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Huang Z, Song D, Tian Z, Wang Y, Tian K. Prevalence and associated factors of myopia among adolescents aged 12-15 in Shandong Province, China: a cross-sectional study. Sci Rep 2024; 14:17289. [PMID: 39068195 PMCID: PMC11283487 DOI: 10.1038/s41598-024-68076-5] [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: 05/25/2024] [Accepted: 07/19/2024] [Indexed: 07/30/2024] Open
Abstract
Myopia is a growing concern worldwide, especially among adolescents. This study aimed to investigate the prevalence and associated factors of myopia in adolescents aged 12-15 in Shandong Province, China. This cross-sectional study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines and involved stratified random cluster sampling of 128,678 students from 186 middle schools across 17 cities in Shandong Province. Data collection was conducted from March to April 2024. We excluded students with organic eye diseases, abnormal binocular vision functions, or a history of eye injuries or surgeries. Myopia was assessed using the standard logarithmic visual acuity chart and autorefractor without inducing ciliary muscle paralysis. A comprehensive questionnaire survey was conducted to gather demographic characteristics and daily life behaviors. With the chi-squared test for univariable analysis and multivariable logistic regression for identifying significant factors. This study included 126,375 participants, with a gender distribution of 51.02% male and 48.98% female. The overall prevalence of myopia was 71.34%. Higher prevalence was observed in girls (72.26%) compared to boys (70.45%), and the prevalence increased with age, peaking at 73.12% in 15-year-olds. Urban residents had a higher prevalence (71.86%) than rural (70.39%). Factors such as increased frequency of eye usage while lying down or leaning forward, frequent use of eyes while walking or riding in a car, prolonged screen time, and extended homework duration were associated with higher odds of developing myopia. Conversely, higher frequency of outdoor exercise, maintaining proper posture during reading and writing, greater distance from eyes to screen, and longer sleep duration were associated with lower odds. Additionally, female gender, older age, urban residence, and parental history of myopia increased the risk. The high prevalence of myopia among adolescents in Shandong Province was influenced by a combination of demographic, behavioral, and environmental factors. The study highlighted the importance of lifestyle modifications, such as increasing outdoor activities and maintaining proper visual habits, limiting the duration of screen exposure and homework sessions, and extending sleep duration, to mitigate the risk of developing myopia. These findings underscored the need for targeted public health interventions and educational campaigns to address this significant public health issue.
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Affiliation(s)
- Zhihao Huang
- School of Big Data and Fundamental Sciences, Shandong Institute of Petroleum and Chemical Technology, Dongying, China
| | - Dingding Song
- Common Course Teaching Department, Shandong University of Art and Design, Jinan, China
| | - Zhiqi Tian
- Department of Clinical Laboratory, Shengli Oilfield Central Hospital, Dongying, China.
| | - Yongming Wang
- School of Big Data and Fundamental Sciences, Shandong Institute of Petroleum and Chemical Technology, Dongying, China
| | - Kunzong Tian
- School of Big Data and Fundamental Sciences, Shandong Institute of Petroleum and Chemical Technology, Dongying, China
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Gajjar S, Ostrin LA. Development of the University of Houston near work, environment, activity, and refraction (UH NEAR) survey for myopia. Clin Exp Optom 2024; 107:544-557. [PMID: 37726150 PMCID: PMC10948375 DOI: 10.1080/08164622.2023.2243264] [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: 02/14/2023] [Accepted: 07/27/2023] [Indexed: 09/21/2023] Open
Abstract
CLINICAL RELEVANCE There is a need to better elucidate demographic and behavioural factors that are contributing to the rising prevalence of myopia. Doing so will aid in developing evidence-based recommendations for behavioural modifications to prevent onset and slow progression of myopia in children. BACKGROUND The contributions of environmental and behavioural factors in myopia remain unclear. The goal of this work was to provide a standardised survey to better understand risk factors for myopia. METHODS Development of the survey was carried out in 4 phases. In phase 1, three methods (direct, lay terms, and indirect) of parental reporting for the presence of myopia in their child were investigated through a questionnaire (N = 109) to determine sensitivity and specificity. The best method determined from phase 1 was used in phase 2, where questions regarding demographics, ocular history, and visual behaviour were compiled and refined. In phase 3, the survey was administered to focus groups of parents (N = 9). In phase 4, a scoring system was developed. RESULTS The highest sensitivity for parental reporting for myopia of their child was the indirect method (0.84), and the lowest sensitivity was the direct method (0.41). The highest specificity was the direct method (0.86), once excluding the 'do not know' responses, and the lowest specificity was the indirect method (0.53). The direct method yielded a 53.2% 'do not know' response rate, 50.5% for the lay method, and 1.8% for the indirect method. Time to complete the survey was 10:09 ± 2:45 minutes. CONCLUSION This study provides a comprehensive and up-to-date myopia risk factor survey that can be utilised by researchers and clinicians. Parents found the survey to be easy to understand and relatively quick to answer, and the scoring system allows quantification of behaviours across different categories using provided equations.
