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Dhakal R, Lawrenson JG, Huntjens B, Shah R, Verkicharla PK. Light exposure profiles differ between myopes and non-myopes outside school hours. BMJ Open Ophthalmol 2024; 9:e001469. [PMID: 38816010 PMCID: PMC11138295 DOI: 10.1136/bmjophth-2023-001469] [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: 09/24/2023] [Accepted: 04/27/2024] [Indexed: 06/01/2024] Open
Abstract
PURPOSE Considering the putative role of light in myopia, and variations in socioeconomic, lifestyle, educational and environmental factors across ethnicities, we objectively investigated light exposure patterns in Indian school children. METHODS The light exposure profile of 143 school children (9-15 years, 50 myopes) recorded using a validated wearable light tracker for six continuous days was analysed. Additional data for non-school days were available for 87 children (26 myopes). The illuminance exposure levels, time spent outdoors and epoch (number of times participant is exposed to a predefined range of lux level per day) were compared between myopes and non-myopes across different light conditions: ≥1000, ≥3000, ≥5000 and ≥10 000 lux. For school days, light exposure profiles during (1) before school, school and after school hours; and (2) class, break and transition (when a student travels to and from school) time were analysed. RESULTS The overall median (IQR) daily illuminance exposure level, time spent outdoors and epochs at outdoors (≥1000 lux) were 807 (507-1079) lux/day, 46 (30-64) min/day and 9 (6-12) times/day, respectively. The daily illuminance exposure on non-school days was significantly higher in non-myopes than myopes (6369 (4508-9112) vs 5623 (2616-6929) lux/day, p=0.04). During transition time (school days), non-myopes had significantly higher illuminance exposure (910 (388-1479) vs 550 (263-1098) lux/day, p=0.04), spent more time outdoors (25 (10-43) vs 14 (4-29) min/day, p=0.01) and had higher outdoor epochs (6 (4-11) vs 5 (2-8) times/day, p=0.01) than myopes. CONCLUSIONS A small but significant difference in illuminance exposure, time spent outdoors and epoch was noted between myopes and non-myopes during transition time, which may have implications in myopia control.
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Affiliation(s)
- Rohit Dhakal
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre & Brien Holden Institute of Optometry and Vision Sceinces, LV Prasad Eye Institute, Hyderabad, India
- Centre for Applied Vision Research, City University of London, London, UK
| | - John G Lawrenson
- Centre for Applied Vision Research, City University of London, London, UK
| | - Byki Huntjens
- Centre for Applied Vision Research, City University of London, London, UK
| | - Rakhee Shah
- Centre for Applied Vision Research, City University of London, London, UK
| | - Pavan Kumar Verkicharla
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre & Brien Holden Institute of Optometry and Vision Sceinces, LV Prasad Eye Institute, Hyderabad, India
- Infor Myopia Centre, L V Prasad Eye Institute, Hyderabad, India
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2
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Boff JM, Shrestha AP, Madireddy S, Viswaprakash N, Della Santina L, Vaithianathan T. The Interplay between Neurotransmitters and Calcium Dynamics in Retinal Synapses during Development, Health, and Disease. Int J Mol Sci 2024; 25:2226. [PMID: 38396913 PMCID: PMC10889697 DOI: 10.3390/ijms25042226] [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: 01/11/2024] [Revised: 02/05/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
The intricate functionality of the vertebrate retina relies on the interplay between neurotransmitter activity and calcium (Ca2+) dynamics, offering important insights into developmental processes, physiological functioning, and disease progression. Neurotransmitters orchestrate cellular processes to shape the behavior of the retina under diverse circumstances. Despite research to elucidate the roles of individual neurotransmitters in the visual system, there remains a gap in our understanding of the holistic integration of their interplay with Ca2+ dynamics in the broader context of neuronal development, health, and disease. To address this gap, the present review explores the mechanisms used by the neurotransmitters glutamate, gamma-aminobutyric acid (GABA), glycine, dopamine, and acetylcholine (ACh) and their interplay with Ca2+ dynamics. This conceptual outline is intended to inform and guide future research, underpinning novel therapeutic avenues for retinal-associated disorders.
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Affiliation(s)
- Johane M Boff
- Department of Pharmacology, Addiction Science, and Toxicology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Abhishek P Shrestha
- Department of Pharmacology, Addiction Science, and Toxicology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Saivikram Madireddy
- College of Medicine, The University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Nilmini Viswaprakash
- Department of Medical Education, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | | | - Thirumalini Vaithianathan
- Department of Pharmacology, Addiction Science, and Toxicology, College of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
- Department of Ophthalmology, Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, TN 38163, USA
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3
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Biswas S, El Kareh A, Qureshi M, Lee DMX, Sun CH, Lam JSH, Saw SM, Najjar RP. The influence of the environment and lifestyle on myopia. J Physiol Anthropol 2024; 43:7. [PMID: 38297353 PMCID: PMC10829372 DOI: 10.1186/s40101-024-00354-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 01/05/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Myopia, commonly known as near-sightedness, has emerged as a global epidemic, impacting almost one in three individuals across the world. The increasing prevalence of myopia during early childhood has heightened the risk of developing high myopia and related sight-threatening eye conditions in adulthood. This surge in myopia rates, occurring within a relatively stable genetic framework, underscores the profound influence of environmental and lifestyle factors on this condition. In this comprehensive narrative review, we shed light on both established and potential environmental and lifestyle contributors that affect the development and progression of myopia. MAIN BODY Epidemiological and interventional research has consistently revealed a compelling connection between increased outdoor time and a decreased risk of myopia in children. This protective effect may primarily be attributed to exposure to the characteristics of natural light (i.e., sunlight) and the release of retinal dopamine. Conversely, irrespective of outdoor time, excessive engagement in near work can further worsen the onset of myopia. While the exact mechanisms behind this exacerbation are not fully comprehended, it appears to involve shifts in relative peripheral refraction, the overstimulation of accommodation, or a complex interplay of these factors, leading to issues like retinal image defocus, blur, and chromatic aberration. Other potential factors like the spatial frequency of the visual environment, circadian rhythm, sleep, nutrition, smoking, socio-economic status, and education have debatable independent influences on myopia development. CONCLUSION The environment exerts a significant influence on the development and progression of myopia. Improving the modifiable key environmental predictors like time spent outdoors and engagement in near work can prevent or slow the progression of myopia. The intricate connections between lifestyle and environmental factors often obscure research findings, making it challenging to disentangle their individual effects. This complexity underscores the necessity for prospective studies that employ objective assessments, such as quantifying light exposure and near work, among others. These studies are crucial for gaining a more comprehensive understanding of how various environmental factors can be modified to prevent or slow the progression of myopia.
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Affiliation(s)
- Sayantan Biswas
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Antonio El Kareh
- Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon
| | - Mariyem Qureshi
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
| | | | - Chen-Hsin Sun
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Janice S H Lam
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Seang-Mei Saw
- Singapore Eye Research Institute, Singapore, Singapore
- Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Raymond P Najjar
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Singapore Eye Research Institute, Singapore, Singapore.
- Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore.
- Department of Biomedical Engineering, College of Design and Engineering, National University of Singapore, Singapore, Singapore.
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4
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Deng B, Li W, Chen Z, Zeng J, Zhao F. Temporal bright light at low frequency retards lens-induced myopia in guinea pigs. PeerJ 2023; 11:e16425. [PMID: 38025747 PMCID: PMC10655705 DOI: 10.7717/peerj.16425] [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: 08/10/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose Bright light conditions are supposed to curb eye growth in animals with experimental myopia. Here we investigated the effects of temporal bright light at very low frequencies exposures on lens-induced myopia (LIM) progression. Methods Myopia was induced by application of -6.00 D lenses over the right eye of guinea pigs. They were randomly divided into four groups based on exposure to different lighting conditions: constant low illumination (CLI; 300 lux), constant high illumination (CHI; 8,000 lux), very low frequency light (vLFL; 300/8,000 lux, 10 min/c), and low frequency light (LFL; 300/8,000 lux, 20 s/c). Refraction and ocular dimensions were measured per week. Changes in ocular dimensions and refractions were analyzed by paired t-tests, and differences among the groups were analyzed by one-way ANOVA. Results Significant myopic shifts in refractive error were induced in lens-treated eyes compared with contralateral eyes in all groups after 3 weeks (all P < 0.05). Both CHI and LFL conditions exhibited a significantly less refractive shift of LIM eyes than CLI and vLFL conditions (P < 0.05). However, only LFL conditions showed significantly less overall myopic shift and axial elongation than CLI and vLFL conditions (both P < 0.05). The decrease in refractive error of both eyes correlated significantly with axial elongation in all groups (P < 0.001), except contralateral eyes in the CHI group (P = 0.231). LFL condition significantly slacked lens thickening in the contralateral eyes. Conclusions Temporal bright light at low temporal frequency (0.05 Hz) appears to effectively inhibit LIM progression. Further research is needed to determine the safety and the potential mechanism of temporal bright light in myopic progression.
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Affiliation(s)
- Baodi Deng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Wentao Li
- Huizhou Third People’s Hospital, Guangzhou Medical University, Huizhou, China
| | - Ziping Chen
- Guangdong Light Visual Health Research Institute, Guangzhou, China
| | - Junwen Zeng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Feng Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
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5
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Harb EN, Sawai ES, Wildsoet CF. Indoor and outdoor human behavior and myopia: an objective and dynamic study. Front Med (Lausanne) 2023; 10:1270454. [PMID: 38020131 PMCID: PMC10643732 DOI: 10.3389/fmed.2023.1270454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/12/2023] [Indexed: 12/01/2023] Open
Abstract
Significance Myopia holds significant public health concern given its social, ocular disease and economic burdens. Although environmental factors are primarily to blame for the rapid rise in prevalence, key risk factors remain unresolved. Purpose The aim of this study was to objectively characterize, using a wearable technology, the temporal indoor and outdoor behavioral patterns and associated environmental lighting characteristics of young myopic and nonmyopic University students. Methods Participants were recruited to continuously wear an Actiwatch for 3 weeks, during either or both academic and non-academic periods. The device allows continuous recording of activity and incident light. Recorded illuminance levels were used as a proxy for outdoors (>1,000 lux), with the dynamics (interval frequency and duration) of indoor and outdoor activities, as well as lighting characteristics derived. In addition, participant input regarding near work was obtained daily. Participants were classified by both myopia and axial length status (based on collected refractive error and biometry data) for the purpose of data analysis. Result A total of 55 students, aged 18 to 25 years of age, participated. Overall, the dosing of indoor and outdoor activities was similar across participants, regardless of myopia status, during the academic period. Nonetheless, an apparent difference in the timing of outdoor activities was noted with myopes going outdoors later in the day, particularly during the weekend (p = 0.03). While a trend was observed between increased lighting levels experienced outdoors and shorter axial lengths, there was no significant relationship with myopia status. Noteworthy, participants generally significantly overestimated time spent outdoors, compared to Actiwatch-derived estimates of the same. Conclusion While the findings from this cohort of young adult students did not reveal substantial myopia-related differences in behavior, the power of a more objective and dynamic approach to quantifying behavior cannot be understated, providing argument for general adoption of wearable technologies in future clinical myopia studies.
