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Ihesiulor CG, Alzahrani K, Rhadhakrishnan H. A review of mechanism of action of outdoor exposure in preventing myopia incidence and progression. Int J Ophthalmol 2024; 17:1144-1155. [PMID: 38895671 PMCID: PMC11144779 DOI: 10.18240/ijo.2024.06.21] [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: 03/10/2023] [Accepted: 01/30/2024] [Indexed: 06/21/2024] Open
Abstract
Various studies have suggested several environmental, pharmacological, medical, and optical interventions and some are in use but their efficacy in myopia control may be transient, and the cellular, molecular, and biochemical mechanisms involved unclear. Daylight exposure is currently regarded as an effective and enduring strategy in the control of myopia development and progression. However, the mechanism behind the effect of outdoor exposure and its association with genetic predisposition and other relatively more significant environmental factors on myopia is still a conundrum. This review focuses on survey-based and intervention-based studies carried out to propose a mechanism that accounts for myopia development and important for its control.
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Affiliation(s)
- Chikezie Grand Ihesiulor
- Division of Pharmacy & Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M139PL, United Kingdom
| | - Khaled Alzahrani
- Department of Ophthalmology, King Fahad Armed Forces Hospital, Jeddah 23311, Saudi Arabia
| | - Hema Rhadhakrishnan
- Division of Pharmacy & Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester M139PL, United Kingdom
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Hao J, Yang Z, Zhang R, Ma Z, Liu J, Bi H, Guo D. Crosstalk between heredity and environment in myopia: An overview. Heliyon 2024; 10:e29715. [PMID: 38660258 PMCID: PMC11040123 DOI: 10.1016/j.heliyon.2024.e29715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 03/04/2024] [Accepted: 04/14/2024] [Indexed: 04/26/2024] Open
Abstract
In recent years, the prevalence of myopia has gradually increased, and it has become a significant global public health problem in the 21st century, posing a serious challenge to human eye health. Currently, it is confirmed that the development of myopia is attributed to the combined action of genes and environmental factors. Thus, elucidating the risk factors and pathogenesis of myopia is of great significance for the prevention and control of myopia. To elucidate the impact of gene-environment interaction on myopia, we used the Pubmed database to search for literature related to myopia. Search terms are as follows: myopia, genes, environmental factors, gene-environment interaction, and treatment. This paper reviews the effects of gene and environmental interaction on myopia.
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Affiliation(s)
- Jiawen Hao
- Shandong University of Traditional Chinese Medicine, Jinan, 250002, China
| | - Zhaohui Yang
- Shandong University of Traditional Chinese Medicine, Jinan, 250002, China
| | - Ruixue Zhang
- Shandong University of Traditional Chinese Medicine, Jinan, 250002, China
| | - Zhongyu Ma
- Shandong University of Traditional Chinese Medicine, Jinan, 250002, China
| | - Jinpeng Liu
- Shandong University of Traditional Chinese Medicine, Jinan, 250002, China
| | - Hongsheng Bi
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250002, China
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Jinan, 250002, China
- Shandong Academy of Eye Disease Prevention and Therapy, Jinan, 250002, China
- Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Jinan, 250002, China
- Shandong Engineering Technology Research Center of Visual Intelligence, Jinan, 250002, China
- Shandong Academy of Health and Myopia Prevention and Control of Children and Adolescents, Jinan, 250002, China
- Medical College of Optometry and Ophthalmology, Shandong University of Traditional Chinese Medicine, Jinan, 250002, China
| | - Dadong Guo
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250002, China
- Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Jinan, 250002, China
- Shandong Academy of Eye Disease Prevention and Therapy, Jinan, 250002, China
- Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Jinan, 250002, China
- Shandong Engineering Technology Research Center of Visual Intelligence, Jinan, 250002, China
- Shandong Academy of Health and Myopia Prevention and Control of Children and Adolescents, Jinan, 250002, China
- Medical College of Optometry and Ophthalmology, Shandong University of Traditional Chinese Medicine, Jinan, 250002, China
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Lang O, Yaya-Stupp D, Traynis I, Cole-Lewis H, Bennett CR, Lyles CR, Lau C, Irani M, Semturs C, Webster DR, Corrado GS, Hassidim A, Matias Y, Liu Y, Hammel N, Babenko B. Using generative AI to investigate medical imagery models and datasets. EBioMedicine 2024; 102:105075. [PMID: 38565004 PMCID: PMC10993140 DOI: 10.1016/j.ebiom.2024.105075] [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: 07/05/2023] [Revised: 03/05/2024] [Accepted: 03/06/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND AI models have shown promise in performing many medical imaging tasks. However, our ability to explain what signals these models have learned is severely lacking. Explanations are needed in order to increase the trust of doctors in AI-based models, especially in domains where AI prediction capabilities surpass those of humans. Moreover, such explanations could enable novel scientific discovery by uncovering signals in the data that aren't yet known to experts. METHODS In this paper, we present a workflow for generating hypotheses to understand which visual