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Affiliation(s)
- Shail Gajjar
- University of Houston College of Optometry, Houston, Texas, USA
| | - Lisa A Ostrin
- University of Houston College of Optometry, Houston, Texas, USA
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Jiang D, Lin S, Gong Q, Hong J, Wang J, Gao H, Guo Y, Tong F, Zhang Y. PAX6 gene promoter methylation is correlated with myopia in Chinese adolescents: a pilot sutdy. Ophthalmic Genet 2024:1-7. [PMID: 38531548 DOI: 10.1080/13816810.2024.2315152] [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: 10/13/2023] [Accepted: 02/01/2024] [Indexed: 03/28/2024]
Abstract
PURPOSE A large number of epidemiological studies have shown that myopia is a complex disease involving genetic, environmental, and behavioral factors. The purpose of this study was to explore the role of PAX6 gene methylation in myopia in Chinese adolescents. METHODS Eighty junior high school students were divided into four groups based on their vision test results: mild myopia, moderate myopia, severe myopia, and non-myopia control. The methylation level of PAX6 gene promoter was detected by bisulfate pyrosequencing. RESULTS The methylation level of PAX6 gene in myopia group (8.06% ± 1.43%) was slightly but significantly higher than that in non-myopia controls (7.26% ± 1.17%). In addition, PAX6 gene methylation levels presented a decreasing pattern along with the aggravation of myopia. Post-hoc analysis indicated significant inter-group differences for the mild myopia group and other groups (All p < .05). In the subgroup analysis by gender, the methylation level of PAX6 gene promoter in girls was higher than that in boys (p = .023). The ROC curves showed a high accuracy of PAX6 gene methylation to predict mild myopia (AUC (95% CI) = 0.828 (0.709-0.947), p < .001). CONCLUSIONS The methylation of PAX6 gene might play a role in the onset and progression of myopia in Chinese adolescents. And this could potentially explore the potential molecular mechanisms of juvenile myopia in the future.
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Affiliation(s)
- Danjie Jiang
- Department of School Health, Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
| | - Shujuan Lin
- Key Laboratory of Translational Tumor Medicine in Fujian Province, Putian University, Putian, China
| | - Qinghai Gong
- Department of School Health, Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
| | - Jia Hong
- Department of School Health, Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
| | - Jinghui Wang
- Department of School Health, Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
| | - Hua Gao
- Department of School Health, Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
| | - Yanbo Guo
- Department of School Health, Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
| | - Feng Tong
- Department of School Health, Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
| | - Yan Zhang
- Department of School Health, Ningbo Municipal Center for Disease Control and Prevention, Ningbo, China
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Li T, Yang J, Yan J, Yao X, Du B, Wu Q, Meng X, Liu Y, Lu Y, Wang Q, Yang Q, Kee CS, Tham CC, Wei R, Huang G, Yan H. Interaction between parental myopia and children lifestyle on the incidence of myopia among children aged 6-18 years: a cross-sectional study in Tianjin, China. BMJ Open 2024; 14:e080929. [PMID: 38238173 PMCID: PMC10806635 DOI: 10.1136/bmjopen-2023-080929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 01/04/2024] [Indexed: 01/23/2024] Open
Abstract
OBJECTIVES This study aimed to explore the influence of the interaction between parental myopia and lifestyle on myopia among school-age children. DESIGN Cross-sectional study. SETTING This study used data from the Tianjin Child and Adolescent Research of Eye between August and October 2022. PARTICIPANTS A total of 49 035 participants between 6 and 18 years of age were eligible for this study. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was the interaction between eye-healthy lifestyle and parental myopia on myopia. Parental myopia and eye-healthy lifestyle were ascertained by a Child and Adolescent Behavior Questionnaire. The lifestyle risk score (LRS) of eye health was calculated based on beta-coefficient in the backward regression model. The interaction between LRS and parental myopia was analysed by multivariate logistic regression. The predictive value of different predicted models was estimated using receiver operating characteristic curves. Multiple linear regression was used to evaluate the associations of lifestyle risk factors and parental myopia with spherical equivalent refraction, which were defined as the secondary outcomes. RESULTS A total of 31 839 participants aged 6-18 years were included, and the myopia prevalence was 55.46%. Eye-healthy lifestyle and parental myopia were significantly associated with myopia, as was interaction. The predictive value for LRS & parental myopia was 0.714 (95% CI: 0.709 to 0.720), which was higher than LRS (0.693, 95% CI: 0.687 to 0.699) and parental myopia (0.710, 95% CI: 0.704 to 0.716) separately. CONCLUSIONS High-risk lifestyles of myopia and parental myopia were significantly associated with a higher risk of myopia, and the combination had the strongest effect. For children, lifestyle adjustment should be prioritised in preventing myopia, especially for those with parental myopia.
