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Gao Z, Guo Z, Song Y, Shi X, Zhao Y, Liu C. Gender Difference of the Association Between Sleep Duration and Myopia Among Children and Adolescents. Nat Sci Sleep 2024; 16:1303-1312. [PMID: 39247908 PMCID: PMC11379028 DOI: 10.2147/nss.s476051] [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: 06/02/2024] [Accepted: 08/26/2024] [Indexed: 09/10/2024] Open
Abstract
Purpose With girls typically exhibiting higher rates of myopia than boys, however, the mechanisms behind this gender difference remain unclear. This study aims to investigate the gender disparities in the relationship between myopia, sleep duration, physical activity, and BMI. Patients and Methods A total of 3138 primary and secondary school students were included. Mplus 8.3 was used to perform the multiple mediation analysis. Results Sleep duration was indicated to directly affect myopia (β=0.273, 95% CI=0.184-0.356) and through physical activity, BMI, physical activity and BMI three significantly mediation pathways, respectively. In terms of gender, the mediating direct effect of sleep duration on myopia of boys was 66.96%, which is much higher than that of girls' 50.91%. And the mediating indirect effect of sleep duration on myopia through physical activity and BMI are 32.65% and 12.10% respectively among girls, both of which are significantly higher than that of boys. Conclusion The study found that there are significant differences in the impact of sleep duration on myopia in children and adolescents of different genders. In this regard, while paying attention to the sleep duration of children and adolescents, special attention should also be paid to the indirect impact of girls' physical activity and BMI on myopia, and targeted measures should be formulated according to children of different genders to effectively protect the eye health of children and adolescents.
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Affiliation(s)
- Zhaorong Gao
- Qingdao Eye Hospital of Shandong First Medical University, Eye Institute of Shandong First Medical University, Qingdao, People's Republic of China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, People's Republic of China
- School of Ophthalmology, Shandong First Medical University, Qingdao, People's Republic of China
| | - Zhen Guo
- Qingdao Eye Hospital of Shandong First Medical University, Eye Institute of Shandong First Medical University, Qingdao, People's Republic of China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, People's Republic of China
- School of Ophthalmology, Shandong First Medical University, Qingdao, People's Republic of China
| | - Yongbo Song
- Qingdao Eye Hospital of Shandong First Medical University, Eye Institute of Shandong First Medical University, Qingdao, People's Republic of China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, People's Republic of China
- School of Ophthalmology, Shandong First Medical University, Qingdao, People's Republic of China
| | - Xiujing Shi
- Qingdao Eye Hospital of Shandong First Medical University, Eye Institute of Shandong First Medical University, Qingdao, People's Republic of China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, People's Republic of China
- School of Ophthalmology, Shandong First Medical University, Qingdao, People's Republic of China
| | - Yingzuo Zhao
- Qingdao Eye Hospital of Shandong First Medical University, Eye Institute of Shandong First Medical University, Qingdao, People's Republic of China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, People's Republic of China
- School of Ophthalmology, Shandong First Medical University, Qingdao, People's Republic of China
| | - Conghui Liu
- Qingdao Eye Hospital of Shandong First Medical University, Eye Institute of Shandong First Medical University, Qingdao, People's Republic of China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, Qingdao, People's Republic of China
- School of Ophthalmology, Shandong First Medical University, Qingdao, People's Republic of China
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Noh YH, Jung KI. The Relationship between Myopia and Obesity in Adults. KOREAN JOURNAL OF OPHTHALMOLOGY 2024; 38:137-146. [PMID: 38449306 PMCID: PMC11016688 DOI: 10.3341/kjo.2023.0102] [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: 09/07/2023] [Revised: 02/27/2024] [Accepted: 03/05/2024] [Indexed: 03/08/2024] Open
Abstract
PURPOSE To investigate the relationship between myopia and obesity through direct measurements of fat content. METHODS A cross-sectional study used a stratified, multistage survey, the Korea National Health and Nutrition Examination Survey (2008-2010). Subjects 19 years or older (n = 10,305) were included. Participants were divided into three groups according to refractive status: myopia (spherical equivalent [SE] ≤ -1.0 diopter [D]), emmetropia (-1.0 D < SE ≤ 1.0 D), and hyperopia (SE > 1.0 D). Obesity was investigated with assessment of fat mass and body mass index or waist circumference. Fat mass was measured with whole-body dual energy x-ray absorptiometry. Body fat percentage was calculated as (total fat mass / body weight × 100). RESULTS Higher obesity index was found in individuals with myopic eyes after adjustment for age, sex, education level, income status, physical activity, residence, and serum vitamin D level. The significant difference in total body fat percentages among myopia, emmetropia, and hyperopia was significant in the young age group (19-39 years, p < 0.05) but not in the middle age group (40-64 years) and the old age group (≥65 years). Individuals with a higher percentage of total body fat had greater odds ratios for myopia (fourth quartile of body fat; odds ratio, 1.352; 95% confidence interval, 1.178-1.551). CONCLUSIONS An association was found between adiposity and myopia in relatively young adults using direct measurements of fat mass.