signals in images are correlated with a classification model's predictions for a given task. This approach leverages an automatic visual explanation algorithm followed by interdisciplinary expert review. We propose the following 4 steps: (i) Train a classifier to perform a given task to assess whether the imagery indeed contains signals relevant to the task; (ii) Train a StyleGAN-based image generator with an architecture that enables guidance by the classifier ("StylEx"); (iii) Automatically detect, extract, and visualize the top visual attributes that the classifier is sensitive towards. For visualization, we independently modify each of these attributes to generate counterfactual visualizations for a set of images (i.e., what the image would look like with the attribute increased or decreased); (iv) Formulate hypotheses for the underlying mechanisms, to stimulate future research. Specifically, present the discovered attributes and corresponding counterfactual visualizations to an interdisciplinary panel of experts so that hypotheses can account for social and structural determinants of health (e.g., whether the attributes correspond to known patho-physiological or socio-cultural phenomena, or could be novel discoveries). FINDINGS To demonstrate the broad applicability of our approach, we present results on eight prediction tasks across three medical imaging modalities-retinal fundus photographs, external eye photographs, and chest radiographs. We showcase examples where many of the automatically-learned attributes clearly capture clinically known features (e.g., types of cataract, enlarged heart), and demonstrate automatically-learned confounders that arise from factors beyond physiological mechanisms (e.g., chest X-ray underexposure is correlated with the classifier predicting abnormality, and eye makeup is correlated with the classifier predicting low hemoglobin levels). We further show that our method reveals a number of physiologically plausible, previously-unknown attributes based on the literature (e.g., differences in the fundus associated with self-reported sex, which were previously unknown). INTERPRETATION Our approach enables hypotheses generation via attribute visualizations and has the potential to enable researchers to better understand, improve their assessment, and extract new knowledge from AI-based models, as well as debug and design better datasets. Though not designed to infer causality, importantly, we highlight that attributes generated by our framework can capture phenomena beyond physiology or pathophysiology, reflecting the real world nature of healthcare delivery and socio-cultural factors, and hence interdisciplinary perspectives are critical in these investigations. Finally, we will release code to help researchers train their own StylEx models and analyze their predictive tasks of interest, and use the methodology presented in this paper for responsible interpretation of the revealed attributes. FUNDING Google.
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Affiliation(s)
| | | | - Ilana Traynis
- Work Done at Google Via Advanced Clinical, Deerfield, IL, USA
| | | | | | - Courtney R Lyles
- Google, Mountain View, CA, USA; University of California San Francisco, Department of Medicine, San Francisco, CA, USA
| | | | | | | | | | | | | | | | - Yun Liu
- Google, Mountain View, CA, USA
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Abebe MG, Alemayehu AM, Munaw MB, Tilahun MM, Alemayehu HB. Prevalence and associated factors of refractive error among adults in South Ethiopia, a community-based cross-sectional study. PLoS One 2024; 19:e0298960. [PMID: 38527026 PMCID: PMC10962790 DOI: 10.1371/journal.pone.0298960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 02/01/2024] [Indexed: 03/27/2024] Open
Abstract
INTRODUCTION The increasing prevalence of refractive error has become a serious health issue that needs serious attention. However, there are few studies regarding the prevalence and associated factors of refractive error at the community level in Ethiopia as well as in the study area. Therefore, providing updated data is crucial to reduce the burdens of refractive error in the community. OBJECTIVE To assess the prevalence and associated factors of refractive error among adults in Hawassa City, South Ethiopia, 2023. METHOD A community-based cross-sectional study was conducted on 951 adults using a multistage sampling technique from May 8 to June 8, 2023, in Hawassa City, South Ethiopia. A pretested, structured questionnaire combined with an ocular examination and a refraction procedure was used to collect data. The collected data from the Kobo Toolbox was exported to a statistical package for social sciences for analysis. Binary and multivariable logistic regression analyses were performed. A P-value of less than 0.05 was considered statistically significant in the multivariable analysis. RESULT A total of 894 study participants were involved in this study with a 94.1% response rate. The prevalence of refractive error was 12.3% (95% CI: 10.2, 14.5%). Regular use of electronic devices (adjusted odds ratio = 3.64, 95% CI: 2.25, 5.91), being diabetic (adjusted odds ratio = 4.02, 95% CI: 2.16, 7.48), positive family history of refractive error (adjusted odds ratio = 2.71, 95% CI 1.59, 4.61) and positive history of cataract surgery (adjusted odds ratio = 5.17, 95% CI 2.19, 12.4) were significantly associated with refractive error. CONCLUSION AND RECOMMENDATION The overall magnitude of refractive error in our study area was high. Regular use of electronic devices, being diabetic, positive family history of refractive error, and a positive history of cataract surgery were associated with refractive error.
