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 02/12/2023]
Abstract
PURPOSE To battle the spreading of the COVID-19 virus, nationwide lockdowns were implemented during 2020 and 2021. Reports from China revealed that their strict home confinements led to an increase in myopia incidence. The Netherlands implemented a more lenient lockdown, which allowed children to go outside. We evaluated the association between COVID-19 restrictions, myopia risk behaviour and myopia progression in Dutch teenagers. METHOD A total of 1101 participants (mean age 16.3 ± 3.65 yrs) completed questionnaires about their activities before, during and after lockdown (March-October 2020). We used a repeated-measures ANOVA to compare time use between these time periods. Ocular measurements were acquired before the COVID-19 pandemic when participants were 13 years old; only 242 participants had ocular measurements at 18 years of age at the time of this analysis. Linear regression analyses were used to evaluate the association between lifestyle factors and myopia progression. RESULTS Children were on average 16.2 (1.03) years of age during lockdown. Total nearwork increased from 8.11 h/day to 11.79 h/day, and remained higher after lockdown at 9.46 h/day (p < 0.001). Non-educational nearwork increased by 2.22 h/day (+49%) during lockdown and was associated with faster axial length progression (B 0.002 mm/h/year; SE 0.001 p = 0.03). Before and during lockdown, the mean time spent outdoors was similar (1.78 h/day and 1.80 h/day, respectively). After lockdown, time spent outdoors decreased to 1.56 h/day (p < 0.001). CONCLUSION The Dutch lockdown significantly increased digitised nearwork in adolescents but did not affect outdoor exposure. The changes in time spent performing nearwork remained after the lockdown measures had ended. We expect that the COVID-19 pandemic may lead to an increase in myopia prevalence and progression in European children.
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Affiliation(s)
- Sander C M Kneepkens
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.,The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Jimmy de Vlieger
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.,The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands
| | - J Willem L Tideman
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.,Martini Hospital, Groningen, The Netherlands
| | - Clair A Enthoven
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.,The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Psychology, Education and Child Studies, Erasmus University, Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Jan Roelof Polling
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.,University of Applied Sciences, Utrecht, The Netherlands
| | - Caroline C W Klaver
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.,The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands.,Radboud University Medical Center, Nijmegen, The Netherlands.,Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
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Najafzadeh MJ, Zand A, Shafiei M, Sharifi M, Nasiri N, Sharifi A. Myopia Progression during the COVID-19 Era: A Systematic Review and Meta-analysis. Semin Ophthalmol 2023:1-10. [PMID: 36734046 DOI: 10.1080/08820538.2023.2168490] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND To evaluate myopia progression during the novel coronavirus disease 2019 (COVID-19) pandemic and its risk factors. METHODS We searched PubMed, Scopus, and Web of Science to find literature until August 2022 related to COVID-19 pandemic and myopia progression. Outcomes of myopia progression included axial length (AL) and spherical equivalent (SE). Factors of screen time and outdoor activity time were analyzed. RESULTS Thirty-three studies were included in this meta-analysis. Compared to the same period before the COVID-19 pandemic, myopia prevalence increased (OR = 1.11; 95% CI, 1.05-1.18). The outcomes of SE decreased -0.61 diopter (95% CI, -0.98 to -0.23), and AL increased 0.42 mm (95% CI, 0.13-0.7). Mean screen time was increased 6.25 hours/day (95% CI, 4.84-7.66), and outdoor activity time was decreased -1.52 hours/day (95% CI, -3.20 to -0.15). CONCLUSION Establishing care policies is necessary to restrict behavioral changes and their consequences during the pandemic.
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Affiliation(s)
| | - Amin Zand
- Department of Ophthalmology, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohadeseh Shafiei
- Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Meraj Sharifi
- Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Naser Nasiri
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Sharifi
- Department of Ophthalmology, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
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Yu M, Jiang L, Chen M. Effect of atropine 0.01% on myopia control in children aged 6-13 years during the 2022 lockdown in Shanghai. Front Public Health 2023; 11:1074272. [PMID: 36778567 PMCID: PMC9909278 DOI: 10.3389/fpubh.2023.1074272] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 01/10/2023] [Indexed: 01/27/2023] Open
Abstract
Purpose To compare the myopic progression in children treated with 0. 01% atropine and those who discontinued atropine during the 2022-home quarantine in Shanghai. Methods In this retrospective study, children aged 6-13 years with follow-up visits before (between January 2022 and February 2022) and after the lockdown (between July 2022 and August 2022) were included. Cycloplegic refraction and axial length (AL) were measured at both visits. The atropine group had continuous medication during the lockdown while the control group discontinued. The 0.01% atropine eyedrops were administered daily before bedtime. The types of spectacle lens were recorded: single vision (SV) spectacles or defocus incorporated multiple segments lenses (DIMS). Results In total, 41 children (81 eyes) in the atropine group and 32 children (64 eyes) in the control group were enrolled. No significant difference was found in the demographic characteristics, spherical diopter, spherical equivalent (SE), AL, and follow-up time between the two groups before the lockdown in 2022 (all p > 0.1). After the home confinement, a greater myopia progression was observed in the control group (-0.46 ± 0.42 D) compared to atropine group (-0.26 ± 0.37 D; p = 0.0023). Axial elongation was also longer in the control group than that in children sustained with atropine (0.21 ± 0.17 vs. 0.13 ± 0.15 mm, p = 0.0035). Moreover, there was no significant change of spherical diopter and SE during lockdown in the atropine + DIMS combined subgroup (0.03 ± 0.033 D for spherical diopter, p = 0.7261 and 0.08 ± 0.27 D for SE, p = 0.2042, respectively). However, significant myopic shift was observed in the atropine + SV subgroup during the quarantine time (-0.31 ± 0.39 D for SE and 0.15 ± 0.16 mm for AL, both p < 0.001). Conclusion Children treated with 0.01% atropine had slower myopia progression during the lockdown period in Shanghai compared with children discontinued. Moreover, the effect of atropine on myopic prevention can be strengthened with DIMS lenses.
