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Wies B, Valls I, Fernandes A, Ubalde-López M, Rocabois A, Vrijheid M, Slama R, Nieuwenhuijsen M. Urban environment and children's health: An umbrella review of exposure response functions for health impact assessment. ENVIRONMENTAL RESEARCH 2024; 263:120084. [PMID: 39369784 DOI: 10.1016/j.envres.2024.120084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Revised: 09/13/2024] [Accepted: 09/27/2024] [Indexed: 10/08/2024]
Abstract
BACKGROUND Urban settlements have become the main living environment. Understanding the impact of urban exposures on human health has therefore become a growing area of research. Up-to-date knowledge about the influence of urban exposures on pregnant women's and children's health is especially relevant, as they are particularly vulnerable to certain external influences. AIM This review aims to provide a synthesis of systematic reviews with meta-analyses reporting on an association between the urban environmental risk factors and health outcomes in pregnancy, infants, children and adolescents. METHODS We conducted an umbrella review, methodically analysing systematic reviews with meta-analyses, published between January 2016 and December 2022 in PubMed or Scopus. Adhering to the PRISMA checklist, we searched for free text using Medical Subject Headings (MeSH) terms related to air pollution, noise pollution, temperature, green space exposure, built and food environment, health outcomes, children (aged 0-18 years), pregnancy and systematic reviews with meta-analyses. We extracted key characteristics of each included study and assessed the quality of the included studies via the R-AMSTAR 2 tool. RESULTS Twenty-four studies met our inclusion criteria and identified 104 associations including 15 exposures and 60 health outcomes. The most frequently studied associations were related to air pollutants, followed by the built and food environment and noise. Birth outcomes (including low birth weight, pre-term birth or stillbirth) were the most commonly affected health outcomes, followed by respiratory outcomes such as asthma or respiratory infections. A total of 45 exposure-response function were reported to be statistically significant, including 10 exposures and 23 health effects. CONCLUSION This umbrella review provides an overview of the evidence and availability of exposure response functions between selected urban exposures and child health outcomes. This helps to identify research gaps and to build the basis for health impact assessment.
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Affiliation(s)
- Blanche Wies
- Institute de Salud Global (ISGlobal), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - Inés Valls
- Institute de Salud Global (ISGlobal), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Amanda Fernandes
- Institute de Salud Global (ISGlobal), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Mònica Ubalde-López
- Institute de Salud Global (ISGlobal), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Audrey Rocabois
- French National Institute of Health and Medical Research (Inserm), University Grenoble Alpes, CNRS, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Grenoble, France
| | - Martine Vrijheid
- Institute de Salud Global (ISGlobal), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Rémy Slama
- French National Institute of Health and Medical Research (Inserm), University Grenoble Alpes, CNRS, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Grenoble, France
| | - Mark Nieuwenhuijsen
- Institute de Salud Global (ISGlobal), Barcelona, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
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Zhao L, Zhang B, Wang J, Yang J, Du L, Wang T, Xu X, He X, Chen J. Short-term effects of sunlight exposure on fundus blood flow perfusion in children: a randomised controlled trial. Br J Ophthalmol 2024:bjo-2024-325715. [PMID: 38981665 DOI: 10.1136/bjo-2024-325715] [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: 04/21/2024] [Accepted: 06/23/2024] [Indexed: 07/11/2024]
Abstract
AIM To evaluate the short-term effects of different sunlight exposure on fundus blood flow perfusion (BFP) after near work. METHODS In this parallel randomised controlled trial, 81 students aged 7-15 with spherical equivalent refraction between -2.00 and +3.00 diopters were randomly assigned to either a low-illuminance (4k lux) group (N=40) or high-illuminance (10k lux) (N=41). Following 1 hour indoor reading, participants had sunlight exposure matching their group's intensity for 15 minutes. BFPs in the superficial retina, deep retina and choroid were measured at four time points: pre-reading, post-reading, 5th-minute and 15th-minute sunlight exposure. RESULTS Within the initial 5 minutes of sunlight exposure, the 10k lux group showed a tendency for decreased BFP, particularly in the choroid (superficial retina: -0.2, 95% CI -0.9 to 0.5; deep retina: -0.1, 95% CI -0.6 to 0.4; choroid: -0.4, 95% CI -0.8 to 0.0), while the 4k lux group exhibited an increase (superficial retina: 0.7, 95% CI 0.1 to 1.3; deep retina: 0.3, 95% CI -0.2 to 0.8; choroid: 0.1, 95% CI -0.2 to 0.5). From 5 to 15 minutes, BFP decreased in both groups. At the 5th-minute mark, the 10k lux group exhibited a greater decrease in choroid (10k -0.4 vs 4k 0.1, p=0.051). No significant difference was observed after 15 minutes of exposure. CONCLUSION Higher illuminance sunlight exposure can restore fundus BFP more rapidly than lower; however, duration remains pivotal. To prevent myopia, continuous sunlight exposure for over 15 minutes is recommended to aid in reinstating the fundus BFP increased by near work. TRIAL REGISTRATION NUMBER NCT05594732.
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Affiliation(s)
- Lingyi Zhao
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai, Shanghai, China
| | - Bo Zhang
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai, Shanghai, China
| | - Jingjing Wang
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai, Shanghai, China
| | - Jinliuxing Yang
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai, Shanghai, China
| | - Linlin Du
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai, Shanghai, China
| | - Tianxiao Wang
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai, Shanghai, China
| | - Xun Xu
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai, Shanghai, China
| | - Xiangui He
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai, Shanghai, China
| | - Jun Chen
- Shanghai Eye Diseases Prevention & Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai, Shanghai, China
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Kido A, Miyake M, Watanabe N. Interventions to increase time spent outdoors for preventing incidence and progression of myopia in children. Cochrane Database Syst Rev 2024; 6:CD013549. [PMID: 38864362 PMCID: PMC11167692 DOI: 10.1002/14651858.cd013549.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
BACKGROUND Myopia or nearsightedness is a type of refractive error. It causes people to see near objects clearly but distant objects as blurred. Good vision can be obtained if the refractive error is corrected properly but, where this is not possible, impaired vision will remain. The remaining myopia imposes a considerable personal and societal burden. In addition, the progression of myopia is more likely to be accompanied by other ocular diseases such as cataract, glaucoma and retinal detachment. Myopia has emerged as a significant global public health problem in recent years. The World Health Organization (WHO) reported uncorrected or undercorrected myopia to be a major cause of visual impairment worldwide. From both an individual and social perspective, it is important to prevent the onset of myopia and slow down its progression. Observational studies have shown that children who spend more time outdoors have a lower incidence of myopia. Several other non-Cochrane systematic reviews have focused on the association between increasing children's outdoor activity time and the prevention of myopia. However, none of these systematic reviews were limited to randomised controlled trials (RCTs), as they included all types of study designs, including observational studies and non-RCTs, in addition to RCTs. OBJECTIVES To assess the effects of interventions to increase outdoor time on the incidence and progression of myopia in children. SEARCH METHODS We searched CENTRAL, MEDLINE Ovid, Embase Ovid, ISRCTN registry, ClinicalTrials.gov, and the WHO ICTRP with no language restrictions. The databases were last searched on 24 June 2022. SELECTION CRITERIA We included RCTs and cluster-RCTs in which interventions were performed to increase the outdoor time for children with the aim of preventing the incidence and progression of myopia. DATA COLLECTION AND ANALYSIS We employed the standard methods recommended by Cochrane and assessed the certainty of the evidence using GRADE. We considered the following outcome measures: mean change in refractive error from baseline, incidence of myopia, mean change in the axial length from baseline, mean change in unaided distance visual acuity from baseline, quality of life and adverse event. MAIN RESULTS We included five RCTs in this review, four of which were cluster-RCTs. The total number of participants was 10,733. The included participants were primary school children, most of whom were in first or second grade (aged six to nine years). Four cluster-RCTs involved school-based interventions to encourage children to spend more time outdoors. The interventions included classroom time outdoors, routine for spending recess outdoors, motivational tools for spending time outdoors, and encouragement through electronic information tools. The intervention groups had less change in refractive errors in the direction of myopia; however, 95% confidence intervals (CIs) included no benefit or both benefit and harm at years one and three, and differences at year two included both clinically important and unimportant benefits (at 1 year: mean difference (MD) 0.08 dioptres (D), 95% CI -0.01 to 0.17; 4 studies, 1656 participants; low-certainty evidence; at 2 years: MD 0.13 D, 95% CI 0.06 to 0.19; 4 studies, 2454 participants; moderate-certainty evidence; at 3 years: MD 0.17 D, 95% CI -0.17 to 0.51; 1 study, 729 participants; low-certainty evidence). Our protocol defined a difference of 0.1 D in the change in refractive error as clinically important. At one year, the difference was less than 0.1 D, but at two and three years it was more than 0.1 D. The incidence of myopia was lower in the intervention groups compared to the control groups, but 95% CIs included no change or clinically unimportant benefits (at 1 year: 7.1% with intervention versus 9.5% with control; risk ratio (RR), 0.82, 95% CI 0.56 to 1.19; 3 studies, 1265 participants; low-certainty evidence; at 2 years: 22.5% with intervention versus 26.7% with control; RR 0.84, 95% CI 0.72 to 0.98; 3 studies, 2104 participants; moderate-certainty evidence; at 3 years: 30.5% with intervention versus 39.8% with control; RR 0.77, 95% CI 0.59 to 1.01; 1 study, 394 participants; moderate-certainty evidence). Our protocol defined a difference of 3% in the incidence of myopia as clinically important. At one year, the difference was 2.4%, but there were clinically important differences between the two groups at two (4.2%) and three years (9.3%). The intervention groups had smaller changes in axial lengths in the direction of myopia than the control groups; however, 95% CIs included no benefit or both benefit and harm at years one and three (at 1 year: MD -0.04 mm, 95% CI -0.09 to 0; 3 studies, 1666 participants; low-certainty evidence; at 2 years: MD -0.04 mm, 95% CI -0.07 to -0.01; 3 studies, 2479 participants; moderate-certainty evidence; at 3 years: MD -0.03 mm, 95% CI -0.13 to 0.07; 1 study, 763 participants; moderate-certainty evidence). No included studies reported changes in unaided distance visual acuity and quality of life. No adverse events were reported. AUTHORS' CONCLUSIONS The intervention methods varied from adopting outdoor activities as part of school lessons to providing information and motivation for encouraging outdoor activities. The results of this review suggest that long-term interventions to increase the time spent outdoors may potentially reduce the development of myopia in children. However, although the interventions may also suppress the progression of myopia, the low certainty of evidence makes it difficult to draw conclusions. Further research needs to be accumulated and reviewed.
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Affiliation(s)
- Ai Kido
- Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masahiro Miyake
- Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Norio Watanabe
- Department of Health Promotion and Human Behavior, Kyoto University School of Public Health, Kyoto, Japan
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Wolf AT, Klawe J, Liu B, Ahmad S. Association Between Serum Vitamin D Levels and Myopia in the National Health and Nutrition Examination Survey (2001-2006). Ophthalmic Epidemiol 2024; 31:229-239. [PMID: 37415384 DOI: 10.1080/09286586.2023.2232460] [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: 07/22/2022] [Accepted: 06/25/2023] [Indexed: 07/08/2023]
Abstract
PURPOSE To assess the relationship between serum vitamin D levels and myopia in people aged 12-50 years using the National Health and Nutrition Examination Survey (NHANES) database. METHODS Demographics, vision, and serum vitamin D levels from NHANES (2001-2006) were analyzed. Multivariate analyses were performed to examine the relationship between serum vitamin D levels and myopia while controlling for sex, age, ethnicity, education level, serum vitamin A, and poverty status. The main outcome was presence or absence of myopia, defined as a spherical equivalent of -1 diopters or more. RESULTS Of the 11669 participants, 5,310 (45.5%) had myopia. The average serum vitamin D concentration was 61.6 ± 0.9 nmol/L for the myopic group and 63.1 ± 0.8 nmol/L for the non-myopic group (p = .01). After adjusting for all covariates, having higher serum vitamin D was associated with lower odds of having myopia (odds ratio 0.82 [0.74-0.92], p = .0007). In linear regression modeling that excluded hyperopes (spherical equivalent > +1 diopters), there was a positive relationship between spherical equivalent and serum vitamin D levels. Specifically, as serum vitamin D doubled, spherical equivalent increased by 0.17 (p = .02) indicating a positive dose-response relationship between vitamin D and myopia. CONCLUSIONS Participants with myopia, on average, had lower serum concentrations of vitamin D compared to those without myopia. While further studies are needed to determine the mechanism, this study suggests that higher vitamin D levels are associated with lower incidence of myopia.
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Affiliation(s)
- Amber T Wolf
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Janek Klawe
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Bian Liu
- Environmental Medicine & Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Sumayya Ahmad
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Cai HM, Li MY, Cao Y, Wu YL, Liang M, Chen YS, Xian BK, Huang YJ, Kong XB. Effect of artificial natural light on the development of myopia among primary school-age children in China: a three-year longitudinal study. Int J Ophthalmol 2024; 17:924-931. [PMID: 38766340 PMCID: PMC11074203 DOI: 10.18240/ijo.2024.05.18] [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: 09/03/2023] [Accepted: 11/20/2023] [Indexed: 05/22/2024] Open
Abstract
AIM To assess the efficacy of artificial natural light in preventing incident myopia in primary school-age children. METHODS This is a prospective, randomized control, intervention study. A total of 1840 students from 39 classes in 4 primary schools in Foshan participated in this study. The whole randomization method was adopted to include classes as a group according to 1:1 randomized control. Classrooms in the control group were illuminated by usual light, and classrooms in the intervention group were illuminated by artificial natural light. All students received uncorrected visual acuity and best-corrected visual acuity measurement, non-cycloplegic autorefraction, ocular biometric examination, slit lamp and strabismus examination. Three-year follow-up, the students underwent same procedures. Myopia was defined as spherical equivalent refraction ≤ -0.50 D and uncorrected visual acuity <20/20. RESULTS There were 894 students in the control group and 946 students in the intervention group with a mean±SD age of 7.50±0.53y. The three-year cumulative incidence rate of myopia was 26.4% (207 incident cases among 784 eligible participants at baseline) in the control group and 21.2% (164 incident cases among 774 eligible participants at baseline) in the intervention group [difference of 5.2% (95%CI, 3.7% to 10.1%); P=0.035]. There was also a significant difference in the three-year change in spherical equivalent refraction for the control group (-0.81 D) compared with the intervention group [-0.63 D; difference of 0.18 D (95%CI, 0.08 to 0.28 D); P<0.001]. Elongation of axial length was significantly different between in the control group (0.77 mm) and the intervention group [0.72 mm; difference of 0.05 mm (95%CI, 0.01 to 0.09 mm); P=0.003]. CONCLUSION Artificial natural light in the classroom of primary schools can result in reducing incidence rate of myopia during a period of three years.