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Affiliation(s)
- Young Ho Noh
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyoung In Jung
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Yang JLX, Li DL, Chen J, Wang JJ, Du LL, Liu SC, He XG, Pan CW. Effect modification of time spent outdoors on the association between early childhood overweight and myopia: a one-year follow-up study. J Public Health (Oxf) 2024; 46:107-115. [PMID: 38264954 DOI: 10.1093/pubmed/fdae006] [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: 08/28/2023] [Revised: 11/19/2023] [Accepted: 12/29/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND This study examined the moderating role of outdoor time on the relationship between overweight and myopia. METHODS The data for this study was obtained from a prospective study in Shanghai, where non-myopic children wore wristwear and were followed up for 1 year. Eye examinations were performed at each visit. The modification effect was assessed on the additive scale using multivariable logistic regression, and relative excess risk due to interaction was used to calculate the modification effect. RESULTS A total of 4683 non-myopic children were included with 32.20% being overweight at baseline. Following a 1-year period, 17.42% of children had myopia. When compared to those who spent <90 minutes outdoors, children who spent >120 had a relative risk of myopia onset that was reduced to 0.61. As time spent outdoors decreased, more risks of myopia onset were identified among overweight children than among normal children, the modification effect on the additive scale was -0.007, with ~70% of this effect attributed to the modifying influence of outdoor time. CONCLUSIONS Increasing outdoor time can reduce myopia more among overweight children than normal. Future interventions should focus on outdoor activities among overweight children to reduce myopia risks.
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Affiliation(s)
- Jin-Liu-Xing Yang
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
- Clinical Research Unit, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Dan-Lin Li
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
| | - Jun Chen
- Clinical Research Unit, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Jing-Jing Wang
- Clinical Research Unit, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Lin-Lin Du
- Clinical Research Unit, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Si-Chen Liu
- Clinical Research Unit, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
| | - Xian-Gui He
- Clinical Research Unit, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Chen-Wei Pan
- School of Public Health, Suzhou Medical College of Soochow University, Suzhou, China
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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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Kim JM, Choi YJ. Nutritional intake, environmental factors, and their impact on myopia prevalence in Korean children aged 5-12 years. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2024; 43:14. [PMID: 38287408 PMCID: PMC10823653 DOI: 10.1186/s41043-024-00506-6] [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: 12/05/2023] [Accepted: 01/13/2024] [Indexed: 01/31/2024]
Abstract
BACKGROUND Myopia is a complex condition influenced by numerous factors, including genetic predisposition, environmental factors, and lifestyle choices. Although evidence indicates that certain dietary factors may influence the development of myopia, this relationship is still not completely understood and is a topic of ongoing research. METHODS This study analyzed the relationship between dietary habits, environmental factors, and the prevalence of myopia in a sample of 24,345 children aged 5-12 years from the seventh Korea National Health and Nutrition Examination Survey (KNHANES VII). The average daily intake of dietary nutrients associated with the refractive error status of the participants was analyzed using analysis of variance (GLM) and the Scheffe method for post-hoc comparison. Multiple logistic regression analysis was conducted between the participant's refractive error status and daily dietary nutrient intake, while taking into consideration the age, sex, BMI, parental myopia, and near-work hours. RESULTS The risk of myopia increased with age, especially notable between ages 11 and 12, and was higher in children with both parents having myopia. Dietary factors played a crucial role; children with myopia had significantly lower intake of fat, omega-3 fatty acids, and retinol but higher intake of other nutrients compared to emmetropic and hyperopic counterparts. High consumption of carbohydrates, protein, phosphorus, iron, potassium, and sodium was associated with increased myopia risk. High sodium intake was particularly associated with a 2.05-fold increased myopia risk. CONCLUSIONS This study highlights the significant role of diet and lifestyle choices in the development of myopia in children. Our findings suggest the importance of considering these specific factors in the management and prevention strategies for myopia, underscoring the need for targeted interventions in children's health and vision care.