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Affiliation(s)
- Manrong Yu
- Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China,Key Laboratory of Visual Impairment and Restoration of Shanghai, Fudan University, Shanghai, China,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China,Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China
| | - Lingli Jiang
- Department of Ophthalmology, The Affiliated Wenling Hospital of Wenzhou Medical University, Wenling, China
| | - Minjie Chen
- Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital of Fudan University, Shanghai, China,Key Laboratory of Visual Impairment and Restoration of Shanghai, Fudan University, Shanghai, China,NHC Key Laboratory of Myopia, Fudan University, Shanghai, China,Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China,*Correspondence: Minjie Chen ✉
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Althnayan YI, Almotairi NM, Alharbi MM, Alamer HB, Alqahtani HB, Alfreihi S. Myopia Progression Among School-Aged Children in the COVID-19 Distance-Learning Era. Clin Ophthalmol 2023; 17:283-290. [PMID: 36711259 PMCID: PMC9880015 DOI: 10.2147/opth.s381061] [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: 08/28/2022] [Accepted: 01/06/2023] [Indexed: 01/21/2023] Open
Abstract
Objective To investigate the effect of online learning and other environmental factors on myopia progression during the Coronavirus pandemic (COVID-19). Methods A retrospective cohort study from 2018 to 2021. Data from children aged 6-14 were gathered during three visits: pre-pandemic, at the beginning, and during the pandemic. Demographics (hours spent on screens for educational, recreational purposes, outdoors, and type of screen), best-corrected distance visual acuity (BCDVA), uncorrected distance visual acuity (UCDVA), and cycloplegic refraction were gathered. Results Of 150 patients, 70 [47%] were boys. The mean age was 11 (2.4) years. Participants mainly used mobile phones (62%) and had insufficient outdoor play (88%). Of the 300 eyes, 221 (74%) showed myopia progression. A significant difference in spherical equivalent (SE) was found between pre-pandemic and post-pandemic periods (-0.29 (0.23) D vs -0.40 (0.11) D; p =0.023). Additionally, UCDVA showed a difference between the initial and 1st follow-up visits (0.57 (0.37) vs 0.64 (0.36), p =0.001), and the first and 2nd follow-up visits (0.64 (0.36) vs 0.70 (0.36), p =0.001). Significant hazard ratio for change in SE in patients with higher age (>9 years), (HR [95% confidence interval (CI)], 0.71 [0.51-0.84]), greater recreational screen usage (HR [95% CI], 1.26 [1.15-1.66]), and insufficient outdoor time (HR [95% CI], 1.45 [1.35-1.67]). Conclusion Myopia progression was accelerated during the COVID-19 pandemic. Younger age, prolonged screen use, and insufficient outdoor time contributed to increased myopia progression. However, the type of device used had no significant effect.
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Affiliation(s)
- Yasser I Althnayan
- Ophthalmology Division, Department of Surgery, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia,King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | - Nawal M Almotairi
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia,Department of Optometry, College of Applied Medical Science, King Saud University, Riyadh, Riyadh Province, Saudi Arabia
| | - Manal M Alharbi
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia,Department of Optometry, College of Applied Medical Science, King Saud University, Riyadh, Riyadh Province, Saudi Arabia
| | - Hadeel B Alamer
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia,Paediatric Ophthalmology Division, Paediatric Surgery Department, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Hanan B Alqahtani
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia,Department of Optometry, College of Applied Medical Science, King Saud University, Riyadh, Riyadh Province, Saudi Arabia,Paediatric Ophthalmology Division, Paediatric Surgery Department, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Shatha Alfreihi
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia,Paediatric Ophthalmology Division, Paediatric Surgery Department, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia,College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia,Correspondence: Shatha Alfreihi, King Abdullah Specialist Children’s Hospital, P.O. Box 22490, Riyadh, 11426, Saudi Arabia, Tel +966-11-8011111, Fax +966-11-8011000 EXT 53273, 53320, Email
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Du W, Ding G, Guo X, Abudukeyimu K, Wang Y, Wang L, Qi X, Ning Y, Hua N, Song L, Li X, Li J, Zhang Y, Wei N, Qian X. Associations between anthropometric indicators and refraction in school-age children during the post-COVID-19 era. Front Public Health 2023; 10:1059465. [PMID: 36743176 PMCID: PMC9891462 DOI: 10.3389/fpubh.2022.1059465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 12/20/2022] [Indexed: 01/19/2023] Open
