1
|
Lin J, Vasudevan B, Gao TY, Zhou HJ, Ciuffreda KJ, Liang YB, Lin Z. Intraocular Pressure and Myopia Progression, Axial Length Elongation in Rural Chinese Children. Optom Vis Sci 2023; 100:708-714. [PMID: 37639709 DOI: 10.1097/opx.0000000000002065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Abstract
SIGNIFICANCE This study reported the relationship between intraocular pressure (IOP) and myopia progression, which helps to understand more comprehensively whether IOP can be an important reference factor to intervene in the progression of myopia. PURPOSE This study aimed to investigate the association between IOP and myopia progression as well as axial length elongation in rural Chinese children. METHODS A total of 598 (598 of 878 [68.1%]) children (6 to 17 years) from the baseline Handan Offspring Myopia Study who completed a 3.5-year follow-up vision examination were included. Ocular examinations at both visits included cycloplegic autorefraction, IOP, and axial length measurements. RESULTS Children with myopia had the highest baseline IOP of the three refractive groups (14.13 ± 1.31, 13.78 ± 1.71, and 13.59 ± 1.64 mmHg in myopes, emmetropes, and hyperopes, respectively, P = .002). However, IOPs showed no significant difference between eyes with or without newly developed myopia (13.63 ± 1.68 vs. 13.89 ± 1.68, P = .16), with or without faster myopia progression (13.75 ± 1.61 vs. 13.86 ± 1.63, P = .46), or with axial length elongation (13.80 ± 1.61 vs. 13.76 ± 1.64, P = .80). The multivariate regression analysis demonstrated that neither baseline refractive error ( β = -0.082, P = .13) nor baseline axial length ( β = -0.156, P = .08) was associated with baseline IOP. CONCLUSIONS Myopic eyes have slightly higher IOP compared with emmetropic and hyperopic eyes, although it was not clinically significant. However, IOP was not found to be associated with either myopia progression or axial length elongation in this cohort sample of rural Chinese children.
Collapse
Affiliation(s)
- Jue Lin
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou, Zhejiang, China
| | | | | | - Hong Jia Zhou
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou, Zhejiang, China
| | - Kenneth J Ciuffreda
- Department of Biological and Vision Sciences, SUNY College of Optometry, New York, New York
| | - Yuan Bo Liang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou, Zhejiang, China
| | | |
Collapse
|
2
|
Mu J, Zeng D, Fan J, Liu M, Zhong H, Shuai X, Zhang S. The accuracy of the axial length and axial length/corneal radius ratio for myopia assessment among Chinese children. Front Pediatr 2022; 10:859944. [PMID: 36147807 PMCID: PMC9488664 DOI: 10.3389/fped.2022.859944] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 07/29/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The aim of this study was to assess the association between axial length/corneal radius ratio (AL/CR ratio), AL, and refractive status and evaluate the accuracy of AL and AL/CR ratio for myopia assessment among Chinese children. METHODS A diagnostic trial was conducted in Shenzhen Eye Hospital from June 2020 to December 2020. Cycloplegic refraction and demographic characteristic survey were carried out, and AL and CR were measured. The Pearson correlation analysis between AL, AL/CR ratio, and spherical equivalent (SE) was carried out. The sensitivity, specificity, Youden index, positive predictive value, and negative predictive value of the AL/CR ratio and AL for myopia assessment were analyzed using cycloplegic refraction as the gold standard by drawing receiver operating characteristic (ROC) curves. RESULTS A total of 300 children aged 8-18 years participated in this study. The Pearson correlation coefficient between AL and SE was -0.667 (P < 0.05) and -0.754 (P < 0.05) between AL/CR ratio and SE. There were significant differences in SE, AL, and AL/CR ratio among different age groups (p < 0.05). SE decreased by 1.185 diopter (D) for every 1 mm increase in AL and decreased by 0.667 D for every 0.1 increase in the AL/CR ratio. Taking cycloplegic refraction SE ≤ -0.50 D as the gold standard for the diagnosis of myopia, the area under the ROC curve of AL for myopia assessment was 0.836 (95% confidence interval [CI]: 0.767-0.906), with specificity, sensitivity, and Youden index of 0.833, 0.767, and 0.600, respectively. The area under the ROC curve of AL/CR ratio for myopia assessment was 0.937 (95% CI: 0.878-0.996), with specificity, sensitivity, Youden index, positive predictive value, and negative predictive value of 0.703, 0.913, 0.622, 0.956, and 0.771, respectively. The area under the ROC curve of the combination of AL/CR ratio and parental myopia for myopia assessment was 0.976 (95% CI: 0.957-0.996). CONCLUSION The correlation between SE and AL/CR ratio was stronger than that between SE and AL in children. The AL/CR ratio may be an alternative indicator for myopia assessment in children, and the combination of demographic factors and AL/CR ratio can improve the accuracy of myopia assessment.
