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Chang LC, Sun CC, Lee TC, Wang YN, Liao LL. Shared decision-making, treatment decision regret, and vision-related quality of life among parents of children with myopia: An online survey in Taiwan. Cont Lens Anterior Eye 2024:102283. [PMID: 39107159 DOI: 10.1016/j.clae.2024.102283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 07/29/2024] [Accepted: 07/30/2024] [Indexed: 08/09/2024]
Abstract
OBJECTIVES To investigate the relationships among myopia treatment, decision regret, shared decision-making, and vision-related quality of life among parents of 6-12-year-old children with myopia. METHODS An online Google Forms questionnaire was developed using a cross-sectional design and distributed between January 16 and August 22, 2023. Parents of 6-12-year-old children with myopia were recruited through school nurses working in Taiwan. The children's and parents' demographic data were collected. Study instruments included the Decisional Regret Scale, Shared Decision-Making, and Vision-Related Quality of Life questionnaires. Multivariable linear regression analysis was used to identify factors influencing vision-related quality of life. RESULTS Of 350 parents contacted, 314 questionnaires were analyzed. Among the respondents, 77.39 % (n = 243) were mothers, and most were aged >40 years. The mean age of children at myopia diagnosis was 7.12 ± 1.24 years; 46.50 % had < - 1.0 diopters of refractive error. Atropine eye drops were the primary treatment; 17.71 % of children were prescribed orthokeratology for myopia control. Parents reported low levels of decision regret and moderate levels of shared decision-making and vision-related quality of life. Children's age, use of orthokeratology lenses, decision regret, and shared decision-making significantly influenced the vision-related quality of life reported by the parents, accounting for 22.5 % of the variance. CONCLUSION The study's findings emphasize the importance of addressing decision regret and promoting shared decision-making in myopia treatment. Eye care professionals should discuss treatment options thoroughly before making decisions. Through shared decision-making, parents can make informed choices about treatments based on a comprehensive understanding of the benefits and drawbacks, ultimately benefitting children's vision health.
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Affiliation(s)
- Li-Chun Chang
- School of Nursing, Chang Gung University of Science and Technology, Gui-Shan Town, Tao-Yuan County, Taiwan; Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan; School of Nursing, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
| | - Chi-Chin Sun
- Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan; School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Tzu-Chi Lee
- Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan
| | - Ya-Ni Wang
- School of Nursing, Chang Gung University of Science and Technology, Gui-Shan Town, Tao-Yuan County, Taiwan
| | - Li-Ling Liao
- Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan.
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Li L, Liao Y, Wang Q, Wang M, Zhang W, Wang X. Trends in myopia development among Chinese children and adolescents in Xuzhou during one academic year. Front Med (Lausanne) 2024; 11:1391269. [PMID: 39050529 PMCID: PMC11266087 DOI: 10.3389/fmed.2024.1391269] [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: 02/27/2024] [Accepted: 07/01/2024] [Indexed: 07/27/2024] Open
Abstract
Purpose This study investigates the prevalence and progression of myopia among primary and secondary school students in Xuzhou City, China, during one academic year. Methods The study employed a prospective research design and utilized a whole-group sampling method to conduct non-cycloplegic spot photo screenings on 37,938 students from 44 primary and secondary schools in Xuzhou City, China. A one-year study was conducted to gather spherical equivalent refraction (SER), and subsequent analysis was carried out to explore the disparities in myopia prevalence among primary and secondary school students within the same academic year, as well as the progression of myopia. Results During the 2022 academic year, the overall prevalence of myopia in the first and second semesters was 62.6 and 64.2% respectively, indicating an increasing trend. Particularly in primary school (Grades 1-6), the prevalence of myopia increased with higher grade levels, and significant variations in myopia prevalence were observed mainly in grades 1-3 and 7 (p < 0.05). The incidence rate of myopia in middle school remained stable, while in primary school, there was a positive correlation between myopia incidence and the grade level, with the highest rate of 20.1% in grade 6. Among the myopic population, the median value of spherical equivalent refraction slightly decreased between the two semesters. The proportion of high myopia increased among students in grades 5-8. Conclusion Our study revealed that within one academic year, the prevalence of myopia and the severity of myopia have significantly increased in Xuzhou City, China, accompanied by an increase in the proportion of high myopia. For different grade levels, we should adopt personalized prevention and control measures, with a particular focus on lower grade levels and students who have just entered a new grade.