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Affiliation(s)
- Elise N. Harb
- Herbert Wertheim School of Optometry and Vision Science, University of California at Berkeley, Berkeley, CA, United States
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Zeitz C, Roger JE, Audo I, Michiels C, Sánchez-Farías N, Varin J, Frederiksen H, Wilmet B, Callebert J, Gimenez ML, Bouzidi N, Blond F, Guilllonneau X, Fouquet S, Léveillard T, Smirnov V, Vincent A, Héon E, Sahel JA, Kloeckener-Gruissem B, Sennlaub F, Morgans CW, Duvoisin RM, Tkatchenko AV, Picaud S. Shedding light on myopia by studying complete congenital stationary night blindness. Prog Retin Eye Res 2023; 93:101155. [PMID: 36669906 DOI: 10.1016/j.preteyeres.2022.101155] [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: 06/03/2022] [Revised: 12/02/2022] [Accepted: 12/05/2022] [Indexed: 01/20/2023]
Abstract
Myopia is the most common eye disorder, caused by heterogeneous genetic and environmental factors. Rare progressive and stationary inherited retinal disorders are often associated with high myopia. Genes implicated in myopia encode proteins involved in a variety of biological processes including eye morphogenesis, extracellular matrix organization, visual perception, circadian rhythms, and retinal signaling. Differentially expressed genes (DEGs) identified in animal models mimicking myopia are helpful in suggesting candidate genes implicated in human myopia. Complete congenital stationary night blindness (cCSNB) in humans and animal models represents an ON-bipolar cell signal transmission defect and is also associated with high myopia. Thus, it represents also an interesting model to identify myopia-related genes, as well as disease mechanisms. While the origin of night blindness is molecularly well established, further research is needed to elucidate the mechanisms of myopia development in subjects with cCSNB. Using whole transcriptome analysis on three different mouse models of cCSNB (in Gpr179-/-, Lrit3-/- and Grm6-/-), we identified novel actors of the retinal signaling cascade, which are also novel candidate genes for myopia. Meta-analysis of our transcriptomic data with published transcriptomic databases and genome-wide association studies from myopia cases led us to propose new biological/cellular processes/mechanisms potentially at the origin of myopia in cCSNB subjects. The results provide a foundation to guide the development of pharmacological myopia therapies.
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Affiliation(s)
- Christina Zeitz
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France.
| | - Jérome E Roger
- Paris-Saclay Institute of Neuroscience, CERTO-Retina France, CNRS, Université Paris-Saclay, Saclay, France
| | - Isabelle Audo
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France; CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, Paris, France
| | | | | | - Juliette Varin
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | - Helen Frederiksen
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | - Baptiste Wilmet
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | - Jacques Callebert
- Service of Biochemistry and Molecular Biology, INSERM U942, Hospital Lariboisière, APHP, Paris, France
| | | | - Nassima Bouzidi
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | - Frederic Blond
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | | | - Stéphane Fouquet
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | | | - Vasily Smirnov
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | - Ajoy Vincent
- Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, ON, Canada; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada; Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Elise Héon
- Department of Ophthalmology and Vision Sciences, The Hospital for Sick Children, Toronto, ON, Canada; Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada; Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - José-Alain Sahel
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France; CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, Paris, France; Department of Ophthalmology, The University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Florian Sennlaub
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | - Catherine W Morgans
- Department of Chemical Physiology & Biochemistry, Oregon Health & Science University, Portland, OR, USA
| | - Robert M Duvoisin
- Department of Chemical Physiology & Biochemistry, Oregon Health & Science University, Portland, OR, USA
| | - Andrei V Tkatchenko
- Oujiang Laboratory, Zhejiang Laboratory for Regenerative Medicine, Vision and Brain Health, Wenzhou, China; Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University, New York, NY, USA
| | - Serge Picaud
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
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Li M, Lanca C, Tan CS, Foo LL, Sun CH, Yap F, Najjar RP, Sabanayagam C, Saw SM. Association of time outdoors and patterns of light exposure with myopia in children. Br J Ophthalmol 2023; 107:133-139. [PMID: 33858839 DOI: 10.1136/bjophthalmol-2021-318918] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/06/2021] [Accepted: 03/28/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND/AIMS To evaluate the association of reported time outdoors and light exposure patterns with myopia among children aged 9 years from the Growing Up in Singapore Towards Healthy Outcomes birth cohort. METHODS We assessed reported time outdoors (min/day), light exposure patterns and outdoor activities of children aged 9 years (n=483) with a questionnaire, the FitSight watch and a 7-day activity diary. Light levels, the duration, timing and frequency of light exposure were assessed. Cycloplegic spherical equivalent (SE), myopia (SE≤-0.5 D) and axial length (AL) of paired eyes were analysed using generalised estimating equations. RESULTS In this study, 483 (966 eyes) multiethnic children (50.0% boys, 59.8% Chinese, 42.2% myopic) were included. Reported time outdoors (mean±SD) was 100±93 min/day, and average light levels were 458±228 lux. Of the total duration children spent at light levels of ≥1000 lux (37±19 min/day), 76% were spent below 5000 lux. Peak light exposure occurred at mid-day. Children had 1.7±1.0 light exposure episodes/day. Common outdoor activities were walks, neighbourhood play and swimming. Greater reported time outdoors was associated with lower odds of myopia (OR=0.82, 95% CI 0.70 to 0.95/hour increase daily; p=0.009). Light levels, timing and frequency of light exposures were not associated with myopia, SE or AL (p>0.05). CONCLUSION Reported time outdoors, light levels and number of light exposure episodes were low among Singaporean children aged 9 years. Reported time outdoors was protective against myopia but not light levels or specific light measures. A multipronged approach to increase time outdoors is recommended in the combat against the myopia epidemic.
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Affiliation(s)
- Mijie Li
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore.,Myopia Research Group, Singapore Eye Research Institute, Singapore
| | - Carla Lanca
- Myopia Research Group, Singapore Eye Research Institute, Singapore
| | - Chuen-Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Li-Lian Foo
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore
| | - Chen-Hsin Sun
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Fabian Yap
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore
| | - Raymond P Najjar
- Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore.,Visual Neuroscience Research Group, Singapore Eye Research Institute, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore
| | - Seang-Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore .,Myopia Research Group, Singapore Eye Research Institute, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore
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Philipp D, Vogel M, Brandt M, Rauscher FG, Hiemisch A, Wahl S, Kiess W, Poulain T. The relationship between myopia and near work, time outdoors and socioeconomic status in children and adolescents. BMC Public Health 2022; 22:2058. [DOI: 10.1186/s12889-022-14377-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 09/04/2022] [Accepted: 09/23/2022] [Indexed: 11/11/2022] Open
Abstract
Abstract
Background
To investigate environmental and social risk factors for myopia in children and adolescents in Germany.
Methods
1437 children aged between 3 and 18 inclusive were examined as part of the LIFE Child study based in Leipzig, Germany. Information about leisure time activities and social status was ascertained by parents and children in a questionnaire. Refractive status was attained by measuring noncycloplegic autorefraction. Myopia was defined as spherical equivalent (SE) ≤ − 0.75 D. Risk factors were identified using multiple logistic regression analysis.
Results
In multiple logistic regression analysis, myopia was significantly associated with less frequent outdoor activity (“once a week” vs. “twice a week or more”: odds ratio (OR) 4.35, 95% confidence interval (CI) 1.89–9.98, p<0.01) and longer near work sessions (1–2 h vs. < 1 h: OR 1.83, CI 1.10–3.04, p=0.02; > 3 h vs. < 1 h: OR 3.71, CI 1.43–9.61, p<0.01) after adjustment for age, sex and socioeconomic status (SES). Duration of outdoor activity, near work frequency and SES showed no significant association with myopia (p > 0.05). Children with a lower SES were involved in longer periods of outdoor and near work activities but on fewer occasions over the course of the week, although this connection was not significant.
Conclusion
Myopia is associated with environmental factors. The present findings suggest that daily exposure to sunlight and a restriction of long-duration near work activities might protect against pathological eye growth. Prevention strategies should be implemented for children at all ages.
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Wen Y, Dai B, Zhang X, Zhu H, Xie C, Xia J, Sun Y, Zhu M, Tong J, Shen Y. Retinal Transcriptomics Analysis Reveals the Underlying Mechanism of Disturbed Emmetropization Induced by Wavelength Defocus. Curr Eye Res 2022; 47:908-917. [PMID: 35225751 DOI: 10.1080/02713683.2022.2048395] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 02/24/2022] [Indexed: 12/28/2022]
Abstract
PURPOSE Wavelength signals play a vital role in refractive development. This study aimed to explore the retinal transcriptome signature in these processes. METHODS Guinea pigs were randomly divided into three groups exposed to white, blue, or green environmental light for eight weeks. Refraction and axial length were evaluated every 4 weeks, and the retinal transcriptome was profiled at 8 weeks. RESULTS Compared with the white group, ocular refraction significantly decreased and ocular axial length significantly extended in the green group whereas these parameters showed opposite trends in the blue group. RNA-sequencing showed that, compared with the white group, 184 and 171 differentially expressed genes (DEGs) were found in the blue and green groups, respectively. Among these DEGs, only 31 overlapped. These two sets of DEGs were enriched in distinct biological processes and pathways. There were 268 DEGs between the blue and green groups, which were primarily enriched in the extracellular matrix, and metabolism, receptor activity, and ion binding processes. In addition, nine human genes, including ECEL1, CHRND, SHBG, PRSS56, OVOL1, RDH5, WNT7B, PEBP4, CA12, were identified to be related to myopia development and wavelength response, indicating the potential role of these genes in human wavelength-induced myopia. CONCLUSIONS In this study, we identified retinal targets and pathways involved in the response to wavelength signals in emmetropization.