Collapse
Affiliation(s)
- Jingfeng Mu
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Dan Zeng
- Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Jingjie Fan
- Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Meizhou Liu
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Haoxi Zhong
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Xinyi Shuai
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Shaochong Zhang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| |
Collapse
|
3
|
Zhou Q, Gao TY, Fan SJ, Peng Y, Li L, Lin Z, Han W, Lin HS, Wang NL, Liang YB. Intraocular Pressure, Age, and Central Corneal Thickness in a Healthy Chinese Children Population: The Handan Offspring Myopia Study. Ophthalmic Epidemiol 2021; 29:499-506. [PMID: 34542011 DOI: 10.1080/09286586.2021.1966806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To assess the distribution and factors related to intraocular pressure (IOP) in a Chinese children population in Northern China. METHODS 1,238 offspring aged 6 to 18 years, residing in six villages, were recruited for this current study, the Handan Offspring Myopia Study. Participants underwent an interviewer-administered questionnaire and a complete ocular examination, including standardized measurement of IOP with Perkins applanation tonometry. RESULTS 1,648 eyes of 828 children were included in the analysis. The mean IOP was 13.9 ± 1.6 mmHg. The mean IOP for the study population increased from 13.0 ± 1.5 mmHg for those 6 to 7 years of age to 14.2 ± 1.4 mmHg for those 15 years of age or older (P < .001). The mean central corneal thickness (CCT) was 548.7 ± 32.1 μm, and had no difference among different age groups and gender. In univariate regression analysis, age (0.12 mmHg per 1 year old), height (0.09 mmHg per 5 cm), weight (0.02 mmHg per kg), body mass index (0.07 mmHg per 1 m/kg2), systolic blood pressure (0.06 mmHg per 5 mmHg), CCT (0.06 mmHg per 5 μm), and SE (-0.11 mmHg per 1 D) were correlated with IOP. In multivariate regression analysis, higher IOP was only associated with older ages (p = .002) and thicker CCT (p = .001). CONCLUSION The mean IOP in healthy rural Chinese children aged 6-18 years is about 14 mmHg, which is lower than in adults in the same locality. The mean IOP is slightly increasing with age during childhood, which is opposite to the result among adults. Age and CCT are the major independent factors associated with IOP.
Collapse
Affiliation(s)
- Qiang Zhou
- Department Of Ophthalmology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Tie Ying Gao
- Department of Ophthalmology, Handan Eye Hospital, Handan, Hebei Province, China
| | - Su Jie Fan
- Department of Ophthalmology, Handan Eye Hospital, Handan, Hebei Province, China
| | - Yi Peng
- Beijing Ophthalmology & Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Lei Li
- Department of Ophthalmology, Handan Eye Hospital, Handan, Hebei Province, China
| | - Zhong Lin
- Department ofGlaucoma, The Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Wei Han
- Department of Ophthalmology, Handan Eye Hospital, Handan, Hebei Province, China
| | - Hai Shuang Lin
- Department ofGlaucoma, The Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Ning Li Wang
- Beijing Ophthalmology & Visual Science Key Lab, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yuan Bo Liang
- Department ofGlaucoma, The Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,Glaucoma Institute, Wenzhou Medical University, Wenzhou, Zhejiang, China
| |
Collapse
|
4
|
