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Mu J, Zhong H, Jiang M, Yang W. Epidemiological characteristics of myopia among school-age children before, during, and after the COVID-19 pandemic: a cohort study in Shenzhen, China. Front Med (Lausanne) 2024; 11:1368219. [PMID: 39281822 PMCID: PMC11392885 DOI: 10.3389/fmed.2024.1368219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 08/21/2024] [Indexed: 09/18/2024] Open
Abstract
Objectives To evaluate the epidemiological characteristics of myopia among school-aged children before, during, and after the coronavirus disease (COVID-19) pandemic. Methods A total of 848,697 students aged 6-15 years from 786 primary and secondary schools in Shenzhen, China, were randomly selected as research subjects. We conducted annual myopia screenings from 2019 to 2022. 2019 was considered before the COVID-19 pandemic, 2020 as during the pandemic, and 2021 and 2022 as after the pandemic. Demographic characteristics, visual acuity, and spherical equivalent refraction (SE) were collected. Results During the 4-year follow-up period, the uncorrected visual acuity (UCVA) of the study subjects progressed following a trend of -0.18 ± 0.30D (-0.17 ± 0.29D for boys, -0.21 ± 0.32Dfor girls) (p < 0.001). Those students who were in grade 4 aged 9-10 years at the baseline examination showed the greatest decline in visual acuity (0.23). The SE of the study subjects progressed following a trend of -1.00 ± 1.27D (-0.96 ± 1.25D for boys, -1.05 ± 1.31D for girls) (p < 0.001). The students who were in grade 5 aged 10-11 years at the baseline examination showed the greatest decline in SE (1.15D ± 1.22, p < 0.001). The prevalence of myopia (UCVA<5.0 and SE < -0.50D of any eye) increased by 28.2% (27.0% for boys and 29.8% for girls). Those students who were in grade 2 aged 7-8 years at the baseline examination showed the greatest increase in myopia prevalence (37.6%, p < 0.001). During the COVID-19 pandemic, the subjects' visual acuity and SE measurements decreased by -0.05 ± 0.19 (p < 0.001) and - 0.36 ± 0.89D (p < 0.001) respectively, and the prevalence of myopia increased by 11.3% (10.6% for boys and 12.2% for girls) (p < 0.001). The 3-year cumulative incidence of myopia for non-myopic grade 1 aged 6-7 years students with baseline SE of ≥1.00D, ≥ 0.50D and < 1.00D, ≥0D and < 0.50D, and ≥ -0.50D and < 0D were 6.8, 24.8, 39.0, and 48.1%, respectively. Conclusion During the COVID-19 pandemic, the SE of school-aged children showed myopic drift and decreased visual acuity. Myopia progressed faster among girls than among boys in the same grades. The risk of myopia among school-aged children persisted even after the home quarantine of the COVID-19 pandemic was lifted.