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Affiliation(s)
- Yingying Wen
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Binbin Dai
- Department of Ophthalmology, Taizhou Hospital, Taizhou, Zhejiang, China
| | - Xuhong Zhang
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Hong Zhu
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Chen Xie
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jianhua Xia
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yuan Sun
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Miaomiao Zhu
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jianping Tong
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Ye Shen
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
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Muralidharan AR, Low SWY, Lee YC, Barathi VA, Saw SM, Milea D, Najjar RP. Recovery From Form-Deprivation Myopia in Chicks Is Dependent Upon the Fullness and Correlated Color Temperature of the Light Spectrum. Invest Ophthalmol Vis Sci 2022; 63:16. [PMID: 35133400 PMCID: PMC8822367 DOI: 10.1167/iovs.63.2.16] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to evaluate the impact of full-spectrum light-emitting diodes mimicking sunlight (Sunlike LEDs) on ocular growth and refractive error development in a chicken model of myopia. Methods One-day old chicks (n = 39) were distributed into 3 groups and raised for 28 days in isoluminant (approximately 285 lux) fluorescent (n = 18, [FL-4000], correlated color temperature [CCT] = 4000 K) or Sunlike LED (n = 12, [SL-4000], CCT = 4000 K; n = 9, [SL-6500], CCT = 6500 K) white lighting environments. Form-deprivation myopia was induced monocularly from day 1 post-hatching (D1) until D14. On D14, form deprivation was halted and the recovery of form-deprived (FD) eyes was monitored until D28. Axial length (AL), refraction, choroidal thickness, and anterior chamber depth were measured in vivo on D1, D7, D14, D22, and D28. Differences in outcome measures between eyes and groups were compared using 2-way repeated-measures ANOVA. Results AL and myopic refraction of FD eyes increased similarly among groups during form-deprivation. FD eyes of animals raised under SL-4000 (D22: P < 0.001 and D28: P < 0.001) and SL-6500 (D22: P = 0.006 and D28: P < 0.001) recovered faster from axial elongation compared with animals raised under FL-4000. The refractive status of FD eyes reared under SL-6500, not under FL-4000 or SL-4000, was similar to control eyes on D28 (P > 0.05). However, SL-4000 and SL-6500 exhibited similar refraction on D28 than FL-4000 (P > 0.05). Choroidal thickness was significantly greater in FD eyes of chickens raised under SL-6500 than in animals raised under FL-4000 (P = 0.03). Conclusions Compared to fluorescent light, moderate intensities of full-spectrum Sunlike LEDs can accelerate recovery from form-deprivation myopia in chickens, potentially through a change in the choroid-mediated pathway.
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Affiliation(s)
- Arumugam R Muralidharan
- Singapore Eye Research Institute, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore
| | | | | | - Veluchamy A Barathi
- Singapore Eye Research Institute, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Seang-Mei Saw
- Singapore Eye Research Institute, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Dan Milea
- Singapore Eye Research Institute, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore.,Singapore National Eye Centre, Singapore
| | - Raymond P Najjar
- Singapore Eye Research Institute, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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11
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Wen L, Cheng Q, Cao Y, Li X, Pan L, Li L, Zhu H, Mogran I, Lan W, Yang Z. The Clouclip, a wearable device for measuring near-work and outdoor time: validation and comparison of objective measures with questionnaire estimates. Acta Ophthalmol 2021; 99:e1222-e1235. [PMID: 33729708 DOI: 10.1111/aos.14785] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 10/26/2020] [Accepted: 01/12/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE To validate a novel wearable device that can measure both viewing distance and light exposure, Clouclip, and compare questionnaire estimates regarding near-work and outdoor time with the objective measures obtained using Clouclip. METHODS Fifteen Clouclips were selected to measure different distances and levels of illuminance. With each Clouclip, five measurements at different distances and light intensities were measured and recorded. Eighty participants wore Clouclips for a week and completed an activity questionnaire afterwards. RESULTS The intra- and inter-Clouclip coefficients were 1.00 and 0.99 for measuring distance and 1.00 and 1.00 for illuminance, respectively. Within the measurement limit, the maximum relative error was 2.07% for distance and 2.23% for illuminance. Assuming that <30 cm was the typical distance for near-work activities and >1000 Lux was the typical cut-off for outdoor environments, the questionnaire showed a trend of overestimation for both. The greatest overestimation of near-work occurred during the school period [Questionnaire: 4.73 hr (4.73, 5.07) versus Clouclip: 2.16 hr (1.74, 2.78); p < 0.01]. The greatest overestimation of outdoor activity also occurred during the school period [Questionnaire: 1.60 hr (1.33, 1.85) versus Clouclip: 1.21 hr (0.96, 1.50); p < 0.01]. Based on Clouclip, the total time spent outdoors was estimated to be 1.55 hr on school days, of which 0.34 hr occurred after school. For weekend days, however, the duration was only 0.17 hr. CONCLUSIONS Clouclip had excellent precision and accuracy. Although the agreement between the questionnaire and Clouclip was relatively poor, they were able to complement each other to provide a more logical and feasible assessment of exposure to near-work and outdoor activity. Indoor-oriented lifestyles were found to predominate in Chinese children.
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Affiliation(s)
- Longbo Wen
- Aier School of Ophthalmology Central South University Hunan China
| | - Qian Cheng
- State Key Laboratory of Software Development Environment Beihang University Beijing China
| | - Yingpin Cao
- Aier School of Ophthalmology Central South University Hunan China
| | - Xiaoning Li
- Aier School of Ophthalmology Central South University Hunan China
- Aier School of Optometry and Vision Science Hubei University of Science and Technology Hubei China
| | - Lun Pan
- Aier School of Ophthalmology Central South University Hunan China
- Aier School of Optometry and Vision Science Hubei University of Science and Technology Hubei China
| | - Lei Li
- State Key Laboratory of Software Development Environment Beihang University Beijing China
| | - Haogang Zhu
- Guangzhou Aier Eye Hospital Jinan University Guangdong China
| | - Ian Mogran
- Research School of Biology Australia National University Canberra ACT Australia
| | - Weizhong Lan
- Aier School of Ophthalmology Central South University Hunan China
- Aier School of Optometry and Vision Science Hubei University of Science and Technology Hubei China
- Guangzhou Aier Eye Hospital Jinan University Guangdong China
| | - Zhikuan Yang
- Aier School of Ophthalmology Central South University Hunan China
- Aier School of Optometry and Vision Science Hubei University of Science and Technology Hubei China
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12
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朱 秋, 刘 陇. [Relationship between Myopia and Light Exposure]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2021; 52:901-906. [PMID: 34841751 PMCID: PMC10408837 DOI: 10.12182/20211160205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Indexed: 02/05/2023]
Abstract
Epidemiological studies found that the incidence of myopia was increasing year by year and the age of onset of myopia was showing a trend of affecting increasingly younger children. Reducing the occurrence of myopia and controlling the increase of myopia diopter have always been the focus of research on the prevention and control of myopia. Large randomized controlled clinical trials have found that outdoor activities can effectively reduce the incidence of myopia and delay the progression of myopia. Basic experiments also revealed that there were certain connections between light exposure and myopia. We herein review the research progress, limitations and future directions of research on light exposure and myopia. From the perspective of light properties, increasing the intensity of light can slow the progression of myopia and reduce the occurrence of experimentally induced myopia. However, the actual mechanism of action is still unclear. The rhythmic changes of light exposure caused by the light/dark cycle may cause abnormalities in the secretion of melatonin and dopamine, and changes in the circadian rhythm of intraocular pressure and choroidal thickness, thus affecting myopia. The red light, with relatively longer wavelength and forming images behind the retina, tends to induce myopia more easily, while the blue light, with medium and short wavelength and forming images before the retina, tends to delay myopia progression. However, different species respond differently to lights of different wavelengths, and the relationship between light wavelength and myopia needs further investigation. Future research can be done to further explore the mechanism of action of how light exposure changes the progression of myopia, including the following aspects: how light changes dopamine levels, causing changes in downstream signal pathways, and thus controlling the growth of the axial length of the eye; how retinal photoreceptor cells receive light signals of different wavelengths in order to adjust the refractive power of the eyes; and how to design artificial lighting of reasonable intensity, composition and properties, and apply the design in myopia prevention and control.
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Affiliation(s)
- 秋蓉 朱
- 四川大学华西临床医学院 眼视光学系 (成都 610041)Department of Optometry and Visual Science, West China School of Medicine, Sichuan University, Chengdu 610041, China
| | - 陇黔 刘
- 四川大学华西临床医学院 眼视光学系 (成都 610041)Department of Optometry and Visual Science, West China School of Medicine, Sichuan University, Chengdu 610041, China
- 四川大学华西医院 眼视光学与视觉科学研究室 (成都 610041)Laboratory of Optometry and Vision Science, West China Hospital, Sichuan University, Chengdu 610041, China
- 四川大学华西医院 眼科 (成都 610041)Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu 610041, China
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13
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Khanal S, Norton TT, Gawne TJ. Amber light treatment produces hyperopia in tree shrews. Ophthalmic Physiol Opt 2021; 41:1076-1086. [PMID: 34382245 DOI: 10.1111/opo.12853] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 05/27/2021] [Accepted: 05/28/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Exposure to narrow-band red light, which stimulates only the long-wavelength sensitive (LWS) cones, slows axial eye growth and produces hyperopia in tree shrews and macaque monkeys. We asked whether exposure to amber light, which also stimulates only the LWS cones but with a greater effective illuminance than red light, has a similar hyperopia-inducing effect in tree shrews. METHODS Starting at 24 ± 1 days of visual experience, 15 tree shrews (dichromatic mammals closely related to primates) received light treatment through amber filters (BPI 500/550 dyed acrylic) either atop the cage (Filter group, n = 8, 300-400 human lux) or fitted into goggles in front of both eyes (Goggle group, n = 7). Non-cycloplegic refractive error and axial ocular dimensions were measured daily. Treatment groups were compared with age-matched animals (Colony group, n = 7) raised in standard colony fluorescent lighting (100-300 lux). RESULTS At the start of treatment, mean refractive errors were well-matched across the three groups (p = 0.35). During treatment, the Filter group became progressively more hyperopic with age (p < 0.001). By contrast, the Goggle and Colony groups showed continued normal emmetropization. When the treatment ended, the Filter group exhibited significantly greater hyperopia (mean [SE] = 3.5 [0.6] D) compared with the Goggle (0.2 [0.8] D, p = 0.01) and Colony groups (1.0 [0.2] D, p = 0.01). However, the refractive error in the Goggle group was not different from that in the Colony group (p = 0.35). Changes in the vitreous chamber were consistent with the refractive error changes. CONCLUSIONS Exposure to ambient amber light produced substantial hyperopia in the Filter group but had no effect on refractive error in the Goggle group. The lack of effect in the Goggle group could be due to the simultaneous activation of the short-wavelength sensitive (SWS) and LWS cones caused by the scattering of the broad-band light from the periphery of the goggles.
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Affiliation(s)
- Safal Khanal
- Department of Optometry and Vision Science, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Thomas T Norton
- Department of Optometry and Vision Science, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Timothy J Gawne
- Department of Optometry and Vision Science, University of Alabama at Birmingham, Birmingham, Alabama, USA
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14
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Zhou X, Zhang S, Zhang G, Chen Y, Lei Y, Xiang J, Xu R, Qu J, Zhou X. Increased Choroidal Blood Perfusion Can Inhibit Form Deprivation Myopia in Guinea Pigs. Invest Ophthalmol Vis Sci 2021; 61:25. [PMID: 33211066 PMCID: PMC7683853 DOI: 10.1167/iovs.61.13.25] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Purpose In guinea pigs, choroidal thickness (ChT) and choroidal blood perfusion (ChBP) simultaneously decrease in experimental myopia, and both increase during recovery. However, the causal relationship between ChBP and myopia requires further investigation. In this study, we examined the changes of ChBP with three different antimyopia treatments. We also actively increased ChBP to examine the direct effect on myopia development in guinea pigs. Methods Experiment 1: Guinea pigs wore occluders on the right eye for two weeks to induce form-deprivation myopia (FDM). Simultaneously they received daily antimyopia treatments: peribulbar injections of atropine or apomorphine or exposure to intense light. Experiment 2: The vasodilator prazosin was injected daily into the form-deprivation eyes to increase ChBP during the two-week induction of FDM. Other FDM animals received appropriate control treatments. Changes in refraction, axial length, ChBP, ChT, and hypoxia-labeled pimonidazole adducts in the sclera were measured. Results The antimyopia treatments atropine, apomorphine, and intense light all significantly inhibited myopia development and the decrease in ChBP. The treatments also reduced scleral hypoxia, as indicated by the decrease in hypoxic signals. Furthermore, actively increasing ChBP with prazosin inhibited the progression of myopia, as well as the increase in axial length and scleral hypoxia. Conclusions Our data strongly indicate that increased ChBP attenuates scleral hypoxia, and thereby inhibits the development of myopia. Thus ChBP may be a promising target for myopia retardation. As such, it can serve as an immediate predictor of myopia development as well as a long-term marker of it.