Abstract
Purpose To explore the associations between anthropometric indicators and refraction in school-aged children in the post-COVID-19 era. Methods Data were collected from 25,644 children aged 7 to 12 years in 48 elementary schools in Tianjin. The comprehensive examination included height, weight, systolic blood pressure (SBP), diastolic blood pressure (DBP), refraction, and calculation of BMI, with a follow-up visit after 6 months. Myopia was defined as spherical equivalent refraction (SER) ≤-0.50 diopter (D). Bivariate correlation coefficients and multiple linear regression models were used to explore the cross-sectional and longitudinal associations between anthropometric indicators (height, weight, BMI, SBP, and DBP) and refraction. Results The mean changes in height, weight, BMI, SBP, DBP, and SER of the participants were 4.03 ± 2.18 cm, 3.10 ± 2.39 kg, 0.45 ± 1.16 kg/m2, 2.26 ± 14.74 mmHg, 2.18 ± 11.79 mmHg and -0.17 ± 0.51 D, respectively. Overall, height, weight, BMI, SBP, and DBP were all correlated with SER (r = -0.324, r = -0.234, r = -0.121, r = -0.112, r = -0.066, both p < 0.001), and changes in height and weight were correlated with changes in SER (r = -0.034, -0.031, both p < 0.001). Furthermore, multiple linear regression analysis revealed that the association of BMI, SBP, and DBP with SER was significant in myopic children but not in non-myopic children. The association between changes in weight and changes in SER was only present in non-myopic children but not in myopic children. Conclusion Height and weight were negatively correlated with SER in both cross-sectional analysis and longitudinal changes, indicating that children's height, weight and growth rate may be used as a reference indicator for myopia risk prediction and myopia progression monitoring.
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Affiliation(s)
- Wenzheng Du
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Gang Ding
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Xiying Guo
- Tianjin Beichen Traditional Chinese Medicine Hospital, Tianjin, China
| | - Kadiya Abudukeyimu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Yanzhu Wang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Lijun Wang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Xiaoli Qi
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Yuxian Ning
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Ning Hua
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Linlin Song
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Xue Li
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Jing Li
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Ying Zhang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Nan Wei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Xuehan Qian
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China,*Correspondence: Xuehan Qian ✉
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Huang L, Chen X, Lin J, Fan X, Chen T, Yu Y, Chen J, Hu J. Association between sleep duration and myopia among Chinese children during the COVID-19 pandemic: A cross-sectional study. Front Public Health 2023; 10:1015138. [PMID: 36699911 PMCID: PMC9868807 DOI: 10.3389/fpubh.2022.1015138] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 12/19/2022] [Indexed: 01/12/2023] Open
Abstract
Background The studies on the association between sleep duration and myopia are limited, and the evidence is inconsistent. This study aimed to evaluate the association between sleep duration and myopia, cycloplegic spherical equivalent (SE) and axial length (AL) among Chinese children during the Corona Virus Disease 2019 (COVID-19) pandemic. Methods The study was a cross-sectional study on Chinese children aged 6-18 years. The comprehensive ophthalmic examinations for children included cycloplegic SE, AL, and standardized questionnaires. The questionnaire included sleep duration, parental myopia, outdoor time, and continuous near work duration without breaks. Myopia was defined as SE ≤-0.50 diopters (D). Results A total of 1,140 children were included in the analyses, with 84.7% of myopic children and 74.4% of children's daily sleep duration being more than 8 h/d. In univariate regression analysis, compared with sleep duration < 8 h/d, children with sleep duration of 8-9 and >9 h/d were less myopia (p < 0.01 for all), and had less myopic SE (p < 0.01 for all), and shorter AL (p < 0.01 for all). After adjusting for age, gender, parental myopia, outdoor time, and continuous near work duration without breaks, sleep duration was not associated with myopia, cycloplegic SE, and AL (p > 0.05 for all). Conclusions This study showed sleep duration was related to myopia, cycloplegic SE, and AL among Chinese children during the COVID-19 pandemic-related lifestyles, but no independent association.