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Affiliation(s)
- Jingfeng Mu
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Haoxi Zhong
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Mingjie Jiang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Weihua Yang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
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He T, Yin L, Zheng Q, He B, Xu Z, Hu T, Wu Y, Chen H, Yu J, Shen T. Survey on pattern of myopia in school children in Hangzhou after the COVID-19 pandemic: a school-based vision screening study. BMC Public Health 2024; 24:1850. [PMID: 38992612 PMCID: PMC11238354 DOI: 10.1186/s12889-024-19338-4] [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: 06/26/2023] [Accepted: 07/02/2024] [Indexed: 07/13/2024] Open
Abstract
BACKGROUND Myopia is a major health issue around the world. Myopia in children has increased significantly during the COVID-19 pandemic in China, but reports are scarce on the prevalence of myopia following the pandemic. This study collected vision screening data of school children in China for five consecutive years to observe the changes in myopia after the pandemic and compare the observed prevalence of myopia before and after the pandemic. METHODS A school-based vision screening study used stratified samplings to collect the vision screening data in school children aged 6-13 from 45 primary schools in Hangzhou. Vision screening data including uncorrected visual acuity(UCVA) and spherical equivalent refraction(SER). Calculating the mean of SER and the prevalence of myopia and hyperopia from 2019 to 2023. RESULTS A total of 79,068 screening results (158,136 eyes) were included in the analysis. A substantial myopic shift (approximately -0.30 diopters [D] on average) was found in 2020 and 2021 compared with 2019 in all age groups and a substantial myopic shift (approximately 0.4 D on average) was found in 2022 compared with 2021. A slight myopic shift (approximately -0.14 D on average) was found in 2023 compared with 2022. The prevalence of myopia in all age groups was the highest for five years in 2020 or 2021, which was 31.3% for 6-year-olds, 43.0% for 7-year-olds, and 53.7% for 8-year-olds. A positive change in the prevalence rate of myopia was found at 6 years old (0.59%, 0.12%, 0.36%, 0.25%, p < 0.001). The change in prevalence rate in myopia was shifted slightly in children aged 10-13 years. Children aged 8 to 13 years had a slight increase in myopia prevalence from 2022 to 2023. The prevalence of hyperopia was low and stable in all grade groups, ranging from 0.7% to 2.2% over five years. CONCLUSION Myopia in children has increased rapidly during the COVID-19 pandemic. After the pandemic, the prevalence of myopia in children gradually decreased temporarily and then rebounded. Myopic shift was more apparent in younger children. Myopic shift in children may be related to the reduction of outdoor time, less light, and near work habits, and further research is needed.
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Affiliation(s)
- Ting He
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, CN, China
| | - Lei Yin
- Department of Ophthalmology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, CN, China
| | - Qingqing Zheng
- Department of Ophthalmology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, CN, China
| | - Bei He
- Hangzhou Xiaoshan Liuliqiao Hospital, Hangzhou, Zhejiang, CN, China
| | - Zhizi Xu
- Hangzhou Xiaoshan Liuliqiao Hospital, Hangzhou, Zhejiang, CN, China
| | - Tingting Hu
- Hangzhou Xiaoshan Liuliqiao Hospital, Hangzhou, Zhejiang, CN, China
| | - Yuanpeng Wu
- Department of Ophthalmology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, CN, China
| | - Hu Chen
- Department of Ophthalmology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, CN, China
| | - Jie Yu
- Department of Ophthalmology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, CN, China
| | - Ting Shen
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, CN, China.
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Au Eong JTW, Chen KS, Teo BHK, Lee SSY, Au Eong KG. Impact of the coronavirus disease 2019 pandemic on the progression, prevalence, and incidence of myopia: A systematic review. Taiwan J Ophthalmol 2024; 14:159-171. [PMID: 39027071 PMCID: PMC11253998 DOI: 10.4103/tjo.tjo-d-24-00027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 04/07/2024] [Indexed: 07/20/2024] Open
Abstract
We systematically reviewed the literature on the effects of the coronavirus disease 2019 (COVID-19) pandemic on the progression, prevalence, and incidence of myopia. A comprehensive literature search was performed on PubMed, Cochrane Central Register of Controlled Trials, and Scopus databases. Studies included in the review assessed myopia progression, prevalence, and/or incidence as the primary outcome. Of 523 articles yielded in the initial search, 23 studies (6 cross-sectional and 17 cohort) were eligible for inclusion. Sixteen of these were conducted in China and one each in Hong Kong, Turkey, Spain, Israel, India, Korea, and Tibet. Quality appraisals were conducted with the Joanna Briggs Institute Critical Appraisal Checklists. Of the included studies, a large majority reported a greater myopic shift and increase in myopia prevalence during the COVID-19 pandemic compared to the pre-COVID-19 years. All three studies on myopia incidence showed increased incidence during the COVID-19 pandemic. Myopia progression accelerated during the COVID-19 pandemic, even in individuals using low-concentration atropine eye drops in two studies but not in those using orthokeratology treatment in one study. Overall, the studies found that the COVID-19 pandemic and its associated home confinement measures generally increased myopia progression, prevalence, and incidence, even in individuals using low-concentration atropine eye drops.