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Affiliation(s)
- Lin Li
- School of Medical Technology, Xuzhou Medical University, Xuzhou, China
| | - Ya Liao
- Department of Ophthalmology, The First People’s Hospital of Xuzhou, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, China
| | - Qian Wang
- Department of Ophthalmology, The First People’s Hospital of Xuzhou, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, China
| | - Mei Wang
- Department of Ophthalmology, The First People’s Hospital of Xuzhou, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, China
| | - Wenxuan Zhang
- Department of Ophthalmology, The First People’s Hospital of Xuzhou, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, China
| | - Xiaojuan Wang
- Department of Ophthalmology, The First People’s Hospital of Xuzhou, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, China
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He SY, He T, Xu MY, Ni YJ, Hong CY, Shen T. Distribution and correlation of refractive parameters in children with different corneal curvatures in southeast China. Int J Ophthalmol 2024; 17:713-720. [PMID: 38638257 PMCID: PMC10988070 DOI: 10.18240/ijo.2024.04.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 12/05/2023] [Indexed: 04/20/2024] Open
Abstract
AIM To analyze the distribution of refractive status in school-age children with different corneal curvatures (CC) and the correlation between CC and refractive status. METHODS A total of 2214 school-aged children of grade 4 in Hangzhou who were screened for school myopia were included. Uncorrected distance visual acuity (UCDVA), non-cycloplegic refraction, axial length (AL), horizontal and vertical corneal curvature (K1, K2) were measured and spherical equivalent (SE), corneal curvature radius (CCR) and axial length/corneal radius of curvature ratio (AL/CR) were calculated. UCDVA<5.0 and SE≤-0.50 D were classified as school-screening myopia. According to the different CCRs, the patients were divided into the lower corneal curvature (LCC) group (CCR≥7.92) and the higher corneal curvature (HCC) group (CCR<7.92). Each group was further divided into the normal AL subgroup and the long AL subgroup. The refractive parameters were compared to identify any differences between the two groups. RESULTS Both SE and AL were greater in the LCC group (P=0.013, P<0.001). The prevalence of myopia was 38% in the LCC group and 44% in the HCC group (P<0.001). The proportion of children without screening myopia was higher in the LCC group (62%) than in the HCC group (56%). Among these children without screening myopia, the proportion of long AL in the LCC group (24%) was significantly higher than that in the HCC group (0.012%; P<0.001). The change of SE in the LCC group was less affected by the increase of AL than that in the HCC group. CONCLUSION School-aged children in the LCC group have a lower incidence of screening myopia and longer AL. Low CC can mask SE reduction and AL growth to some extent, and the change of AL growth change more in children with low CC than high CC. Before the onset of myopia, its growth rate is even faster than that after the onset of myopia.