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Affiliation(s)
- Luoming Huang
- Department of Ophthalmology and Optometry, The School of Medical Technology and Engineering, Fujian Medical University, Fuzhou, China,The Research Center for Juvenile Myopia Prevention and Control of Fujian Province, Fuzhou, China
| | - Xuelan Chen
- Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China,The Research Center for Juvenile Myopia Prevention and Control of Fujian Province, Fuzhou, China,Engineering Research Center of Assistive Technology for Visual Impairment, Fujian Province University, Quanzhou, China
| | - Jiajia Lin
- Eye Institute and Affiliated Xiamen Eye Center of Xiamen University, Xiamen, China
| | | | - Ting Chen
- Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China,The Research Center for Juvenile Myopia Prevention and Control of Fujian Province, Fuzhou, China,Engineering Research Center of Assistive Technology for Visual Impairment, Fujian Province University, Quanzhou, China
| | - Yang Yu
- Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China,The Research Center for Juvenile Myopia Prevention and Control of Fujian Province, Fuzhou, China,Engineering Research Center of Assistive Technology for Visual Impairment, Fujian Province University, Quanzhou, China
| | - Jiaxin Chen
- Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China,The Research Center for Juvenile Myopia Prevention and Control of Fujian Province, Fuzhou, China,Engineering Research Center of Assistive Technology for Visual Impairment, Fujian Province University, Quanzhou, China
| | - Jianmin Hu
- Department of Ophthalmology and Optometry, The School of Medical Technology and Engineering, Fujian Medical University, Fuzhou, China,Department of Ophthalmology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China,The Research Center for Juvenile Myopia Prevention and Control of Fujian Province, Fuzhou, China,Engineering Research Center of Assistive Technology for Visual Impairment, Fujian Province University, Quanzhou, China,*Correspondence: Jianmin Hu ✉
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Wu Y, Luo X, Feng Y, Yang J, Fan H, Cen X, Li W. Comparison of the accuracy of axial length measurement by different imaging methods in Sprague Dawley rats. Front Neurosci 2023; 16:1106904. [PMID: 36685229 PMCID: PMC9854123 DOI: 10.3389/fnins.2022.1106904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 12/12/2022] [Indexed: 01/09/2023] Open
Abstract
Background Obtaining accurate axial length (AL) is very important for the establishment of animal models of myopia. The purpose of this study is to compare the accuracy of Quantel A-B scan, OD-1 A scan, and vernier caliper in measuring AL in Sprague Dawley (SD) rats. Methods In total, 60 5-week-old SD rats were divided into female rat group (n = 30) and male rat group (n = 30). Quantel A-B scan and OD-1 A scan were, respectively, used to measure the AL of both eyes of each living rat, and vernier caliper was used to measure the anterior-posterior diameter of each rat's eyeball. Besides, the correlation between refractive error (RE) and AL measured by different instruments was evaluated, and the accuracy of the three measurement methods was compared according to gender and left/right eyes. Results There were significant differences in AL and diopter of SD rats at the same age (p < 0.05). the AL of male rats was greater than that of female rats, while diopter (D) was the opposite; There was no significant difference in AL and D between left and right eyes in the same SD rats (p > 0.05); There were statistical differences among the three measurement methods (p < 0.05), AL measured by vernier caliper was the largest, followed by Quantel A-B scan, OD-1 A scan; Difference in AL between male and female was not statistically significant between the results obtained by Quantel A-B scan and vernier caliper (p > 0.05), but there were statistically significant differences between the other two measurement methods (p < 0.05). Conclusion Sex is the influencing factor of AL and RE. Imaging measurement can accurately measure the AL in living small rodents. Compared with OD-1 A scan, Quantel A-B scan may be more accurate.
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Affiliation(s)
- Yajun Wu
- Aier School of Ophthalmology, Central South University, Changsha, Hunan, China,Department of Ophthalmology, Shanghai Aier Eye Ophthalmology Hospital, Shanghai, China,Shanghai Aier Eye Institute, Shanghai, China
| | - Xiangdong Luo
- Department of Ophthalmology, Xiamen Eye Center of Xiamen University, Xiamen, Fujian, China
| | - Yuliang Feng
- Aier School of Ophthalmology, Central South University, Changsha, Hunan, China,Department of Ophthalmology, Shanghai Aier Eye Ophthalmology Hospital, Shanghai, China,Shanghai Aier Eye Institute, Shanghai, China
| | - Jiasong Yang
- Aier School of Ophthalmology, Central South University, Changsha, Hunan, China,Department of Ophthalmology, Shanghai Aier Eye Ophthalmology Hospital, Shanghai, China,Shanghai Aier Eye Institute, Shanghai, China
| | - Hua Fan
- Department of Ophthalmology, Shanghai Aier Eye Ophthalmology Hospital, Shanghai, China,Shanghai Aier Eye Institute, Shanghai, China
| | - Xiaobo Cen
- WestChina-Frontier PharmaTech Co., Ltd., Chengdu, Sichuan, China,Xiaobo Cen,
| | - Wensheng Li
- Aier School of Ophthalmology, Central South University, Changsha, Hunan, China,Department of Ophthalmology, Shanghai Aier Eye Ophthalmology Hospital, Shanghai, China,Shanghai Aier Eye Institute, Shanghai, China,*Correspondence: Wensheng Li,
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Abstract
SIGNIFICANCE The use of digital devices has increased substantially in recent years across all age groups for both vocational and avocational purposes. There are a wide range of proposed therapeutic and management options for this condition, including optical, medical, and ergonomic interventions. PURPOSE Regular breaks are frequently recommended by clinicians to minimize digital eye strain. The so-called 20-20-20 rule, whereby individuals are advised to fixate on an object at least 20 feet (6 m) away for at least 20 seconds every 20 minutes is widely cited. Unfortunately, there is relatively little peer-reviewed evidence to support this rule. The aim of this investigation was to determine whether scheduled breaks are effective in reducing the adverse effects of digital device usage. METHODS The study was carried out on 30 young subjects who performed a 40-minute, cognitively demanding reading task from a tablet computer. The task required them to read random words and to identify which ones began with a specific letter chosen by the experimenter. The task was undertaken on four separate occasions, with 20-second breaks being allowed every 5, 10, 20, or 40 minutes (i.e., no break), respectively. Both before and after each trial, subjects completed a questionnaire regarding ocular and visual symptoms experienced during the session. In addition, both reading speed and task accuracy were quantified during each trial. RESULTS A significant increase in post-task symptoms (with respective to the pre-task value) was observed for all four trials ( P < .001). However, there was no significant effect of scheduled breaks on reported symptoms ( P = .70), reading speed ( P = .93), or task accuracy ( P = .55). CONCLUSIONS Although widely cited as a treatment option, these results do not support the proposal of using 20-second scheduled breaks as a therapeutic intervention for digital eye strain.