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Affiliation(s)
- Jeong-Mee Kim
- Department of Visual Optics, Far East University, Eumseong, South Korea
| | - Yean-Jung Choi
- Department of Food and Nutrition, Sahmyook University, 815, Hwarang-ro, Nowon-gu, Seoul, 01795, South Korea.
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Kim JM, Choi YJ. Association between dietary nutrient intake and prevalence of myopia in Korean adolescents: evidence from the 7th Korea National Health and Nutrition Examination Survey. Front Pediatr 2024; 11:1285465. [PMID: 38283403 PMCID: PMC10811780 DOI: 10.3389/fped.2023.1285465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/27/2023] [Indexed: 01/30/2024] Open
Abstract
Background The rise in myopia prevalence, particularly among adolescents in East Asia, is a cause for concern. While a combination of environmental and genetic factors is understood to contribute to this trend, the role of dietary nutrients is not yet fully clarified. Objective To assess the potential association between the intake of specific nutrients and the prevalence of myopia in a large, population-based sample of Korean adolescents. Methods Data from 18,077 adolescents (average age: 15.05 ± 1.67 years; 51.7% male, 48.3% female) who participated in the 7th Korea National Health and Nutrition Examination Survey (KNHANES VII, 2016) were analyzed. Refractive error was measured using an auto-refractor-keratometer (KR-8800) without cycloplegia. Dietary intake of 14 nutrients was assessed through a 24-h personalized dietary recall method. Results The study revealed a myopia prevalence of 87.6% among the adolescents. Multivariable models adjusted for age, gender, BMI, and other confounding factors indicated that higher intakes of carbohydrates, proteins, cholesterol, sodium, and vitamin B2 were associated with an increased risk of myopia. Conversely, higher intake of vitamin C was found to be associated with a decreased risk. Conclusion The findings suggested a potential association between dietary nutrient intake and myopia prevalence in Korean adolescents. While the study did not establish a causal link, the differences in nutrient intake between the myopic and non-myopic groups could indicate that diet plays a role in the development or progression of myopia. Further research is warranted to corroborate these findings and explore the underlying mechanisms.