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Affiliation(s)
- Hui-Min Cai
- Department of Ophthalmology, the Second People's Hospital of Foshan, Affiliated Foshan Hospital of Southern Medical University, Foshan 528000, Guangdong Province, China
| | - Meng-Yan Li
- Guangdong Medical University, Zhanjiang 524023, Guangdong Province, China
| | - Yi Cao
- Department of Ophthalmology, the Second People's Hospital of Foshan, Affiliated Foshan Hospital of Southern Medical University, Foshan 528000, Guangdong Province, China
| | - Yu-Lin Wu
- Guangdong Cosio Lighting Corporation, Foshan 528000, Guangdong Province, China
| | - Ming Liang
- Guangdong Cosio Lighting Corporation, Foshan 528000, Guangdong Province, China
| | - Yu-Shi Chen
- Department of Ophthalmology, the Second People's Hospital of Foshan, Affiliated Foshan Hospital of Southern Medical University, Foshan 528000, Guangdong Province, China
| | - Bi-Kun Xian
- Department of Ophthalmology, the Second People's Hospital of Foshan, Affiliated Foshan Hospital of Southern Medical University, Foshan 528000, Guangdong Province, China
| | - Yu-Juan Huang
- Department of Ophthalmology, the Second People's Hospital of Foshan, Affiliated Foshan Hospital of Southern Medical University, Foshan 528000, Guangdong Province, China
| | - Xiang-Bin Kong
- Department of Ophthalmology, the Second People's Hospital of Foshan, Affiliated Foshan Hospital of Southern Medical University, Foshan 528000, Guangdong Province, China
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Zhou S, Niu Y, Li X, Yue J, Zhang H. The knowledge structure and research trends between light and myopia: A bibliometric analysis from 1981 to 2024. Medicine (Baltimore) 2024; 103:e38157. [PMID: 38758893 PMCID: PMC11098238 DOI: 10.1097/md.0000000000038157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 04/16/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND This bibliometric analysis explored the knowledge structure of and research trends in the relationship between light and myopia. METHODS Relevant literature published from 1981 to 2024 was collected from the Web of Science Core Collection database. Visual maps were generated using CiteSpace and VOSviewer. We analyzed the included studies in terms of the annual publication count, countries, institutional affiliations, prolific authors, source journals, top 10 most cited articles, keyword co-occurrence, and cocitations. RESULTS A total of 525 papers examining the relationship between light and myopia published between 1981 and 2024 were collected. The United States ranked first in terms of the number of publications and actively engaged in international cooperation with other countries. The New England College of Optometry, which is located in the United States, was the most active institution and ranked first in terms of the number of publications. Schaeffel Frank was the most prolific author. The most active journal in the field was Investigative Ophthalmology & Visual Science. The most frequently cited paper in the included studies was written by Saw, SM and was published in 2002. The most common keywords in basic research included "refractive error," "longitudinal chromatic aberration," and "compensation." The most common keywords in clinical research mainly included "light exposure," "school," and "outdoor activity." The current research hotspots in this field are "progression," "refractive development," and "light exposure." The cocitation analysis generated 17 clusters. CONCLUSION This study is the first to use bibliometric methods to analyze existing research on the relationship between light and myopia. In recent years, the intensity and wavelength of light have become research hotspots in the field. Further research on light of different intensities and wavelengths may provide new perspectives in the future for designing more effective treatments and interventions to reduce the incidence of myopia.
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Affiliation(s)
- Shuaibing Zhou
- Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Henan Eye Hospital, Henan Eye Institution, Henan Key Laboratory for Ophthalmology and Visual Science, Zhengzhou University, Zhengzhou, China
| | - Yueyue Niu
- Henan University People’s Hospital, Henan Eye Hospital, Zhengzhou, China
| | - Xuejiao Li
- Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Henan Eye Hospital, Henan Eye Institution, Henan Key Laboratory for Ophthalmology and Visual Science, Zhengzhou University, Zhengzhou, China
- Department of Ophthalmology, Sanmenxia Central Hospital, Sanmenxia, China
| | - Juan Yue
- Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Henan Eye Hospital, Henan Eye Institution, Henan Key Laboratory for Ophthalmology and Visual Science, Zhengzhou University, Zhengzhou, China
| | - Hongmin Zhang
- Zhengzhou University People’s Hospital, Henan Provincial People’s Hospital, Henan Eye Hospital, Henan Eye Institution, Henan Key Laboratory for Ophthalmology and Visual Science, Zhengzhou University, Zhengzhou, China
- Henan University People’s Hospital, Henan Eye Hospital, Zhengzhou, China
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Li D, Min S, Li X. Is Spending More Time Outdoors Able to Prevent and Control Myopia in Children and Adolescents? A Meta-Analysis. Ophthalmic Res 2024; 67:393-404. [PMID: 38710180 DOI: 10.1159/000539229] [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: 06/24/2023] [Accepted: 04/29/2024] [Indexed: 05/08/2024]
Abstract
INTRODUCTION Spending more time outdoors was treated as a safe and cost-effective method to prevent and control myopia. While prior research has established an inverse association between outdoor time and the risk of myopia onset, the effect of increasing outdoor time in delaying the progression of myopia remains a subject of debate. The present meta-analysis aimed to assess the relationship between outdoor time and the myopia onset, and further examine whether there is a dose-response relationship between outdoor time and the risk of myopia onset. Meanwhile, perform whether the outdoor time is related to delaying the progression of myopia. METHODS Studies were retrieved from PubMed, Web of Science, Embase, Medline, and the Cochrane Database, spanning from their inception to February 2023. Three cohort studies and 5 prospective intervention studies were included, with a total of 12,922 participants aged 6-16 years. RESULTS Comparing the highest with the lowest exposure levels of time spent outdoors, the highest outdoor time was strongly associated with a reduced risk of myopia onset (odds ratio [OR]: 0.53; 95% confidence interval [CI]: 0.34, 0.82). A nonlinear dose-response relationship was found between outdoor time and myopia onset risk. Compared to 3.5 h of outdoor time per week, an increase to 7, 16.3, and 27 h per week corresponded with a respective reduction in the risk of myopia onset by 20%, 53%, and 69%. Among children and adolescents who were not myopic, spending more time outdoors significantly slowed down the speed of change in spherical equivalent refractive (weighted mean difference [WMD] = 0.10D, 95% CI: 0.07, 0.14) and axial length (WMD = -0.05 mm, 95% CI: -0.06, -0.03). Among children and adolescents who were already myopic, spending more time outdoors did not slow myopia progression. CONCLUSIONS Overall, spending more time outdoors can prevent the onset of myopia, but it does not seem to slow its progression. Further studies are needed to better understand these trends.
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Affiliation(s)
- Dan Li
- School of Physical Education, Hunan Normal University, Changsha, China
| | - Sicheng Min
- School of Physical Education, Hunan Normal University, Changsha, China
| | - Xianxiong Li
- School of Physical Education, Hunan Normal University, Changsha, China
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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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Sharma S, Rose L, Schulz A, Sharma DP, Zeldovich A, Azzi C, Nischal K. Myopia intervention and ultraviolet radiation related eye diseases: A narrative literature review. Taiwan J Ophthalmol 2024; 14:151-158. [PMID: 39027060 PMCID: PMC11253989 DOI: 10.4103/tjo.tjo-d-24-00011] [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: 01/23/2024] [Accepted: 03/05/2024] [Indexed: 07/20/2024] Open
Abstract
There has been an increased understanding of the protective effect of two or more hours in high lux light on the development and progression of myopia. The aim of myopia management is to reduce the incidence of high myopia and sight-threatening myopic complications. Equally important are the sight-threatening complications of ultraviolet radiation (UVR) on the eye and adnexal structures. This review will analyze the literature for both these epidemics to help guide public health policy. Whilst increasing childhood high lux light exposure is important, consideration of a holistic eye health policy should ensure that UV eye diseases are also prevented. The advent of ultraviolet (UV) fluorescence photography has increased our understanding that significant UV eye damage occurs in childhood, with 81% of children aged 12-15 years having signs of UV eye damage. Hence, the need to reduce myopia and protect from UV-related eye diseases needs simultaneous consideration. Advocating for eye protection is important, particularly as the natural squint reflex is disabled with dark sunglasses lenses. The pathways UV reaches the eye need to be considered and addressed to ensure that sunglasses offer optimum UV eye protection. The design of protective sunglasses that simultaneously allow high lux light exposure and protect from UVR is critical in combating both these epidemics.
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Affiliation(s)
| | | | | | | | | | | | - Ken Nischal
- UPMC Children’s Hospital Pittsburgh, Pennsylvania, USA
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10
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Biswas S, El Kareh A, Qureshi M, Lee DMX, Sun CH, Lam JSH, Saw SM, Najjar RP. The influence of the environment and lifestyle on myopia. J Physiol Anthropol 2024; 43:7. [PMID: 38297353 PMCID: PMC10829372 DOI: 10.1186/s40101-024-00354-7] [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: 10/23/2023] [Accepted: 01/05/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Myopia, commonly known as near-sightedness, has emerged as a global epidemic, impacting almost one in three individuals across the world. The increasing prevalence of myopia during early childhood has heightened the risk of developing high myopia and related sight-threatening eye conditions in adulthood. This surge in myopia rates, occurring within a relatively stable genetic framework, underscores the profound influence of environmental and lifestyle factors on this condition. In this comprehensive narrative review, we shed light on both established and potential environmental and lifestyle contributors that affect the development and progression of myopia. MAIN BODY Epidemiological and interventional research has consistently revealed a compelling connection between increased outdoor time and a decreased risk of myopia in children. This protective effect may primarily be attributed to exposure to the characteristics of natural light (i.e., sunlight) and the release of retinal dopamine. Conversely, irrespective of outdoor time, excessive engagement in near work can further worsen the onset of myopia. While the exact mechanisms behind this exacerbation are not fully comprehended, it appears to involve shifts in relative peripheral refraction, the overstimulation of accommodation, or a complex interplay of these factors, leading to issues like retinal image defocus, blur, and chromatic aberration. Other potential factors like the spatial frequency of the visual environment, circadian rhythm, sleep, nutrition, smoking, socio-economic status, and education have debatable independent influences on myopia development. CONCLUSION The environment exerts a significant influence on the development and progression of myopia. Improving the modifiable key environmental predictors like time spent outdoors and engagement in near work can prevent or slow the progression of myopia. The intricate connections between lifestyle and environmental factors often obscure research findings, making it challenging to disentangle their individual effects. This complexity underscores the necessity for prospective studies that employ objective assessments, such as quantifying light exposure and near work, among others. These studies are crucial for gaining a more comprehensive understanding of how various environmental factors can be modified to prevent or slow the progression of myopia.
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Affiliation(s)
- Sayantan Biswas
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Antonio El Kareh
- Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon
| | - Mariyem Qureshi
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
| | | | - Chen-Hsin Sun
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Janice S H Lam
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Seang-Mei Saw
- Singapore Eye Research Institute, Singapore, Singapore
- Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Raymond P Najjar
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Singapore Eye Research Institute, Singapore, Singapore.
- Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore.
- Department of Biomedical Engineering, College of Design and Engineering, National University of Singapore, Singapore, Singapore.
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Ying ZQ, Li DL, Zheng XY, Zhang XF, Pan CW. Risk factors for myopia among children and adolescents: an umbrella review of published meta-analyses and systematic reviews. Br J Ophthalmol 2024; 108:167-174. [PMID: 36754586 DOI: 10.1136/bjo-2022-322773] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 01/24/2023] [Indexed: 02/10/2023]
Abstract
AIMS To identify potential risk factors for myopia in children and adolescents and assess the credibility of each evidence, providing reference for the development of myopia prevention strategies. METHODS We searched PubMed, Web of Science and Embase databases from inception to April 2022 to find systematic reviews or meta-analyses investigating the relationship between potential risk factors and myopia, and conducted an umbrella review. We recalculated the pooled effect sizes and 95% CIs of each potential risk factor through random-effects model, and reported its 95% prediction interval and between-study heterogeneity. Small-study effect and excess of significance bias were assessed to reveal potential publication bias. RESULTS Twelve publications were included in this umbrella review, including eight meta-analyses and four qualitative systematic reviews. Twenty-two factors were identified, of which 16 were analysed quantitatively. Ten factors showed statistically significant association with myopia. Myopia in one or two parents and per additional hour of time spend outdoors per week were rated as highly suggestive evidence. Near work and gender were evaluated as suggestive evidence. The other five factors are weak evidence. CONCLUSIONS We found several risk factors for myopia with different levels of evidence, of which parental myopia presented the strongest association with myopia in children and adolescents. Our findings contribute to a better understanding of the association between potential risk factors and myopia among children and adolescents and are important for informing parenting, education, clinical practice guidelines and public health policy. PROSPERO TRIAL REGISTRATION NUMBER CRD42022333053.
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Affiliation(s)
- Zhi-Qi Ying
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Dan-Lin Li
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Xin-Yu Zheng
- School of Public Health, Medical College of Soochow University, Suzhou, China
| | - Xiao-Feng Zhang
- Department of Ophthalmology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China
| | - Chen-Wei Pan
- School of Public Health, Medical College of Soochow University, Suzhou, China
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12
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Marcellán Vidosa MC, Remón L, Ávila FJ. Peripheral refraction under different levels of illuminance. Ophthalmic Physiol Opt 2024; 44:191-198. [PMID: 37950504 DOI: 10.1111/opo.13244] [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: 06/09/2023] [Revised: 10/21/2023] [Accepted: 10/24/2023] [Indexed: 11/12/2023]
Abstract
Peripheral refraction is believed to be involved in the development of myopia. The aim of this study was to compare the relative peripheral refraction (RPR) at four different levels of illuminance, ranging from photopic conditions to complete darkness, using an open-field autorefraction method. The RPR was calculated for each eccentricity by subtracting central from peripheral autorefraction measurements. The study included 114 myopic eyes from 114 subjects (mean age of 21.81 ± 1.91 years) and the mean difference in RPR between scotopic and photopic conditions (0 and 300 lux, respectively) was +0.32 D at 30° temporal and +0.37 D at 30° in the nasal visual field (NVF). Statistically significant differences were observed between 0 and 300 lux at 30° in the temporal visual field and at 30° and 20° in the NVF. Our results revealed a significant increase in relative peripheral hyperopia with increasing visual field eccentricity along the horizontal visual field in myopic eyes of young adults. Furthermore, this relative peripheral hyperopia increased as illumination decreased. These findings suggest that an increase in peripheral illuminance may protect against myopic eye growth.