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Affiliation(s)
- Xuan Zhou
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.,Research Unit of Myopia Basic Research and Clinical Prevention and Control, Chinese Academy of Medical Sciences (2019RU025), Wenzhou, China
| | - Sen Zhang
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.,Research Unit of Myopia Basic Research and Clinical Prevention and Control, Chinese Academy of Medical Sciences (2019RU025), Wenzhou, China
| | - Guoyun Zhang
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.,Research Unit of Myopia Basic Research and Clinical Prevention and Control, Chinese Academy of Medical Sciences (2019RU025), Wenzhou, China
| | - Yizhong Chen
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.,Research Unit of Myopia Basic Research and Clinical Prevention and Control, Chinese Academy of Medical Sciences (2019RU025), Wenzhou, China
| | - Yi Lei
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.,Research Unit of Myopia Basic Research and Clinical Prevention and Control, Chinese Academy of Medical Sciences (2019RU025), Wenzhou, China
| | - Jing Xiang
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.,Research Unit of Myopia Basic Research and Clinical Prevention and Control, Chinese Academy of Medical Sciences (2019RU025), Wenzhou, China
| | - Renchang Xu
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.,Research Unit of Myopia Basic Research and Clinical Prevention and Control, Chinese Academy of Medical Sciences (2019RU025), Wenzhou, China
| | - Jia Qu
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.,Research Unit of Myopia Basic Research and Clinical Prevention and Control, Chinese Academy of Medical Sciences (2019RU025), Wenzhou, China
| | - Xiangtian Zhou
- School of Optometry and Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology and Vision Science, Wenzhou, Zhejiang, China.,Research Unit of Myopia Basic Research and Clinical Prevention and Control, Chinese Academy of Medical Sciences (2019RU025), Wenzhou, China
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15
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Wen Y, Jin L, Zhang D, Zhang L, Xie C, Guo D, Wang Y, Wang L, Zhu M, Tong J, Shen Y. Quantitative proteomic analysis of scleras in guinea pig exposed to wavelength defocus. J Proteomics 2021; 243:104248. [PMID: 33964483 DOI: 10.1016/j.jprot.2021.104248] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/21/2021] [Accepted: 04/22/2021] [Indexed: 12/14/2022]
Abstract
Myopia is the most common optical disorder in the world, and wavelength defocus induced ametropia and myopia have attracted great attention. The objective was to identify and quantify scleral proteins involved in the response to the wavelength defocus. Guinea pigs were randomly divided into 3 groups that received different lighting conditions for 8 weeks: white light, short wavelength light, and long wavelength light. Refraction and axial length were measured, Hematoxylin-Eosin staining and transmission electron microscope were adopted to observe the scleral structure, and scleral proteome was also detected to analyze protein abundance by employing TMT labeling method. After light stimulation, the long- and short -wavelength light induced myopic and hyperopic effect on the guinea pig's eye and induced distinct protein signature, respectively. 186 dyregulated proteins between the short- and long-wavelength group were identified, which were mainly located in extracellular region and involved in metabolic process. We also found that 5 proteins in the guinea pigs scleras in response to wavelength defocus were also human myopic candidate targets, suggesting functional overlap between dyregulated proteins in scleral upon exposure to wavelength defocus and genes causing myopia in humans. SIGNIFICANCE: Wavelength defocus induces refractive errors and leads to myopia or hyperopia. However, sclera proteomics respond to wavelength defocus is lacking, which is crucial to understanding how wavelength defocus influences refractive development and induces myopia. In this proteome analysis, we identified unique protein signatures response to wavelength defocus in sclera of guinea pigs, identified potential mechanisms contributing to myopia formation, and found that several human myopia-related genes may involve in response to wavelength defocus. The results of this study provide a foundation to understand the mechanisms of myopia and wavelength defocus induced ametropia.
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Affiliation(s)
- Yingying Wen
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China; Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
| | - Le Jin
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China; Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
| | - Dongyan Zhang
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China; Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
| | - Liyue Zhang
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China; Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
| | - Chen Xie
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China; Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
| | - Dongyu Guo
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China; Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
| | - Yang Wang
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China; Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
| | - Liyin Wang
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China; Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
| | - Miaomiao Zhu
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China; Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China
| | - Jianping Tong
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China; Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China.
| | - Ye Shen
- Department of Ophthalmology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China; Clinical Research Center, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, China.
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16
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Morgan IG, Wu PC, Ostrin LA, Tideman JWL, Yam JC, Lan W, Baraas RC, He X, Sankaridurg P, Saw SM, French AN, Rose KA, Guggenheim JA. IMI Risk Factors for Myopia. Invest Ophthalmol Vis Sci 2021; 62:3. [PMID: 33909035 PMCID: PMC8083079 DOI: 10.1167/iovs.62.5.3] [Citation(s) in RCA: 141] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Risk factor analysis provides an important basis for developing interventions for any condition. In the case of myopia, evidence for a large number of risk factors has been presented, but they have not been systematically tested for confounding. To be useful for designing preventive interventions, risk factor analysis ideally needs to be carried through to demonstration of a causal connection, with a defined mechanism. Statistical analysis is often complicated by covariation of variables, and demonstration of a causal relationship between a factor and myopia using Mendelian randomization or in a randomized clinical trial should be aimed for. When strict analysis of this kind is applied, associations between various measures of educational pressure and myopia are consistently observed. However, associations between more nearwork and more myopia are generally weak and inconsistent, but have been supported by meta-analysis. Associations between time outdoors and less myopia are stronger and more consistently observed, including by meta-analysis. Measurement of nearwork and time outdoors has traditionally been performed with questionnaires, but is increasingly being pursued with wearable objective devices. A causal link between increased years of education and more myopia has been confirmed by Mendelian randomization, whereas the protective effect of increased time outdoors from the development of myopia has been confirmed in randomized clinical trials. Other proposed risk factors need to be tested to see if they modulate these variables. The evidence linking increased screen time to myopia is weak and inconsistent, although limitations on screen time are increasingly under consideration as interventions to control the epidemic of myopia.
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Affiliation(s)
- Ian G Morgan
- Research School of Biology, Australian National University, Canberra, ACT, Australia.,State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Pei-Chang Wu
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Lisa A Ostrin
- College of Optometry, University of Houston, Houston, Texas, United States
| | - J Willem L Tideman
- Department of Ophthalmology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.,Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.,The Generation R Study Group, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Jason C Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China.,Hong Kong Eye Hospital, Hong Kong, China.,Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong, China
| | - Weizhong Lan
- Aier School of Ophthalmology, Central South University, Changsha, China.,Aier School of Optometry, Hubei University of Science and Technology, Xianning, China.,Aier Institute of Optometry and Vision Science, Aier Eye Hospital Group, Changsha, China.,Guangzhou Aier Eye Hospital, Jinan University, Guangzhou, China
| | - Rigmor C Baraas
- National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Xiangui He
- Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China.,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Key Laboratory of Ocular Fundus Diseases, National Clinical Research Center for Eye Diseases, Shanghai, China
| | - Padmaja Sankaridurg
- Brien Holden Vision Institute Limited, Sydney, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Seang-Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore (NUS), Singapore.,Singapore Eye Research Institute, Singapore.,Duke-NUS Medical School, Singapore
| | - Amanda N French
- Discipline of Orthoptics, Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | - Kathryn A Rose
- Discipline of Orthoptics, Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | - Jeremy A Guggenheim
- School of Optometry & Vision Sciences, Cardiff University, Cardiff, United Kingdom
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17
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Muralidharan AR, Lança C, Biswas S, Barathi VA, Wan Yu Shermaine L, Seang-Mei S, Milea D, Najjar RP. Light and myopia: from epidemiological studies to neurobiological mechanisms. Ther Adv Ophthalmol 2021; 13:25158414211059246. [PMID: 34988370 PMCID: PMC8721425 DOI: 10.1177/25158414211059246] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 10/25/2021] [Indexed: 12/22/2022] Open
Abstract
Myopia is far beyond its inconvenience and represents a true, highly prevalent, sight-threatening ocular condition, especially in Asia. Without adequate interventions, the current epidemic of myopia is projected to affect 50% of the world population by 2050, becoming the leading cause of irreversible blindness. Although blurred vision, the predominant symptom of myopia, can be improved by contact lenses, glasses or refractive surgery, corrected myopia, particularly high myopia, still carries the risk of secondary blinding complications such as glaucoma, myopic maculopathy and retinal detachment, prompting the need for prevention. Epidemiological studies have reported an association between outdoor time and myopia prevention in children. The protective effect of time spent outdoors could be due to the unique characteristics (intensity, spectral distribution, temporal pattern, etc.) of sunlight that are lacking in artificial lighting. Concomitantly, studies in animal models have highlighted the efficacy of light and its components in delaying or even stopping the development of myopia and endeavoured to elucidate possible mechanisms involved in this process. In this narrative review, we (1) summarize the current knowledge concerning light modulation of ocular growth and refractive error development based on studies in human and animal models, (2) summarize potential neurobiological mechanisms involved in the effects of light on ocular growth and emmetropization and (3) highlight a potential pathway for the translational development of noninvasive light-therapy strategies for myopia prevention in children.
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Affiliation(s)
| | | | | | | | | | | | - Dan Milea
- Singapore Eye Research Institute, Singapore
| | - Raymond P Najjar
- Visual Neurosciences Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower Level 6, Singapore 169856
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18
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Du B, Jin N, Zhu X, Lu D, Jin C, Li Z, Han C, Zhang Y, Lai D, Liu K, Wei R. A prospective study of serum metabolomic and lipidomic changes in myopic children and adolescents. Exp Eye Res 2020; 199:108182. [PMID: 32781198 DOI: 10.1016/j.exer.2020.108182] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 07/24/2020] [Accepted: 08/02/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Myopia is a prevalent eye disorder, especially among children and adolescents in eastern Asian countries. Multiple measures have already been taken to prevent and treat myopia, including atropine and dopamine. However, the serum metabolic picture of myopia has not yet been studied as a whole and remains largely unclear. In this paper, a prospective and panoramic study was carried out to find out the whole serum metabolomic and lipidomic picture of myopia. METHODS With untargeted mass spectrometry (MS), myopia among 211 children and adolescents was studied. The MS features were first grouped across the samples. Then, compound annotation was carried out based on these features. Finally, the metabolite features were mapped to pathways, whose biological functions in myopia were studied and discussed. RESULTS A total of 275 metabolite features were derived from 92 aligned MS peak groups with significant fold changes, and then mapped to 33 pathways. By a comprehensive consideration of significance, fold change, importance score and appearance in different omics, 9 pathways were selected, and their biological functions were further analyzed. Among these selected pathways, 5 pathways were related with oxidative stress, a validated phenomenon during myopia development, while 5 pathways were related with dopamine receptor D2, whose molecular function in myopia treatment is not fully understood. A total of 177 metabolite features from 45 peak groups were related with the studied pathways. CONCLUSION This prospective study shed light on the whole picture of metabolomic mechanism underlying myopia and provided guidance to further elucidation of compounds and pathways in this whole picture.