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Affiliation(s)
- Si-Yuan He
- The Second Clinical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
| | - Ting He
- Department of Ophthalmology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
| | - Meng-Yue Xu
- Department of Ophthalmology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
| | - Ying-Jie Ni
- The Second Clinical College, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
| | - Chao-Yang Hong
- Department of Ophthalmology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
| | - Ting Shen
- Eye Center, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
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Kim JM, Choi YJ. Nutritional intake, environmental factors, and their impact on myopia prevalence in Korean children aged 5-12 years. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:14. [PMID: 38287408 PMCID: PMC10823653 DOI: 10.1186/s41043-024-00506-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 01/13/2024] [Indexed: 01/31/2024]
Abstract
BACKGROUND Myopia is a complex condition influenced by numerous factors, including genetic predisposition, environmental factors, and lifestyle choices. Although evidence indicates that certain dietary factors may influence the development of myopia, this relationship is still not completely understood and is a topic of ongoing research. METHODS This study analyzed the relationship between dietary habits, environmental factors, and the prevalence of myopia in a sample of 24,345 children aged 5-12 years from the seventh Korea National Health and Nutrition Examination Survey (KNHANES VII). The average daily intake of dietary nutrients associated with the refractive error status of the participants was analyzed using analysis of variance (GLM) and the Scheffe method for post-hoc comparison. Multiple logistic regression analysis was conducted between the participant's refractive error status and daily dietary nutrient intake, while taking into consideration the age, sex, BMI, parental myopia, and near-work hours. RESULTS The risk of myopia increased with age, especially notable between ages 11 and 12, and was higher in children with both parents having myopia. Dietary factors played a crucial role; children with myopia had significantly lower intake of fat, omega-3 fatty acids, and retinol but higher intake of other nutrients compared to emmetropic and hyperopic counterparts. High consumption of carbohydrates, protein, phosphorus, iron, potassium, and sodium was associated with increased myopia risk. High sodium intake was particularly associated with a 2.05-fold increased myopia risk. CONCLUSIONS This study highlights the significant role of diet and lifestyle choices in the development of myopia in children. Our findings suggest the importance of considering these specific factors in the management and prevention strategies for myopia, underscoring the need for targeted interventions in children's health and vision care.
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Affiliation(s)
- Jeong-Mee Kim
- Department of Visual Optics, Far East University, Eumseong, South Korea
| | - Yean-Jung Choi
- Department of Food and Nutrition, Sahmyook University, 815, Hwarang-ro, Nowon-gu, Seoul, 01795, South Korea.
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Tang T, Zhao H, Liu D, Li X, Wang K, Li Y, Zhao M. Axial length to corneal radius of curvature ratio and refractive error in Chinese preschoolers aged 4-6 years: a retrospective cross-sectional study. BMJ Open 2023; 13:e075115. [PMID: 38159956 PMCID: PMC10759075 DOI: 10.1136/bmjopen-2023-075115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 11/27/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVE This study aims to investigate the associations of axial length to corneal radius of curvature (AL/CRC) ratio with refractive error and to determine the effect of AL/CRC ratio on hyperopia reserve and myopia assessment among Chinese preschoolers. METHODS This was a retrospective cross-sectional study that evaluated subjects aged 4-6 years. AL and CRC were obtained using a non-contact ocular biometer. Correlation analysis was performed to explore the associations of AL/CRC ratio with spherical equivalent refractive error (SER). The accuracy of AL/CRC ratio for hyperopia reserve and myopia assessment was analysed using cycloplegic refraction by drawing receiver operating characteristic (ROC) curves. RESULTS The analysis included 1024 participants (537 boys, 52.4%). The mean AL/CRC ratios in hyperopes, emmetropes and myopes were 2.90±0.06, 2.95±0.05 and 3.08±0.07, respectively. The SER was found to be more strongly correlated with AL/CRC ratio (ρ=-0.66, p<0.001) than either AL or CRC alone (ρ=-0.52, p<0.001; ρ=-0.03, p=0.33, respectively). AL/CRC was correlated with SER in hyperopes (ρ=-0.54, p<0.001), emmetropes (ρ=-0.33, p<0.001) and myopes (r=-0.67, p<0.001). For low hyperopia reserve assessment, the area under the ROC curves of AL/CRC ratio was 0.861 (95% CI 0.829 to 0.892), the optimal cut-off value of the AL/CRC ratio was ≥2.955. For myopia assessment, the area under the ROC curves of AL/CRC ratio was 0.954 (95% CI 0.925 to 0.982), the optimal cut-off value of the AL/CRC ratio was ≥2.975. CONCLUSIONS The SER showed a better correlation with AL/CRC ratio than either AL or CRC alone, especially in myopes, among children aged 4-6 years. These findings indicate that when cycloplegic refraction is unavailable, AL/CRC ratio could be used as an alternative indicator for identifying low hyperopia reserve and myopia among preschoolers, helping clinicians and parents screen children with low hyperopia reserve before primary school in a timely manner.