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Affiliation(s)
- Marshet Gete Abebe
- Department of Ophthalmology and Optometry, Hawassa University, Comprehensive Specialized Hospital, Hawassa, Ethiopia
| | - Abiy Maru Alemayehu
- Department of Optometry, School of Medicine, University of Gondar, Comprehensive Specialized Hospital, Gondar, Ethiopia
| | - Minychil Bantihun Munaw
- Department of Optometry, School of Medicine, University of Gondar, Comprehensive Specialized Hospital, Gondar, Ethiopia
| | - Mikias Mered Tilahun
- Department of Optometry, School of Medicine, University of Gondar, Comprehensive Specialized Hospital, Gondar, Ethiopia
| | - Henok Biruk Alemayehu
- Department of Ophthalmology and Optometry, Hawassa University, Comprehensive Specialized Hospital, Hawassa, Ethiopia
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Coverdale S, Rountree L, Webber K, Cufflin M, Mallen E, Alderson A, Ghorbani-Mojarrad N. Eyecare practitioner perspectives and attitudes towards myopia and myopia management in the UK. BMJ Open Ophthalmol 2024; 9:e001527. [PMID: 38216174 PMCID: PMC10806590 DOI: 10.1136/bmjophth-2023-001527] [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: 10/09/2023] [Accepted: 12/21/2023] [Indexed: 01/14/2024] Open
Abstract
OBJECTIVE Many children with progressive myopia are still prescribed single-vision correction. An investigation into UK eyecare practitioners' (ECPs) perceptions of myopia management was carried out to ascertain factors which may be limiting its implementation and uptake within clinical practice. METHODS AND ANALYSIS Online focus groups were held with UK ECPs. Participants were encouraged to discuss their knowledge of the available myopia management options, their perception of how myopia management is being delivered in the UK and any barriers limiting ECPs' prescribing of these management options in practice. The discussions were transcribed and analysed thematically. RESULTS Focus groups were held with 41 ECPs from primary and secondary eyecare. ECPs felt that provision of myopia management in the UK is variable. Most ECPs believe they have sufficient knowledge, but felt a lack of confidence in decision-making and practical experience. Less experienced ECPs sought more definitive guidance to support their decision-making. ECPs desired clarity on their duty of care obligations and were concerned over possible future litigation if they had not offered, or referred for, myopia management when indicated. The greatest barrier appears to be financial-treatment is expensive and ECPs are uncomfortable communicating this to parents. Many barriers were indicative of systemic problems within UK eyecare, such as commercial pressures, inadequate National Health Service funding and poor public awareness of paediatric eyecare. CONCLUSION Myopia management is not implemented consistently across the UK. To improve accessibility, changes are required at multiple levels, from individual ECPs through to wider stakeholders in UK eyecare provision.