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Chen Y, Tan C, Foo LL, He S, Zhang J, Bulloch G, Saw SM, Li J, Morgan I, Guo X, He M. Development and Validation of a Model to Predict Who Will Develop Myopia in the Following Year as a Criterion to Define Premyopia. Asia Pac J Ophthalmol (Phila) 2023; 12:38-43. [PMID: 36706333 DOI: 10.1097/apo.0000000000000591] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 11/14/2022] [Indexed: 01/28/2023] Open
Abstract
PURPOSE To develop and validate models to predict who will develop myopia in the following year based on cycloplegic refraction or ocular biometry and to identify thresholds of premyopia. METHODS Prospective longitudinal data of nonmyopic children at baseline from the Guangzhou Twins Eye Study and the Guangzhou Outdoor Activity Longitudinal Study were used as the training set, and the Singapore Cohort Study of the Risk factors for Myopia study formed the external validation set. Age, sex, cycloplegic refraction, ocular biometry, uncorrected visual acuity, and parental myopia were integrated into 3 logistic regression models to predict the onset of myopia in the following year. Premyopia cutoffs and an integer risk score system were derived based on the identified risk. RESULTS In total, 2896 subjects with at least 2 visits were included. Cycloplegic refraction at baseline is a better predictor to identify the children with myopia onset [C-statistic=0.91, 95% confidence interval (CI), 0.87-0.94; C-statistic=0.92, 95% CI, 0.92-0.92 for internal and external validation, respectively], comparing to axial length, corneal curvature radius (CR) and anterior chamber depth (C-statistic=0.81, 95% CI, 0.73-0.88; C-statistic=0.80, 95% CI, 0.79-0.80, respectively), and axial length/CR (C-statistic=0.78, 95% CI, 0.71-0.85; C-statistic=0.76, 95% CI, 0.75-0.76). With a risk of >70%, the definitions of premyopia indicating approaching myopia onset were 0.00 D for 6-8 years and -0.25 D for ≥9 years in children with 2 myopic parents. CONCLUSIONS Either cycloplegic refraction or ocular biometry can predict 1-year risk of myopia. Premyopia can be successfully defined through risk assessments based on children's age and predict who would require more aggressive myopia prophylaxis.
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Affiliation(s)
- Yanxian Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Department of Ophthalmology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China
| | - Cheng Tan
- Department of Statistical Science, School of Mathematics, Sun Yat-Sen University, Guangzhou, China
- Southern China Center for Statistical Science, Sun Yat-Sen University, Guangzhou, China
| | - Li-Lian Foo
- Singapore National Eye Centre, Singapore, Singapore
- Singapore Eye Research Institute, Singapore, Singapore
| | - Siyan He
- Department of Statistical Science, School of Mathematics, Sun Yat-Sen University, Guangzhou, China
- Southern China Center for Statistical Science, Sun Yat-Sen University, Guangzhou, China
| | - Jian Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Gabriella Bulloch
- Centre for Eye Research Australia, Department of Surgery and Ophthalmology, University of Melbourne, Melbourne, Australia
| | - Seang-Mei Saw
- Singapore National Eye Centre, Singapore, Singapore
- Singapore Eye Research Institute, Singapore, Singapore
| | - Jinying Li
- Department of Ophthalmology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China
| | - Ian Morgan
- Research School of Biology, Australian National University, Canberra, Australia
| | - Xiaobo Guo
- Department of Statistical Science, School of Mathematics, Sun Yat-Sen University, Guangzhou, China
- Southern China Center for Statistical Science, Sun Yat-Sen University, Guangzhou, China
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
- Department of Ophthalmology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China
- Centre for Eye Research Australia, Department of Surgery and Ophthalmology, University of Melbourne, Melbourne, Australia
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Bikbov MM, Kazakbaeva GM, Fakhretdinova AA, Tuliakova AM, Rakhimova EM, Panda-Jonas S, Gilemzianova LI, Garipova LA, Khakimov DA, Jonas JB. Myopic axial elongation in school children and the COVID-19 lockdown in Russia: The Ural Children Myopia Study. PLoS One 2023; 18:e0279020. [PMID: 36696436 PMCID: PMC9876376 DOI: 10.1371/journal.pone.0279020] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 10/17/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND To explore an influence of the COVID-19-related lockdown on ocular axial elongation in school children in Russia. METHODS The participants of the school-based Ufa Children Myopia Study in Ufa/Russia underwent, at baseline in 2019/2020 before the COVID-19 outbreak and after a COVID-19-related lockdown, a