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Affiliation(s)
- Tao Tang
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Heng Zhao
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Duanke Liu
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Xuewei Li
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Kai Wang
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Yan Li
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
| | - Mingwei Zhao
- Institute of Medical Technology, Peking University Health Science Center, Beijing, China
- Department of Ophthalmology & Clinical Centre of Optometry, Peking University People's Hospital, Beijing, China
- College of Optometry, Peking University Health Science Center, Beijing, China
- Eye Disease and Optometry Institute, Peking University People's Hospital, Beijing, China
- Beijing Key Laboratory of the Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China
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Shi JJ, Wang YJ, Lyu PP, Hu JW, Wen XS, Shi HJ. Effects of school myopia management measures on myopia onset and progression among Chinese primary school students. BMC Public Health 2023; 23:1819. [PMID: 37726699 PMCID: PMC10508019 DOI: 10.1186/s12889-023-16719-z] [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: 01/05/2023] [Accepted: 09/07/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Schools play an organizational role in managing myopia-related behavioral habits among students. We evaluated the effects of school myopia management measures on myopia onset and progression in a school-based prospective 1-year observational study. METHODS In total, 8319 children from 26 elementary schools were included. Online questionnaire completed by a parent, in which school myopia management experience including outdoor activities in recess or physical education class, teachers' supervision, and teaching facilities. Variables were defined as implemented well or poorly, according to the Comprehensive Plan to Prevent Myopia among Children and Teenagers. Children underwent ophthalmic examinations, and the incidence and progression of myopia from 2019 to 2020 were estimated. Multilevel logistic regression models were constructed to analyze the association between school management measures and myopia development in 8,9 years and 10,11 years students. RESULTS From 2019 to 2020, the incidence of myopia among primary school students was 36.49%; the mean difference of spherical equivalent in myopic children was - 0.29 ± 1.22 diopters. The risk of incident myopia was reduced by 20% in 8,9 years participants with well-implemented class recess compared with those with poorly implemented class recess (adjusted odds ratio [aOR]: 0.80, p = 0.032). PE outdoor time was significantly associated with myopia incidence in 10,11 years students (aOR: 0.76, p = 0.043). Compared with poorly implemented reading and writing posture, desk and chair height, 10,11 participants with well-implemented desk and chair height were less likely to have rapid myopic progression (p = 0.029, p = 0.022). CONCLUSION In Shanghai, children's myopia is associated with better implementation of school myopia management measures. The present findings suggest that outdoor activities during class recess or PE class, providing suitable desks and chairs, and adequate instruction in reading and writing postures might protect against pathological eye growth. An age-specific myopia prevention and control programs in school is of primary importance.
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Affiliation(s)
- Jiao- Jiao Shi
- Department Maternal Child & Adolescent Health, School of Public Health, Fudan University, 138 Yixueyuan Road, Shanghai, 200032, China
| | - Yu-Jie Wang
- Department Maternal Child & Adolescent Health, School of Public Health, Fudan University, 138 Yixueyuan Road, Shanghai, 200032, China
| | - Ping-Ping Lyu
- Department Maternal Child & Adolescent Health, School of Public Health, Fudan University, 138 Yixueyuan Road, Shanghai, 200032, China
| | - Jing-Wen Hu
- Department Maternal Child & Adolescent Health, School of Public Health, Fudan University, 138 Yixueyuan Road, Shanghai, 200032, China
| | - Xiao-Sa Wen
- Department of Immunizations, Minhang Centers for Disease Control and Prevention, Shanghai, 201100, China
| | - Hui-Jing Shi
- Department Maternal Child & Adolescent Health, School of Public Health, Fudan University, 138 Yixueyuan Road, Shanghai, 200032, China.