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Affiliation(s)
- Sophie Coverdale
- School of Optometry and Vision Science, University of Bradford, Bradford, UK
| | - Lindsay Rountree
- School of Optometry and Vision Science, University of Bradford, Bradford, UK
| | - Kathryn Webber
- School of Optometry and Vision Science, University of Bradford, Bradford, UK
| | - Matthew Cufflin
- School of Optometry and Vision Science, University of Bradford, Bradford, UK
| | - Edward Mallen
- School of Optometry and Vision Science, University of Bradford, Bradford, UK
| | - Alison Alderson
- School of Optometry and Vision Science, University of Bradford, Bradford, UK
| | - Neema Ghorbani-Mojarrad
- School of Optometry and Vision Science, University of Bradford, Bradford, UK
- Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, UK
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Ten W, Yuan Y, Zhang W, Wu Y, Ke B. High myopia is protective against diabetic retinopathy in the participants of the National Health and Nutrition Examination Survey. BMC Ophthalmol 2023; 23:468. [PMID: 37978475 PMCID: PMC10655330 DOI: 10.1186/s12886-023-03191-x] [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: 04/13/2023] [Accepted: 10/28/2023] [Indexed: 11/19/2023] Open
Abstract
PURPOSE To investigate the association of subjects with refractive error and diabetic retinopathy (DR) in the United States comparing results between different race groups. METHODS All data were derived from National Health and Nutrition Examination Survey (NHANES) from 2005 to 2008. The data were divided into four groups (emmetropia, mild myopia, high myopia, hypertropia) according to the spherical equivalent (SE), and those who met the enrollment conditions were selected as the study subjects. Multivariable logistic regression analysis was used to evaluate the relationship between refractive error and diabetic retinopathy risk. RESULTS A total of 1317 participants were included in the study, including 331 participants with diabetic retinopathy, and 986 without diabetic retinopathy. After adjustment for potential confounders, subjects with high myopia were associated with a lower risk of diabetic retinopathy. The odds ratio (OR) was 0.44, 95% confidence interval (CI): (0.20-0.96), P-value = 0.040 in the multivariate regression analysis. Subgroup analyses showed that subjects with high myopia in the non-Hispanic Black group were associated with decreased odds of diabetic retinopathy. (OR was 0.20, and 95% CI: 0.04-0.95, P-value = 0.042). CONCLUSION The results show that high myopia is associated with diabetic retinopathy in diabetic patients.
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Affiliation(s)
- Weijung Ten
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Shanghai, 200080, China
- Shanghai Key Laboratory of Fundus Disease, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital,, Fudan University, Shanghai, China
| | - Ying Yuan
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Shanghai, 200080, China
- Shanghai Key Laboratory of Fundus Disease, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Wei Zhang
- Shanghai Public Health Clinical Center & Institutes of Biomedical Sciences, Fudan University, Shanghai, China
| | - Yue Wu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Shanghai, 200080, China
- Shanghai Key Laboratory of Fundus Disease, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Bilian Ke
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100 Haining Road, Shanghai, 200080, China.
- Shanghai Key Laboratory of Fundus Disease, Shanghai, China.
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China.
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Agyekum S, Chan PP, Adjei PE, Zhang Y, Huo Z, Yip BHK, Ip P, Wong ICK, Zhang W, Tham CC, Chen LJ, Zhang XJ, Pang CP, Yam JC. Cost-Effectiveness Analysis of Myopia Progression Interventions in Children. JAMA Netw Open 2023; 6:e2340986. [PMID: 37917061 PMCID: PMC10623196 DOI: 10.1001/jamanetworkopen.2023.40986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 09/15/2023] [Indexed: 11/03/2023] Open
Abstract
Importance Several interventions exist for treating myopia progression in children. While these interventions' efficacy has been studied, their cost-effectiveness remains unknown and has not been compared. Objective To determine cost-effective options for controlling myopia progression in children. Design, Setting, and Participants In this cost-effectiveness analysis, a Markov model was designed to compare the cost-effectiveness of interventions for controlling myopia progression over 5 years from a societal perspective in a simulated hypothetical cohort of patients aged 10 years with myopia. Myopia interventions considered included atropine eye drops, 0.05% and 0.01%, defocus incorporated multiple segment spectacles, outdoor activity, soft contact lenses (daily disposable and multifocal), rigid gas-permeable contact lenses, progressive addition lenses, bifocal spectacle lenses, orthokeratology, highly aspherical lenslets (HALs), and red light therapy; all interventions were compared with single-vision lenses. Deterministic and probabilistic sensitivity analysis determined the association of model uncertainties with the cost-effectiveness. Costs were obtained from the charges of the Hospital Authority of Hong Kong and The Chinese University of Hong Kong Eye Center. Main Outcome and Measures The mean costs (in US dollars) per child included the cost of hospital visits, medications, and optical lenses. The outcomes of effectiveness were the annual spherical equivalent refraction (SER) and axial length (AL) reductions. Incremental cost-effectiveness ratios (ICERs) were calculated for each strategy relative to single-vision lenses over a time horizon of 5 years. Results Outdoor activity, atropine (0.05%), red light therapy, HALs, and orthokeratology were cost-effective. The ICER of atropine, 0.05%, was US $220/SER reduction; red light therapy, US $846/SER reduction; and HALs, US $448/SER reduction. Outdoor activity yielded a savings of US $5/SER reduction and US $8/AL reduction. Orthokeratology resulted in an ICER of US $2376/AL reduction. Conclusions and Relevance These findings suggest that atropine eye drops, 0.05%, and outdoor activity are cost-effective for controlling myopia progression in children. Though more expensive, red light therapy, HALs, and orthokeratology may also be cost-effective. The use of these interventions may help to control myopia in a cost-effective way.