Zhang JS, Li J, Wang JD, Xiong Y, Cao K, Hou SM, Yusufu M, Wang KJ, Li M, Mao YY, Sun XL, Chen SY, Liu ZY, Jin ZB, Wang NL, Wan XH. The association of myopia progression with the morphological changes of optic disc and β-peripapillary atrophy in primary school students. Graefes Arch Clin Exp Ophthalmol 2021; 260:677-687. [PMID: 34357418 DOI: 10.1007/s00417-021-05331-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 07/09/2021] [Accepted: 07/16/2021] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To study the association of myopia progression with the morphological changes of optic disc and β-peripapillary atrophy (β-PPA) in 8-11 years old primary school students. METHODS This study was a prospective, school-based investigation. This study included 610 children (1008 eyes) who were continuously observed and had data available from 2016 to 2017 in the Sanhe Cohort Study of the Risk Factors for Myopia (SCSRFM). The children underwent a comprehensive eye examination including measurement of visual acuity, autorefractometry, and posterior segment of the eye. β-PPA regions and optic disc ovality index were identified and measured on the fundus photographs. RESULTS The prevalence of myopia was 72.62% (732/1008) in 2016. In myopic children, the prevalence of the vertical β-PPA, the horizontal β-PPA, and the oval optic disc were 75.68% (554/732), 75.96% (556/732) and, 11.61% (85/732) respectively. From 2016 to 2017, with the progression of vertical β-PPA, horizontal β-PPA, area of β-PPA, and optic disc ovality index, the myopic diopter and the axial length (AL) were increased. The progression of horizontal β-PPA was significantly correlated with the progression of myopic diopter and AL (all p < 0.05). The analysis on the distribution of progression rate of parameters in different groups found that the progression rate of horizontal β-PPA, area of β-PPA, and optic disc ovality index increased with the increase of the progression of diopter and AL. The progression of horizontal β-PPA, area of β-PPA, optic disc ovality index, and diopter in girls were greater than that in boys, and the progression of optic disc ovality index and diopter had a statistical significance (all p < 0.05). CONCLUSIONS The 1-year follow-up study of the third-grade primary school students showed that with the progression of myopia and the growth of AL, β-PPA and optic disc ovality index also changed. There was a positive correlation between the change of β-PPA and optic disc ovality index and the progression of myopia diopter and AL.
Collapse
Affiliation(s)
- Jing-Shang Zhang
- Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing, 100005, China
| | - Jing Li
- Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing, 100005, China
| | - Jin-Da Wang
- Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing, 100005, China
| | - Ying Xiong
- Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing, 100005, China
| | - Kai Cao
- Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing, 100005, China
| | - Si-Meng Hou
- Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing, 100005, China
| | - Mayinuer Yusufu
- Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing, 100005, China
| | - Kai-Jie Wang
- Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing, 100005, China
| | - Meng Li
- Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing, 100005, China
| | - Ying-Yan Mao
- Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing, 100005, China
| | - Xiu-Li Sun
- Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing, 100005, China
| | - Shu-Ying Chen
- Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing, 100005, China
| | - Zhen-Yu Liu
- Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing, 100005, China
| | - Zi-Bing Jin
- Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing, 100005, China
| | - Ning-Li Wang
- Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing, 100005, China
| | - Xiu-Hua Wan
- Beijing Key Laboratory of Ophthalmology & Visual Sciences, Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital of Capital Medical University, Beijing, 100005, China.