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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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Zhou Y, Zhang XF, Chen XJ, Wang M, Cai JR, Xiong YJ, Song Y, Sun ZM. Prevalence of anisometropia and influencing factors among school-age children in Nantong, China: a cross-sectional study. Front Public Health 2023; 11:1190285. [PMID: 37397717 PMCID: PMC10307961 DOI: 10.3389/fpubh.2023.1190285] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/25/2023] [Indexed: 07/04/2023] Open
Abstract
Objective To investigate the prevalence of anisometropia and associated parameters among school-aged children in Nantong, China. Methods This school-based, cross-sectional study examined students from primary schools, junior high schools, and senior high schools in an urban area of Nantong, China. Univariate and multivariate logistic regression analyses were used to investigate the specific correlations between anisometropia and related parameters. Non-cycloplegic autorefraction was assessed for each student. Anisometropia was defined as the spherical equivalent refraction (SE) difference ≥ 1.0 D between eyes. Results A total of 9,501 participants were validated for analyses, of which 53.2% (n = 5,054) were male, and 46.8% (n = 4,447) were female. The mean of age was 13.32 ± 3.49 years, ranging from 7-19 years. The overall prevalence of anisometropia was 25.6%. Factors such as myopia, scoliosis screening positive, hyperopia, female sex, older age, and higher weight had a significantly higher risk of anisometropia (p < 0.05). Conclusion There was a high prevalence of anisometropia in school-age children. Some physical examination parameters are closely related to children's anisometropia, especially myopia and scoliosis. Preventing myopia and controlling its progression may be the most important ways to reduce the prevalence of anisometropia. Correcting scoliosis may be an important factor in controlling the prevalence of anisometropia, and maintaining good reading and writing posture may be helpful in controlling the prevalence of anisometropia.
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Affiliation(s)
- Yue Zhou
- Department of Ophthalmology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Xiao Fang Zhang
- Department of Nantong Fifth People’s Hospital, Nantong, Jiangsu, China
| | - Xiao Juan Chen
- Department of Ophthalmology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Min Wang
- Department of Ophthalmology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Jian Ru Cai
- Department of Ophthalmology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Yao Jia Xiong
- Department of Ophthalmology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Yu Song
- Department of Ophthalmology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Zhi Min Sun
- Department of Ophthalmology, Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
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Sankaridurg P, Berntsen DA, Bullimore MA, Cho P, Flitcroft I, Gawne TJ, Gifford KL, Jong M, Kang P, Ostrin LA, Santodomingo-Rubido J, Wildsoet C, Wolffsohn JS. IMI 2023 Digest. Invest Ophthalmol Vis Sci 2023; 64:7. [PMID: 37126356 PMCID: PMC10155872 DOI: 10.1167/iovs.64.6.7] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
Myopia is a dynamic and rapidly moving field, with ongoing research providing a better understanding of the etiology leading to novel myopia control strategies. In 2019, the International Myopia Institute (IMI) assembled and published a series of white papers across relevant topics and updated the evidence with a digest in 2021. Here, we summarize findings across key topics from the previous 2 years. Studies in animal models have continued to explore how wavelength and intensity of light influence eye growth and have examined new pharmacologic agents and scleral cross-linking as potential strategies for slowing myopia. In children, the term premyopia is gaining interest with increased attention to early implementation of myopia control. Most studies use the IMI definitions of ≤-0.5 diopters (D) for myopia and ≤-6.0 D for high myopia, although categorization and definitions for structural consequences of high myopia remain an issue. Clinical trials have demonstrated that newer spectacle lens designs incorporating multiple segments, lenslets, or diffusion optics exhibit good efficacy. Clinical considerations and factors influencing efficacy for soft multifocal contact lenses and orthokeratology are discussed. Topical atropine remains the only widely accessible pharmacologic treatment. Rebound observed with higher concentration of atropine is not evident with lower concentrations or optical interventions. Overall, myopia control treatments show little adverse effect on visual function and appear generally safe, with longer wear times and combination therapies maximizing outcomes. An emerging category of light-based therapies for children requires comprehensive safety data to enable risk versus benefit analysis. Given the success of myopia control strategies, the ethics of including a control arm in clinical trials is heavily debated. IMI recommendations for clinical trial protocols are discussed.