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Affiliation(s)
| | - Laura Remón
- Department of Applied Physics, Universidad de Zaragoza, Zaragoza, Spain
| | - Francisco J Ávila
- Department of Applied Physics, Universidad de Zaragoza, Zaragoza, Spain
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Wen L, Liu H, Chen Z, Xu Q, Hu Z, Lan W, Yang Z. Effect of mount location on the quantification of light intensity in myopia study. BMJ Open Ophthalmol 2023; 8:e001409. [PMID: 38154910 PMCID: PMC10759099 DOI: 10.1136/bmjophth-2023-001409] [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: 07/21/2023] [Accepted: 12/19/2023] [Indexed: 12/30/2023] Open
Abstract
PURPOSE To investigate how the mounting location of wearable devices affects the measurement of light intensity. METHODS Two commercially available wearable devices, HOBO and Clouclip, were used to compare the effects of different mount locations on light intensity measurement. We assessed the consistency of the measurements of the two devices by placing a HOBO and a Clouclip simultaneously in 26 different light environments and measuring the light intensity. To simulate the real-life usage scenarios of the two devices, we had 29 participants wear two HOBOs-one on the wrist and the other on the chest-along with a Clouclip on their spectacles for 1 day; meanwhile, the light intensity was measured and analysed. RESULTS When under the same light environments, the light intensity measured by the Clouclip was 1.09 times higher than that by the HOBO, with an additional 82.62 units (r2=1.00, p<0.001). When simulating the real-life scenarios, the mean light intensity at the eye-level position was significantly lower than that at the chest position (189.13±665.78 lux vs 490.75±1684.29 lux, p<0.001) and the wrist position (189.13±665.78 lux vs 483.87±1605.50 lux, p<0.001). However, there was no significant difference in light intensity between the wrist and chest positions (483.87±1605.50 lux vs 490.75±1684.29 lux, p=1.00). Using a threshold of 1000 lux for outdoor exposure, the estimated light exposure at the eye-level position was significantly lower than that at the chest position (3.9% vs 7.8%, χ2=266.14, p<0.001) and the wrist position (3.9% vs 7.7%, χ2=254.25, p<0.001). CONCLUSIONS Our findings revealed significant variations in light exposure among the wrist, chest and eye position. Therefore, caution must be exercised when comparing results obtained from different wearable devices.
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Affiliation(s)
- Longbo Wen
- Aier School of Ophthalmology, Central South University, Changsha Aier Eye Hospital, Aier Eye Hospital Group, Changsha, China
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, China
| | - Hong Liu
- Aier School of Ophthalmology, Central South University, Changsha Aier Eye Hospital, Aier Eye Hospital Group, Changsha, China
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, China
| | - Zhao Chen
- Aier School of Ophthalmology, Central South University, Changsha Aier Eye Hospital, Aier Eye Hospital Group, Changsha, China
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, China
| | - Qinglin Xu
- Aier School of Ophthalmology, Central South University, Changsha Aier Eye Hospital, Aier Eye Hospital Group, Changsha, China
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, China
| | - Ziqi Hu
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, China
| | - Weizhong Lan
- Aier School of Ophthalmology, Central South University, Changsha Aier Eye Hospital, Aier Eye Hospital Group, Changsha, China
- Guangzhou Aier Eye Hospital, Jinan University, Guangzhou, Guangdong, China
| | - Zhikuan Yang
- Aier School of Ophthalmology, Central South University, Changsha Aier Eye Hospital, Aier Eye Hospital Group, Changsha, China
- Hunan Province Optometry Engineering and Technology Research Center, Changsha, China
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14
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Liao S, Li X, Bai N, Wu D, Yang W, Wang F, Ji HZ. An empirical study on the effect of outdoor illumination and exercise intervention on Children's vision. Front Public Health 2023; 11:1270826. [PMID: 38155899 PMCID: PMC10754518 DOI: 10.3389/fpubh.2023.1270826] [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: 08/01/2023] [Accepted: 11/28/2023] [Indexed: 12/30/2023] Open
Abstract
Objective To explore the relationship between outdoor lighting and sports and the development of myopia, and to analyze the effects of outdoor lighting and exercise on the diopter of children with normal vision and myopia, so as to provide guidance for the prevention and treatment of myopia in children and adolescents in the future. Methods A total of 201 children were divided into two groups according to myopia or not. Each group was randomly divided into 4 groups: outdoor exercise group, outdoor control group, indoor exercise group and indoor control group. Among them, the outdoor exercise group and indoor exercise group received moderate and high intensity aerobic exercise 3 times a week for 60 min each time for 12 months, while the outdoor control group and indoor control group had normal study and life during the corresponding period of time. No additional exercise intervention. At the end of the experiment, the diopter of each group was compared. Results The diopter of all groups with normal vision and myopia decreased significantly after the experiment (p < 0.01). There were significant differences in diopter between outdoor exercise group and indoor control group (p < 0.01), between outdoor exercise group and indoor control group (p < 0.05), and between indoor exercise group and indoor control group (p < 0.01). There were significant differences in diopter between indoor exercise group and indoor control group (p < 0.01). The differences among myopic children after the experiment showed that there was significant difference in diopter between outdoor exercise group and indoor exercise group (p < 0.05), between outdoor exercise group and indoor control group (p < 0.01), and between outdoor control group and indoor control group (p < 0.05). There were significant differences in the changes of diopter between the outdoor control group and the indoor exercise group with normal vision and myopia before and after the experiment (p < 0.05). Conclusion Outdoor light and exercise intervention can have a beneficial effect on children's vision, but because of whether children are myopic or not, the effect is different, outdoor light and exercise have a better effect on reducing the diopter of children with normal vision.
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Affiliation(s)
- Shuaixiong Liao
- Inner Mongolia University of Science and Technology, Baotou, China
| | - Xueying Li
- Inner Mongolia University of Science and Technology, Baotou, China
| | - Nan Bai
- Inner Mongolia University of Science and Technology, Baotou, China
| | | | - Wenliang Yang
- Inner Mongolia University of Science and Technology, Baotou, China
| | - Feng Wang
- Inner Mongolia University of Science and Technology, Baotou, China
| | - Hao Zong Ji
- Chongqing Liangjiang Yucai Middle School, Chongqing, China
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15
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Jong M, Naduvilath T, Saw J, Kim K, Flitcroft DI. Association between Global Myopia Prevalence and International Levels of Education. Optom Vis Sci 2023; 100:702-707. [PMID: 37855831 DOI: 10.1097/opx.0000000000002067] [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: 10/20/2023] Open
Abstract
SIGNIFICANCE The Global Myopia Prevalence and International Levels of Education study models national trends in educational performance with myopia prevalence in children; it examines the association of near work with myopia in the form of an ecologic analysis and also discusses how this may relate to educational frameworks. PURPOSE This study aimed to investigate the relationship between myopia prevalence and national educational performance. METHODS The prevalence of myopia in the 15- to 19-year age group in 35 regions was obtained from a meta-analysis by Holden et al. (Ophthalmology 2016;123:1036-1042) and matched with educational performance quantified by the Organisation for Economic Cooperation and Development Programme for International Student Assessment (PISA) testing from 2000 to 2018. A generalized estimating equation was used to describe the relationship between PISA scores and myopia prevalence. Clustering effects of country and chronological year were accounted for in the analysis. Linear and nonlinear terms of PISA scores using lines of best fit were further explored. RESULTS There is a significant positive relationship between Organisation for Economic Cooperation and Development PISA educational performance and myopia prevalence in teenagers with higher PISA scores correlating with higher myopia prevalence, even after accounting for chronological year (generalized estimating equation model: P = .001, .008, and .005 for math, science, and reading, respectively). Scatterplots with cubic and logistic fits indicated that PISA math showed the strongest relationship with myopia prevalence ( r2 = 0.64), followed by science ( r2 = 0.41) and reading ( r2 = 0.31). CONCLUSIONS These results strongly suggest that educational achievement at a national level is associated with higher myopia prevalence. Programme for International Student Assessment scores are a significant driver of many countries' education policies, and countries that have a balance between high PISA scores and lower myopia prevalence may be good models of educational policies to address the myopia public health issue.
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Affiliation(s)
| | | | - Jeanne Saw
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
| | - Kunyoung Kim
- School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
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16
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Wang X, Sun Y, Wang K, Yang S, Luan C, Wu B, Zhang W, Hao R. Effects of blue light exposure on ocular parameters and choroidal blood perfusion in Guinea pig. Exp Eye Res 2023; 235:109619. [PMID: 37633324 DOI: 10.1016/j.exer.2023.109619] [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: 03/05/2023] [Revised: 08/03/2023] [Accepted: 08/19/2023] [Indexed: 08/28/2023]
Abstract
PURPOSE To investigate the impact of different duration of blue light exposure on ocular parameters and choroidal blood perfusion in guinea pigs with lens-induced myopia. METHOD Three-week-old Guinea pigs were randomly assigned to different light-environment groups. All groups were subjected to 12-h light/dark cycle. The control (NC) group was conditioned without intervention. While lens-induced myopia (LIM) groups had a -10D lens placed in the right eye and 0D in the left eye. The guinea pigs were exposed to increasing periods of blue-light (420 nm) environment for 3,6,9,12 h per day. Changes in refraction, axial length (AL), the radius of corneal curvature (CCR), choroidal thickness (ChT), and choroidal blood perfusion (ChBP)were measured in both LIM-eye and fellow-eye during the second and fourth week of LIM duration. RESULTS During the first two weeks of the experiment, blue light exposure raised ChBP and ChT, and the effect of suppressing myopia was proportional to the duration of blue light exposure. However, in the fourth week of the experiment, prolonged blue light (12BL) exposure led to a reduction in retinal thickness and the increase in ChT and ChBP ceased. Shorter blue light exposure had a better effect on myopia suppression, with all blue light groups statistically different from the LIM group. CONCLUSION Exposure to blue-light appears to have the potential to improve ChBP and ChT, thereby inhibiting the development of myopia. we speculate that blue-light inhibits the development of myopia for reasons other than longitudinal chromatic aberration (LCA). However,long-term exposure to blue-light may have adverse effects on ocular development. The next step is to investigate in depth the mechanisms by which the rational use of blue light regulates choroidal blood flow, offering new hope for the treatment of myopia.
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Affiliation(s)
- Xiao Wang
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300020, PR China; Tianjin Key Lab of Ophthalmology and Vision Science, Tianjin Eye Hospital, Tianjin, 300020, PR China
| | - Yifan Sun
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300020, PR China; Tianjin Key Lab of Ophthalmology and Vision Science, Tianjin Eye Hospital, Tianjin, 300020, PR China
| | - Kailei Wang
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300020, PR China; Tianjin Key Lab of Ophthalmology and Vision Science, Tianjin Eye Hospital, Tianjin, 300020, PR China
| | - Shiqiao Yang
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300020, PR China; Tianjin Key Lab of Ophthalmology and Vision Science, Tianjin Eye Hospital, Tianjin, 300020, PR China
| | - Changlin Luan
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300020, PR China; Tianjin Key Lab of Ophthalmology and Vision Science, Tianjin Eye Hospital, Tianjin, 300020, PR China
| | - Bin Wu
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300020, PR China; Tianjin Key Lab of Ophthalmology and Vision Science, Tianjin Eye Hospital, Tianjin, 300020, PR China; Nankai University Eye Institute, Nankai University Affiliated Eye Hospital, Nankai University, Tianjin, 300020, PR China
| | - Wei Zhang
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300020, PR China; Tianjin Key Lab of Ophthalmology and Vision Science, Tianjin Eye Hospital, Tianjin, 300020, PR China; Nankai University Eye Institute, Nankai University Affiliated Eye Hospital, Nankai University, Tianjin, 300020, PR China.
| | - Rui Hao
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300020, PR China; Tianjin Key Lab of Ophthalmology and Vision Science, Tianjin Eye Hospital, Tianjin, 300020, PR China; Nankai University Eye Institute, Nankai University Affiliated Eye Hospital, Nankai University, Tianjin, 300020, PR China.
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Quint WH, van Buuren R, Kokke NCCJ, Meester-Smoor MA, Willemsen R, Broersma R, Iglesias AI, Lucassen M, Klaver CCW. Exposure to cyan or red light inhibits the axial growth of zebrafish eyes. Exp Eye Res 2023; 230:109437. [PMID: 36924981 DOI: 10.1016/j.exer.2023.109437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/01/2023] [Accepted: 03/10/2023] [Indexed: 03/18/2023]
Abstract
Myopia, or nearsightedness, is the most common type of refractive error and is characterized by a mismatch between the optical power and ocular axial length. Light, and more specifically the spectral composition of light, has been known to influence myopic axial growth. In this pilot study, we exposed zebrafish to illuminations that vary in spectral composition and screened for changes in axial length. The illumination spectra included narrow band ultra-violet A (UVA) (peak wavelength 369 nm), violet (425 nm), cyan (483 nm), green/yellow (557 nm), and red (633 nm) light, as well as broad band white light (2700 K and 6500 K), dim white light and broad spectrum (day) light. We found that rearing zebrafish in cyan or red light leads to a reduction of the ocular axial length. The results of this pilot study may contribute to new perspectives on the role of light and lighting as an intervention strategy for myopia control.
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Affiliation(s)
- Wim H Quint
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Renee van Buuren
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Nina C C J Kokke
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Magda A Meester-Smoor
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Rob Willemsen
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Rémy Broersma
- Signify Research, Signify, Eindhoven, the Netherlands
| | - Adriana I Iglesias
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, the Netherlands
| | | | - Caroline C W Klaver
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Ophthalmology, Radboud University Medical Center, Nijmegen, the Netherlands; Institute of Molecular and Clinical Ophthalmology Basel, Basel, Switzerland.
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18
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Dhakal R, Huntjens B, Shah R, Lawrenson JG, Verkicharla PK. Influence of location, season and time of day on the spectral composition of ambient light: Investigation for application in myopia. Ophthalmic Physiol Opt 2023; 43:220-230. [PMID: 36637143 DOI: 10.1111/opo.13085] [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: 10/08/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 01/14/2023]
Abstract
PURPOSE Given the possible role of spectral composition of light and myopia, this study aimed at investigating the variation in the spectral composition of ambient light in different (a) outdoor/indoor locations, (b) time of a day and (c) seasons. METHODS The spectral power distribution (SPD), categorised into short (380-500 nm), middle (505-565 nm) and long wavelengths (625-780 nm), was recorded using a handheld spectrometer at three outdoor locations ('open playground', 'under shade of tree' and 'canopy') and three indoor locations ('room with multiple windows', 'closed room' and 'closed corridor'). Readings were taken at five different time points (3-h intervals between 6:30 and 18:00 hours) on two days, each during the summer and monsoon seasons. RESULTS The overall median SPD (IQR [25th-75th percentile] W/nm/m2 ) across the three outdoor locations (0.11 [0.09, 0.12]) was 157 times higher than that of the indoor locations (0.0007 [0.0001, 0.001]). Considerable locational, diurnal and seasonal variation was observed in the distribution of the median SPD value, with the highest value being recorded in the 'open playground' (0.27 [0.21, 0.28]) followed by 'under shade of tree' (0.083 [0.074, 0.09]), 'canopy' (0.014 [0.012, 0.015]) and 'room with multiple windows' (0.023 [0.015, 0.028]). The relative percentage composition of short, middle and long wavelengths was similar in both the outdoor and indoor locations, with the proportion of middle wavelengths significantly higher (p < 0.01) than short and long wavelengths in all the locations, except 'canopy'. CONCLUSION Irrespective of variation in SPD values with location, time, day and season, outdoor locations always exhibited significantly higher spectral power than indoor locations. The relative percentage composition of short, middle and long wavelengths of light was similar across all locations. These findings establish a foundation for future research to understand the relationship between spectral power and the development of myopia.