detailed interview and ophthalmological examination including laser interferometric biometry for axial length measurement. RESULTS The study included 461 children (age:10.7±2.1 years;range:6.8-16.9 years). The mean follow-up was 1.41±0.33 years. Mean axial length at baseline was 23.96±0.95mm and 23.94±0.95mm in the right and left eyes, respectively. During the study period, annual axial elongation (right/left eyes) was 0.19±0.17mm/0.19±0.22mm. Before the COVID-19 lockdown, the age-dependent coefficient for axial length (ADCAL) for the right/left eyes was 0.21mm (95%CI:0.17,0.25)/0.20mm (95%CI:0.16,0.24). In children younger than 9.6 years (n = 157), annual axial elongation (right eyes) during the study period was larger than the ADCAL before the COVID-19 outbreak (0.29 mm (95%:0.00,0.66) versus 0.21 mm (95%CI:0.02,0.41)). In the groups aged 9.6 to 11.4 years (n = 148) and aged >11.4 years (n = 156), annual axial elongation during the study period was comparable to the ADCAL before the COVID-19 outbreak (0.18mm (95%CI:-0.07,0.46) versus 0.22mm (95%CI:-0.05,0.48), and (0.09mm (95%CI:-0.15,0.34) versus 0.14mm (95%CI:0.00,0.28), respectively). In children aged ≤9 years at study end, axial length at study end was 0.20 mm larger than axial length at baseline in the participants aged ≤9 years at baseline. Larger axial elongation during the study period was associated (multivariable analysis) with younger age (beta:-0.62;P<0.001), female sex (beta:0.21;P<0.001), longer study period (beta:0.22;P<0.001), and longer axial length at baseline (beta:0.28;P<0.001), and marginally, with less time spent outdoors (beta:-0.07;P = 0.06). CONCLUSIONS The COVID-19-related lockdown in the Russian city of Ufa was associated with a relatively minor increase in axial elongation, detected only in children aged <9.6 years.
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Affiliation(s)
| | | | | | | | | | - Songhomitra Panda-Jonas
- Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany
- Privatpraxis Prof Jonas und Dr Panda-Jonas, Heidelberg, Germany
| | | | | | | | - Jost B. Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland
- * E-mail: (JBJ); (MMB)
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46
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Pan W, Lin J, Zheng L, Lan W, Ying G, Yang Z, Li X. Myopia and axial length in school-aged children before, during, and after the COVID-19 lockdown-A population-based study. Front Public Health 2022; 10:992784. [PMID: 36589986 PMCID: PMC9799254 DOI: 10.3389/fpubh.2022.992784] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 11/22/2022] [Indexed: 12/23/2022] Open
Abstract
Background Myopic shift had been observed during the COVID-19 lockdown in young school children. It remains unknown whether myopic shift is accompanied with increase in axial length. We aimed to evaluate the impact of the COVID-19 lockdown on myopia and axial length of school children in China by comparing them before, during and after the lockdown. Methods In this population-based cross-sectional study, school-based myopia screenings were conducted in the Fall of 2019, 2020, and 2021 (representing before, during and after COVID-19 lockdown respectively) in Chengdu, China. Myopia screenings were performed on 83,132 students aged 6 to 12 years. Non-cycloplegic refractive error was examined using NIDEK auto-refractor (ARK-510A; NIDEK Corp., Tokyo, Japan) and axial length was measured using AL-Scan (NIDEK Corp., Tokyo, Japan). Spherical equivalent (SER, calculated as sphere+ 0.5*cylinder), prevalence of myopia (SER ≤ -0.50 D), and axial length were compared across 3 years stratified by age. Results Myopia prevalence rate was 45.0% (95% CI: 44.6-45.5%) in 2019, 48.7% (95% CI: 48.3-49.1%) in 2020, and 47.5% (95% CI: 47.1-47.9%) in 2021 (p < 0.001). The mean non-cycloplegic SER (SD) was -0.70 (1.39) D, -0.78 (1.44) D, and -0.78 (1.47) D respectively (p < 0.001). The mean (SD) axial length was 23.41 (1.01) mm, 23.45 (1.03) mm, and 23.46 (1.03) mm across 3 years respectively (p < 0.001). From the multivariable models, the risk ratio (RR) of myopia was 1.07 (95% CI: 1.06-1.08) times, the SER was 0.05 D (95% CI: 0.04 D to 0.06 D) more myopic and the mean axial length increased by 0.01 mm (95% CI: 0.01 mm to 0.02 mm) in 2020 compared to 2019. In 2021, the risk ratio (RR) of myopia was 1.05 (95% CI: 1.04-1.06), the mean SER was 0.06 D (95% CI: 0.05 D to 0.07 D) more myopic, and the mean axial length increased by 0.03 mm (95% CI: 0.02 mm to 0.04 mm) compared to 2019. Conclusions The COVID-19 lockdown had significant impact on myopia development and axial length, and these impacts remained 1 year after the lockdown. Further longitudinal studies following-up with these students are needed to help understand the long-term effects of COVID-19 lockdown on myopia.