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Affiliation(s)
- Padmaja Sankaridurg
- Brien Holden Vision Institute, Sydney, Australia
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - David A Berntsen
- University of Houston, College of Optometry, Houston, Texas, United States
| | - Mark A Bullimore
- University of Houston, College of Optometry, Houston, Texas, United States
| | - Pauline Cho
- West China Hospital, Sichuan University, Sichuan, China
- Eye & ENT Hospital of Fudan University, Shanghai, China
- Affiliated Eye Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ian Flitcroft
- Centre for Eye Research Ireland, School of Physics and Clinical and Optometric Sciences, Technological University Dublin, Dublin, Ireland
- Department of Ophthalmology, Children's Health Ireland at Temple Street Hospital, Dublin, Ireland
| | - Timothy J Gawne
- Department of Optometry and Vision Science, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Kate L Gifford
- Queensland University of Technology, Brisbane, Australia
| | - Monica Jong
- Johnson & Johnson Vision, Jacksonville, Florida, United States
| | - Pauline Kang
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Lisa A Ostrin
- University of Houston, College of Optometry, Houston, Texas, United States
| | | | - Christine Wildsoet
- UC Berkeley Wertheim School Optometry & Vision Science, Berkeley, California, United States
| | - James S Wolffsohn
- College of Health & Life Sciences, Aston University, Birmingham, United Kingdom
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Yin C, Gan Q, Xu P, Yang T, Xu J, Cao W, Wang H, Pan H, Ren Z, Xiao H, Wang K, Xu Y, Zhang Q. Dietary Patterns and Associations with Myopia in Chinese Children. Nutrients 2023; 15:nu15081946. [PMID: 37111164 PMCID: PMC10142016 DOI: 10.3390/nu15081946] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/13/2023] [Accepted: 04/15/2023] [Indexed: 04/29/2023] Open
Abstract
Dietary shifts in populations undergoing rapid economic transitions have been proposed as partly contributing toward the rapid intergenerational rise in myopia prevalence; however, empirical evidence of the effect of dietary factors on myopia is limited. This study investigated the association between dietary factors and incident myopia in Chinese children aged 10-11 years. We evaluated dietary habits using a 72-item food frequency questionnaire (FFQ) among 7423 children. Myopic status was assessed using the "General Personal Information Questionnaire". Principal component analysis was used to extract dietary patterns and investigate their association with myopia. After adjusting for potential confounders, participants with the highest adherence to dietary pattern A (95% confidence interval (CI): 0.66-0.92, p for trend = 0.007) and dietary pattern C (95% CI: 0.58-0.80, p for trend < 0.001) had a lower risk of myopia than participants with the least adherence. Both of these dietary patterns are characterized by high consumption of meats, aquatic product, dairy and its products, eggs, legumes, vegetables, fruits, grains, and potatoes. Our findings suggest that other environmental factors, such as those related to the dietary environment, may contribute to the development of myopia. These findings can serve as a reference for diet-related primary prevention of myopia.
