Influencing factors associated with high myopia in Chinese college students

The Effect of Partial Sleep Deprivation on Retinal Microvasculature in Myopia With Different Axial Lengths

Purpose

To investigate the effects of partial sleep deprivation (PSD) on the retinal microvasculature in individuals with myopia, using optical coherence tomography angiography (OCTA).

Methods

In total, 87 right eyes were categorized by axial length (AL) into three groups: A (AL < 24 mm, n = 20), B (24 ≤ AL < 26 mm, n = 41), and C (AL ≥ 26 mm, n = 26). Participants underwent macular (6 mm × 6 mm) and optic disc (4.5 mm × 4.5 mm) OCTA scans. Vessel density (VD) parameters-including superficial capillary plexus VD (SCP-VD), deep capillary plexus VD (DCP-VD), radial peripapillary capillary VD (RPC-VD), inside disc RPC VD (iVD), and peripapillary RPC VD (ppVD)-were compared at baseline, before and after PSD, and following 3 days of regular sleep.

Results

Compared with group A, groups B and C had lower baseline DCP-VD in all subregions (P < 0.05), except for the perifovea-inferior area, where only groups C and A showed significant differences (P = 0.001). After PSD, group C showed a decrease in SCP-VD in certain subregions of the parafovea (P = 0.013 and P = 0.022 for parafovea-temporal and parafovea-inferior, respectively), along with an increase in ppVD (P = 0.012). All VD parameters recovered after 3 days of regular sleep (P < 0.05).

Conclusions

The retinal microvasculature of myopic eyes with an AL of ≥26 mm show greater susceptibility to PSD than those with an AL of <26 mm. However, short-term PSD effects can be restored by setting a regular sleep schedule.

Digital Screen Time and Myopia: A Systematic Review and Dose-Response Meta-Analysis

Importance

The association of digital screen time with myopia has been documented, but the dose-response association and safe exposure threshold remain unclear.

Objective

To evaluate the dose-response association of time spent on digital screens with myopia risk.

Data Sources

PubMed, EMBASE, Cochrane Library databases, CINAHL, and ClinicalTrials.gov were searched for full-length articles from peer-reviewed journals without restrictions on study design, publication date, or language from inception to November 25, 2024.

Study Selection

Primary research articles investigating the association of exposure to digital screen devices (ie, smartphones, tablets, game consoles, computers, or television) with myopia-related outcomes (ie, prevalent or incident myopia and the rate of myopia progression) were identified by reviewers.

Data Extraction and Synthesis

Two independent reviewers extracted data using a standardized procedure in accordance with the Meta-Analysis of Observational Studies in Epidemiology (MOOSE) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. A random-effects, dose-response meta-analysis (DRMA) was utilized to examine the pattern of the association of screen time with myopia.

Main Outcome and Measures

Increased odds of myopia per hour of daily screen time.

Results

In the linear DRMA of 45 studies with 335 524 participants (mean [SD] age, 9.3 [4.3] years), an additional hour of daily screen time was associated with higher odds of myopia (odds ratio [OR], 1.21; 95% CI, 1.13-1.30). The nonlinear DRMA of 34 studies with 314 910 participants also indicated higher odds of myopia with increasing screen time, ranging from 1 hour of daily exposure (OR, 1.05; 95% CI, 1.01-1.09) to 4 hours (OR, 1.97; 95% CI, 1.56-2.40). The dose-response curve showed myopia risk increasing significantly between 1 to 4 hours of daily screen time, and then rising more gradually after 4 hours.

Conclusions and Relevance

In this systematic review and DRMA, a daily 1-hour increment in digital screen time was associated with 21% higher odds of myopia and the dose-response pattern exhibited a sigmoidal shape, indicating a potential safety threshold of less than 1 hour per day of exposure, with an increase in odds up to 4 hours. These findings can offer guidance to clinicians and researchers regarding myopia risk.

Associations of Near Work, Time Outdoors, and Sleep Duration With Myopic Regression 5 Years After SMILE and FS-LASIK: A Cross-sectional Study

PURPOSE

To investigate the association of near work, time outdoors, and sleep duration with myopic regression 5 years after small incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK) .

METHODS

This cross-sectional study included patients who received SMILE or FS-LASIK at Beijing Tongren Hospital 5 years ago. The patients underwent ophthalmic examinations including visual acuity, intraocular pressure, subjective refraction, slit-lamp examination, keratometry, corneal topography, optical coherence tomography, and fundus examination from January 2020 to March 2023. Fluorescein break-up time was measured and the Ocular Surface Disease Index questionnaire was completed to exclude dry eye. A self-administered questionnaire was used to collect data on near work exposure, physical activities, and sleep duration.

RESULTS

A total of 323 eyes were included in the analysis, with a 5-year incidence rate of myopic regression after SMILE or FSLASIK of 16.1%. After adjusted for all confounders, total near work more than 8 hours/day revealed a significant association with myopic regression (odds ratio: 2.461; 95% CI: 1.143 to 5.298, P = .021), particularly in younger adults, women, and patients with high myopia and FS-LASIK treatment. The significant association between sleep duration 8 hours/day or more and myopic regression was restricted to women and patients with FS-LASIK (near significant). However, no significant associations were observed between continuous near work or time outdoors and myopic regression.

CONCLUSIONS

Excessive near work exposure was associated with greater myopic regression 5 years after SMILE or FS-LASIK. It is crucial to maintain good visual behavior and care for preventing regression after SMILE or FS-LASIK, especially for younger patients and eyes with high myopia. [J Refract Surg. 2024;40(1):e10-e19.].