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Affiliation(s)
- Rohit Dhakal
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Infor Myopia Centre, L V Prasad Eye Institute, Hyderabad, India.,Centre for Applied Vision Research, School of Health Sciences, City University of London, London, UK
| | - Byki Huntjens
- Centre for Applied Vision Research, School of Health Sciences, City University of London, London, UK
| | - Rakhee Shah
- Centre for Applied Vision Research, School of Health Sciences, City University of London, London, UK
| | - John G Lawrenson
- Centre for Applied Vision Research, School of Health Sciences, City University of London, London, UK
| | - Pavan K Verkicharla
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Infor Myopia Centre, L V Prasad Eye Institute, Hyderabad, India
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Shneor E, Ostrin LA, Doron R, Benoit JS, Levine J, Davidson K, Gordon-Shaag A. Baseline characteristics in the Israel refraction, environment, and devices (iREAD) study. Sci Rep 2023; 13:2855. [PMID: 36806309 PMCID: PMC9938253 DOI: 10.1038/s41598-023-29563-3] [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: 01/05/2023] [Accepted: 02/07/2023] [Indexed: 02/19/2023] Open
Abstract
The purpose of this study is to present baseline data from a longitudinal study assessing behavioral factors in three groups of boys in Israel with varying myopia prevalence. Ultra-Orthodox (N = 57), religious (N = 67), and secular (N = 44) Jewish boys (age 8.6 ± 1.4 years) underwent cycloplegic autorefraction and axial-length measurement. Time-outdoors and physical-activity were assessed objectively using an Actiwatch. Ocular history, educational factors, and near-work were assessed with a questionnaire. Group effects were tested and mixed effects logistic and linear regression were used to evaluate behaviors and their relationship to myopia. The prevalence of myopia (≤ - 0.50D) varied by group (ultra-Orthodox: 46%, religious: 25%, secular: 20%, P < 0.021). Refraction was more myopic in the ultra-Orthodox group (P = 0.001). Ultra-Orthodox boys learned to read at a younger age (P < 0.001), spent more hours in school (P < 0.001), spent less time using electronic devices (P < 0.001), and on weekdays, spent less time outdoors (P = 0.02). Increased hours in school (OR 1.70) and near-work (OR 1.22), increased the odds of myopia. Being ultra-Orthodox (P < 0.05) and increased near-work (P = 0.007) were associated with a more negative refraction. Several factors were associated with the prevalence and degree of myopia in young boys in Israel, including being ultra-Orthodox, learning to read at a younger age, and spending more hours in school.
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Affiliation(s)
- Einat Shneor
- Department of Optometry, Hadassah Academic College, Haniviim St. 37, 9101001, Jerusalem, Israel.
| | - Lisa A. Ostrin
- grid.266436.30000 0004 1569 9707College of Optometry, University of Houston, Houston, TX 77004 USA
| | - Ravid Doron
- grid.443085.e0000 0004 0366 7759Department of Optometry, Hadassah Academic College, Haniviim St. 37, 9101001 Jerusalem, Israel
| | - Julia S. Benoit
- grid.266436.30000 0004 1569 9707Texas Institute for Measurement, Evaluation, and Statistics, Houston, TX 77004 USA
| | - Jonathan Levine
- grid.443085.e0000 0004 0366 7759Department of Optometry, Hadassah Academic College, Haniviim St. 37, 9101001 Jerusalem, Israel
| | - Kevin Davidson
- grid.266436.30000 0004 1569 9707Texas Institute for Measurement, Evaluation, and Statistics, Houston, TX 77004 USA
| | - Ariela Gordon-Shaag
- grid.443085.e0000 0004 0366 7759Department of Optometry, Hadassah Academic College, Haniviim St. 37, 9101001 Jerusalem, Israel
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20
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Kneepkens SCM, de Vlieger J, Tideman JWL, Enthoven CA, Polling JR, Klaver CCW. Myopia risk behaviour related to the COVID-19 lockdown in Europe: The generation R study. Ophthalmic Physiol Opt 2023; 43:402-409. [PMID: 36772877 DOI: 10.1111/opo.13100] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 02/12/2023]
Abstract
PURPOSE To battle the spreading of the COVID-19 virus, nationwide lockdowns were implemented during 2020 and 2021. Reports from China revealed that their strict home confinements led to an increase in myopia incidence. The Netherlands implemented a more lenient lockdown, which allowed children to go outside. We evaluated the association between COVID-19 restrictions, myopia risk behaviour and myopia progression in Dutch teenagers. METHOD A total of 1101 participants (mean age 16.3 ± 3.65 yrs) completed questionnaires about their activities before, during and after lockdown (March-October 2020). We used a repeated-measures ANOVA to compare time use between these time periods. Ocular measurements were acquired before the COVID-19 pandemic when participants were 13 years old; only 242 participants had ocular measurements at 18 years of age at the time of this analysis. Linear regression analyses were used to evaluate the association between lifestyle factors and myopia progression. RESULTS Children were on average 16.2 (1.03) years of age during lockdown. Total nearwork increased from 8.11 h/day to 11.79 h/day, and remained higher after lockdown at 9.46 h/day (p < 0.001). Non-educational nearwork increased by 2.22 h/day (+49%) during lockdown and was associated with faster axial length progression (B 0.002 mm/h/year; SE 0.001 p = 0.03). Before and during lockdown, the mean time spent outdoors was similar (1.78 h/day and 1.80 h/day, respectively). After lockdown, time spent outdoors decreased to 1.56 h/day (p < 0.001). CONCLUSION The Dutch lockdown significantly increased digitised nearwork in adolescents but did not affect outdoor exposure. The changes in time spent performing nearwork remained after the lockdown measures had ended. We expect that the COVID-19 pandemic may lead to an increase in myopia prevalence and progression in European children.
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Affiliation(s)
- Sander C M Kneepkens
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.,The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Jimmy de Vlieger
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.,The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands
| | - J Willem L Tideman
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.,Martini Hospital, Groningen, The Netherlands
| | - Clair A Enthoven
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.,The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands.,Department of Psychology, Education and Child Studies, Erasmus University, Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Jan Roelof Polling
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.,University of Applied Sciences, Utrecht, The Netherlands
| | - Caroline C W Klaver
- Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.,The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands.,Radboud University Medical Center, Nijmegen, The Netherlands.,Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
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21
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Zhu Z, Chen Y, Tan Z, Xiong R, McGuinness MB, Müller A. Interventions recommended for myopia prevention and control among children and adolescents in China: a systematic review. Br J Ophthalmol 2023; 107:160-166. [PMID: 34844916 DOI: 10.1136/bjophthalmol-2021-319306] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 11/09/2021] [Indexed: 01/25/2023]
Abstract
In 2018, a consortium of government bodies in China led by the Ministry of Education released the Comprehensive Plan to Prevent Nearsightedness among Children and Teenagers (CPPNCT), aiming to reduce the incidence of myopia and control myopic progression in China. Recommendations span from home-based to school-based interventions, including time outdoors, physical activity, light exposure, near-work activity, screen time, Chinese eye exercises, diet and sleep. To date, the levels of evidence for this suite of interventions have not been thoroughly investigated. This review has summarised the evidence of the interventions recommended by the CPPNCT in myopia prevention and control. Thus, the following statements are supposed by the evidence: (1) Increasing time outdoors and reducing near-work time are effective in lowering incident myopia in school-aged children. (2) All interventions have a limited effect on myopia progression. Ongoing research may lead to a better understanding of the underlying mechanisms of myopia development, the interaction of different interventions and recommendations, confounding variables and their true effect on myopia prevention, and the identification of those most likely to respond to specific interventions. This field may also benefit from longer-term studies of the various interventions or strategies covered within this review article, to better understand the persistence of treatment effects over time and explore more novel approaches to myopia control.
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Affiliation(s)
- Zhuoting Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yanxian Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Zachary Tan
- Centre for Eye Research Australia, East Melbourne, Victoria, Australia
| | - Ruilin Xiong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Myra Beth McGuinness
- Centre for Eye Research Australia, East Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Andreas Müller
- Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
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22
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Mu J, Zhong H, Zeng D, Fan J, Jiang M, Liu M, Shuai X, Chen Y, Zhang S. Research trends and hotspots in the relationship between outdoor activities and myopia: A bibliometric analysis based on the web of science database from 2006 to 2021. Front Public Health 2022; 10:1047116. [PMID: 36388306 PMCID: PMC9644123 DOI: 10.3389/fpubh.2022.1047116] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 10/10/2022] [Indexed: 01/31/2023] Open
Abstract
Objectives This study aimed to explore the current status, hotspots, and emerging research trends regarding the relationship between outdoor activities and myopia. Methods Publications on the relationship between outdoor activities and myopia from 2006 to 2021 were collected from the Web of Science Core Collection database. CiteSpace (version 6.1.R2) was used to performed a bibliometric analysis, and R software (version 4.1.0) was used to visualize the trends and hot map of publications. Results A total of 640 publications were collected and analyzed in the present study. China was the major contributor (n = 204), followed by the United States of America (n = 181) and Australia (n = 137). The United States of America had the most extensive foreign cooperation (centrality = 0.25), followed by Australia (centrality = 0.20). The National University of Singapore contributed the largest number of publications (n = 48), followed by Sun Yat-Sen University (n = 41) and the Australian National University (n = 41). Among institutions, Cardiff University in the United Kingdom had the most extensive foreign cooperation (centrality = 0.12), followed by the National University of Singapore (centrality = 0.11). Saw S from Singapore had the largest number of publications (n = 39), followed by Morgan I from Australia (n = 27) and Jonas J from Germany (n = 23). Investigative ophthalmology & visual science is the most important journal to study the relationship between outdoor activities and myopia. "Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050" published by Holden BA was the most cited paper in this field with 177 citations. Co-occurrence and burst analyses of keywords showed that research trends and hotspots in this field focused mainly on "risk," "prevention" and "school". Conclusions The influence of outdoor activities on myopia remains a concern. In the future, deeper cooperation between countries or institutions is required to explore the effects of outdoor activities on myopia. Outdoor activities for the prevention of myopia and reduction of the risk of myopia among school students may be the focus of future research.
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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
| | - 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
| | - Mingjie Jiang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Meizhou Liu
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Xinyi Shuai
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Yanjie Chen
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China
| | - Shaochong Zhang
- Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China,*Correspondence: Shaochong Zhang
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23
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Short-Term Exposure to Violet Light Emitted from Eyeglass Frames in Myopic Children: A Randomized Pilot Clinical Trial. J Clin Med 2022; 11:jcm11206000. [PMID: 36294321 PMCID: PMC9604831 DOI: 10.3390/jcm11206000] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 10/05/2022] [Accepted: 10/08/2022] [Indexed: 11/20/2022] Open
Abstract
Violet light (VL), 360−400 nm wavelength, is contained in the sunlight and is an effective element for myopia suppression. This study is to investigate the safety and efficacy of novel eyeglasses that emit VL from the frames. This is a double-masked, randomized, pilot clinical trial conducted in a clinic in Japan. Forty-three children with myopia were enrolled. Participants were randomly assigned to two groups, wearing VL-emitting eyeglass frames (VLf) that emitted VL of 310 μW/cm2 (VLf group, n = 22) or pseudo-placebo eyeglass frames with a minimal emission of VL (<10 μW/cm2) (control group, n = 21). The exposure time was 3 h per day. The primary outcomes were visual acuity, tear film break-up time, corneal endothelial cell density, and the slit-lamp/fundus examinations. The secondary outcome was the 6-month changes in the axial lengths and cycloplegic refractions. Forty-one (95%) participants were included; twenty-one in the VLf group and twenty in the control group. No significant differences were seen in any safety evaluation. Significant changes were seen in axial elongation, choroidal thickness, and cycloplegic refractions in the subgroup analysis of 8- to 10-year-old children (p < 0.05), but otherwise no significant differences were seen. The VLf showed short-term safety and effectiveness against myopia progression.
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24
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Does Physical Activity Moderate the Relationship between Myopia and Functional Status in Children 9-11 Years of Age? J Clin Med 2022; 11:jcm11195672. [PMID: 36233536 PMCID: PMC9572250 DOI: 10.3390/jcm11195672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/15/2022] [Accepted: 09/21/2022] [Indexed: 11/17/2022] Open
Abstract
Although previous studies have reported an association between physical activity (PA) and myopia in school-aged children, little is known about the link between myopia and children’s functional status. The purpose of this study was to investigate dynamic balance control in relation to the daily PA levels of myopic schoolchildren aged 9−11 years (n = 52) versus a non-myopic control group (n = 53). A single leg stance test performed on the instability platform of the Biodex Balance System was used to assess balance control. The overall stability index (OSI), anterior-posterior stability index (APSI) and medial-lateral stability index (MLSI) were analyzed. PA levels were calculated using the World Health Organization European Childhood Obesity Surveillance Initiative family record form. Myopes and non-myopes were separated into three subgroups based on PA level (low, moderate and high). Myopia significantly affected OSI (F = 40.46, p < 0.001), APSI (F = 33.93, p < 0.001) and MLSI (F = 49.51, p < 0.001). There were significant differences (p < 0.001) between myopic and non-myopic children with low and moderate levels of PA, whilst there were no differences between compared children with high levels of PA. High PA levels had a positive impact on balance control in myopes. Our results showed that PA levels moderate the relationship between myopia and children’s functional status.
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25
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A comparative study of the prevalence of myopia and behavioral changes in primary school students. BMC Ophthalmol 2022; 22:370. [PMID: 36115954 PMCID: PMC9482727 DOI: 10.1186/s12886-022-02594-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 09/02/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Objective
To analyze the changes in the prevalence of myopia and its relation to ocular biological parameters, and behaviors among primary school students in China, and understand the prevention and control of myopia.
Methods
Cross-sectional surveys were performed on 7–9-year-old children in the yrs. 2012 and 2019. In addition, spherical equivalent refraction (SER), axial length (AL), and AL/corneal radius ratio (AL/CR ratio) were collected without cycloplegia. Participants completed detailed questionnaires on behavior related to myopia.
Results
Data was collected on 623 children (8.02 ± 0.57 years old) in 2012 and 536 students in 2019 (8.09 ± 0.65 years old). The prevalence of myopia was 37.7% in 2012 and 39.9% in 2019. The SER was -0.25 (0.92) D in 2012 and -0.25 (1.25) in 2019. There was no statistical difference in the prevalence of myopia and SER over the 7 years (all P > 0.05). In 2019, the prevalence of myopia among girls demonstrated an increasing trend (33.8% vs. 37.8%), but there was no statistical difference (P > 0.05). The mean AL and AL/CR ratio of boys were decreasing (all P < 0.05). The proportion of children reading more than 2 h and using digital devices for more than 2 h per day after their classes in the 2019 group both decreased (all P < 0.05). However, the proportion of activities performed outdoors for more than 2 h./day decreased significantly (P = 0.001).
Conclusion
Compared with 2012, the prevalence of myopia in primary school students in 2019 was under control, which may be related to the improvement of children's near-work behavior, but there was the problem of insufficient outdoor activity time. In terms of ocular biological parameters, the risk of myopia for boys in 2019 was lower.