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Affiliation(s)
- Chunjie Yin
- School of Public Health, Xinjiang Medical University, Urumqi 830017, China
| | - Qian Gan
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
| | - Peipei Xu
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
| | - Titi Yang
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
| | - Juan Xu
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
| | - Wei Cao
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
| | - Hongliang Wang
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
| | - Hui Pan
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
| | - Zhibin Ren
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
| | - Hui Xiao
- School of Public Health, Xinjiang Medical University, Urumqi 830017, China
| | - Kai Wang
- School of Medical Engineering and Technology, Xinjiang Medical University, Urumqi 830017, China
| | - Ying Xu
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
| | - Qian Zhang
- Chinese Center for Disease Control and Prevention, NHC Key Laboratory of Trace Element Nutrition, National Institute for Nutrition and Health, Beijing 100050, China
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Zhou Z, Li S, Yang Q, Yang X, Liu Y, Hao K, Xu S, Zhao N, Zheng P. Association of n-3 polyunsaturated fatty acid intakes with juvenile myopia: A cross-sectional study based on the NHANES database. Front Pediatr 2023; 11:1122773. [PMID: 37138572 PMCID: PMC10150007 DOI: 10.3389/fped.2023.1122773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 03/27/2023] [Indexed: 05/05/2023] Open
Abstract
Aim Inflammation is involved in the development of myopia. n-3 polyunsaturated fatty acids (n-3 PUFAs) have vasodilating and anti-inflammatory effects, which may be involved in controlling myopia. It is of great significance to explore the relationship between n-3 PUFA intakes and juvenile myopia in order to control and alleviate myopia among teenagers through dietary intervention. Methods Sociodemographic data, information of nutrient intakes, cotinine, PUFAs, and eye refractive status of 1,128 juveniles were extracted from the National Health and Nutrition Examination Survey (NHANES) database in this cross-sectional study. PUFAs contained total polyunsaturated fatty acid (TPFAs), alpha-linolenic acid, octadecatetraenoic acid, eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA). Covariates were screened by comparison among groups of normal vision, low myopia, and high myopia. The association between n-3 PUFA intakes and the risk of juvenile myopia was evaluated using univariate and multivariate logistic regression analyses with odds ratios (ORs) and 95% confidence intervals (CIs). Results Among the juveniles, 788 (70.68%) had normal vision, 299 (25.80%) had low myopia, and 41 (3.52%) had high myopia. There were significant differences in average EPA and DHA intakes among the three groups, and mean DPA and DHA intakes in the normal vision group were lower than those in the low myopia group (P < 0.05). After adjustment for age, gender, TPFAs, and cotinine, a high dietary intake of EPA (≥11 mg/1,000 kcal) in juveniles seemed to be associated with the risk of high myopia (OR = 0.39, 95% CI: 0.18-0.85), while no significant associations were identified between n-3 PUFA intakes and the risk of low myopia. Conclusion A high dietary intake of EPA may be associated with a decreased risk of high myopia among juveniles. A further prospective study is needed to validate this observation.
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Shi Y. Effect of Atropine Eye Drops Combined with VR-Based Binocular Visual Function Balance Training for Prevention and Control of Juvenile Myopia. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:4159996. [PMID: 36147642 PMCID: PMC9489366 DOI: 10.1155/2022/4159996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/26/2022] [Accepted: 08/08/2022] [Indexed: 11/20/2022]
Abstract
Purpose This study mainly analyzes the efficacy of 0.01% atropine eye drops (low-dose atropine (LDA)) combined with virtual reality (VR)-based binocular visual function (BVF) balance training in the prevention and control of juvenile myopia. Methods One hundred and thirty-six juvenile myopia patients admitted between November 2018 to November 2021 were selected, including 76 cases (research group) receiving LDA + VR-based BVF balance training and 60 cases (control group) treated by LDA intervention alone. Visual acuity (VA; naked vision), ocular parameters (pupil diameter (PD), axial length (AXL), and diopter), intraocular pressure (IOP), accommodation facility, clinical efficacy, and incidence of adverse reactions were observed, compared, and analyzed in both groups. Results After analysis, it was found that the research group showed significantly higher naked vision and PD while statistically lower D after intervention than the corresponding preinterventional parameters than the control group. While AXL showed no statistical difference between the groups and within groups. The IOP also differed insignificantly between groups, but the post-treatment accommodation facility was better in the research group compared with the baseline (before treatment) and control group. In terms of curative effects, an obviously higher total effective rate was determined in the research group. In addition, the two groups showed no significant difference in the incidence of adverse reactions. Conclusions LDA + VR-based BVF balance training deserves clinical popularization, as it can prevent and control myopia among teenagers, with better adjusting effects on eye function and certain safety.
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Affiliation(s)
- Yuping Shi
- Chengdu Aier Eye Hospital, Chengdu 610041, Sichuan, China
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