| |
Collapse
|
5
|
Lin Z, Vasudevan B, Gao T, Zhou H, Ciuffreda KJ, Liang Y. Refractive change and incidence of myopia among rural Chinese children: the Handan Offspring Myopia Study. Br J Ophthalmol 2021; 106:628-632. [PMID: 33441318 DOI: 10.1136/bjophthalmol-2020-317811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 12/03/2020] [Accepted: 12/07/2020] [Indexed: 11/04/2022]
Abstract
PURPOSE To assess the refractive change and incidence of myopia, as well as their risk factors, among Chinese rural children aged 6-17 years. METHODS Children who completed the baseline vision examination of the Handan Offspring Myopia Study were re-examined, including both cycloplegic and non-cyloplegic autorefraction, with a mean follow-up time of 42.4±1.47 months. RESULTS A total of 601 children (68.5%) who completed both baseline and the follow-up examinations were enrolled. The cumulative refractive change and axial length change were -0.53±1.03 diopter and 0.39±0.46 mm (-0.15 diopter/year and 0.11 mm/year), respectively. A hundred and five out of the 469 non-myopic children at baseline become myopic at the follow-up, yielding a cumulative myopia incidence of 22.4% (95% CI: 18.6% to 26.2%), or annual myopia incidence of 6.3%. After adjustment, younger age (β=0.08, p<0.001), more myopic baseline refraction (β=0.31, p<0.001), larger difference between cycloplegic and non-cycloplegic refraction (β=-0.20, p=0.007) and more myopic paternal refraction (β=0.09, p=0.007) were found to be associated with more rapid myopic refractive change. More myopic baseline refraction (relative risk (RR), 95% CI: 0.19, 0.13-0.28, p<0.001) and more myopic paternal refraction (RR, 95% CI: 0.92, 0.84-1.00, p=0.039) were also associated with myopia incidence. CONCLUSION Relatively low myopic refractive change and myopia incidence were found in this study cohort. Children's refraction and paternal refraction were associated with both myopic refractive change and myopia incidence. Such information will be helpful for further comparisons in other rural versus urban areas of China, and other countries.
Collapse
Affiliation(s)
- Zhong Lin
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | | | | | - Hongjia Zhou
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China.,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| | - Kenneth J Ciuffreda
- Department of Biological and Vision Sciences, SUNY College of Optometry, New York, NY, USA, New York, NY, USA
| | - Yuanbo Liang
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China .,National Clinical Research Center for Ocular Diseases, Wenzhou, Zhejiang, China
| |
Collapse
|
6
|
Tsai TH, Liu YL, Ma IH, Su CC, Lin CW, Lin LLK, Hsiao CK, Wang IJ. Evolution of the Prevalence of Myopia among Taiwanese Schoolchildren: A Review of Survey Data from 1983 through 2017. Ophthalmology 2020; 128:290-301. [PMID: 32679159 DOI: 10.1016/j.ophtha.2020.07.017] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 06/18/2020] [Accepted: 07/07/2020] [Indexed: 12/13/2022] Open
Abstract
PURPOSE The aim of this study was to evaluate the changes in the prevalence of myopia in Taiwanese schoolchildren over the past few decades and to analyze the risk factors for myopia. DESIGN Analysis of 8 consecutive population-based myopia surveys conducted from 1983 through 2017. PARTICIPANTS An average of 8917 (5019-11 656) schoolchildren 3 to 18 years of age were selected using stratified systematic cluster sampling or by probability proportional to size sampling. METHODS All participants underwent complete ophthalmic evaluations. Three drops of 0.5% tropicamide were used to obtain the cycloplegic refractive status of each participant. Questionnaires were used to acquire participant data from the 1995, 2005, 2010, and 2016 surveys. MAIN OUTCOME MEASURES Prevalence of myopia (spherical equivalence of ≤-0.25 diopter [D]) and high myopia (≤-6.0 D) was assessed. Multivariate analyses of risk factors were conducted. RESULTS The prevalence of myopia among all age groups increased steadily. From 1983 through 2017, the weighted prevalence increased from 5.37% (95% confidence interval [CI], 3.50%-7.23%) to 25.41% (95% CI, 21.27%-29.55%) for 7-year-olds (P = 0.001 for trend) and from 30.66% (95% CI, 26.89%-34.43%) to 76.67% (95% CI, 72.94%-80.40%) for 12-year-olds (P = 0.001 for trend). The prevalence of high myopia also increased from 1.39% (95% CI, 0.43%-2.35%) to 4.26% (95% CI, 3.35%-5.17%) for 12-year-olds (P = 0.008 for trend) and from 4.37% (95% CI, 2.91%-5.82%) to 15.36% (95% CI, 13.78%-16.94%) for 15-year-olds (P = 0.039 for trend). In both the 2005 and 2016 survey samples, children who spent less than 180 minutes daily on near-work activities showed significantly lower risks for myopia developing (<60 minutes: odds ratio [OR], 0.48 and 0.56; 60-180 minutes: OR, 0.69 and 0.67). In the 2016 survey, spending more than 60 minutes daily on electronic devices was associated significantly with both myopia and high myopia (OR, 2.43 and 2.31). CONCLUSIONS The prevalence of myopia among schoolchildren increased rapidly from 1983 through 2017 in Taiwan. The major risk factors are older age and time spent on near-work activities. Use of electronic devices increased the amount of time spent on near-work and may increase the risk of developing myopia.