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Affiliation(s)
- Tongtong Li
- School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Ocular Trauma, Tianjin, China
| | - Jing Yang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Laboratory of Molecular Ophthalmology, Tianjin Medical University, Tianjin, China
| | - Jing Yan
- School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Ocular Trauma, Tianjin, China
| | - Xuyang Yao
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Bei Du
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Qi Wu
- School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Ocular Trauma, Tianjin, China
| | - Xiangda Meng
- Tianjin Key Laboratory of Ocular Trauma, Tianjin, China
- Department of Ophthalmology, Tianjin Medical University General Hospital, Laboratory of Molecular Ophthalmology, Tianjin Medical University, Tianjin, China
| | - Yuanyuan Liu
- Tianjin Key Laboratory of Ocular Trauma, Tianjin, China
- Department of Ophthalmology, Tianjin Medical University General Hospital, Laboratory of Molecular Ophthalmology, Tianjin Medical University, Tianjin, China
| | - Yuezhu Lu
- Department of Ophthalmology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Qihua Wang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Laboratory of Molecular Ophthalmology, Tianjin Medical University, Tianjin, China
- Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Qiang Yang
- Shenyang Xingqi Pharmaceutical Co., Ltd, Shenyang, China
| | - Chea-Su Kee
- School of Optometry, Centre for Myopia Research, Research Centre for SHARP Vision, The Hong Kong Polytechnic University, Hong Kong, China
| | - Clement C Tham
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, Hong KonSARg, China
| | - Ruihua Wei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Guowei Huang
- School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Ocular Trauma, Tianjin, China
| | - Hua Yan
- Tianjin Key Laboratory of Ocular Trauma, Tianjin, China
- Department of Ophthalmology, Tianjin Medical University General Hospital, Laboratory of Molecular Ophthalmology, Tianjin Medical University, Tianjin, China
- School of Medicine, Nankai University, Tianjin, China
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Yu D, Wang L, Zhou X, Liu L, Wu S, Tang Q, Zhang X. Sleep Quality is Associated with Axial Length Elongation in Myopic Children Receiving Orthokeratology: A Retrospective Study. Nat Sci Sleep 2023; 15:993-1001. [PMID: 38050564 PMCID: PMC10693766 DOI: 10.2147/nss.s421407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 11/14/2023] [Indexed: 12/06/2023] Open
Abstract
Purpose To identify potential demographic and lifestyle factors associated with progression of myopia with orthokeratology (ortho-k) treatment via follow-up of axial length (AL). Methods In this retrospective observational study, demographics, ocular parameters, near-work distance, outdoor activities, and sleep quality were analyzed in 134 children with myopia aged 8~15 years using ortho-k and a follow-up for one year. Results Compared with the slow progression group, the participants in the fast progression group were younger in age (10.55 ±1.70 years vs 9.90 ±1.18 years, P = 0.009), demonstrated higher spherical equivalent (SE) value (-2.52 ±0.63 diopters (D) vs -3.05 ±0.89 D, P < 0.001), shorter near-work distance (P = 0.010), and poorer sleep quality (Pittsburgh sleep quality index [PSQI], 4.79 ±1.29 vs 3.81 ±1.38, P < 0.001) in the one-year follow-up. Furthermore, multivariate linear regression analyses showed that baseline age (B =-0.020, P = 0.020), SE (B = 0.0517, P < 0.001), and total PSQI (B=0.026, P = 0.001) were associated with axial elongation. Advanced logistic regression analyses demonstrated that shorter average near-work distance (P = 0.034), higher SE value (P = 0.023), and poorer sleep quality (P = 0.003) were associated with fast axial elongation. Conclusion Sleep quality is one of the key factors associated with axial elongation in children with myopia after using ortho-k for one year. Further studies are required to confirm this observation and expand its practical applications.