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Affiliation(s)
- Bei Du
- Tianjin Key Laboratory of Retinal Functions and Diseases, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Nan Jin
- Tianjin Key Laboratory of Retinal Functions and Diseases, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Xiurui Zhu
- Tianjin Yunjian Medical Technology Co., Ltd., Tianjin, China; Department of Cardiothoracic Surgery, School of Medicine, Stanford University, CA, USA
| | - Daqian Lu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Chengcheng Jin
- Tianjin Key Laboratory of Retinal Functions and Diseases, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Zhen Li
- Tianjin Yunjian Medical Technology Co., Ltd., Tianjin, China; School of Electrical Engineering, Southeast University, Jiangsu Province, China
| | - Chunle Han
- Tianjin Yunjian Medical Technology Co., Ltd., Tianjin, China
| | - Yani Zhang
- Tianjin Yunjian Medical Technology Co., Ltd., Tianjin, China
| | - Donghai Lai
- Tianjin Yunjian Medical Technology Co., Ltd., Tianjin, China
| | - Kang Liu
- Tianjin Yunjian Medical Technology Co., Ltd., Tianjin, China.
| | - Ruihua Wei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.
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Sarfare S, Yang J, Nickla DL. The effects of brief high intensity light on ocular growth in chicks developing myopia vary with time of day. Exp Eye Res 2020; 195:108039. [PMID: 32339518 DOI: 10.1016/j.exer.2020.108039] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 03/04/2020] [Accepted: 04/02/2020] [Indexed: 12/31/2022]
Abstract
Evidence suggests that the relevant variable in the anti-myopigenic effect of increased time spent outdoors is the increase in light intensity. Because light is the strongest Zeitgeber, it is plausible that the effects of bright light exposure depend on time of day, and may impact circadian rhythms. In these studies, we asked whether the effects on eye growth rates and ocular rhythms of brief daily exposures to bright light differed depending on time of day in eyes developing myopia in response to form deprivation (FD) or negative lens-induced hyperopic defocus (LENS). We also studied the effects of concurrent exposures to brief hyperopic defocus and bright light. Exp. 1: Starting at 12d, chicks wearing monocular diffusers or -10 D lenses were exposed to 3 daily hours (h) of bright light (30K lux) in the morning (FD: n = 12; LENS: n = 7) or evening (FD: n = 21; LENS: n = 7) for a total of 6 exposures. Controls wore diffusers or lenses but weren't exposed to bright light ("not bright" FD: n = 14; LENS: n = 9). Exp. 2: Untreated chicks were exposed to 3 h bright light in the morning (n = 12) or evening (n = 14) for a total of 6 exposures. Controls were not exposed to bright light (n = 11). Exp. 3: Chicks were exposed to 2 h simultaneous monocular hyperopic defocus and bright light in the morning (n = 11), mid-day (n = 7) or evening (n = 8) for 5 exposures. "Not bright" lens-wearing controls were data from published work (Nickla et al., 2017). High frequency A-scan ultrasonography was done at the start and end to measure growth rates. The FD group in Exp. 1 and the morning and evening groups in Exp. 3 were measured at 6-h intervals over the final 24 h to determine parameters for the rhythms in axial length and choroidal thickness. 1. Brief bright light in the evening inhibited eye growth in eyes wearing diffusers or lenses relative to "not bright" controls(interocular differences: FD: 316 vs 468 μm, p = 0.026; LENS: 233 vs 438 μm, p = 0.03); morning bright light had no effect. There was no differential effect of time of day of exposure on the rhythm in axial length; for choroid thickness, "time" accounted for the variance between groups (2-way ANOVA interaction p = 0.027). 2. In binocularly untreated chicks, bright light in the morning had a small but significant growth stimulatory effect relative to evening exposures (803 vs 679 μm/7d; post-hoc p = 0.048). 3. Eyes exposed to simultaneous hyperopic defocus and bright light were significantly more inhibited relative to "not bright" controls for morning exposures (interocular differences: -207 vs 69 μm; p < 0.01). In conclusion, the effects of brief periods of bright light on the growth controller depended on the time of day of exposure and on the contemporaneous state ofocular growth .
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Affiliation(s)
- Shanta Sarfare
- The New England College of Optometry, 424 Beacon St, Boston, MA, USA
| | - Jane Yang
- The New England College of Optometry, 424 Beacon St, Boston, MA, USA
| | - Debora L Nickla
- The New England College of Optometry, 424 Beacon St, Boston, MA, USA.
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20
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Zhang J, Deng G. Protective effects of increased outdoor time against myopia: a review. J Int Med Res 2020; 48:300060519893866. [PMID: 31854216 PMCID: PMC7607527 DOI: 10.1177/0300060519893866] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 11/19/2019] [Indexed: 12/27/2022] Open
Abstract
Myopia has become a major cause for concern globally, particularly in East Asian countries. The increasing prevalence of myopia has been associated with a high socioeconomic burden owing to severe ocular complications that may occur with progressive myopia. There is an urgent need to identify effective and safe measures to address the growing number of people with myopia in the general population. Among the numerous strategies implemented to slow the progression of myopia, longer time spent outdoors has come to be recognized as a protective factor against this disorder. Although our understanding of the protective effects of outdoor time has increased in the past decade, considerably more research is needed to understand the mechanisms of action. Here, we summarize the main potential factors associated with the protective effects against myopia of increased outdoor time, namely, exposure to elevated levels and shorter wavelengths of light, and increased dopamine and vitamin D levels. In this review, we aimed to identify safe and effective therapeutic interventions to prevent myopia-related complications and vision loss.
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Affiliation(s)
- Jun Zhang
- Department of Ophthalmology, The Third People’s Hospital of Changzhou, Changzhou, Jiangsu, China
| | - Guohua Deng
- Department of Ophthalmology, The Third People’s Hospital of Changzhou, Changzhou, Jiangsu, China
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21
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Wen L, Cao Y, Cheng Q, Li X, Pan L, Li L, Zhu H, Lan W, Yang Z. Objectively measured near work, outdoor exposure and myopia in children. Br J Ophthalmol 2020; 104:1542-1547. [PMID: 32075819 PMCID: PMC7587221 DOI: 10.1136/bjophthalmol-2019-315258] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 01/05/2020] [Accepted: 01/30/2020] [Indexed: 11/12/2022]
Abstract
Aim To reassess the association between near work, outdoor exposure and myopia in children through an objective approach. Methods Eighty-six children (10.13±0.48 years) were asked to wear Clouclip, a newly developed wearable device that is able to measure working distance and eye-level illuminance, for a complete week to obtain information on near work and outdoor exposure. The mean daily Clouclip wearing time was 11.72±1.14 hour. The spherical equivalent refraction was determined by cycloplegic autorefraction. Results The myopic children were found to be exposed to light intensities >3000 lux (0.68±0.50 hour vs 1.02±0.53 hour, p=0.012) and >5000 lux (0.42±0.35 hour vs 0.63±0.31 hour, p=0.004) for shorter durations on average each day than the non-myopic children. Additionally, the myopic children spent more time on average each day on activities at a distance of <20 cm than non-myopic children (1.89±0.61 hour vs 1.52±0.77 hour, p=0.019). In the multivariate logistic analysis, the time spent with a higher light intensity (>3000 lux (OR=0.27, 95% CI: 0.10 to 0.72, p=0.009); >5000 lux (OR=0.11, 95% CI: 0.02 to 0.56, p=0.008)) and a working distance of <20 cm (in a circumstance of >3000 lux (OR=1.17, 95% CI: 1.09 to 1.86, p=0.038) or in that of >5000 lux (OR=1.12, 95% CI: 1.03 to 1.77, p=0.046)) were the independent protective factors and risk factors, respectively. Conclusion The current study provides novel evidence, based on objective data, to support the association between the intensity of near work, light intensity and myopia. However, the causality and the dose-effect relationship need to be investigated further.
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Affiliation(s)
- Longbo Wen
- Aier School of Ophthalmology, Central South University, Changsha, Hunan, China
| | - Yingpin Cao
- Aier School of Ophthalmology, Central South University, Changsha, Hunan, China
| | - Qian Cheng
- State Key Laboratory of Software Development Environment, Beihang University, Beijing, China
| | - Xiaoning Li
- Aier School of Ophthalmology, Central South University, Changsha, Hunan, China.,Aier School of Optometry and Vision Science, Hubei University of Science and Technology, Xianning, Hubei, China
| | - Lun Pan
- Aier School of Ophthalmology, Central South University, Changsha, Hunan, China.,Aier School of Optometry and Vision Science, Hubei University of Science and Technology, Xianning, Hubei, China
| | - Lei Li
- State Key Laboratory of Software Development Environment, Beihang University, Beijing, China
| | | | - Weizhong Lan
- Aier School of Ophthalmology, Central South University, Changsha, Hunan, China .,Aier School of Optometry and Vision Science, Hubei University of Science and Technology, Xianning, Hubei, China
| | - Zhikuan Yang
- Aier School of Ophthalmology, Central South University, Changsha, Hunan, China .,Aier School of Optometry and Vision Science, Hubei University of Science and Technology, Xianning, Hubei, China
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22
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Mathis U, Feldkaemper M, Wang M, Schaeffel F. Studies on retinal mechanisms possibly related to myopia inhibition by atropine in the chicken. Graefes Arch Clin Exp Ophthalmol 2019; 258:319-333. [PMID: 31879820 DOI: 10.1007/s00417-019-04573-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 11/28/2019] [Accepted: 12/13/2019] [Indexed: 10/25/2022] Open
Abstract
PURPOSE While low-dose atropine eye drops are currently widely used to inhibit myopia development in children, the underlying mechanisms are poorly understood. Therefore, we studied possible retinal mechanisms and receptors that are potentially involved in myopia inhibition by atropine. METHODS A total of 250 μg atropine were intravitreally injected into one eye of 19 chickens, while the fellow eyes received saline and served as controls. After 1 h, 1.5 h, 2 h, 3 h, and 4 h, eyes were prepared for vitreal dopamine (DA) measurements, using high-pressure liquid chromatography with electrochemical detection. Twenty-four animals were kept either in bright light (8500 lx) or standard light (500 lx) after atropine injection for 1.5 h before DA was measured. In 10 chickens, the α2A-adrenoreceptor (α2A-ADR) agonists brimonidine and clonidine were intravitreally injected into one eye, the fellow eye served as control, and vitreal DA content was measured after 1.5 h. In 6 chickens, immunohistochemical analyses were performed 1.5 h after atropine injection. RESULTS Vitreal DA levels increased after a single intravitreal atropine injection, with a peak difference between both eyes after 1.97 h. DA was also enhanced in fellow eyes, suggesting a systemic action of intravitreally administered atropine. Bright light and atropine (which both inhibit myopia) had additive effects on DA release. Quantitative immunolabelling showed that atropine heavily stimulated retinal activity markers ZENK and c-Fos in cells of the inner nuclear layer. Since atropine was recently found to also bind to α2A-ADRs at doses where it can inhibit myopia, their retinal localization was studied. In amacrine cells, α2A-ADRs were colocalized with tyrosine hydroxylase (TH), glucagon, and nitric oxide synthase, peptides known to play a role in myopia development in chickens. Intravitreal atropine injection reduced the number of neurons that were double-labelled for TH and α2A-ADR. α2A-ADR agonists clonidine and brimonidine (which were also found by other authors to inhibit myopia) severely reduced vitreal DA content in both injected and fellow eyes, compared to eyes of untreated chicks. CONCLUSIONS Merging our results with published data, it can be concluded that both muscarinic and α2A-adrenergic receptors are expressed on dopaminergic neurons and both atropine and α2A-ADR antagonists stimulate DA release whereas α2A-ADR agonists strongly suppress its release. Stimulation of DA by atropine was enhanced by bright light. Results are in line with the hypothesis that inhibition of deprivation myopia is correlated with DA stimulation, as long as no toxicity is involved.