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Affiliation(s)
- Wei Pan
- Aier Institute of Optometry and Vision Science, Aier Eye Hospital Group, Changsha, China
| | - Jiang Lin
- Chengdu Aier Eye Hospital, Chengdu, China
| | - Li Zheng
- Education Bureau of Qingyang District, Chengdu, China
| | - Weizhong Lan
- Aier Institute of Optometry and Vision Science, Aier Eye Hospital Group, Changsha, China,Aier School of Ophthalmology, Central South University, Changsha, China,Aier School of Optometry and Vision Science, Hubei University of Science and Technology, Xianning, China,Guangzhou Aier Eye Hospital, Jinan University, Guangzhou, China
| | - Guishuang Ying
- Center for Preventive Ophthalmology and Biostatistics, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Zhikuan Yang
- Aier Institute of Optometry and Vision Science, Aier Eye Hospital Group, Changsha, China,Aier School of Ophthalmology, Central South University, Changsha, China,Aier School of Optometry and Vision Science, Hubei University of Science and Technology, Xianning, China
| | - Xiaoning Li
- Aier School of Optometry and Vision Science, Hubei University of Science and Technology, Xianning, China,Changsha Aier Eye Hospital, Changsha, China,Hunan Province Optometry Engineering and Technology Research Center, Changsha, China,Hunan Province International Cooperation Base for Optometry Science and Technology, Changsha, China,*Correspondence: Xiaoning Li
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Abounoori M, Aghajani A, Chaibakhsh S, Babakhanian M, Pourazizi M, Peyman A. Paediatric myopia shift during the COVID-19 pandemic home quarantine: a systematic review and meta-analysis. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2022-001755. [PMID: 36645798 PMCID: PMC9805827 DOI: 10.1136/bmjpo-2022-001755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 12/14/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Outdoor activities were restricted during the COVID-19 outbreak, although digital learning grew. Concerns have been raised about the impact of these environmental changes on myopia status. This research aimed to examine myopia shift during the COVID-19 pandemic and offer the community evidence-based data. METHODS The literature search was undertaken in PubMed, SCOPUS, Science Direct, Web of Science and Google Scholar databases on published papers before 17 May 2022. The main outcome was mean spherical equivalent refraction (SER) before, at the onset and at the end of follow-up during the COVID-19 pandemic. RESULTS Among 518 articles, 10 studies were included in the meta-analysis. The mean SER differences during the COVID-19 pandemic follow-up (mean follow-up time was 10 months) compared with before the pandemic was 0.15 dioptre (D) (95% CI -0.39 to 0.69, p=0.58). After age adjustment using meta-regression, the mean SER differences during the COVID-19 follow-up compared with before the pandemic was - 0.46 D (95% CI -0.59 to -0.34, p<0.001). Over the mean follow-up time during the COVID-19 pandemic, the SER mean difference was -0.55 D (95% CI -0.78 to -0.32, p<0.001), showing that the mean SER had decreased significantly during the COVID-19 pandemic. The mean SER differences in myopic patients before COVID-19 compared with during the pandemic follow-up was -0.49 D (95% CI -0.53 to -0.45, p=0.00). So the prior pandemic myopic patients became more myopic during the pandemic follow-up time. CONCLUSION During home quarantine, the mean SRE shifting in paediatrics accelerated. This phenomenon should be given more attention by policymakers, eyecare experts, educators and parents.
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Affiliation(s)
- Mahdi Abounoori
- Isfahan Eye Research Center, Isfahan University of Medical Sciences, Isfahan, Iran (the Islamic Republic of)
| | - Ali Aghajani
- Department of Ophthalmology, Eye Research Center, Rassoul Akram Hospital, Eye Department, The Five Senses Health Institute, School of Medicine, Iran University of Medical Sciences, Isfahan, Iran (the Islamic Republic of)
| | - Samira Chaibakhsh
- Department of Ophthalmology, Eye Research Center, Rassoul Akram Hospital, Eye Department, The Five Senses Health Institute, School of Medicine, Iran University of Medical Sciences, Isfahan, Iran (the Islamic Republic of)
| | - Masoudeh Babakhanian
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran (the Islamic Republic of)
| | - Mohsen Pourazizi
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran (the Islamic Republic of)
| | - Alireza Peyman
- Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran (the Islamic Republic of)
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Dong Y, Jan C, Chen L, Ma T, Liu J, Zhang Y, Ma Q, Zhong P, Song Y, Ma J, Patton GC, Sawyer SM. The Cumulative Effect of Multilevel Factors on Myopia Prevalence, Incidence, and Progression Among Children and Adolescents in China During the COVID-19 Pandemic. Transl Vis Sci Technol 2022; 11:9. [PMID: 36515964 DOI: 10.1167/tvst.11.12.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Purpose To estimate the effects of school closures and associated lifestyle changes on myopia in Chinese children and adolescents during the coronavirus disease 2019 (COVID-19) pandemic. Methods Two cross-sectional surveys recruited 14,296 Chinese students aged 7 to 18 years in November 2019 and June 2020 from which an open cohort study (nested queue design) was derived and used to assess myopia prevalence, incidence, and progression rates (defined as students with progression in myopia severity at the second survey wave among those with myopia at baseline). The severity of myopia was determined by measurements of visual acuity (<5.0) and noncycloplegic refraction (spherical equivalent <-0.50 diopters). Twenty-three myopia-influencing factors were divided into three categories: eye-use habits, lifestyle, and family and subjective factors. Responses to each of these 23 factors were labeled as either positive or negative options and then combined to generate a comprehensive score. Results Boys and girls were equally represented (50%) and had the same average age (11.5 years) at each wave. The myopia prevalence increased from 48.2% to 60.0%, with 27.1% myopia incidence and 13.2% myopia progression rates for Chinese children and adolescents. Each of the 23 factors was associated with myopia prevalence but had no significant effect on myopia incidence or progression. However, these 23 factors had a cumulative effect on myopia risks; higher scores were associated with more positive factors and lower risk ratios of myopia and vice versa. Except for the progression rate, the myopia prevalence and incidence and risk ratios decreased with higher comprehensive scores. Conclusions School closures during the COVID-19 pandemic increased the risk of myopia in Chinese children and adolescents due to the accumulation of poor eyesight habits, unhealthy lifestyles, and excessive screen time. Translational Relevance Rather than focusing on single risk factors for myopia, future myopia prevention strategies should focus on integrating multiple comprehensive approaches across schools, families, and communities.