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26
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Iyer V, Enthoven CA, van Dommelen P, van Samkar A, Groenewoud JH, Jaddoe VVW, Reijneveld SA, Klaver CCW. Rates of spectacle wear in early childhood in the Netherlands. BMC Pediatr 2022; 22:409. [PMID: 35820880 PMCID: PMC9275042 DOI: 10.1186/s12887-022-03467-z] [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: 01/12/2022] [Accepted: 06/30/2022] [Indexed: 11/21/2022] Open
Abstract
Background Refractive errors are relatively common all around the world. In particular, early onset myopia is associated with a significant burden in later life. Little is known about refractive errors in preschool children. The aim of this study was to assess the prevalence of spectacle wear, visual acuity and refractive errors in young Dutch children. Methods We analyzed data of three prospective population-based studies: 99,660 3- to 5-year-olds undergoing vision screening at preventive child healthcare organizations, 6934 6-year-olds from the Generation R study, and 2974 7-year-olds from the RAMSES study. Visual acuity was measured with Landolt-C or LEA charts, spectacle wear was assessed, and refractive errors at age 6 and 7 were measured with cycloplegic refraction. Results The prevalence of spectacle wear ranged from 1.5 to 11.8% between 3 to 7 years with no significant gender differences. Among children with spectacle wear at 6 years (N = 583) and 7 years (N = 350) 29.8 and 34.6% had myopia respectively, of which 21.1 and 21.6% combined with astigmatism; 19.6 and 6.8% had hyperopia, 37.2 and 11.1% hyperopia and astigmatism, and 12.5 and 32.7% astigmatism only. Conclusions Spectacle wear in European children starts early in preschool and increases to a relatively frequent visual aid at school age. Advocating early detection and monitoring of refraction errors is warranted in order to prevent visual morbidities later in life. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03467-z.
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Affiliation(s)
- Vasanthi Iyer
- Department of Child Health, TNO, PO Box 3005, Leiden, 2301DA, The Netherlands
| | - Clair A Enthoven
- Department of Ophthalmology, Erasmus Medical Center, Postbus 2040, Rotterdam, 3000CA, The Netherlands.,Department of Epidemiology, Erasmus Medical Center, Postbus 2040, Rotterdam, 3000CA, The Netherlands.,The Generation R Study Group, Erasmus Medical Center, Postbus 2040, Rotterdam, 3000CA, The Netherlands
| | - Paula van Dommelen
- Department of Child Health, TNO, PO Box 3005, Leiden, 2301DA, The Netherlands
| | - Ashwin van Samkar
- Resident in Elderly Medicine, Omring, Azalealaan 18, Lutjebroek, 1614SN, The Netherlands
| | | | - Vincent V W Jaddoe
- The Generation R Study Group, Erasmus Medical Center, Postbus 2040, Rotterdam, 3000CA, The Netherlands
| | - Sijmen A Reijneveld
- Department of Child Health, TNO, PO Box 3005, Leiden, 2301DA, The Netherlands.,Department of Health Sciences, University Medical Center Groningen, University of Groningen, Postbus 30.001, Groningen, 9700RB, The Netherlands
| | - Caroline C W Klaver
- Department of Ophthalmology, Erasmus Medical Center, Postbus 2040, Rotterdam, 3000CA, The Netherlands. .,Department of Epidemiology, Erasmus Medical Center, Postbus 2040, Rotterdam, 3000CA, The Netherlands. .,Department of Ophthalmology, Radboudumc, Postbus 9101, Nijmegen, 6500HB, The Netherlands. .,Institute of Molecular and Clinical Ophthalmology, Mittlere Street 91, 4056, Basel, Switzerland.
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27
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A Review of Intraocular Pressure (IOP) and Axial Myopia. J Ophthalmol 2022; 2022:5626479. [PMID: 35855886 PMCID: PMC9288324 DOI: 10.1155/2022/5626479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 11/18/2022] Open
Abstract
The pathogenesis of myopia is driven by genetic and environmental risk factors. Accommodation not only alters the curvature and shape of the lens but also involves contraction of the ciliary and extraocular muscles, which influences intraocular pressure (IOP). Scleral matrix remodeling has been shown to contribute to the biomechanical susceptibility of the sclera to accommodation-induced IOP fluctuations, resulting in reduced scleral thickness, axial length (AL) elongation, and axial myopia. The rise in IOP can increase the burden of scleral stretching and cause axial lengthening. Although the accommodation and IOP hypotheses were proposed long ago, they have not been validated. This review provides a brief and updated overview on studies investigating the potential role of accommodation and IOP in myopia progression.
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28
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Fernández Irigaray L, Balsa A, Armesto A, Magnetto I, Szeps A, Iribarren LR, Iribarren R, Grzybowski A. Outdoor exposure in children from Buenos Aires Province, Argentina. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2022; 97:396-401. [PMID: 35779896 DOI: 10.1016/j.oftale.2021.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 02/09/2021] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To evaluate myopia risk factors, mainly outdoor exposure and reading habits, in a country with low prevalence of myopia (Buenos Aires Province, Argentina). METHODS Consecutive children interviewed in a clinical private practice setting were autorefracted under cycloplegia with cyclopentolate 1%. Their parents consented to fill a questionnaire about schooling, tutorial classes, outdoor exposure, reading habits, and cellphone use, both on weekdays and weekends. The Spanish questionnaire was based on past English questionnaires of myopia clinical trials. The spherical equivalent of the right eye was used for the refractive distribution. The average daily hours spent for each activity were calculated. RESULTS This study involved 115 children aged 10.48 ± 3.65 years (range 5-18 years), with 56.5% being girls. Children had 8 h of schooling per day in 62.6% of cases, and only 14.8 % had tutorial classes after school. There were 38.3% myopes (<-0.50 D), 24.3% hyperopes (>+2.00 D) and the rest were emmetropes. The mean time that these children spent outdoors per day was 3.94 ± 1.45 h (27.60 ± 10.16 h per week). The total mean time spent reading and writing per day was 1.50 ± 0.98 h, and that spent using cellphones and tablets was 2.43 ± 1.66 h. CONCLUSION In an environment with low myopia prevalence, children spend almoast 4 h per day outdoors, much more than the usual recommendation of 2 h a day for myopia prevention.
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Affiliation(s)
| | - A Balsa
- Oftalmólogos Augen, Ciudad de Buenos Aires, Argentina
| | - A Armesto
- Consulta Ocular Iribarren & Asoc., Ciudad de Buenos Aires, Argentina
| | - I Magnetto
- Centro de Visión Dr. Magnetto, Marcos Juárez, Provincia de Córdoba, Argentina
| | - A Szeps
- Departamento de Oftalmología, Prof. Alejandro Posadas, Hospital Nacional, Provincia de Buenos Aires, Argentina
| | - L R Iribarren
- Grupo de Enseñanza Científica, Instituto de Física de Líquidos y Sistemas Biológicos (IFLySIB), CONICET, Buenos Aires, Argentina
| | - R Iribarren
- Consulta Ocular Iribarren & Asoc., Ciudad de Buenos Aires, Argentina.
| | - A Grzybowski
- Departamento de Oftalmología, Universidad de Warmia y Mazury, Olsztyn, Poland; Instituto de Investigación de Oftalmología, Fundación de Desarrollo de Oftalmología, Poznan, Poland
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29
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Ma FF, Luo H, Zhao GH, Luo XL. The Prevalence and Progression of Myopia in Elementary School Students in Shanxi Province, China During the COVID-19 Pandemic. Semin Ophthalmol 2022; 37:756-766. [PMID: 35695548 DOI: 10.1080/08820538.2022.2087474] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To investigate the prevalence of myopia and the risk factors associated with its progression in elementary school students during the COVID-19 pandemic in Shanxi Province, China. METHODS The investigation included 960 students spanning first to sixth grade from six elementary schools in Shanxi Province, China. All participants received non-cycloplegic refraction and vision tests in December of 2019 (before the COVID-19 pandemic) and in June of 2020 (after classes resumed). Information concerning the students' eye-use behaviors, physical activities, diet and sleep during the pandemic was collected using a questionnaire survey. A total of 913 students (457 males) completed all tests and the questionnaire. RESULTS The overall prevalence rate of myopia was 16.6% in December of 2019, and it increased with age. There was no gender difference in the prevalence of myopia (χ2 = 3.210, P = .073), but females exhibited a lower average spherical equivalent (SE) (P = .026). When the classes were resumed 6 months later, the overall prevalence rate of myopia was found to be 39.4%, which was significantly higher than it before the pandemic (χ2 = 117.425, P < .001). The average SE of the participants was -0.95D, which was significantly lower than the average SE (-0.43D) before the pandemic (P < .001). SE variation (ΔSE) in grade 6 was significantly higher than that in grade 1. No significant difference in ΔSE was found between males and females. Analyses of ordinary least squares (OLS)-estimated linear, natural logarithmic and quadratic functions revealed that the progression of myopia during the COVID-19 pandemic was significantly correlated with screen time, types of electronic devices, the amount of sleep, age, and the number of parents with myopia. CONCLUSIONS The prevalence rate and progression of myopia among elementary school students in Shanxi Province increased significantly during the COVID-19 pandemic, which was likely related to China's home-based online learning programs. Therefore, it is necessary to optimize the educational programs for elementary school students when they study at home. We recommend increased time for outdoor activities and limiting screen time.
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Affiliation(s)
- Fei F Ma
- School of Sport Science, Beijing Sport University, Beijing, China.,School of Physical Education, Shanxi University, Taiyuan, China
| | - Hao Luo
- School of Physical Education, Shanxi University, Taiyuan, China
| | - Guo H Zhao
- School of Physical Education, Shanxi University, Taiyuan, China
| | - Xiu L Luo
- Shanxi Key Laboratory of Signal Detection and Processing, North University of China, Taiyuan, China
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Dhakal R, Shah R, Huntjens B, Verkicharla PK, Lawrenson J. Time spent outdoors as an intervention for myopia prevention and control in children: an overview of systematic reviews. Ophthalmic Physiol Opt 2022; 42:545-558. [PMID: 35072278 PMCID: PMC9305934 DOI: 10.1111/opo.12945] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 12/02/2021] [Accepted: 12/04/2021] [Indexed: 12/22/2022]
Abstract
PURPOSE Outdoor light exposure is considered a safe and effective strategy to reduce myopia development and aligns with existing public health initiatives to promote healthier lifestyles in children. However, it is unclear whether this strategy reduces myopia progression in eyes that are already myopic. This study aims to conduct an overview of systematic reviews (SRs) reporting time spent outdoors as a strategy to prevent myopia or slow its progression in children. METHODS We searched the Cochrane Library, EMBASE, MEDLINE and CINAHL from inception to 1 November 2020 to identify SRs that evaluated the association between outdoor light exposure and myopia development or progression in children. Outcomes included incident myopia, prevalent myopia and change in spherical equivalent refraction (SER) and axial length (AL) to evaluate annual rates of myopia progression. The methodological quality and risk of bias of included SRs were assessed using the AMSTAR-2 and ROBIS tools, respectively. RESULTS Seven SRs were identified, which included data from 47 primary studies with 63,920 participants. Pooled estimates (risk or odds ratios) consistently demonstrated that time outdoors was associated with a reduction in prevalence and incidence of myopia. In terms of slowing progression in eyes that were already myopic, the reported annual reductions in SER and AL from baseline were small (0.13-0.17 D) and regarded as clinically insignificant. Methodological quality assessment using AMSTAR-2 found that all reviews had one or more critical flaws and the ROBIS tool identified a low risk of bias in only two of the included SRs. CONCLUSION This overview found that increased exposure to outdoor light reduces myopia development. However, based on annual change in SER and AL, there is insufficient evidence for a clinically significant effect on myopia progression. The poor methodological quality and inconsistent reporting of the included systematic reviews reduce confidence in the estimates of effect.
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Affiliation(s)
- Rohit Dhakal
- Myopia Research LabProf. Brien Holden Eye Research CentreL V Prasad Eye InstituteHyderabadIndia
- Centre for Applied Vision ResearchSchool of Health Sciences, CityUniversity of LondonLondonUK
| | - Rakhee Shah
- Centre for Applied Vision ResearchSchool of Health Sciences, CityUniversity of LondonLondonUK
| | - Byki Huntjens
- Centre for Applied Vision ResearchSchool of Health Sciences, CityUniversity of LondonLondonUK
| | - Pavan K Verkicharla
- Myopia Research LabProf. Brien Holden Eye Research CentreL V Prasad Eye InstituteHyderabadIndia
| | - John G Lawrenson
- Centre for Applied Vision ResearchSchool of Health Sciences, CityUniversity of LondonLondonUK
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Noi S, Shikano A, Imai N, Tamura F, Tanaka R, Kidokoro T, Yoshinaga M. The Changes in Visual Acuity Values of Japanese School Children during the COVID-19 Pandemic. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9030342. [PMID: 35327714 PMCID: PMC8947095 DOI: 10.3390/children9030342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 02/26/2022] [Accepted: 02/28/2022] [Indexed: 11/16/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic may result in a greater decrease in visual acuity (VA) among Japanese children. Our study aimed to examine Japanese children’s VA during the pandemic. VA data were collected using standard eye tests during school health check-ups conducted in 2019 and 2020 on 5893 children, in seven public elementary schools and four public junior high schools in Tokyo, Saitama, Kanagawa, and Shizuoka. VA changes were statistically analyzed. The relationship between the survey year and poor VA yielded a significant regression coefficient for the surveyed years in elementary and junior high school students. The 2019 VA value and VA change from 2019 to 2020 demonstrated a significant regression coefficient in elementary school students with VAs of “B (0.7−0.9)” and “C (0.3−0.6)”, and junior high school students with VAs of “B”, “C”, and “D (<0.3)”. An analysis of the relationship between the survey year and eye laterality of VA yielded a significant regression coefficient in the surveyed years for elementary (OR, 1.516; 95% CI, 1.265−1.818) and junior high school students (OR, 1.423; 95% CI, 1.136−1.782). Lifestyle changes during the COVID-19 pandemic might have affected VA and eye laterality in Japanese children.
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Affiliation(s)
- Shingo Noi
- Research Institute for Health and Sport Science, Nippon Sport Science University, Tokyo 158-8508, Japan; (A.S.); (R.T.); (T.K.)
- Correspondence:
| | - Akiko Shikano
- Research Institute for Health and Sport Science, Nippon Sport Science University, Tokyo 158-8508, Japan; (A.S.); (R.T.); (T.K.)
| | - Natsuko Imai
- Doctoral Program in Health and Sport Science, Nippon Sport Science University, Tokyo 158-8508, Japan;
| | - Fumie Tamura
- Masterl Program in Health and Sport Science, Nippon Sport Science University, Tokyo 158-8508, Japan;
| | - Ryo Tanaka
- Research Institute for Health and Sport Science, Nippon Sport Science University, Tokyo 158-8508, Japan; (A.S.); (R.T.); (T.K.)