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Affiliation(s)
- Ute Mathis
- Section of Neurobiology of the Eye, Ophthalmic Research Institute, University of Tuebingen, Tuebingen, Germany
| | - Marita Feldkaemper
- Section of Neurobiology of the Eye, Ophthalmic Research Institute, University of Tuebingen, Tuebingen, Germany
| | - Min Wang
- Section of Neurobiology of the Eye, Ophthalmic Research Institute, University of Tuebingen, Tuebingen, Germany
| | - Frank Schaeffel
- Section of Neurobiology of the Eye, Ophthalmic Research Institute, University of Tuebingen, Tuebingen, Germany.
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23
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Spillmann L. Stopping the rise of myopia in Asia. Graefes Arch Clin Exp Ophthalmol 2019; 258:943-959. [DOI: 10.1007/s00417-019-04555-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 10/16/2019] [Accepted: 11/25/2019] [Indexed: 10/25/2022] Open
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24
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Effectiveness and safety of topical levodopa in a chick model of myopia. Sci Rep 2019; 9:18345. [PMID: 31797988 PMCID: PMC6892936 DOI: 10.1038/s41598-019-54789-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 11/19/2019] [Indexed: 01/18/2023] Open
Abstract
Animal models have demonstrated a link between dysregulation of the retinal dopamine system and the excessive ocular growth associated with the development of myopia. Here we show that intravitreal or topical application of levodopa, which is widely used in the treatment of neurological disorders involving dysregulation of the dopaminergic system, inhibits the development of experimental myopia in chickens. Levodopa slows ocular growth in a dose dependent manner in chicks with a similar potency to atropine, a common inhibitor of ocular growth in humans. Topical levodopa remains effective over chronic treatment periods, with its effectiveness enhanced by coadministration with carbidopa to prevent its premature metabolism. No changes in normal ocular development (biometry and refraction), retinal health (histology), or intraocular pressure were observed in response to chronic treatment (4 weeks). With a focus on possible clinical use in humans, translation of these avian safety findings to a mammalian model (mouse) illustrate that chronic levodopa treatment (9 months) does not induce any observable changes in visual function (electroretinogram recordings), ocular development, and retinal health, suggesting that levodopa may have potential as a therapeutic intervention for human myopia.
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25
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Belnap SC, Lickliter R. Prenatal light exposure influences gait performance and body composition in bobwhite quail chicks. Physiol Behav 2019; 212:112706. [PMID: 31647991 DOI: 10.1016/j.physbeh.2019.112706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 10/08/2019] [Accepted: 10/09/2019] [Indexed: 11/19/2022]
Abstract
Maternal nesting behavior, which includes periods of patterned inattention, provides key elements essential for avian embryonic development, including regulation of temperature and light. For example, avian research consistently shows the importance of prenatal light exposure for several developmental processes; however, this research has primarily focused on artificial light regimens (i.e. 24 hr, 0 hr light). Comparatively less is known about how exposure to naturally occurring light patterns during incubation influence motor performance, body composition (i.e. body mass, bone length), and developmental age (incubation length). Here we conducted two experiments which investigated the effects of prenatal light exposure on developmental age, body composition, and gait performance in 1-day-old bobwhite quail. Experiment 1 investigated crepuscular light exposure during the last two days of incubation under two light duration treatments (2 hr & 6 hr) compared to a 12 hr continuous light schedule. Results indicated crepuscular prenatal light experience extended the incubation period for 2 hr exposed embryos, but not for 6 hr exposed embryos and negatively influenced postnatal body composition and postnatal gait performance when compared to 12 hr continuous light embryos. Experiment 2 examined the influence of prenatal light duration (2 hr vs 6 hr) and light presentation (crepuscular vs sporadic). Results demonstrated sporadic light presentation improved gait performance in 2 hr exposed hatchlings, but not 6 hr exposed hatchlings, improved body composition in 6 hr exposed hatchlings, but not 2 hr exposed hatchlings, and did not alter incubation length when compared to crepuscular light counterparts. This study provides further evidence for the importance of maternally regulated sensory stimulation during the prenatal period on early postnatal motor development.
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Affiliation(s)
- Starlie C Belnap
- Department of Psychology, Florida International University, 11200 SW 8th Street, DM 256, Miami, FL 33199, United States.
| | - Robert Lickliter
- Department of Psychology, Florida International University, 11200 SW 8th Street, DM 256, Miami, FL 33199, United States
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26
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Abstract
Refractive errors are the product of a mismatch between the axial length of the eye and its optical power, creating blurred vision. Uncorrected refractive errors are the second leading cause of worldwide blindness. One refractive error currently attracting significant scientific interest is myopia, mostly owing to the recent rise in its prevalence worldwide and associated ocular disease burden. This increase in myopia prevalence has also been rapid, suggesting environmental influences in addition to any genetic influences on eye growth. This review defines refractive errors, describes their prevalence, and presents evidence for the influence of genetic and environmental factors related to refractive error development.
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Affiliation(s)
- Elise N. Harb
- School of Optometry, University of California, Berkeley, California 94720, USA;,
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27
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Troilo D, Smith EL, Nickla DL, Ashby R, Tkatchenko AV, Ostrin LA, Gawne TJ, Pardue MT, Summers JA, Kee CS, Schroedl F, Wahl S, Jones L. IMI - Report on Experimental Models of Emmetropization and Myopia. Invest Ophthalmol Vis Sci 2019; 60:M31-M88. [PMID: 30817827 PMCID: PMC6738517 DOI: 10.1167/iovs.18-25967] [Citation(s) in RCA: 215] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Accepted: 10/20/2018] [Indexed: 11/24/2022] Open
Abstract
The results of many studies in a variety of species have significantly advanced our understanding of the role of visual experience and the mechanisms of postnatal eye growth, and the development of myopia. This paper surveys and reviews the major contributions that experimental studies using animal models have made to our thinking about emmetropization and development of myopia. These studies established important concepts informing our knowledge of the visual regulation of eye growth and refractive development and have transformed treatment strategies for myopia. Several major findings have come from studies of experimental animal models. These include the eye's ability to detect the sign of retinal defocus and undergo compensatory growth, the local retinal control of eye growth, regulatory changes in choroidal thickness, and the identification of components in the biochemistry of eye growth leading to the characterization of signal cascades regulating eye growth and refractive state. Several of these findings provided the proofs of concepts that form the scientific basis of new and effective clinical treatments for controlling myopia progression in humans. Experimental animal models continue to provide new insights into the cellular and molecular mechanisms of eye growth control, including the identification of potential new targets for drug development and future treatments needed to stem the increasing prevalence of myopia and the vision-threatening conditions associated with this disease.
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Affiliation(s)
- David Troilo
- SUNY College of Optometry, State University of New York, New York, New York, United States
| | - Earl L. Smith
- College of Optometry, University of Houston, Houston, Texas, United States
| | - Debora L. Nickla
- Biomedical Sciences and Disease, New England College of Optometry, Boston, Massachusetts, United States
| | - Regan Ashby
- Health Research Institute, University of Canberra, Canberra, Australia
| | - Andrei V. Tkatchenko
- Department of Ophthalmology, Department of Pathology and Cell Biology, Columbia University, New York, New York, United States
| | - Lisa A. Ostrin
- College of Optometry, University of Houston, Houston, Texas, United States
| | - Timothy J. Gawne
- School of Optometry, University of Alabama Birmingham, Birmingham, Alabama, United States
| | - Machelle T. Pardue
- Biomedical Engineering, Georgia Tech College of Engineering, Atlanta, Georgia, United States31
| | - Jody A. Summers
- College of Medicine, University of Oklahoma, Oklahoma City, Oklahoma, United States
| | - Chea-su Kee
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Falk Schroedl
- Departments of Ophthalmology and Anatomy, Paracelsus Medical University, Salzburg, Austria
| | - Siegfried Wahl
- Institute for Ophthalmic Research, University of Tuebingen, Zeiss Vision Science Laboratory, Tuebingen, Germany
| | - Lyndon Jones
- CORE, School of Optometry and Vision Science, University of Waterloo, Ontario, Canada
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28
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Sid H, Schusser B. Applications of Gene Editing in Chickens: A New Era Is on the Horizon. Front Genet 2018; 9:456. [PMID: 30356667 PMCID: PMC6189320 DOI: 10.3389/fgene.2018.00456] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 09/18/2018] [Indexed: 01/15/2023] Open
Abstract
The chicken represents a valuable model for research in the area of immunology, infectious diseases as well as developmental biology. Although it was the first livestock species to have its genome sequenced, there was no reverse genetic technology available to help understanding specific gene functions. Recently, homologous recombination was used to knockout the chicken immunoglobulin genes. Subsequent studies using immunoglobulin knockout birds helped to understand different aspects related to B cell development and antibody production. Furthermore, the latest advances in the field of genome editing including the CRISPR/Cas9 system allowed the introduction of site specific gene modifications in various animal species. Thus, it may provide a powerful tool for the generation of genetically modified chickens carrying resistance for certain pathogens. This was previously demonstrated by targeting the Trp38 region which was shown to be effective in the control of avian leukosis virus in chicken DF-1 cells. Herein we review the current and future prospects of gene editing and how it possibly contributes to the development of resistant chickens against infectious diseases.