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Affiliation(s)
| | - Krystal S. Chen
- International Eye Cataract Retina Centre, Mount Elizabeth Medical Centre and Farrer Park Medical Centre, Singapore
| | - Benjamin H. K. Teo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Samantha S. Y. Lee
- Centre for Ophthalmology and Visual Science (Incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia
| | - Kah-Guan Au Eong
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
- International Eye Cataract Retina Centre, Mount Elizabeth Medical Centre and Farrer Park Medical Centre, Singapore
- Department of Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital, Singapore
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Wang M, Ji N, Yu SA, Liang LL, Ma JX, Fu AC. Comparison of 0.02% atropine eye drops, peripheral myopia defocus design spectacle lenses, and orthokeratology for myopia control. Clin Exp Optom 2023:1-7. [PMID: 38043135 DOI: 10.1080/08164622.2023.2288180] [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: 11/30/2022] [Accepted: 09/22/2023] [Indexed: 12/05/2023] Open
Abstract
CLINICAL RELEVANCE There are many methods to control the progression of myopia. However, it is currently unknown which method could better control myopia progression: 0.02% atropine eye drops, peripheral myopic defocus design spectacle lenses (PMDSL), or orthokeratology (OK). BACKGROUND To compare the efficacy of 0.02% atropine, PMDSL, and OK to control axial length (AL) elongation in children with myopia. METHODS This study was analysed based on a previous cohort study (0.02% atropine group) and retrospective data (PMDSL and OK group). Overall, 387 children aged 6-14 years with myopia - 1.00D to - 6.00D in the three groups were divided into four subgroups according to age and spherical equivalent refraction (SER). The primary outcome was changed in AL over 1-year. RESULTS The mean axial elongation was 0.30 ± 0.21 mm, 0.23 ± 0.16 mm, and 0.17 ± 0.19 mm in the 0.02% atropine, PMDSL, and OK groups, respectively. Multivariate linear regression analyses showed significant differences in axial elongation among the three groups, especially in children aged 6-10, but not in children aged 10.1-14; the corresponding axial elongation was 0.35 ± 0.21 mm, 0.23 ± 0.17 mm, and 0.21 ± 0.20 mm (P < 0.05 between any two groups, except between PMDSL and OK groups at P > 0.05) and 0.22 ± 0.20 mm, 0.21 ± 0.13 mm, and 0.13 ± 0.18 mm (P < 0.05 between any two groups, except between 0.02% atropine and PMDSL groups at P > 0.05) in children with SER from - 1.00D to - 3.00D and from - 3.01D to - 6.00D, respectively. CONCLUSIONS Within the limits of this study design and using only the current brand of PMDSL, OK appeared to be the best method, followed by PMDSL and then 0.02% atropine, for controlling AL elongation over one year. However, different effects were found in the various age and SER subgroups.