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Affiliation(s)
- Sylvia Agyekum
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Poemen P. Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Eye Hospital, Hong Kong SAR, China
- Lam Kin Chung. Jet King-Shing Ho Glaucoma Treatment and Research Centre, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, The Prince of Wales Hospital, Hong Kong SAR, China
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, China
| | - Prince E. Adjei
- School of Life Science, Department of Biomedical Engineering, University of Electronic Science and Technology, Chengdu, China
- Department of Computer Engineering, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Yuzhou Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Zhaohua Huo
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Benjamin H. K. Yip
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Patrick Ip
- Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Ian C. K. Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Wei Zhang
- Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, Nankai University Affiliated Eye Hospital, Clinical College of Ophthalmology Tianjin Medical University, Tianjin, China
| | - Clement C. Tham
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Eye Hospital, Hong Kong SAR, China
- Lam Kin Chung. Jet King-Shing Ho Glaucoma Treatment and Research Centre, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, The Prince of Wales Hospital, Hong Kong SAR, China
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, China
- Department of Ophthalmology, Hong Kong Children Hospital, Hong Kong SAR. China
- Hong Kong Hub of Pediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Li Jia Chen
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Eye Hospital, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, The Prince of Wales Hospital, Hong Kong SAR, China
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, China
- Hong Kong Hub of Pediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiu Juan Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, China
- Hong Kong Hub of Pediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jason C. Yam
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
- Hong Kong Eye Hospital, Hong Kong SAR, China
- Department of Ophthalmology and Visual Sciences, The Prince of Wales Hospital, Hong Kong SAR, China
- Joint Shantou International Eye Center of Shantou University and the Chinese University of Hong Kong, Shantou, China
- Department of Ophthalmology, Hong Kong Children Hospital, Hong Kong SAR. China
- Hong Kong Hub of Pediatric Excellence, The Chinese University of Hong Kong, Hong Kong SAR, China
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Wei P, Han G, He M, Wang Y. Retinal Neurotransmitter Alteration in Response to Dopamine D2 Receptor Antagonist from Myopic Guinea Pigs. ACS Chem Neurosci 2023; 14:3357-3367. [PMID: 37647579 DOI: 10.1021/acschemneuro.3c00099] [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] [Indexed: 09/01/2023] Open
Abstract
This study aimed to investigate the changes in retinal neurotransmitters and the role of the dopamine D2 receptor (D2R) pathway in regulating the myopic refractive state. Tricolor guinea pigs were randomly divided into two groups: the normal control group (NC) and the form-deprivation myopia group (FDM). Animals in the FDM group had their right eye covered with a balloon for 4 weeks. These two groups were further divided into two subgroups based on intravitreal injection with D2R antagonist sulpiride once a week for 3 weeks (NC, NC-Sul, FDM, and FDM-Sul groups). Ultrahigh-performance liquid chromatography-tandem mass spectrometry was used to quantitatively detect the changes in 17 retinal neurotransmitters. Compared to the NC group, the concentrations of dopamine (DA) and γ-aminobutyric acid (GABA) decreased, while those of glutamate (Glu), 3-methoxytyramine (3-MT), and glycine increased, accompanied by an increase in myopic refraction and axial length (AL) in the FDM group. In the FDM-Sul group, glycine and DA levels were upregulated, whereas 3-MT and Glu levels were downregulated, accompanied by a decrease in myopic refraction and AL. The ratio of Glu to GABA (RGG) represents the balance between excitatory and inhibitory neurotransmitters. Notably, RGG changes occurred with corresponding AL changes, which increased in the FDM group and decreased in the FDM-Sul group. Decreased retinal DA concentration, with an increase in Glu, may be involved in the myopia progression. D2R antagonists might effectively slow myopia progression by increasing retinal DA, regulating Glu concentration to match GABA, and maintaining the balance between excitatory and inhibitory neurotransmitters.