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Affiliation(s)
- Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Catherine Jan
- Centre for Eye Research Australia, Department of Ophthalmology, Royal Victorian Eye and Ear Hospital, East Melbourne, Melbourne, Australia.,School of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia.,Lost Child's Vision Project, Sydney, New South Wales, Australia
| | - Li Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Tao Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Jieyu Liu
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Yi Zhang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Qi Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Panliang Zhong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Yi Song
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - George C Patton
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Susan M Sawyer
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Victoria, Australia.,Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Centre for Adolescent Health, Royal Children's Hospital, Parkville, Victoria, Australia
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Németh J, Aclimandos WA, Tapasztó B, Jonas JB, Grzybowski A, Nagy ZZ. The impact of the pandemic highlights the urgent need for myopia guidelines: The clinicians' role. Eur J Ophthalmol 2022; 33:11206721221143008. [PMID: 36448253 PMCID: PMC9713518 DOI: 10.1177/11206721221143008] [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: 05/12/2022] [Accepted: 10/30/2022] [Indexed: 12/05/2022]
Abstract
Myopia is already one of the leading causes of permanent vision impairment, including blindness, and the COVID-19 pandemic has exacerbated the global myopia-related burden among children owing to home confinement, increased screen time (e-learning), and decreased outside activities. To reverse the rising trend of myopia and myopia-related blindness, collaborative efforts are required. There is a wealth of evidence-based medicine (EBM) data on the epidemiology of myopia and effective interventions, but very little has been published on the clinicians' roles and responsibilities. However, this aspect is critical because preventing the onset and progression of myopia necessitates extensive health promotion and advocacy efforts among decision-makers. Only broad medical expert collaboration can bring about the necessary changes in children's lifestyle and education. This article discusses clinicians' critical roles in preventing the onset and progression of myopia.
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Affiliation(s)
- János Németh
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Wagih A Aclimandos
- King's College Hospital, London,
UK
- European Society of Ophthalmology,
Rotterdam, The Netherlands
| | - Beáta Tapasztó
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Jost B Jonas
- Department of Ophthalmology, Heidelberg University, Mannheim, Germany
- Institute of Molecular and Clinical
Ophthalmology Basel, Basel, Switzerland
| | - 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
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50
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Cabanes‐Martí E, García‐Ayuso D. Myopia control with dual-focus soft contact lenses during the first year of measures to contain the COVID-19 pandemic. Ophthalmic Physiol Opt 2022; 42:1227-1231. [PMID: 35894156 PMCID: PMC9796312 DOI: 10.1111/opo.13031] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 06/28/2022] [Accepted: 06/28/2022] [Indexed: 01/01/2023]
Abstract
PURPOSE This study compared refractive and axial length (AL) changes in children wearing dual-focus soft contact lenses for myopia control (MiSight®) with myopic children wearing spectacles one year from the start of lockdown during the COVID-19 pandemic. METHODS This retrospective, descriptive, parallel-group, observational study reviewed the charts of 11 children who began treatment for myopia control with dual-focus soft contact lenses for myopia control (MiSight®) in March 2020 and 11 matched spectacle-wearing controls. The mean increase in spherical equivalent refraction (SER) and AL from the beginning of the lockdown and up to 1 year later were compared. The parents of the children were asked about the average time spent on near work, contact lens wearing time both during and after the strict confinement and whether they had discontinued contact lens wear during lockdown. RESULTS During this first year of preventive COVID-19 measures (March 2020-March 2021), for the contact lens group the average SER and AL increased -0.14 ± 0.09D and 0.13 ± 0.05 mm, respectively. For the spectacle wearers, the corresponding increases were -0.54 ± 0.16D and 0.25 ± 0.08 mm, respectively. A significant difference was found between the groups for both SER (p < 0.001) and AL (p < 0.05). The average time spent outdoors was restricted for both groups during lockdown and increased after. However, statistically significant changes in the time spent outdoors during and after lockdown were only found for the spectacle group (p < 0.05; t-test), whereas this change was not significant for the contact lens group (p = 0.08). CONCLUSIONS Over the observed time period, dual-focus soft contact lenses for myopia control were effective despite the decreased time spent outdoors during the COVID-19 pandemic.
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Affiliation(s)
| | - Diego García‐Ayuso
- Facultad de Óptica y OptometríaUniversidad de MurciaMurciaSpain,Departamento de Oftalmología, Facultad de Medicina, Universidad de Murciaand Instituto Murciano de Investigación Biosanitaria Hospital Virgen de la Arrixaca (IMIB‐virgen de la Arrixaca)MurciaSpain
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