- School of Health and Sport Sciences, Osaka University of Health and Sport Sciences, Osaka 590-0496, Japan
| | - Tetsuhiro Kidokoro
- Research Institute for Health and Sport Science, Nippon Sport Science University, Tokyo 158-8508, Japan; (A.S.); (R.T.); (T.K.)
| | - Mari Yoshinaga
- Faculty of Pharmaceutical Science, Showa Pharmaceutical University, Tokyo 194-8543, Japan;
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Bhandari KR, Shukla D, Mirhajianmoghadam H, Ostrin LA. Objective Measures of Near Viewing and Light Exposure in Schoolchildren during COVID-19. Optom Vis Sci 2022; 99:241-252. [PMID: 35086121 PMCID: PMC8897254 DOI: 10.1097/opx.0000000000001871] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE Wearable sensors provide the opportunity for continuous objective measurement of the visual environment with high resolution. Our findings show that absolute and temporal properties of near viewing and time outdoors vary between myopic and nonmyopic schoolchildren, which are important considerations when studying refractive error pathogenesis. PURPOSE Numerous behavioral factors, including near work, time outdoors, electronic device use, and sleep, have been linked to myopia. The purpose of this study was to assess behaviors using subjective and objective methods in myopic and nonmyopic schoolchildren in the United States. METHODS Forty children (aged 14.6 ± 0.4 years) simultaneously wore two sensors for 1 week, a Clouclip for objective measurement of near viewing and light exposure and an Actiwatch for objective measurement of activity and sleep. Parents completed an activity questionnaire for their child. Near-viewing distance, daily duration, short-duration (>1 minute) and long-duration (>30 minutes) near-viewing episodes, light exposure, time outdoors, electronic device use, and sleep duration were analyzed by refractive error group and day of the week. RESULTS Objectively measured daily near-viewing duration was 6.9 ± 0.3 hours. Myopes spent more time in near + intermediate viewing than nonmyopes (P = .008) and had higher diopter hours (P = .03). Short- and long-duration near-viewing episodes were similar between groups (P < .05 for both). Daily light exposure and time outdoors were significantly lower for myopes (P < .05 for both). Electronic device use (12.0 ± 0.7 hours per day) and sleep duration (8.2 ± 0.2 hours per night) were similar between groups (P > .05 for both). CONCLUSIONS Objective and subjective measures confirm that myopic and nonmyopic schoolchildren exhibit different behaviors. Combining wearable sensors with questionnaires provides a comprehensive description of children's visual environment to better understand factors that contribute to myopia.
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Affiliation(s)
| | - Divya Shukla
- University of Houston College of Optometry, Houston, Texas
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Cohen Y, Iribarren R, Ben-Eli H, Massarwa A, Shama-Bakri N, Chassid O. Light Intensity in Nursery Schools: A Possible Factor in Refractive Development. Asia Pac J Ophthalmol (Phila) 2022; 11:66-71. [PMID: 35030135 DOI: 10.1097/apo.0000000000000474] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Increased levels of outdoor light have been found to be associated causally with decreased rates of myopia. The goal of this study was to measure the effect of indoor nursery school light intensity on refraction of preschool children in Israel. METHODS A total of 1596 children aged 4 to 5 years from 27 nursery schools were examined. Light intensity was tested with a luxmeter device (Lux) inside and outside the nursery school. Noncycloplegic refractions were measured with the PlusOptix vision A09 screening device. Data analysis was performed using Pearson coefficients, chi-square tests for proportions and ANOVA tests by tertiles of illuminance. RESULTS This study included 1131 kindergarten children with a mean age of 4.87 ± 0.33 years, of which 571 were female (50.5%). The mean light intensity of the low, medium, and high intensity groups differed significantly (ANOVA P < 0.001) at 359 ± 2.64 lux (range 264-431), 490 ± 2.21 lux (range 432-574), and 670.76 ± 3.73 lux (range 578-804), respectively. Mean spherical equivalent (SE) was +0.56 ± 0.03D for the low-intensity group, +0.73 ± 0.03D for the medium-intensity group, and +0.89 ± 0.03D for the high-intensity group (ANOVA P < 0.001). The low-intensity group had 42.1% of children with zero refraction or less, while the high-intensity group had 19.3%. CONCLUSIONS In the nursery schools, lower amounts of illumination were associated with less hyperopic refractive error. As the low hyperopic reserve is a risk factor for developing myopia, this finding needs to be followed up to establish whether this association reflects a causal relationship, which could be modulated for the prevention of myopia.
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Affiliation(s)
- Yuval Cohen
- Department of Ophthalmology, Ziv Medical Center, Safed, Israel
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | | | - Hadas Ben-Eli
- Department of Optometry and Vision Science, Hadassah Academic College, Jerusalem, Israel
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Arwa Massarwa
- Department of Optometry and Vision Science, Hadassah Academic College, Jerusalem, Israel
| | - Nagham Shama-Bakri
- Department of Optometry and Vision Science, Hadassah Academic College, Jerusalem, Israel
| | - Otzem Chassid
- Department of Ophthalmology, Ziv Medical Center, Safed, Israel
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
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Thakur S, Dhakal R, Verkicharla PK. Short-Term Exposure to Blue Light Shows an Inhibitory Effect on Axial Elongation in Human Eyes Independent of Defocus. Invest Ophthalmol Vis Sci 2021; 62:22. [PMID: 34935883 PMCID: PMC8711007 DOI: 10.1167/iovs.62.15.22] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Given the potential role of light and its wavelength on ocular growth, we investigated the effect of short-term exposure to the red, green, and blue light on ocular biometry in the presence and absence of lens-induced defocus in humans. Methods Twenty-five young adults were exposed to blue (460 nm), green (521 nm), red (623 nm), and white light conditions for 1-hour each on 4 separate experimental sessions conducted on 4 different days. In each light condition, hyperopic defocus (3D) was induced to the right eye with the fellow eye experiencing no defocus. Axial length and choroidal thickness were measured before and immediately after the light exposure with a non-contact biometer. Results Axial length increased from baseline after red light (mean difference ± standard error in the defocussed eye and non-defocussed eye = 11.2 ± 2 µm and 6.4 ± 2.3 µm, P < 0.001 and P < 0.01, respectively) and green light exposure (9.2 ± 3 µm and 7.0 ± 2.5 µm, P < 0.001 and P < 0.001) with a significant decrease in choroidal thickness (P < 0.05, both red and green light) after 1-hour of exposure. Blue light exposure resulted in a reduction in axial length in both the eyes (−8.0 ± 3 µm, P < 0.001 in the defocussed eye and −6.0 ± 3 µm, P = 0.11 in the non-defocused eye) with no significant changes in the choroidal thickness. Conclusions Exposure to red and green light resulted in axial elongation, and blue light resulted in inhibition of axial elongation in human eyes. Impact of such specific wavelength exposure on children and its application in myopia control need to be explored.
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Affiliation(s)
- Swapnil Thakur
- Myopia Research Lab - Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India and Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, India
| | - Rohit Dhakal
- Myopia Research Lab - Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India and Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, India
| | - Pavan K Verkicharla
- Myopia Research Lab - Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India and Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, India
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Wu Q, Tian Q, Zhang X, Xu J, Tang G, Li R, Guo X, Xu Z, Feng J, Song J, Bi H. Prevalence of Refractive Error and Visual Acuity Among School Children in the Plateau Region of Qinghai, China. Int J Gen Med 2021; 14:5795-5805. [PMID: 34557031 PMCID: PMC8453643 DOI: 10.2147/ijgm.s326046] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 09/01/2021] [Indexed: 12/22/2022] Open
Abstract
Purpose This study aimed to investigate the prevalence of refractive error and visual acuity among school children in the plateau region of Qinghai, China. Methods The school-based, cross-sectional study was performed in Menyuan, Qinghai, China. Three kindergartens and three primary schools were randomly enrolled from both rural areas and county towns. The participants had undergone ophthalmic examinations of the intraocular pressure (IOP), uncorrected visual acuity (UCVA), presenting visual acuity (PVA) and best corrected visual acuity (BCVA), cycloplegic refraction, and axial length (AL). Regression analysis was applied to investigate the potential risk factors affecting the prevalence of various refractive errors. Results A total of 3770 children were invited to participate, and 3524 (93.5%) had undergone examination. Among the 3524 children (51.8% boys) with a mean age of 8.3±2.3 years, 1049 (29.8%) had myopia, 30 (0.9%) had high myopia, 1692 (48.0%) had mild hyperopia, 152 (4.3%) had medium to marked hyperopia and 925 (26.2%) had astigmatism. The mean SER was −0.16±1.86 D and decreased with age. The AL increased with age from 21.80±0.59 mm at 4-years to 23.53±1.05 mm at 12-years. The myopia prevalence increased with age from 2.0% at 4 years to 62.8% at 12-years. Myopia was associated with increasing age, county town habitation and girls. Among the 723 participants with PVA 20/40 or worse in one eye, 564 (78.0%) were due to uncorrected refractive error, and 83 (22.0%) were due to undercorrected refractive error. Among the 1049 children with myopia, only 254 wore glasses, and 151 children with PVA had a worse BCVA and did not have accurate spectacles. Conclusion The prevalence of myopia is very high among school children in Menyuan. Only 24.2% of myopic children wore glasses, and 59.4% of children did not have accurate spectacles. Strategies to improve access to eye care and affordable glasses are needed.
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Affiliation(s)
- Qiuxin Wu
- Shandong University of Traditional Chinese Medicine, Jinan, 250014, People's Republic of China.,Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250002, People's Republic of China.,Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Eye Institute of Shandong University of Traditional Chinese Medicine, Jinan, 250002, People's Republic of China
| | - Qingmei Tian
- Shandong University of Traditional Chinese Medicine, Jinan, 250014, People's Republic of China.,Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250002, People's Republic of China.,Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Eye Institute of Shandong University of Traditional Chinese Medicine, Jinan, 250002, People's Republic of China
| | - Xiuyan Zhang
- Shandong University of Traditional Chinese Medicine, Jinan, 250014, People's Republic of China.,Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250002, People's Republic of China.,Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Eye Institute of Shandong University of Traditional Chinese Medicine, Jinan, 250002, People's Republic of China
| | - Jing Xu
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250002, People's Republic of China
| | - Guodong Tang
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250002, People's Republic of China
| | - Runkuan Li
- Shandong University of Traditional Chinese Medicine, Jinan, 250014, People's Republic of China
| | - Xiaoxiao Guo
- Shandong University of Traditional Chinese Medicine, Jinan, 250014, People's Republic of China
| | - Zongqing Xu
- Shandong University of Traditional Chinese Medicine, Jinan, 250014, People's Republic of China
| | - Jiaojiao Feng
- Shandong University of Traditional Chinese Medicine, Jinan, 250014, People's Republic of China
| | - Jike Song
- Shandong University of Traditional Chinese Medicine, Jinan, 250014, People's Republic of China.,Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250002, People's Republic of China.,Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Eye Institute of Shandong University of Traditional Chinese Medicine, Jinan, 250002, People's Republic of China.,Shandong Provincial Key Laboratory of Integrative Medicine for Eye Diseases, Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Institute of Children Health and Myopia Prevention and Control, Jinan, 250002, People's Republic of China
| | - Hongsheng Bi
- Shandong University of Traditional Chinese Medicine, Jinan, 250014, People's Republic of China.,Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250002, People's Republic of China.,Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Eye Institute of Shandong University of Traditional Chinese Medicine, Jinan, 250002, People's Republic of China.,Shandong Provincial Key Laboratory of Integrative Medicine for Eye Diseases, Shandong Provincial Clinical Research Center of Ophthalmology and Children Visual Impairment Prevention and Control, Shandong Engineering Technology Research Center of Visual Intelligence, Shandong Institute of Children Health and Myopia Prevention and Control, Jinan, 250002, People's Republic of China
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Rozema JJ, Boulet C, Cohen Y, Stell WK, Iribarren L, van Rens GHMB, Iribarren R. Reappraisal of the historical myopia epidemic in native Arctic communities. Ophthalmic Physiol Opt 2021; 41:1332-1345. [PMID: 34533229 DOI: 10.1111/opo.12879] [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: 04/26/2021] [Revised: 07/30/2021] [Accepted: 08/03/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE This study was developed to explain the extraordinary rise in myopia prevalence beginning after 1950 in Indigenous Arctic communities considering recent findings about the risk factors for school myopia development. Myopia prevalence changed drastically from a historical low of less than 3% to more than 50% in new generations of young adults following the Second World War. At that time, this increase was attributed to concurrent alterations in the environment and way of life which occurred in an aggressive programme of de-culturalization and re-acculturation through residential school programmes that introduced mental, emotional and physical stressors. However, the predominant idea that myopia was genetic in nature won the discussion of the day, and research in the area of environmental changes was dismissed. There may have also been an association between myopia progression and the introduction of extreme mental, emotional and physical stressors at the time. RECENT FINDINGS Since 1978, animal models of myopia have demonstrated that myopiagenesis has a strong environmental component. Furthermore, multiple studies in human populations have shown since 2005 how myopia could be produced by a combination of limited exposure to the outdoors and heavy emphasis on academic subjects associated with intense reading habits. This new knowledge was applied in the present study to unravel the causes of the historical myopia epidemics in Inuit communities. SUMMARY After reviewing the available published data on myopia prevalence in circumpolar Inuit populations in the 20th century, the most likely causes for the Inuit myopia epidemic were the combination of increased near work (from almost none to daily reading) and the move from a mostly outdoor to a much more indoor way of life, exacerbated by fewer hours of sunshine during waking hours, the lower illuminance in the Arctic and the extreme psychophysical stress due to the conditions in the Residential Schools.
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Affiliation(s)
- Jos J Rozema
- Visual Optics Lab Antwerp (VOLANTIS), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium
| | - Charles Boulet
- Diamond Valley Vision Care, Black Diamond, Alberta, Canada
| | - Yuval Cohen
- Ziv Medical Centre, Safed, Israel.,Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - William K Stell
- Department of Cell Biology and Anatomy, Department of Surgery, Hotchkiss Brain Institute and Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Luciano Iribarren
- Science Teaching Group, Institute of Physics of Liquids and Biological Systems, The National Scientific and Technical Research Council, Buenos Aires, Argentina
| | - Ger H M B van Rens
- Department of Ophthalmology, Amsterdam University Medical Centre, Amsterdam, The Netherlands
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Shneor E, Doron R, Levine J, Zimmerman DR, Benoit JS, Ostrin LA, Gordon-Shaag A. Objective Behavioral Measures in Children before, during, and after the COVID-19 Lockdown in Israel. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168732. [PMID: 34444483 PMCID: PMC8394769 DOI: 10.3390/ijerph18168732] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/12/2021] [Accepted: 08/13/2021] [Indexed: 02/06/2023]
Abstract
Studies using questionnaires report that COVID-19 restrictions resulted in children spending significantly less time outdoors. This study used objective measures to assess the impact of pandemic-related restrictions on children’s behavior. A total of 19 healthy 8–12-year-old boys were observed before and during social restriction periods. Of these, 11 boys were reassessed after restrictions were lifted. For each session, Actiwatches were dispensed for measures of time outdoors, activity, and sleep. Changes overall and by school status were assessed using signed-rank test and Wilcoxon rank sum tests. During restrictions, children spent significantly less time outdoors (p = 0.001), were less active (p = 0.001), and spent less time engaged in moderate-to-vigorous physical activity (p = 0.004). Sleep duration was not significantly different between sessions (p > 0.99), but bedtime and wake time shifted to a later time during restrictions (p < 0.05 for both). Time outdoors and activity returned close to pre-pandemic levels after restrictions were lifted (p > 0.05 for both). Children’s behaviors significantly changed during the COVID-19 pandemic. The reduction in outdoor light exposure is of importance due to the role of light in the etiology of myopia and vitamin D production. The reduction in physical activity may have negative health effects in terms of obesity and depression, although further research is required to ascertain the long-term effects.