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Affiliation(s)
- Pinghui Wei
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin 300020, PR China
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300020, PR China
- Nankai University Eye Institute, Nankai University Affiliated Eye Hospital, Nankai University, Tianjin 300020, China
| | - Guoge Han
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin 300020, PR China
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300020, PR China
- Nankai University Eye Institute, Nankai University Affiliated Eye Hospital, Nankai University, Tianjin 300020, China
| | - Meiqin He
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300192, PR China
| | - Yan Wang
- Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Hospital, Tianjin 300020, PR China
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin 300020, PR China
- Nankai University Eye Institute, Nankai University Affiliated Eye Hospital, Nankai University, Tianjin 300020, China
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Zhang J, Li Z, Ren J, Wang W, Dai J, Li C, Huang X, Sun X, Liu L, Wang C. Prevalence of myopia: A large-scale population-based study among children and adolescents in weifang, china. Front Public Health 2022; 10:924566. [PMID: 35958863 PMCID: PMC9358211 DOI: 10.3389/fpubh.2022.924566] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Abstract
PurposeThis study aimed to determine the prevalence of myopia among school-aged children and adolescents at the whole city level of Weifang, China.MethodsThis study was a large scale school-based cross-sectional study among children and adolescents aged 5–20 years old. Participants were selected by the school-based registration system in 2020. All the subjects underwent spherical equivalent (SE) error with non-cycloplegic autorefraction measurement. Myopia was defined as an SE refraction of ≤-0.75 diopters (D) and graded into low myopia (−0.75 to −3.00 D), moderate myopia (−3.01 to −5.99 D), and high myopia (≤-6.00 D).ResultsA total of 1,059,838 participants were eligible for this survey and 1,013,206 (95.6% participation rate) were selected through data quality control, which comprised 17 districts/counties and 1,254 schools, including 861 elementary schools, 313 middle schools, and 80 high schools. The mean age of participants was 11.57 ± 3.36 years (5–20 years), and the male-to-female ratio was 1.11. The whole city-level prevalence of total myopia was 75.35%. The prevalence of total myopia among the students in the Hanting District was 45.47%, but ≈82.37% of students living in Changyi have myopia. The overall prevalence of low myopia in elementary, middle, and high school students was 48.56, 47.30, and 31.62%, respectively, while high myopia (SE ≤ −6.00 D) prevalence was 1.12, 8.89, and 20.12%, respectively. The overall prevalence of myopia increased fastest in children aged 7–9 years old. The prevalence of high myopia was 7.59% for girls and 6.43% for boys, respectively (p < 0.001). The prevalence of myopia increased with increasing age and grade, but SE decreased with increasing age and grade.ConclusionsThe current investigation demonstrated a high proportion of myopia among school students in the city of Weifang, and gradually increased with age, and the prevalence of myopia was the highest in Changyi areas. The high myopia prevalence for girls was higher than that in boys.
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Affiliation(s)
- Jie Zhang
- Department of Environmental Hygiene, School of Public Health, Weifang Medical University, Weifang, China
| | - Zhenhua Li
- Department of Environmental Hygiene, School of Public Health, Weifang Medical University, Weifang, China
| | - Jiantao Ren
- Department of Ophthalmology, Weifang Eye Hospital, Weifang, China
| | - Wenting Wang
- Department of Ophthalmology, Weifang Eye Hospital, Weifang, China
| | - Jiazhen Dai
- Department of Ophthalmology, Weifang Eye Hospital, Weifang, China
| | - Cong Li
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xudong Huang
- Department of Ophthalmology, Weifang Eye Hospital, Weifang, China
| | - Xianyong Sun
- Department of Ophthalmology, Weifang Eye Hospital, Weifang, China
- *Correspondence: Xianyong Sun
| | - Lei Liu
- Department of Ophthalmology, Guangdong Eye Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
- Department of Ophthalmology, Jincheng People's Hospital, Jincheng, China
- Lei Liu
| | - Chunping Wang
- Department of Environmental Hygiene, School of Public Health, Weifang Medical University, Weifang, China
- Chunping Wang
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