Collapse
Affiliation(s)
- Tzu-Hsun Tsai
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yao-Lin Liu
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - I-Hsin Ma
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chien-Chia Su
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chao-Wen Lin
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Luke Long-Kuang Lin
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chuhsing Kate Hsiao
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - I-Jong Wang
- Department of Ophthalmology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
| |
Collapse
|
7
|
Generational Difference of Axial Length and Its Risk Factors in Urban and Rural China. J Ophthalmol 2019; 2019:1607064. [PMID: 31885881 PMCID: PMC6899268 DOI: 10.1155/2019/1607064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 09/26/2019] [Accepted: 10/15/2019] [Indexed: 11/17/2022] Open
Abstract
Purpose To compare the axial length difference (ALD) and the estimated generational axial length shift (ALS) from parents to their children and its risk factors in urban and rural China. Methods Participants were enrolled from two longitudinal cohort studies, the Beijing Myopia Progression Study (BMPS) and the Handan Offspring Myopia Study (HOMS). Ocular biometry was performed in both parents and their children. ALD was defined as the difference between the children's axial length and the corresponding parental axial length. Generational ALS was estimated according to a binominal prediction model at 18 years of age. Results 237 and 380 urban and rural Chinese children (6–17 years) and their parents from the BMPS and HOMS, respectively, were enrolled. Children's axial length was estimated to be closest to the parental axial length at 11 and 9 years of age in the urban and rural areas, respectively; the estimated generational ALS would be 1.53 and 0.57 mm, respectively. Multivariable regression analysis revealed that older children (urban β = 0.26, p < 0.001; rural β = 0.11, p < 0.001) and males had larger ALD (urban β = 0.55, p < 0.001; rural β = 0.52, p < 0.001) in both areas. Furthermore, urban children with more educated parents (fathers: β = −0.30, p=0.002; mothers: β = −0.29, p=0.004) and more outdoor activity (β = −0.23, p=0.006) had a less ALD. Conclusions The urban generational axial length shift was estimated to be approximately 1 mm longer than that of the rural area. These results suggest different environmental effects on the ocular development in these two populations of Chinese children.
Collapse
|
8
|
|
9
|
Lin Z, Gao TY, Vasudevan B, Ciuffreda KJ, Liang YB, Jhanji V, Fan SJ, Han W, Wang NL. Near work, outdoor activity, and myopia in children in rural China: the Handan offspring myopia study. BMC Ophthalmol 2017; 17:203. [PMID: 29149871 PMCID: PMC5693484 DOI: 10.1186/s12886-017-0598-9] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 11/07/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The near work and outdoor activity are the most important environmental risk factors for myopia. However, data from Chinese rural children are relatively rare and remain controversial. Therefore, the purpose of this study was to evaluate the relationship of both near work and outdoor activities with refractive error in rural children in China. METHODS In this cross-sectional study, 572 (65.1%) of 878 children (6-18 years of age) were included from the Handan Offspring Myopia Study (HOMS). Information from the parents on these children, as well as the parent's non-cycloplegic refraction, were obtained from the database of the Handan Eye Study conducted in the years 2006-2007. A comprehensive vision examination, including cycloplegic refraction, and a related questionnaire, were assessed on all children. RESULTS The overall time spent on near work and outdoor activity in the children was 4.8 ± 1.6 and 2.9 ± 1.4 h per day, respectively. Myopic children spent more time on near work (5.0 ± 1.7 h vs.4.7 ± 1.6 h, p = 0.049), while no significant difference was found in outdoor activity hours (2.8 ± 1.3 h vs. 3.0 ± 1.4 h, p = 0.38), as compared to non-myopic children. In the multiple logistic analysis, in general, no association between near work and myopia was found after adjusting for the children's age, gender, parental refractive error, parental educational level, and daily outdoor activity hours [odds ratio (OR), 95% confidence interval (CI): 1.10, 0.94-1.27]. However, a weak protective effect of the outdoor activity on myopia was found (OR, 95% CI: 0.82, 0.70-0.96), after adjusting for similar confounders. CONCLUSIONS In general, no association between near work and myopia was found, except for the high near work subgroup with moderate outdoor activity levels. A weak protective effect of outdoor activity on myopia in Chinese rural children was observed.