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Affiliation(s)
- Jeong-Mee Kim
- Department of Visual Optics, Far East University, Eumseong, Republic of Korea
| | - Yean Jung Choi
- Department of Food and Nutrition, Sahmyook University, Seoul, Republic of Korea
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Yang L, Xu Y, Zhou P, Wan G. The SNTB1 and ZFHX1B gene have susceptibility in northern Han Chinese populations with high myopia. Exp Eye Res 2023; 237:109694. [PMID: 37890754 DOI: 10.1016/j.exer.2023.109694] [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: 08/12/2023] [Revised: 10/11/2023] [Accepted: 10/24/2023] [Indexed: 10/29/2023]
Abstract
The aim of this study was to explore the association between SNTB1 and ZFHX1B polymorphisms and high myopia (HM) in a Northern Han Chinese population. This case-control study included 457 HM and 860 healthy subjects from the Northern Han Chinese population. Four single nucleotide polymorphisms (SNPs) (rs7839488, rs4395927, rs4455882, and rs6469937) in SNTB1 and one SNP in ZFHX1B (rs13382811)were selected based on two previous genome-wide association study (GWAS) studies. The allele and genotype distributions of SNPs in SNTB1 and ZFHX1B were compared between the two groups using the chi-square test. The allele results were adjusted for age and sex using Plink software (Plink 1.9). Pairwise linkage disequilibrium (LD) and haplotype analyses were performed using SHEsis software. For HM subjects, the mean age was 44.80 ± 17.11 years, and for the control subjects, it was 44.41 ± 14.26 years. For rs7839488 of the SNTB1 gene, the A allele is a risk allele and the G allele is a wild allele. The A allele had no statistical significance with the HM cases and controls (OR = 0.90, 95% CI = 0.74-1.09, aP = 0.273, Pc = NS). There was a LD in SNTB1 (rs7839488, rs4395927, rs4455882, and rs6469937). The G-C-A-G haplotype frequency was higher in HM subjects than that of the controls (OR = 1.31, 95% CI = 1.07-1.60, P = 0.008). Meanwhile, the A-T-G-A haplotype frequency was slightly lower in the HM group (OR = 0.81, 95% CI = 0.66-0.99, P = 0.048). In the ZFHX1B gene, the frequency of the minor T allele of rs13382811 was significant higher in the HM group than in the control group (OR = 1.34, 95% CI = 1.11-1.61, aP = 0.001, Pc = 0.009). Furthermore, compared to the CC genotype, there were significant differences in the CT genotype (OR = 1.57, 95% CI = 1.23-2.00, aP < 0.001, Pc = 0.002). In conclusion, G-C-A-G is a risk haplotype from the SNTB1 gene in high myopia patients. The minor T-allele of ZFHX1B rs13382811 is a risk factor for high myopia. SNTB1 and ZFHX1B are both risk genes associated with increased susceptibility to high myopia in the Northern Han Chinese population.
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Affiliation(s)
- Lin Yang
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China
| | - Youmei Xu
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China
| | - Pengyi Zhou
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China
| | - Guangming Wan
- Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.
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Wang X, Dang J, Liu J, Liu Y, Wang Y, Shi D, Chen Z, Yuan W, Cai S, Mi J, Xiao P, Li L, Fan Y, Gao A, Chen H, Zhuang L, Yu Z, Li J, Yang D, Yang G, Guo L, Li Y, Song J, Li J, Ma J, Dong Y, Song Y. A cluster randomized trial of a comprehensive intervention nesting family and clinic into school centered implementation to reduce myopia and obesity among children and adolescents in Beijing, China: study protocol. BMC Public Health 2023; 23:1435. [PMID: 37501063 PMCID: PMC10373331 DOI: 10.1186/s12889-023-16270-x] [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: 04/18/2023] [Accepted: 07/09/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Myopia and obesity in children and adolescents have become serious public health problems that endanger public health, especially in China. Unhealthy lifestyle behaviors are environmental drivers of both myopia and obesity. This protocol describes a study to evaluate the effectiveness of "22510SS", that is 2 h of daytime outdoor activities ('2'); Limit screen time to no more than 2 h per day ('2'); Consume at least 5 servings of fruits and vegetables daily ('5'); Attain 1 h of physical activity daily ('1'); Consume 0 sugar-sweetened beverages ('0'); Reasonable sleep duration ('S'); Regular supervision ('S'). A school-based, multifaceted intervention strategy for myopia and obesity prevention, and to assess and explore the implementation of "22510SS" with regards to acceptability, feasibility, adoption, usage and maintenance. METHODS AND ANALYSIS This study aims to develop a comprehensive intervention strategy "22510SS" based on the socio-ecological model, and A two-arm cluster randomized trial with a parallel-group of a 1:1 allocation ratio in 36 primary and secondary schools to test its evidence-based intervention programs on the effects and implementation of myopia and obesity epidemics in children and adolescents in grades 4 and 7. The primary outcomes will include differences in visual acuity, body mass index, outdoor activity indicators, screen time, fruit and vegetable intake, high-quality protein intake, sugar-sweetened beverage intake, sleep duration, and level of monitoring among children and adolescents. Secondary outcomes will assess the acceptability, feasibility, uptake, use, and maintenance of the intervention. Effects on the primary and secondary outcomes will be analyzed using linear and logistic regression analyses, as well as difference-in-difference analysis, taking into account cluster effects and possible confounding factors. Process assessments will also be conducted through quantitative and qualitative analyses, including acceptability, feasibility, gender, adoption, implementation, and sustainability. DISCUSSION This study will evaluate the effectiveness of "22510SS" and examine its implementation in the school-based network nesting family and clinic. Following this intervention study, the integrated intervention program focused on myopia and obesity among children and adolescents have great potential to be implemented in China to promote and support healthy lifestyle behavior change and reduce the risk of myopia and obesity in children and adolescents. TRIAL REGISTRATION NCT05275959. Registered 23 Mach 2022.