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Affiliation(s)
- Einat Shneor
- Department of Optometry, Hadassah Academic College, Jerusalem 9101001, Israel; (E.S.); (R.D.); (J.L.)
| | - Ravid Doron
- Department of Optometry, Hadassah Academic College, Jerusalem 9101001, Israel; (E.S.); (R.D.); (J.L.)
| | - Jonathan Levine
- Department of Optometry, Hadassah Academic College, Jerusalem 9101001, Israel; (E.S.); (R.D.); (J.L.)
| | - Deena Rachel Zimmerman
- Maternal Child and Adolescent Division Public Health Services, Israel Ministry of Health, Jerusalem 9101002, Israel;
| | - Julia S. Benoit
- Texas Institute for Measurement, Evaluation, and Statistics, Houston, TX 77004, USA;
- College of Optometry, University of Houston, Houston, TX 77004, USA;
| | - Lisa A. Ostrin
- College of Optometry, University of Houston, Houston, TX 77004, USA;
| | - Ariela Gordon-Shaag
- Department of Optometry, Hadassah Academic College, Jerusalem 9101001, Israel; (E.S.); (R.D.); (J.L.)
- Correspondence:
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Gordon-Shaag A, Shneor E, Doron R, Levine J, Ostrin LA. Environmental and Behavioral Factors with Refractive Error in Israeli Boys. Optom Vis Sci 2021; 98:959-970. [PMID: 34387583 PMCID: PMC8407447 DOI: 10.1097/opx.0000000000001755] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Accepted: 04/08/2021] [Indexed: 12/30/2022] Open
Abstract
SIGNIFICANCE Evidence supporting the contributions of near work in myopia is equivocal. Findings from this pilot study suggest that a high prevalence of myopia in ultra-Orthodox boys may be attributed to intense near work at school and learning to read in preschool at an early age. PURPOSE This study aimed to assess factors that may influence myopia in three groups of Jewish boys with different educational demands. METHODS Healthy ultra-Orthodox, religious, and secular Jewish boys (n = 36) aged 8 to 12 years participated. Refractive status, education, time spent reading and writing, and electronic device use were assessed using a questionnaire, and time outdoors and physical activity were assessed objectively using an Actiwatch. Data were analyzed with χ2 and Kruskal-Wallis tests with Bonferroni post hoc comparisons. RESULTS Ultra-Orthodox (n = 14) and religious (n = 13) children had greater myopia prevalence compared with secular children (n = 9; P = .01), despite no differences in parental myopia. Actigraph data showed that there were no differences in activity (P = .52) or time spent outdoors (P = .48) between groups. Ultra-Orthodox children learned to read at a younger age and spent more hours at school (P < .001 for both). All groups engaged in a similar amount of near work while not in school (P = .52). However, ultra-Orthodox boys had less electronic device use than did religious (P = .007) and secular children (P < .001). CONCLUSIONS This pilot study demonstrates that ultra-Orthodox, religious, and secular children have distinct educational demands but similar time outdoors, physical activity, and near work while not in school. The findings suggest that near work at school and/or learning to read in preschool at an early age may contribute to previously reported differences in refractive error between groups. However, conclusions should be confirmed in a larger sample size.
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Affiliation(s)
- Ariela Gordon-Shaag
- Department of Optometry, Hadassah Academic College Jerusalem, Jerusalem, Israel
| | - Einat Shneor
- Department of Optometry, Hadassah Academic College Jerusalem, Jerusalem, Israel
| | - Ravid Doron
- Department of Optometry, Hadassah Academic College Jerusalem, Jerusalem, Israel
| | - Jonathan Levine
- Department of Optometry, Hadassah Academic College Jerusalem, Jerusalem, Israel
| | - Lisa A. Ostrin
- College of Optometry, University of Houston, Houston, Texas
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Bhandary SK, Dhakal R, Sanghavi V, Verkicharla PK. Ambient light level varies with different locations and environmental conditions: Potential to impact myopia. PLoS One 2021; 16:e0254027. [PMID: 34234353 PMCID: PMC8263252 DOI: 10.1371/journal.pone.0254027] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 06/17/2021] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Considering that time spent outdoors is protective for myopia, we investigated how ambient light levels reaching the eye varies across 9 outdoor and 4 indoor locations in 5 different environmental conditions. METHODS Illuminance (lux) was recorded using a lux meter under conditions of weather (sunny/cloudy), time of a day (7:00,10:00,13:00, and 16:00 hours), seasons (summer/winter), and sun protection (hat and cap) in outdoor and indoor locations. Nine outdoor locations were "open playground", "under a translucent artificial-shade", "under a porch facing east", "under a porch facing south", "under a big tree", "between three buildings", "within 4 buildings", and "canopy". As a ninth outdoor location, "Under a glass bowl" in the outdoor location was used as a simulation for "glass classroom model" and measurement was taken at the floor level only to determine in overall the illuminance conditions with glass covered on all sides. The 4 indoor locations included "room with multiple large windows", "room with combination light source", "room with multiple artificial lights", and "room with single artificial light". RESULTS The overall median illuminance level (median; Q1-Q3) recorded in 9 outdoor locations was 8 times higher than that of all indoor locations (1175;197-5400 lux vs. 179;50-333 lux). Highest illuminance in outdoor locations was recorded in "open playground" (9300;4100-16825 lux), followed by "under a translucent artificial shade (8180;4200-13300 lux) and the lowest in "within 4 buildings" (11;6-20 lux). Illuminance under 'Canopy', 'between three buildings' and 'within four buildings' was similar to that of indoor locations (<1000 lux). Time of the day, weather, season, sensor position and using sun protection did not alter illuminance to change from high to low level (>1000 to <1000 lux). Among indoor locations, illuminance in "room with multiple large windows" crossed 1000 lux at a specific time points on both sunny and cloudy days. CONCLUSIONS Illuminance levels in outdoors and indoors varied with location type, but not with other conditions. Given the variation in illuminance in different locations, and the impact it may have on myopia control, appropriate detailed recommendations seems necessary while suggesting time outdoors as an anti-myopia strategy to ensure desired outcomes.
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Affiliation(s)
- Shashank Kishore Bhandary
- Prof. Brien Holden Eye Research Centre, Myopia Research Lab, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, India
| | - Rohit Dhakal
- Prof. Brien Holden Eye Research Centre, Myopia Research Lab, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, India
| | - Vishwa Sanghavi
- Prof. Brien Holden Eye Research Centre, Myopia Research Lab, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, India
| | - Pavan Kumar Verkicharla
- Prof. Brien Holden Eye Research Centre, Myopia Research Lab, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, India
- * E-mail:
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40
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Peng L, Gao L, Zheng Y, Dai Y, Xie Q. Refractive errors and visual impairment among children and adolescents in southernmost China. BMC Ophthalmol 2021; 21:227. [PMID: 34016090 PMCID: PMC8139091 DOI: 10.1186/s12886-021-01993-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/10/2021] [Indexed: 11/24/2022] Open
Abstract
Background Refractive errors and visual impairment in southernmost China have not been reported previously. We aim to investigate and determine the age-specific prevalence of myopia, hyperopia, astigmatism, and visual impairment based on a large population cross-sectional study in Hainan area of southernmost tropical province in China. Methods A population-based sample of 31,524 children aged 615years from Hainan was assessed. Non-cycloplegic autorefraction and visual acuity (VA) analyses were performed on all participants and a subgroup of participants undergoing cycloplegia. Results Of all participants, 23.0% presented uncorrected VA (UCVA) was worse than 20/40 in worse eye, 6.0% presented mild presenting visual acuity impairment (PVAI), 7.0% presented moderate PVAI, 0.2% presented severe PVAI in the better eye, and 46.9% presented abnormal UCVA [worse than 20/25 (6,<8years old) and worse than 20/20 (8years and older)] at least in one eye. The overall prevalence of myopia [spherical equivalent (SE)0.50 D] and high myopia (SE6.00 D) were 46.0%, 1.0% respectively. Hyperopia [SE+1.00 D (7years old) and SE+2.00 D (6,<7years old)] and significant hyperopia (SE+3.00 D) were 4.2 and 0.6%, respectively. Astigmatism [cylinder1.00 D (7years old) and1.75 D (6,<7years old)] was found in 31.9%. Conclusions Myopia was the most common refractive error in southernmost province in China (Hainan). Its prevalence increased with age, while hyperopia prevalence showed a decreasing trend. However, myopia, especially high myopia prevalence was much lower than in other urban regions across China.
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Affiliation(s)
- Li Peng
- Department of Ophthalmology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, 570208, Hainan, China.,Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, 410000, Hunan, China
| | - Ling Gao
- Department of Neurosurgery, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, 570208, Hainan, China
| | - Yunyan Zheng
- Department of Ophthalmology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, 570208, Hainan, China
| | - Yanan Dai
- Department of Ophthalmology, Changsha Central Hospital, University of South China, Changsha, 410004, Hunan, China
| | - Qing Xie
- Department of Ophthalmology, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, 570208, Hainan, China.
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Spitzer M. Open schools! Weighing the effects of viruses and lockdowns on children. Trends Neurosci Educ 2021; 22:100151. [PMID: 33845978 DOI: 10.1016/j.tine.2021.100151] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 02/16/2021] [Accepted: 02/16/2021] [Indexed: 12/20/2022]
Abstract
This review weighs the risk of infection with SARS-CoV-2 against the side effects of school closures on physical and mental health, education, and well-being of those affected by the school closures. Whereas short term effects - decreased learning and food security, and increased anxiety, violence against children, child labor and teen pregnancies - are frequently discussed, the long-term effects of school closures will be much more detrimental across the lifespan of the "Generation Corona": Existing pandemics of inactivity and myopia, already affecting billions of people, are worsening due to less physical exercise and less time spent outdoors, poor diet, weight gain, and increased screen time during lockdowns, causing future increases of stroke, heart attack, cancer, and blindness. Socio-emotional complications of isolation, learned helplessness, economic and existential insecurity will include increased depression and suicide, decreased empathy and increased loneliness. Together with decreased educational attainment and economic productivity, the amount of ensuing increased future global morbidity and mortality justifies immediate action of school reopening.
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Affiliation(s)
- Manfred Spitzer
- University of Ulm, Department of Psychiatry, Leimgrubenweg 12-14, D-89075 Ulm, Germany.
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Rojas-Rueda D, Morales-Zamora E, Alsufyani WA, Herbst CH, AlBalawi SM, Alsukait R, Alomran M. Environmental Risk Factors and Health: An Umbrella Review of Meta-Analyses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020704. [PMID: 33467516 PMCID: PMC7830944 DOI: 10.3390/ijerph18020704] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/31/2020] [Accepted: 01/12/2021] [Indexed: 12/13/2022]
Abstract
Background: Environmental health is a growing area of knowledge, continually increasing and updating the body of evidence linking the environment to human health. Aim: This study summarizes the epidemiological evidence on environmental risk factors from meta-analyses through an umbrella review. Methods: An umbrella review was conducted on meta-analyses of cohort, case-control, case-crossover, and time-series studies that evaluated the associations between environmental risk factors and health outcomes defined as incidence, prevalence, and mortality. The specific search strategy was designed in PubMed using free text and Medical Subject Headings (MeSH) terms related to risk factors, environment, health outcomes, observational studies, and meta-analysis. The search was limited to English, Spanish, and French published articles and studies on humans. The search was conducted on September 20, 2020. Risk factors were defined as any attribute, characteristic, or exposure of an individual that increases the likelihood of developing a disease or death. The environment was defined as the external elements and conditions that surround, influence, and affect a human organism or population’s life and development. The environment definition included the physical environment such as nature, built environment, or pollution, but not the social environment. We excluded occupational exposures, microorganisms, water, sanitation and hygiene (WASH), behavioral risk factors, and no-natural disasters. Results: This umbrella review found 197 associations among 69 environmental exposures and 83 diseases and death causes reported in 103 publications. The environmental factors found in this review were air pollution, environmental tobacco smoke, heavy metals, chemicals, ambient temperature, noise, radiation, and urban residential surroundings. Among these, we identified 65 environmental exposures defined as risk factors and 4 environmental protective factors. In terms of study design, 57 included cohort and/or case-control studies, and 46 included time-series and/or case-crossover studies. In terms of the study population, 21 included children, and the rest included adult population and both sexes. In this review, the largest body of evidence was found in air pollution (91 associations among 14 air pollution definitions and 34 diseases and mortality diagnoses), followed by environmental tobacco smoke with 24 associations. Chemicals (including pesticides) were the third larger group of environmental exposures found among the meta-analyses included, with 19 associations. Conclusion: Environmental exposures are an important health determinant. This review provides an overview of an evolving research area and should be used as a complementary tool to understand the connections between the environment and human health. The evidence presented by this review should help to design public health interventions and the implementation of health in all policies approach aiming to improve populational health.
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Affiliation(s)
- David Rojas-Rueda
- Department of Environmental and Radiological Health Sciences, Colorado State University, Environmental Health Building, 1601 Campus Delivery, Fort Collins, CO 80523, USA
- Correspondence: ; Tel.: +1-(970)-491-7038; Fax: +1-(970)-491-2940
| | | | - Wael Abdullah Alsufyani
- Saudi Center for Disease Prevention and Control, 70 SCDC Building, Al Aarid, King Abdulaziz Rd, Riyadh 13354, Saudi Arabia; (W.A.A.); (S.M.A.); (M.A.)
| | - Christopher H. Herbst
- Health, Nutrition and Population Global Practice, The World Bank, Diplomatic Quarter, Riyadh Country Office, Riyadh 94623, Saudi Arabia; (C.H.H.); (R.A.)
| | - Salem M. AlBalawi
- Saudi Center for Disease Prevention and Control, 70 SCDC Building, Al Aarid, King Abdulaziz Rd, Riyadh 13354, Saudi Arabia; (W.A.A.); (S.M.A.); (M.A.)
| | - Reem Alsukait
- Health, Nutrition and Population Global Practice, The World Bank, Diplomatic Quarter, Riyadh Country Office, Riyadh 94623, Saudi Arabia; (C.H.H.); (R.A.)
- Community Health Department, King Saud University, Riyadh 11433, Saudi Arabia
| | - Mashael Alomran
- Saudi Center for Disease Prevention and Control, 70 SCDC Building, Al Aarid, King Abdulaziz Rd, Riyadh 13354, Saudi Arabia; (W.A.A.); (S.M.A.); (M.A.)