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Affiliation(s)
- Ming Wang
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Na Ji
- Department of Optometry, The Affiliated Eye Hospital of Suzhou Vocational Health College, Suzhou, China
| | - Shi-Ao Yu
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ling-Ling Liang
- Department of Ophthalmology, Shi Jiazhuang Aier Eye Hospital, Shi Jiazhuang, China
| | - Jing-Xue Ma
- Department of Ophthalmology, Shi Jiazhuang Aier Eye Hospital, Shi Jiazhuang, China
| | - Ai-Cun Fu
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Guo C, Li Y, Luo L, Lin J, Qiu K, Zhang M. Progression and incidence of myopia among schoolchildren in the post-COVID-19 pandemic period: a prospective cohort study in Shantou, China. BMJ Open 2023; 13:e074548. [PMID: 37550020 PMCID: PMC10407384 DOI: 10.1136/bmjopen-2023-074548] [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: 04/10/2023] [Accepted: 07/26/2023] [Indexed: 08/09/2023] Open
Abstract
OBJECTIVES To determine the progression and incidence of myopia in Chinese schoolchildren in the post-COVID-19 pandemic period in Shantou, China. DESIGN Prospective cohort study. SETTING Shantou Myopia Study, China. PARTICIPANTS 1-year follow-up data were available for 621 881 schoolchildren (301 999 females). Data on spherical equivalent refraction (SER) were collected. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcomes were myopia progression and incidence. Myopia progression is defined as a change of SER towards the negative direction in the follow-up visit. Incidence is defined as the proportion of schoolchildren who were not myopic but developed myopia in the follow-up study. Age, sex and SER at baseline were evaluated as associated factors for myopia burden, which were defined as the secondary outcomes. RESULTS Mean progression of SER was -0.35±0.97 D for the population (ranging from -0.06 D at 18 years of age to -0.46 D at 11 years of age), with a rapid myopic progression for students at the age of 10-12 years (-0.50 D in girls and -0.44 D in boys). A myopic shift greater than -0.50 D/year occurred in 256 299 eyes (41.21%). Myopic progression in refraction was associated with the 10-12 years age groups (OR 1.42; 95% CI 1.39 to 1.45, p<0.001), female sex (OR 1.09; 95% CI 1.08 to 1.10, p<0.001) and higher refractive errors at baseline (OR>1.00, p<0.001). The annual incidence of myopia among schoolchildren was 24.85%, with an incidence of 26.69% in girls and 23.02% in boys. CONCLUSIONS Our study revealed an annual myopia progression of -0.35 D and an incidence of 24.85% among schoolchildren in the post-COVID-19 pandemic period. Myopia progressed rapidly at 10-12 years of age, with -0.50 D in girls and -0.44 D in boys. The incidence was higher for children aged 10-11 years and for girls.
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Affiliation(s)
- Chengyao Guo
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China
- Shantou University Medical College, Shantou, China
| | - Yuancun Li
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China
| | - Li Luo
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China
| | - Jianwei Lin
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China
| | - Kunliang Qiu
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China
| | - Mingzhi Zhang
- Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China
- The Chinese University of Hong Kong, Hong Kong, China
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Najafzadeh MJ, Zand A, Shafiei M, Sharifi M, Nasiri N, Sharifi A. Myopia Progression during the COVID-19 Era: A Systematic Review and Meta-analysis. Semin Ophthalmol 2023:1-10. [PMID: 36734046 DOI: 10.1080/08820538.2023.2168490] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND To evaluate myopia progression during the novel coronavirus disease 2019 (COVID-19) pandemic and its risk factors. METHODS We searched PubMed, Scopus, and Web of Science to find literature until August 2022 related to COVID-19 pandemic and myopia progression. Outcomes of myopia progression included axial length (AL) and spherical equivalent (SE). Factors of screen time and outdoor activity time were analyzed. RESULTS Thirty-three studies were included in this meta-analysis. Compared to the same period before the COVID-19 pandemic, myopia prevalence increased (OR = 1.11; 95% CI, 1.05-1.18). The outcomes of SE decreased -0.61 diopter (95% CI, -0.98 to -0.23), and AL increased 0.42 mm (95% CI, 0.13-0.7). Mean screen time was increased 6.25 hours/day (95% CI, 4.84-7.66), and outdoor activity time was decreased -1.52 hours/day (95% CI, -3.20 to -0.15). CONCLUSION Establishing care policies is necessary to restrict behavioral changes and their consequences during the pandemic.
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Affiliation(s)
| | - Amin Zand
- Department of Ophthalmology, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohadeseh Shafiei
- Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Meraj Sharifi
- Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Naser Nasiri
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Sharifi
- Department of Ophthalmology, Shafa Hospital, Kerman University of Medical Sciences, Kerman, Iran
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