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Affiliation(s)
| | - Benjamin Schusser
- Department of Animal Sciences, Reproductive Biotechnology, School of Life Sciences Weihenstephan, Technical University Munich, Freising, Germany
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29
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Vera-Diaz FA, Bex PJ, Ferreira A, Kosovicheva A. Binocular temporal visual processing in myopia. J Vis 2018; 18:17. [PMID: 30372727 PMCID: PMC6205559 DOI: 10.1167/18.11.17] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 07/16/2018] [Indexed: 02/07/2023] Open
Abstract
Our ability to utilize binocular visual information depends on the visibility of the retinal images in each eye, which varies with both their spatial and temporal frequency content. Although the effects of spatial information on binocular function have been established, the effects of temporal frequency on binocularity are less well understood. These factors may also vary with refractive error if spatiotemporal sensitivity is affected by structural changes during the emmetropization process that may differentially affect distinct ganglion cells. In a cross-sectional study, we evaluated the potential effects of temporal and spatial frequency on binocularity in young individuals with emmetropia or myopia. Stereopsis and binocular balance were measured as a function of temporal (0-12 Hz) and spatial (1-8 c/deg) frequency. Stereopsis thresholds were measured by determining the minimum disparity at which subjects accurately identified the depth of bandpass-filtered rings. Binocular balance was measured by determining the relative contrast at which subjects reported dichoptic bandpass-filtered letters with equal frequency. Stereopsis thresholds were temporal but not spatial frequency dependent whereas binocular balance was spatial and temporal frequency dependent. There were no differences in monocular spatiotemporal contrast sensitivity between refractive groups in our sample. However, individuals with myopia showed reduced stereopsis with flickering stimuli and greater binocular imbalance at higher spatial and lower temporal frequencies compared to emmetropes. Differences in binocular vision between emmetropia and corrected myopia depend on temporal as well as spatial frequency and may be the cause or consequence of abnormal emmetropization during visual development.
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30
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31
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Tsai DC, Huang N, Fang SY, Hsu CC, Lin PY, Chen SY, Liou YM, Chiu AWH, Liu CJL. Seasonal variation of refractive error change among young schoolchildren in a population-based cohort study in Taipei. Br J Ophthalmol 2018; 103:343-348. [PMID: 29793927 DOI: 10.1136/bjophthalmol-2017-311642] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 04/02/2018] [Accepted: 04/29/2018] [Indexed: 11/03/2022]
Abstract
PURPOSE To investigate the relationship between seasonal variation of daylight length and spherical equivalent (SE) progression among the schoolchildren participating in the Myopia Investigation Study in Taipei. METHODS We used the first-year data from grade 2 schoolchildren who completed all the baseline and two follow-up examinations (n=6790). There were two 6-month intervals between visits over winter and summer, respectively. For each interval, we calculated average daily daylight length using data from Taiwan's Central Weather Bureau and measured 6-month SE progression rate based on right eye cycloplegic autorefraction data. The midpoint month was defined as the month midway between two consecutive visits. RESULTS By the midpoint month, average daily daylight length was the shortest in December (671±7 min/day) and the longest (785±7 min/day) in June, and SE progression rate was the fastest (-0.23±0.48 D) in December and the slowest (-0.17±0.51 D) in June. Significant variation of SE progression rate with season can be observed only among the schoolchildren (n=1905) whose midpoint months for the winter and summer intervals were December and June (winter rate, -0.25±0.47 D; summer rate, -0.17±0.49 D; p<0.001). Of those, the summer progression rate was approximately 80%, 65% and 61.5% of that measured in winter for myopic (p=0.252), emmetropic (p=0.012) and hyperopic (p=0.012) schoolchildren, respectively. CONCLUSION Our data demonstrate a seasonal variation of minus shift in refractive error among Taipei schoolchildren who had significant daytime fluctuation during the 1-year follow-up. Of those, non-myopic children had significant and more pronounced variation of SE progression than myopic children.
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Affiliation(s)
- Der-Chong Tsai
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan .,Department of Ophthalmology, National Yang-Ming University Hospital, Yilan, Taiwan
| | - Nicole Huang
- Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Shao-You Fang
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chih-Chien Hsu
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Pei-Yu Lin
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shing-Yi Chen
- Department of Health, Taipei City Government, Taipei, Taiwan
| | - Yiing-Mei Liou
- School Health Research Center, Institute of Community Health Care, National Yang-Ming University School of Nursing, Taipei, Taiwan
| | - Allen Wen-Hsiang Chiu
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Catherine Jui-Ling Liu
- Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan .,Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan
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Chakraborty R, Ostrin LA, Nickla DL, Iuvone PM, Pardue MT, Stone RA. Circadian rhythms, refractive development, and myopia. Ophthalmic Physiol Opt 2018; 38:217-245. [PMID: 29691928 PMCID: PMC6038122 DOI: 10.1111/opo.12453] [Citation(s) in RCA: 121] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 03/11/2018] [Indexed: 12/14/2022]
Abstract
PURPOSE Despite extensive research, mechanisms regulating postnatal eye growth and those responsible for ametropias are poorly understood. With the marked recent increases in myopia prevalence, robust and biologically-based clinical therapies to normalize refractive development in childhood are needed. Here, we review classic and contemporary literature about how circadian biology might provide clues to develop a framework to improve the understanding of myopia etiology, and possibly lead to rational approaches to ameliorate refractive errors developing in children. RECENT FINDINGS Increasing evidence implicates diurnal and circadian rhythms in eye growth and refractive error development. In both humans and animals, ocular length and other anatomical and physiological features of the eye undergo diurnal oscillations. Systemically, such rhythms are primarily generated by the 'master clock' in the surpachiasmatic nucleus, which receives input from the intrinsically photosensitive retinal ganglion cells (ipRGCs) through the activation of the photopigment melanopsin. The retina also has an endogenous circadian clock. In laboratory animals developing experimental myopia, oscillations of ocular parameters are perturbed. Retinal signaling is now believed to influence refractive development; dopamine, an important neurotransmitter found in the retina, not only entrains intrinsic retinal rhythms to the light:dark cycle, but it also modulates refractive development. Circadian clocks comprise a transcription/translation feedback control mechanism utilizing so-called clock genes that have now been associated with experimental ametropias. Contemporary clinical research is also reviving ideas first proposed in the nineteenth century that light exposures might impact refraction in children. As a result, properties of ambient lighting are being investigated in refractive development. In other areas of medical science, circadian dysregulation is now thought to impact many non-ocular disorders, likely because the patterns of modern artificial lighting exert adverse physiological effects on circadian pacemakers. How, or if, such modern light exposures and circadian dysregulation contribute to refractive development is not known. SUMMARY The premise of this review is that circadian biology could be a productive area worthy of increased investigation, which might lead to the improved understanding of refractive development and improved therapeutic interventions.
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Affiliation(s)
- Ranjay Chakraborty
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | | | | | | | - Machelle T. Pardue
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta
- Atlanta VA Center for Visual and Neurocognitive Rehabilitation, Decatur
| | - Richard A. Stone
- University of Pennsylvania School of Medicine, Philadelphia, USA
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Ward AH, Norton TT, Huisingh CE, Gawne TJ. The hyperopic effect of narrow-band long-wavelength light in tree shrews increases non-linearly with duration. Vision Res 2018; 146-147:9-17. [PMID: 29655781 DOI: 10.1016/j.visres.2018.03.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 02/28/2018] [Accepted: 03/05/2018] [Indexed: 10/17/2022]
Abstract
During postnatal refractive development, an emmetropization mechanism uses refractive error to modulate the growth rate of the eye. Hyperopia (image focused behind the retina) produces what has been described as "GO" signaling that increases growth. Myopia (image focused in front of the retina) produces "STOP" signaling that slows growth. The interaction between GO and STOP conditions is non-linear; brief daily exposure to STOP counteracts long periods of GO. In young tree shrews, long-wavelength (red) light, presented 14 h per day, also appears to produce STOP signals. We asked if red light also shows temporal non-linearity; does brief exposure slow the normal decrease in hyperopia in infant animals? At 11 days after eye opening (DVE), infant tree shrews (n = 5/group) began 13 days of daily treatment (red LEDs, 624 ± 10 or 636 ± 10 nm half peak intensity bandwidth) at durations of 0 h (normal animals, n = 7) or 1, 2, 4, or 7 h. Following each daily red period, colony lighting resumed. A 14 h red group had no colony lights. Refractive state was measured daily; ocular component dimensions at the end of the 13-day red-light period. Even 1 h of red light exposure produced some hyperopia. The average hyperopic shift from normal rose exponentially with duration (time constant 2.5 h). Vitreous chamber depth decreased non-linearly with duration (time constant, 3.3 h). After red treatment was discontinued, refractions in colony lighting recovered toward normal; the initial rate was linearly related to the amount of hyperopia. The red light may produce STOP signaling similar to myopic refractive error.
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Affiliation(s)
- Alexander H Ward
- Department of Optometry and Vision Science, University of Alabama at Birmingham, Birmingham, AL 35294, United States
| | - Thomas T Norton
- Department of Optometry and Vision Science, University of Alabama at Birmingham, Birmingham, AL 35294, United States
| | - Carrie E Huisingh
- Department of Ophthalmology, University of Alabama at Birmingham, Birmingham, AL 35294, United States
| | - Timothy J Gawne
- Department of Optometry and Vision Science, University of Alabama at Birmingham, Birmingham, AL 35294, United States.
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Morgan IG, French AN, Ashby RS, Guo X, Ding X, He M, Rose KA. The epidemics of myopia: Aetiology and prevention. Prog Retin Eye Res 2017; 62:134-149. [PMID: 28951126 DOI: 10.1016/j.preteyeres.2017.09.004] [Citation(s) in RCA: 568] [Impact Index Per Article: 81.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 09/11/2017] [Accepted: 09/20/2017] [Indexed: 02/06/2023]
Abstract
There is an epidemic of myopia in East and Southeast Asia, with the prevalence of myopia in young adults around 80-90%, and an accompanying high prevalence of high myopia in young adults (10-20%). This may foreshadow an increase in low vision and blindness due to pathological myopia. These two epidemics are linked, since the increasingly early onset of myopia, combined with high progression rates, naturally generates an epidemic of high myopia, with high prevalences of "acquired" high myopia appearing around the age of 11-13. The major risk factors identified are intensive education, and limited time outdoors. The localization of the epidemic appears to be due to the high educational pressures and limited time outdoors in the region, rather than to genetically elevated sensitivity to these factors. Causality has been demonstrated in the case of time outdoors through randomized clinical trials in which increased time outdoors in schools has prevented the onset of myopia. In the case of educational pressures, evidence of causality comes from the high prevalence of myopia and high myopia in Jewish boys attending Orthodox schools in Israel compared to their sisters attending religious schools, and boys and girls attending secular schools. Combining increased time outdoors in schools, to slow the onset of myopia, with clinical methods for slowing myopic progression, should lead to the control of this epidemic, which would otherwise pose a major health challenge. Reforms to the organization of school systems to reduce intense early competition for accelerated learning pathways may also be important.