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Muralidharan AR, Lança C, Biswas S, Barathi VA, Wan Yu Shermaine L, Seang-Mei S, Milea D, Najjar RP. Light and myopia: from epidemiological studies to neurobiological mechanisms. Ther Adv Ophthalmol 2021; 13:25158414211059246. [PMID: 34988370 PMCID: PMC8721425 DOI: 10.1177/25158414211059246] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 10/25/2021] [Indexed: 12/22/2022] Open
Abstract
Myopia is far beyond its inconvenience and represents a true, highly prevalent, sight-threatening ocular condition, especially in Asia. Without adequate interventions, the current epidemic of myopia is projected to affect 50% of the world population by 2050, becoming the leading cause of irreversible blindness. Although blurred vision, the predominant symptom of myopia, can be improved by contact lenses, glasses or refractive surgery, corrected myopia, particularly high myopia, still carries the risk of secondary blinding complications such as glaucoma, myopic maculopathy and retinal detachment, prompting the need for prevention. Epidemiological studies have reported an association between outdoor time and myopia prevention in children. The protective effect of time spent outdoors could be due to the unique characteristics (intensity, spectral distribution, temporal pattern, etc.) of sunlight that are lacking in artificial lighting. Concomitantly, studies in animal models have highlighted the efficacy of light and its components in delaying or even stopping the development of myopia and endeavoured to elucidate possible mechanisms involved in this process. In this narrative review, we (1) summarize the current knowledge concerning light modulation of ocular growth and refractive error development based on studies in human and animal models, (2) summarize potential neurobiological mechanisms involved in the effects of light on ocular growth and emmetropization and (3) highlight a potential pathway for the translational development of noninvasive light-therapy strategies for myopia prevention in children.
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Affiliation(s)
| | | | | | | | | | | | - Dan Milea
- Singapore Eye Research Institute, Singapore
| | - Raymond P Najjar
- Visual Neurosciences Group, Singapore Eye Research Institute, The Academia, 20 College Road, Discovery Tower Level 6, Singapore 169856
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Yotsukura E, Torii H, Ozawa H, Hida RY, Shiraishi T, Corso Teixeira I, Rautha YVBL, Moraes do Nascimento CF, Mori K, Uchino M, Kurihara T, Negishi K, Tsubota K. Axial Length and Prevalence of Myopia among Schoolchildren in the Equatorial Region of Brazil. J Clin Med 2020; 10:jcm10010115. [PMID: 33396242 PMCID: PMC7794886 DOI: 10.3390/jcm10010115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 12/26/2020] [Accepted: 12/27/2020] [Indexed: 12/14/2022] Open
Abstract
The prevalence of myopia is increasing globally, and the outdoor light environment is considered as a possible factor that can retard myopia. The aim of this study was to evaluate the prevalence of myopia and the light environment in Aracati, equatorial Brazil. We surveyed 421 children (421 right eyes; mean age, 10.6 years) and performed ocular examinations that included non-cycloplegic refraction and axial length (AL). Multiple regression analyses were performed to identify factors affecting myopia such as time spent outdoors and in near work. We measured illuminance and violet light irradiance in Aracati. The mean spherical equivalent (SE) and AL were −0.44 ± 1.38 diopters (D) and 22.98 ± 0.87 mm, respectively. The prevalence of myopia (SE ≤ −0.75 D) and high myopia (SE ≤ −6.0 D/AL ≥ 26.0 mm) was 20.4 and 1.4/0.48%, respectively. Multiple regression analyses showed that myopia was not associated with lifestyle factors. The average illuminance in Aracati was about 100,000 lux from morning to evening. The current results reflect the ALs and the prevalence of myopia among Brazilian schoolchildren. There is a possibility that the light environment in addition to other confounding factors including racial differences affects the ALs and refractive errors.
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Affiliation(s)
- Erisa Yotsukura
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (E.Y.); (H.T.); (H.O.); (R.Y.H.); (K.M.); (M.U.)
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Hidemasa Torii
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (E.Y.); (H.T.); (H.O.); (R.Y.H.); (K.M.); (M.U.)
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Hiroko Ozawa
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (E.Y.); (H.T.); (H.O.); (R.Y.H.); (K.M.); (M.U.)
| | - Richard Yudi Hida
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (E.Y.); (H.T.); (H.O.); (R.Y.H.); (K.M.); (M.U.)
- Department of Ophthalmology, Universidade de Sao Paulo, Av. Dr. Enéas Carvalho de Aguiar, 255-Cerqueira César, São Paulo SP 05402-000, Brazil;
- Department of Ophthalmology, Universidade Federal de Sao Paulo, R. Botucatu, 822-Vila Clementino, São Paulo SP 04039-032, Brazil
| | - Tetsuro Shiraishi
- Department of Obstetrics and Gynecology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan;
| | - Ivan Corso Teixeira
- Department of Ophthalmology, Santa Casa de Sao Paulo, Rua Dr. Cesario Mota Junior, 112-Vila Buarque, São Paulo SP 01221-010, Brazil; (I.C.T.); (C.F.M.d.N.)
| | | | - Caio Felipe Moraes do Nascimento
- Department of Ophthalmology, Santa Casa de Sao Paulo, Rua Dr. Cesario Mota Junior, 112-Vila Buarque, São Paulo SP 01221-010, Brazil; (I.C.T.); (C.F.M.d.N.)
| | - Kiwako Mori
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (E.Y.); (H.T.); (H.O.); (R.Y.H.); (K.M.); (M.U.)
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Miki Uchino
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (E.Y.); (H.T.); (H.O.); (R.Y.H.); (K.M.); (M.U.)
| | - Toshihide Kurihara
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (E.Y.); (H.T.); (H.O.); (R.Y.H.); (K.M.); (M.U.)
- Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Correspondence: (T.K.); (K.N.); (K.T.); Tel.: +81-3-5363-3204 (T.K.); +81-3-3353-1211 (K.N.); +81-3-3353-1211 (K.T.)
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (E.Y.); (H.T.); (H.O.); (R.Y.H.); (K.M.); (M.U.)
- Correspondence: (T.K.); (K.N.); (K.T.); Tel.: +81-3-5363-3204 (T.K.); +81-3-3353-1211 (K.N.); +81-3-3353-1211 (K.T.)
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (E.Y.); (H.T.); (H.O.); (R.Y.H.); (K.M.); (M.U.)
- Tsubota Laboratory, Inc., 304 Toshin Shinanomachi-Ekimae Bldg., 34 Shinanomachi Shinjuku-ku, Tokyo 160-0016, Japan
- Correspondence: (T.K.); (K.N.); (K.T.); Tel.: +81-3-5363-3204 (T.K.); +81-3-3353-1211 (K.N.); +81-3-3353-1211 (K.T.)
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Recent Epidemiology Study Data of Myopia. J Ophthalmol 2020; 2020:4395278. [PMID: 33489329 PMCID: PMC7803099 DOI: 10.1155/2020/4395278] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 10/21/2020] [Indexed: 12/22/2022] Open
Abstract
Myopia, a pandemic refractive error, is affecting more and more people. The progression of myopia could cause numerously serious complications, even leading to blindness. This review summarizes the epidemiological studies on myopia after 2018 and analyzes the risk factors associated with myopia. The prevalence of myopia varies in different regions, age, and observation time. East Asia has been gripped by an unprecedented rise in myopia, and other parts of the world have also seen an increase. The prevalence of myopia in children continues to rise and aggravates with age. The prevalence of high myopia has also increased along with myopia. Racial dependence and family aggregation can be seen frequently in myopia patients. Increased outdoor activities are proven to be protective factors for myopia, as near-distance work and higher education levels affect in the opposite. The impact of gender or urbanization on myopia is controversial. The relationship between nutrition, digital screens, Kawasaki disease, pregnant women smoking during pregnancy, and myopia is still not clear for lack of sufficient evidence. Understanding the various factors that affect myopia helps to clarify the mechanism of myopia formation and also to formulate reasonable prevention and control measures of myopia to protect people's health, especially for adolescents.
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Alvarez-Peregrina C, Sánchez-Tena MÁ, Martinez-Perez C, Villa-Collar C. The Relationship Between Screen and Outdoor Time With Rates of Myopia in Spanish Children. Front Public Health 2020; 8:560378. [PMID: 33178659 PMCID: PMC7592393 DOI: 10.3389/fpubh.2020.560378] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 09/02/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Nowadays, digital devices have become usual in children's lives around the world. Five percent of the children between 5 and 7 years old have their own smartphone and forty-two percent of them have their own tablet. This fact has produced a change in their lifestyle that can imply some risks, threats and/or opportunities. The light emitted by digital devices' screens could involve, among others, possible risks to children's vision. Methods: This study shows a detailed analysis of the vision of 7,497 children between 5 and 7 years old carried out in the "Annual school campaign for children's visual health" in Spain during the years 2016, 2017, and 2019. The study connects the results in the visual screening with children's lifestyle, taking into account both, the number of hours per day that they use all digital devices and the daily time of outdoor exposure. Results: The study shows that children with myopia have more screen time use and shorter outdoor activity time when compared to those without myopia (p < 0.01). Conclusions: Myopia in children is a public health problem and requires healthy lifestyle interventions at individual as well as at community level.
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Lu SC, Liu FY, Hsieh CJ, Su FY, Wong TY, Tai MC, Chen JT, Lin GM. Quantitative Physical Fitness Measures Inversely Associated With Myopia Severity in Military Males: The CHIEF Study. Am J Mens Health 2020; 13:1557988319883766. [PMID: 31646931 PMCID: PMC6820180 DOI: 10.1177/1557988319883766] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Myopia has been linked to body weight and sedentary status, but the association with quantitatively measured physical fitness in adults has not been examined. Cross-sectional analyses were performed to investigate the association between physical fitness and myopia in 3,669 military men (aged 29.4 years) in Taiwan. The severity of myopia obtained from the left eye was classified as mild (−0.5 to −3.0 diopters; n = 544), moderate −3.1 to −6.0 diopters; n = 563), and high (<−6.0 diopters; n =150); others were defined as nonmyopia (n = 2,412). Aerobic fitness was evaluated by time for a 3000-meter run test, and muscular endurance was evaluated by numbers of 2-min sit-ups and 2-min push-ups. A value of p < .0125 was considered significant. A multiple linear regression analysis was used to determine the relationship. Individuals who were less physically fit had higher risk of myopia. The associations were dose-dependently significant with mild, moderate, and high myopia for 3000-meter running time (β = 9.64; 95% confidence intervals [3.22, 16.05], β = 12.41; 95% CI [6.05, 18.76], and β = 20.87; 95% CI [9.22, 32.51], respectively) after controlling for the potential covariates. There tended to be an inverse association with moderate and high myopia for numbers of 2-min push-ups (β = −1.38; 95% CI [−2.43, −0.34] and β = −2.10; 95% CI [− 3.97, −0.22], respectively) and 2-min sit-ups (β = −0.83; 95% CI [−1.54, −0.12] and β = −1.29; 95% CI [−2.56, −0.02], respectively), respectively. This study suggested that physical fitness, particularly aerobic fitness of the military males who received regular training, is inversely associated with myopia severity, independent of service specialty, body mass index, and educational level.
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Affiliation(s)
- Shao-Chi Lu
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien.,Department of Public Health, Tzu-Chi University, Hualien
| | - Fang-Yu Liu
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien.,Department of Ophthalmology and Visual Sciences, Tri-Service General Hospital, National Defense Medical Center, Taipei
| | | | - Fang-Ying Su
- Biotechnology R & D Center, National Taiwan University Hospital Hsinchu Branch, Hsinchu
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Medical School, National University of Singapore, Singapore
| | - Ming-Cheng Tai
- Department of Ophthalmology and Visual Sciences, Tri-Service General Hospital, National Defense Medical Center, Taipei
| | - Jiann-Torng Chen
- Department of Ophthalmology and Visual Sciences, Tri-Service General Hospital, National Defense Medical Center, Taipei.,Medical Affairs Bureau Ministry of National Defense, Taipei
| | - Gen-Min Lin
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien.,Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei.,Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Du B, Jin N, Zhu X, Lu D, Jin C, Li Z, Han C, Zhang Y, Lai D, Liu K, Wei R. A prospective study of serum metabolomic and lipidomic changes in myopic children and adolescents. Exp Eye Res 2020; 199:108182. [PMID: 32781198 DOI: 10.1016/j.exer.2020.108182] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 07/24/2020] [Accepted: 08/02/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Myopia is a prevalent eye disorder, especially among children and adolescents in eastern Asian countries. Multiple measures have already been taken to prevent and treat myopia, including atropine and dopamine. However, the serum metabolic picture of myopia has not yet been studied as a whole and remains largely unclear. In this paper, a prospective and panoramic study was carried out to find out the whole serum metabolomic and lipidomic picture of myopia. METHODS With untargeted mass spectrometry (MS), myopia among 211 children and adolescents was studied. The MS features were first grouped across the samples. Then, compound annotation was carried out based on these features. Finally, the metabolite features were mapped to pathways, whose biological functions in myopia were studied and discussed. RESULTS A total of 275 metabolite features were derived from 92 aligned MS peak groups with significant fold changes, and then mapped to 33 pathways. By a comprehensive consideration of significance, fold change, importance score and appearance in different omics, 9 pathways were selected, and their biological functions were further analyzed. Among these selected pathways, 5 pathways were related with oxidative stress, a validated phenomenon during myopia development, while 5 pathways were related with dopamine receptor D2, whose molecular function in myopia treatment is not fully understood. A total of 177 metabolite features from 45 peak groups were related with the studied pathways. CONCLUSION This prospective study shed light on the whole picture of metabolomic mechanism underlying myopia and provided guidance to further elucidation of compounds and pathways in this whole picture.
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Affiliation(s)
- Bei Du
- Tianjin Key Laboratory of Retinal Functions and Diseases, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Nan Jin
- Tianjin Key Laboratory of Retinal Functions and Diseases, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Xiurui Zhu
- Tianjin Yunjian Medical Technology Co., Ltd., Tianjin, China; Department of Cardiothoracic Surgery, School of Medicine, Stanford University, CA, USA
| | - Daqian Lu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Chengcheng Jin
- Tianjin Key Laboratory of Retinal Functions and Diseases, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Zhen Li
- Tianjin Yunjian Medical Technology Co., Ltd., Tianjin, China; School of Electrical Engineering, Southeast University, Jiangsu Province, China
| | - Chunle Han
- Tianjin Yunjian Medical Technology Co., Ltd., Tianjin, China
| | - Yani Zhang
- Tianjin Yunjian Medical Technology Co., Ltd., Tianjin, China
| | - Donghai Lai
- Tianjin Yunjian Medical Technology Co., Ltd., Tianjin, China
| | - Kang Liu
- Tianjin Yunjian Medical Technology Co., Ltd., Tianjin, China.
| | - Ruihua Wei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.
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Hussaindeen JR, Gopalakrishnan A, Sivaraman V, Swaminathan M. Managing the myopia epidemic and digital eye strain post COVID-19 pandemic - What eye care practitioners need to know and implement? Indian J Ophthalmol 2020; 68:1710-1712. [PMID: 32709834 PMCID: PMC7640876 DOI: 10.4103/ijo.ijo_2147_20] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Affiliation(s)
| | - Aparna Gopalakrishnan
- Myopia Clinic, Sankara Nethralaya, Chennai, Tamil Nadu, India; School of Medicine, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia
| | | | - Meenakshi Swaminathan
- Department of Pediatric Ophthalmology and Strabismus, Sankara Nethralaya, Chennai, Tamil Nadu, India
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