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Affiliation(s)
- Xinxin Wang
- School of Public Health, Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, No.1160, Shengli Street, Yinchuan, 750004, Xingqing District, China
| | - Jiajia Dang
- School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Institute of Child and Adolescent Health, Peking University, Beijing, 100191, China
| | - Jieyu Liu
- School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Institute of Child and Adolescent Health, Peking University, Beijing, 100191, China
| | - Yunfei Liu
- School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Institute of Child and Adolescent Health, Peking University, Beijing, 100191, China
| | - Yaqi Wang
- School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Institute of Child and Adolescent Health, Peking University, Beijing, 100191, China
| | - Di Shi
- School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Institute of Child and Adolescent Health, Peking University, Beijing, 100191, China
| | - Ziyue Chen
- School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Institute of Child and Adolescent Health, Peking University, Beijing, 100191, China
| | - Wen Yuan
- School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Institute of Child and Adolescent Health, Peking University, Beijing, 100191, China
| | - Shan Cai
- School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Institute of Child and Adolescent Health, Peking University, Beijing, 100191, China
| | - Jie Mi
- Center for Non-Communicable Disease Management, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Pei Xiao
- Center for Non-Communicable Disease Management, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Li Li
- Department of Ophthalmology, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Yunwei Fan
- Department of Ophthalmology, National Center for Children's Health, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Aiyu Gao
- Dongcheng Primary and Secondary School Health Care Center, Beijing, China
| | - Haihua Chen
- Dongcheng Primary and Secondary School Health Care Center, Beijing, China
| | - Lili Zhuang
- Dongcheng Primary and Secondary School Health Care Center, Beijing, China
| | - Zhaocang Yu
- Beijing Tongzhou District Primar Yand Secondary School Health Carelnstitute, Beijing, China
| | - Jianhui Li
- Beijing Tongzhou District Primar Yand Secondary School Health Carelnstitute, Beijing, China
| | - Dongmei Yang
- Tongzhou District Center for Disease Control and Prevention, Beijing, China
| | - Gang Yang
- Tongzhou District Center for Disease Control and Prevention, Beijing, China
| | - Lipo Guo
- Health Education Center forPrimary and Secondary Schools Changping Beijing, Beijing, China
| | - Yuanyuan Li
- Health Education Center forPrimary and Secondary Schools Changping Beijing, Beijing, China
| | - Jieyun Song
- School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Institute of Child and Adolescent Health, Peking University, Beijing, 100191, China
| | - Jing Li
- School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Institute of Child and Adolescent Health, Peking University, Beijing, 100191, China
| | - Jun Ma
- School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Institute of Child and Adolescent Health, Peking University, Beijing, 100191, China
| | - Yanhui Dong
- School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Institute of Child and Adolescent Health, Peking University, Beijing, 100191, China.
| | - Yi Song
- School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Institute of Child and Adolescent Health, Peking University, Beijing, 100191, China.