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Affiliation(s)
- Ian G Morgan
- Division of Biochemistry and Molecular Biology, Research School of Biology, Australian National University, Canberra, ACT, Australia; State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yatsen University, Guangzhou, China.
| | - Amanda N French
- Discipline of Orthoptics, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Regan S Ashby
- Centre for Research in Therapeutic Solutions, Biomedical Sciences, Faulty of Education, Science, Technology and Mathematics, University of Canberra, Canberra, Australia
| | - Xinxing Guo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yatsen University, Guangzhou, China; Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Xiaohu Ding
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yatsen University, Guangzhou, China
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yatsen University, Guangzhou, China; Centre for Eye Research Australia, University of Melbourne, Parkville, VIC, Australia
| | - Kathryn A Rose
- Discipline of Orthoptics, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia
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Abstract
Epidemiological studies have demonstrated that spending time outdoors during your childhood is protective against the development of myopia. It has been hypothesized that this protective effect is associated with light-induced increases in retinal dopamine levels, a critical neuromodulator that has long been postulated to be involved in the regulation of ocular growth. This paper, along with the paper entitled "What do animal studies tell us about the mechanism of myopia-protection by light?" discusses the evidence provided by animal models for this hypothesis.
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Zhou X, Pardue MT, Iuvone PM, Qu J. Dopamine signaling and myopia development: What are the key challenges. Prog Retin Eye Res 2017; 61:60-71. [PMID: 28602573 DOI: 10.1016/j.preteyeres.2017.06.003] [Citation(s) in RCA: 182] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 05/23/2017] [Accepted: 06/05/2017] [Indexed: 01/11/2023]
Abstract
In the face of an "epidemic" increase in myopia over the last decades and myopia prevalence predicted to reach 2.5 billion people by the end of this decade, there is an urgent need to develop effective and safe therapeutic interventions to slow down this "myopia booming" and prevent myopia-related complications and vision loss. Dopamine (DA) is an important neurotransmitter in the retina and mediates diverse functions including retina development, visual signaling, and refractive development. Inspired by the convergence of epidemiological and animal studies in support of the inverse relationship between outdoor activity and risk of developing myopia and by the close biological relationship between light exposure and dopamine release/signaling, we felt it is timely and important to critically review the role of DA in myopia development. This review will revisit several key points of evidence for and against DA mediating light control of myopia: 1) the causal role of extracellular retinal DA levels, 2) the mechanism and action of dopamine D1 and D2 receptors and 3) the roles of cellular/circuit retinal pathways. We examine the experiments that show causation by altering DA, DA receptors and visual pathways using pharmacological, transgenic, or visual environment approaches. Furthermore, we critically evaluate the safety issues of a DA-based treatment strategy and some approaches to address these issues. The review identifies the key questions and challenges in translating basic knowledge on DA signaling and myopia from animal studies into effective pharmacological treatments for myopia in children.
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Affiliation(s)
- Xiangtian Zhou
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, Zhejiang 325003, China; State Key Laboratory of Ophthalmology, Optometry and Vision Science. 270 Xueyuan Road, Wenzhou, Zhejiang, 325003, China
| | - Machelle T Pardue
- Department of Biomedical Engineering, Georgia Institute of Technology, 313 Ferst Dr, Atlanta, GA 30332, United States; Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Medical Center, 1670 Clairmont Rd, Decatur, GA 30033, United States
| | - P Michael Iuvone
- Department of Ophthalmology, Emory University School of Medicine, 1365B Clifton Rd NE, Atlanta, GA 30322, United States; Department of Pharmacology, Emory University School of Medicine, 1365B Clifton Rd NE, Atlanta, GA 30322, United States
| | - Jia Qu
- School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical University, 270 Xueyuan Road, Wenzhou, Zhejiang 325003, China; State Key Laboratory of Ophthalmology, Optometry and Vision Science. 270 Xueyuan Road, Wenzhou, Zhejiang, 325003, China.
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Stone RA, Cohen Y, McGlinn AM, Davison S, Casavant S, Shaffer J, Khurana TS, Pardue MT, Iuvone PM. Development of Experimental Myopia in Chicks in a Natural Environment. Invest Ophthalmol Vis Sci 2017; 57:4779-89. [PMID: 27618415 PMCID: PMC5024671 DOI: 10.1167/iovs.16-19310] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose The hypothesis that outdoor exposure might protect against myopia has generated much interest, although available data find only modest clinical efficacy. We tested the effect of outdoor rearing on form-deprivation myopia in chicks, a myopia model markedly inhibited by high-intensity indoor laboratory lighting. Methods Unilaterally goggled cohorts of White Leghorn chicks were maintained in a species-appropriate, outdoor rural setting during daylight hours to the extent permitted by weather. Control chicks were reared indoors with incandescent lighting. Besides ocular refraction and ultrasound, we determined dopamine and 3,4-dihydroxyphenylacetic acid (DOPAC) content in retina and vitreous and measured mRNA expression levels of selected clock and circadian rhythm-related genes in the retina/RPE. Results Myopia developed in the goggled eyes of all cohorts. Whereas outdoor rearing lessened myopia by 44% at 4 days, a protective effect was no longer evident at 11 days. Outdoor rearing had no consistent effect on retinal or vitreous content of dopamine or DOPAC. Conforming to prior data on form-deprivation myopia, retina and vitreous levels of DOPAC were reduced in goggled eyes. Compared with contralateral eyes, the retinal expression of clock and circadian rhythm-related genes was modestly altered in myopic eyes of chicks reared indoors or outdoors. Conclusions Outdoor rearing of chicks induces only a partial decrease of goggle-induced myopia that is not maintained, without evidence that retinal dopamine metabolism accounts for the partial myopia inhibition under these outdoor conditions. Although modest, alterations in retinal gene expression suggest that studying circadian signals might be informative for understanding refractive mechanisms.
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Affiliation(s)
- Richard A Stone
- Department of Ophthalmology University of Pennsylvania School of Medicine, Scheie Eye Institute, Philadelphia, Pennsylvania, United States
| | - Yuval Cohen
- Department of Ophthalmology University of Pennsylvania School of Medicine, Scheie Eye Institute, Philadelphia, Pennsylvania, United States
| | - Alice M McGlinn
- Department of Ophthalmology University of Pennsylvania School of Medicine, Scheie Eye Institute, Philadelphia, Pennsylvania, United States
| | - Sherrill Davison
- Laboratory of Avian Medicine and Pathology, University of Pennsylvania School of Veterinary Medicine, New Bolton Center, Kennett Square, Pennsylvania, United States
| | - Susan Casavant
- Laboratory of Avian Medicine and Pathology, University of Pennsylvania School of Veterinary Medicine, New Bolton Center, Kennett Square, Pennsylvania, United States
| | - James Shaffer
- Department of Ophthalmology University of Pennsylvania School of Medicine, Scheie Eye Institute, Philadelphia, Pennsylvania, United States
| | - Tejvir S Khurana
- Department of Physiology and Pennsylvania Muscle Institute, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, United States
| | - Machelle T Pardue
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia, United States 5Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Medical Center, Decatur, Georgia, United States
| | - P Michael Iuvone
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, United States 7Department of Pharmacology, Emory University School of Medicine, Atlanta, Georgia, United States
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Abstract
Myopia is not a simple refractive error, but an eyesight-threatening disease. There is a high prevalence of myopia, 80% to 90%, in young adults in East Asia; myopia has become the leading cause of blindness in this area. As the myopic population increases globally, the severity of its impact is predicted. Approximately one fifth of the myopic population has high myopia (≥-6 diopters), which results in irreversible vision loss such as retinal detachment, choroidal neovascularization, cataracts, glaucoma, and macular atrophy. The increasing prevalence of school myopia in the past few decades may be a result of gene-environment interactions. However, earlier school myopia onset would accompany faster myopia progression and greater risk of high myopia later in life. Recently, there have been effective interventions to delay the onset of myopia, such as outdoor activity and decreasing the duration of near work. Hyperopia (≤0.5 diopters) is a predictor of myopia. Pharmacological agents and optic interventions such as low-concentration atropine and orthokeratology may slow progression in myopic children. Novel surgeries and anti-vascular endothelial growth factor drugs could deal with some myopic complications. From available evidence, the prevention, control, and treatment of myopia seem to be promising. However, to reduce the impact of myopia in future decades, more work and effort are still needed, including that by governments and intercountry eye health organizations.
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Affiliation(s)
- Pei-Chang Wu
- From the Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan, Republic of China
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Lan W, Yang Z, Feldkaemper M, Schaeffel F. Changes in dopamine and ZENK during suppression of myopia in chicks by intense illuminance. Exp Eye Res 2016; 145:118-124. [DOI: 10.1016/j.exer.2015.11.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 11/20/2015] [Accepted: 11/25/2015] [Indexed: 11/25/2022]
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Yuan Y, Zong Y, Zheng Q, Qian G, Qian X, Li Y, Shao W, Gao Q. The efficacy and safety of a novel posterior scleral reinforcement device in rabbits. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2016; 62:233-41. [PMID: 26952419 DOI: 10.1016/j.msec.2015.12.046] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 11/14/2015] [Accepted: 12/19/2015] [Indexed: 01/18/2023]
Abstract
PURPOSE To evaluate the efficacy and safety of posterior scleral reinforcement (PSR) device for myopia suppression in rabbits' eyes. METHODS PSR surgery was performed on the normal 12 8-week-old New Zealand white rabbits' right eyes. To determine efficacy of the device, ophthalmic examination would be taken at pre-operation and post-operation (1 week, 1 month, 3 months, 6 months, and 1 year), such as A-ultrasound, diopter and B-ultrasound. Evaluation of safety were based on the following indicators: intraocular pressure (IOP), slit lamp, fundus photography, fundus fluorescein angiography and pathological examination after surgery. The efficacy and safety of PSR device were evaluated by comparison (treated eyes and contralateral eyes) of pre and post-operation. RESULTS The novel PSR device could significantly shorten axial length (preoperative axial length: 16.36 ± 0.14 mm, postoperative 1 week, 1 month, 3 months, 6 months and 1 year axial lengths: 15.03 ± 0.28 mm, 15.23 ± 0.32 mm, 15.39 ± 0.31 mm, 15.45 ± 0.22 mm and 15.45 ± 0.22 mm; P=0.00037<0.001) in the treated eyes (right eyes) after surgery. At different postoperative time points, the B-ultrasound images showed that the PSR located in appropriate position and supported the posterior sclera very well. At the same time, IOP of treated eyes kept a relatively stable level (preoperative IOP: 12.56 ± 2.01 mmHg, postoperative IOP: ranging from 11.33 ± 1.23 mmHg to 13.44 ± 2.19 mmHg, P>0.05) post-operation 1 year. During observation period, there was no significant inflammatory reaction and complications such as anterior chamber flare, empyema, endophthalmitis, vitreous hemorrhage, retina detachment and retinal choroid neovascularization by slit lamp, fundus photography and fundus fluorescein angiography. In addition, there were no pathologic changes be found by comparison treated eyes group and contralateral group eyes based on pathological examinations. CONCLUSIONS In vivo study, effectively and safely, the novel PSR device can inhibit rabbits' axial length elongation during postoperative 1 year. This study demonstrates that this novel PSR could be a potential treatment approach for myopia.
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Affiliation(s)
- Yongguang Yuan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yao Zong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Qishan Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | | | - Xiaobin Qian
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yujie Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Wanwen Shao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Qianying Gao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
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