Collapse
Affiliation(s)
- Zhong Lin
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, No. 270 West College Road, Wenzhou, Zhejiang, 325027, China
| | | | | | - Kenneth J Ciuffreda
- Department of Biological and Vision Sciences, SUNY College of Optometry, New York, NY, USA
| | - Yuan Bo Liang
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, No. 270 West College Road, Wenzhou, Zhejiang, 325027, China. .,Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, UK.
| | - Vishal Jhanji
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Su Jie Fan
- Handan Eye Hospital, Handan, Hebei, China
| | - Wei Han
- Handan Eye Hospital, Handan, Hebei, China
| | - Ning Li Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
10
|
Ding BY, Shih YF, Lin LL, Hsiao CK, Wang IJ. Myopia among schoolchildren in East Asia and Singapore. Surv Ophthalmol 2017; 62:677-697. [DOI: 10.1016/j.survophthal.2017.03.006] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 03/16/2017] [Accepted: 03/16/2017] [Indexed: 11/30/2022]
|
11
|
Eye exercises of acupoints: their impact on myopia and visual symptoms in Chinese rural children. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 16:349. [PMID: 27599547 PMCID: PMC5013592 DOI: 10.1186/s12906-016-1289-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 08/13/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Chinese traditional "eye exercises of acupoints" have been advocated as a compulsory measure to reduce visual symptoms, as well as to retard the development of refractive error, among Chinese students for decades. The exercises are comprised of a 5-min, bilateral eye acupoint self-massage. This study evaluated the possible effect of these eye exercises among Chinese rural students. METHODS Eight hundred thirty-six students (437 males, 52.3 %), aged 10.6 ± 2.5 (range 6-17) years from the Handan Offspring Myopia Study (HOMS) who completed the eye exercises and vision questionnaire, the convergence insufficiency symptom survey (CISS) questionnaire, and had a cycloplegic refraction were included in this study. RESULTS 121 (14.5 %) students (64 males, 52.9 %) performed the eye exercises of acupoints in school. The multiple odds ratio (OR) and 95 % confidence interval (CI) for those having a "serious attitude" towards performing the eye exercises (0.12, 0.03-0.49) demonstrated a protective effect for myopia, after adjusting for the children's age, gender, average parental refractive error, and the time spent on near work and outdoor activity. The more frequently, and the more seriously, the students performed the eye exercises each week, the less likely was their chance of being myopic (OR, 95 % CI: 0.17, 0.03-0.99), after adjusting for the same confounders. However, neither the "seriousness of attitude" of performing the eye exercises (multiple β coefficients: -1.58, p = 0.23), nor other related aspects of these eye exercises, were found to be associated with the CISS score in this sample. CONCLUSIONS The traditional eye exercises of acupoints appeared to have a modest protective effect on myopia among these Chinese rural students aged 6-17 years. However, no association between the eye exercises and near vision symptoms was found.
Collapse
|
12
|
Abstract
PURPOSE OF REVIEW The aim of the present review was to summarize the evidence implicating the association between myopia and glaucoma, the possible underlying mechanisms for this relation, and the controversies surrounding detection of glaucomatous changes in coexisting myopia. RECENT FINDINGS Numerous studies have shown that increasing categories of myopia are associated with a higher risk for optic neuropathy and glaucoma-like visual field defects. Recently, some high-resolution imaging modalities have been developed that aid further detection of the microanatomical changes of the optic nerve head and thus may provide a new insight to explain the association between myopia and glaucoma. Although the highly myopic eye usually shows many structural and functional defects that are difficult to distinguish from those caused by glaucoma, some new methods have been introduced to better differentiate between these changes. SUMMARY The interaction of myopia with glaucoma risk remains complex, largely because of the retinal and nerve fiber layer damage that occurs in myopia alone. Whether to treat for glaucoma relies on the suspicion level of the clinician who must consider other risk factors for vision loss. Ultimately, it is the progression of glaucoma-like findings that determines whether a myopic patient has glaucoma.
Collapse
|