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Li FF, Zhu MC, Shao YL, Lu F, Yi QY, Huang XF. Causal Relationships Between Glycemic Traits and Myopia. Invest Ophthalmol Vis Sci 2023; 64:7. [PMID: 36867130 PMCID: PMC9988699 DOI: 10.1167/iovs.64.3.7] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
Purpose Little is known about whether sugar intake is a risk factor for myopia, and the influence of glycemic control remains unclear, with inconsistent results reported. This study aimed to clarify this uncertainty by evaluating the link between multiple glycemic traits and myopia. Methods We employed a two-sample Mendelian randomization (MR) design using summary statistics from independent genome-wide association studies. A total of six glycemic traits, including adiponectin, body mass index, fasting blood glucose, fasting insulin, hemoglobin A1c (HbA1c), and proinsulin levels, were used as exposures, and myopia was used as the outcome. The inverse-variance-weighted (IVW) method was the main applied analytic tool and was complemented with comprehensive sensitivity analyses. Results Out of the six glycemic traits studied, we found that adiponectin was significantly associated with myopia. The genetically predicted level of adiponectin was consistently negatively associated with myopia incidence: IVW (odds ratio [OR] = 0.990; P = 2.66 × 10-3), MR Egger (OR = 0.983; P = 3.47 × 10-3), weighted median method (OR = 0.989; P = 0.01), and weighted mode method (OR = 0.987; P = 0.01). Evidence from all sensitivity analyses further supported these associations. In addition, a higher HbA1c level was associated with a greater risk of myopia: IVW (OR = 1.022; P = 3.06 × 10-5). Conclusions Genetic evidence shows that low adiponectin levels and high HbA1c are associated with an increased risk of myopia. Given that physical activity and sugar intake are controllable variables in blood glycemia treatment, these findings provide new insights into potential strategies to delay myopia onset.
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Affiliation(s)
- Fen-Fen Li
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China.,State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Meng-Chao Zhu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China.,State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yi-Lei Shao
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China.,State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Fan Lu
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, China.,State Key Laboratory of Ophthalmology, Optometry and Visual Science, Eye Hospital, Wenzhou Medical University, Wenzhou, China
| | - Quan-Yong Yi
- The Affiliated Ningbo Eye Hospital of Wenzhou Medical University, Ningbo, Zhejiang, China
| | - Xiu-Feng Huang
- The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, Zhejiang, China
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10
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Rozema J, Dankert S, Iribarren R. Emmetropization and nonmyopic eye growth. Surv Ophthalmol 2023:S0039-6257(23)00037-1. [PMID: 36796457 DOI: 10.1016/j.survophthal.2023.02.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 02/02/2023] [Accepted: 02/06/2023] [Indexed: 02/16/2023]
Abstract
Most eyes start with a hypermetropic refractive error at birth, but the growth rates of the ocular components, guided by visual cues, will slow in such a way that this refractive error decreases during the first 2 years of life. Once reaching its target, the eye enters a period of stable refractive error as it continues to grow by balancing the loss in corneal and lens power with the axial elongation. Although these basic ideas were first proposed over a century ago by Straub, the exact details on the controlling mechanism and the growth process remained elusive. Thanks to the observations collected in the last 40 years in both animals and humans, we are now beginning to get an understanding how environmental and behavioral factors stabilize or disrupt ocular growth. We survey these efforts to present what is currently known regarding the regulation of ocular growth rates.
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Affiliation(s)
- Jos 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; Institute for Medical Informatics, Statistics, and Epidemiology (IMISE), Leipzig University, Leipzig, Germany.