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Affiliation(s)
- Dongyi Yu
- Department of Ophthalmology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, 215006, People’s Republic of China
- Department of Ophthalmology, Kunshan First People’s Hospital Affiliated to Jiangsu University, Suzhou, Jiangsu, 215300, People’s Republic of China
| | - Libo Wang
- Department of Ophthalmology, Kunshan First People’s Hospital Affiliated to Jiangsu University, Suzhou, Jiangsu, 215300, People’s Republic of China
| | - Xin Zhou
- Department of Ophthalmology, Kunshan First People’s Hospital Affiliated to Jiangsu University, Suzhou, Jiangsu, 215300, People’s Republic of China
| | - Lili Liu
- Department of Ophthalmology, Kunshan First People’s Hospital Affiliated to Jiangsu University, Suzhou, Jiangsu, 215300, People’s Republic of China
| | - Shuang Wu
- Department of Ophthalmology, Kunshan First People’s Hospital Affiliated to Jiangsu University, Suzhou, Jiangsu, 215300, People’s Republic of China
| | - Qing Tang
- Department of Neurology, Kunshan First People’s Hospital Affiliated to Jiangsu University, Suzhou, Jiangsu, 215300, People’s Republic of China
| | - Xiaofeng Zhang
- Department of Ophthalmology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, 215006, People’s Republic of China
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Zhang D, Sun B, Wu M, Liu H, Zhou L, Guo L. Prevalence and associated factors of myopia among school students in Shenyang, China: a cross-sectional study. Front Public Health 2023; 11:1239158. [PMID: 37711238 PMCID: PMC10499391 DOI: 10.3389/fpubh.2023.1239158] [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: 06/12/2023] [Accepted: 08/16/2023] [Indexed: 09/16/2023] Open
Abstract
Background In recent years, the prevalence of myopia has increased significantly and caused great concern. Nevertheless, an estimate of myopia in the student population in Shenyang, Liaoning Province, China is still lacking. This study aims to determine the prevalence of myopia among students in Shenyang and investigate the associated factors affecting myopia development. Methods Standard logarithmic visual acuity chart and automatic computerized optometry under non-ciliary muscle paralysis were used to test the students' naked visual acuity of their right and left eyes. The included students were organized to fill in questionnaires on WeChat to collect the factors affecting myopia. Results A total of 34,644 students with a median age of 11.9 years were examined, including 17,563 males and 17,081 females. The overall prevalence of myopia was 60%, with a prevalence of 45% for mild myopia, 13% for moderate myopia, and 1.9% for high myopia. The sex, high educational stage, family history of myopia, doing homework after school or reading and writing for more than 2 h were associated with a higher risk of myopia, while doing eye exercises twice a day or more, going outdoors during recess, reading and writing with eyes more than one foot from books, and sleeping more than 8 h a day were associated factors for preventing myopia. The associated factors influencing myopia vary among different subgroups. Conclusion The prevalence of myopia in Shenyang is at a high level. In addition to sex, high educational stage and genetic factors, environmental factors including length of eye usage, eye exercises, outdoor activities, eye working distance, and sleep duration are associated with myopia prevalence. Therefore, it is recommended that the occurrence and development of myopia can be prevented by controlling the above environmental factors.
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Affiliation(s)
- Dan Zhang
- School of Public Health, Shenyang Medical College, Shenyang, China
- Shenyang Center for Disease Control and Prevention, Shenyang, China
| | - Baijun Sun
- Shenyang Center for Disease Control and Prevention, Shenyang, China
| | - Ming Wu
- Liaoning Center for Disease Control and Prevention, Shenyang, China
| | - Huiying Liu
- School of Public Health, Shenyang Medical College, Shenyang, China
| | - Lin Zhou
- School of Public Health, Shenyang Medical College, Shenyang, China
| | - Lianying Guo
- School of Public Health, Shenyang Medical College, Shenyang, China
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