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11
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Liu Z, Wang Q, Zhao Q, Gao F, Jin N, Wang D, Wang B, Du B, Wei R. Association between whole-grain intake and myopia in chinese children: a cross-sectional epidemiological study. BMC Ophthalmol 2023; 23:1. [PMID: 36593443 PMCID: PMC9809013 DOI: 10.1186/s12886-022-02764-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 12/30/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Nutritional status influences the growth and development of the eyes. However, there are few studies on the association between diet, especially whole grains (WG) consumption, and myopia. The study aimed to evaluate the association between WG intake and myopia prevalence among primary school-age children in China. METHODS This cross-sectional epidemiological study conducted between November 2019 and December 2019 included 586 children, aged 6-12 years, attending primary school in Binhai district, Tianjin, China. Ophthalmologic examinations and optometric cycloplegic refraction measurements were conducted. Information was collected on known risks and protective factors for myopia and the consumption of WGs, vegetables, and fruits. This association between the probability of myopia and the proportion of WG consumption (WG proportion was calculated as the mean intake from WG sources divided by total grain intake), adjusted for protective and risk factors, was analysed using crude and multivariable logistic regression. RESULTS Among the study participants, 226/586 (38.57%) children had myopia in at least one eye. WG intake was inversely correlated with the prevalence of myopia. Furthermore, in the multivariate analysis, WG intake of > 50% was identified as a protective factor against myopia after subsequent adjustment for children's age, sex, parental myopia, near-work activity, screen time, reading and writing habits, visual fatigue, outdoor time, and classroom light environment (all P < 0.05). CONCLUSION WG intake (> 50%) was an independent protective factor against myopia. Modifying the form of grains consumed (whole versus refined) could be one of the targets of future public health measures.
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Affiliation(s)
- Zhuzhu Liu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute, School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Qingxin Wang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute, School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Qianyu Zhao
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Fei Gao
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute, School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Nan Jin
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute, School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Di Wang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute, School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Biying Wang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute, School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Bei Du
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute, School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.
| | - Ruihua Wei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute, School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.
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Liu ZH, Zhao MF, Ma S, Li Y, Sun ZY, Gao L. Exercise is the dominant factor affecting the development of teenagers' eyesight-Based on the Bayesian model averaging. Front Public Health 2022; 10:1014227. [PMID: 36589959 PMCID: PMC9801519 DOI: 10.3389/fpubh.2022.1014227] [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: 08/08/2022] [Accepted: 11/28/2022] [Indexed: 12/15/2022] Open
Abstract
Objective The model uncertainty may result in inconsistency about the environmental factors of myopia among students, and the Bayesian model average (BMA) is an effective way to eliminate it. We aimed to explore the influencing factors of myopia in primary and middle school students by BMA. Methods The data came from the 2021 National Surveillance of Common Diseases and Health Influencing Factors of students. By stratified random cluster sampling, the physical and mental health status of students in Tianjin and the factors affecting their physical health, such as diet, exercise, mental stress, school bullying, sleep time, and internet use, were investigated. The sample consisted of 8,457 primary school students, 8,191 junior middle school students, and 5,901 senior middle school students. Besides the physical examination, we used computer optometry (non-ciliary paralysis) to screen myopia. And we used BMA to select the risk factors through the BMS package in R. Results The exercise was the only factor that affected the eyesight of junior and senior middle schoolers by BMA, with the posterior probability of 0.9736 and 0.9762, but not for the primary students. And we failed to select variables that affected eyesight in grades 4-6 of primary school. Conclusion The exercise was a strong influencing factor for the eyesight of students in Tianjin's junior and senior middle schools.
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Affiliation(s)
- Zhong-hui Liu
- Tianjin Center for Disease Control and Prevention, Tianjin, China
| | - Meng-fei Zhao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Shuai Ma
- Department of Maternal, Child & Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yin Li
- Department of Maternal, Child & Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Zhi-ying Sun
- Tianjin Center for Disease Control and Prevention, Tianjin, China
| | - Lei Gao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Tianjin Medical University, Tianjin, China,*Correspondence: Lei Gao
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13
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Li M, Wang W, Zhu B, Tan X. A Latent Class Analysis of Student Eye Care Behavior: Evidence From a Sample of 6–17 Years Old in China. Front Public Health 2022; 10:914592. [PMID: 35784217 PMCID: PMC9240341 DOI: 10.3389/fpubh.2022.914592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 05/16/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose To understand the latent classes and distribution of an adolescent eye care behavior, and to provide a basis for the formulation of appropriate adolescent vision health management interventions. Methods Information on eye behavior and eye health of primary and secondary school students in Wuhan was collected by multistage stratified cluster sampling. The latent class analysis (LCA) method was used to analyze the students' eye care behavior, and the latent class model (LCM) was built. Results A total of 6,130 students were enrolled in this study, of which 53.56% were males, aged from 6 to 17 years old, with an average age of 10.33 ± 2.60. The latent class results classified the adolescents' eye care behaviors into bad behaviors, moderate behaviors, and healthy behaviors. The model fitting results were as follows: Akaike Information Criterion (AIC) was 36,698.216, Bayesian Information Criterion (BIC) was 36,906.565, Adjusted Bayesian Information Criterion (aBIC) was 36,808.056, and entropy was 0.838.Compared with the healthy behaviors class, the bad behaviors class was more prevalent in high schools (p = 0.003), non-demonstration schools (p = 0.001), and most of this group had astigmatism (p = 0.002). The moderate behaviors class predominately consisted of females (p = 0.001), 15–17 years old (p = 0.005, 6~8 years old as the reference), from non-demonstration schools (p < 0.001), and most had myopia (p = 0.009). Conclusion There were differences in basic demographic characteristics, visual acuity development level, and family visual environment among different classes. In the management and intervention of an adolescent vision health, we should continue to promote the visual health management of adolescents based on visual monitoring and realize the early intervention and guidance of individuals in bad behaviors class.
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14
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Botelho DDP, Takahashi DM, Ibrahim LF, Reis LS, Donato MG, Kanadani TCM. Epidemiologia e prevalência da maculopatia miópica em centro de referência em oftalmologia. REVISTA BRASILEIRA DE OFTALMOLOGIA 2022. [DOI: 10.37039/1982.8551.20220014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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15
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Machine Learning to Determine Risk Factors for Myopia Progression in Primary School Children: The Anyang Childhood Eye Study. Ophthalmol Ther 2022; 11:573-585. [PMID: 35061239 PMCID: PMC8927561 DOI: 10.1007/s40123-021-00450-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 12/23/2021] [Indexed: 02/01/2023] Open
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16
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Li M, Tan CS, Foo LL, Sugianto R, Toh JY, Sun CH, Yap F, Sabanayagam C, Chong FFM, Saw SM. Dietary intake and associations with myopia in Singapore children. Ophthalmic Physiol Opt 2021; 42:319-326. [PMID: 34862645 DOI: 10.1111/opo.12929] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 11/02/2021] [Accepted: 11/02/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate associations of dietary factors with myopia, spherical equivalent refractive error (SE) and axial length (AL) in children at age 9 from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort. METHODS We included 467 multi-ethnic children (933 eyes) who participated in the GUSTO prospective birth cohort and were delivered in two major hospitals in Singapore (2009-2010). At the 9-year visit, we assessed the 6-year incidence of myopia (between ages 3 to 9), cycloplegic SE and AL in children without myopia (SE ≤ -0.5 D in either eye) at the 3-year visit. Using a validated 112-item food frequency questionnaire, parents reported each child's average daily intake of dietary factors (nutrients and food groups) in the past month. Paired eyes were analysed using Generalised Estimating Equations with multivariable logistic or linear regression. Bonferroni corrections were applied, correcting for multiple comparisons between the 13 nutrients (p < 0.004) or 8 food groups (p < 0.006) and each outcome. RESULTS In children aged 9 years (51.0% boys; 56.3% Chinese), the 6-year incidence of myopia was 35.5%. Overall, the mean (SD) SE and AL were -0.3 (1.7) D and 23.4 (1.0) mm, respectively. In multivariable regression, macronutrients or micronutrients were not associated with incident myopia (p ≥ 0.004 for all), adjusting for total energy, gender, ethnicity, time outdoors, near-work and the number of myopic parents (additionally child's height for outcome AL). Similarly, all food groups (including refined grains, sugar-sweetened beverages, protein foods, fruits and vegetables) were not associated with incident myopia (p ≥ 0.006 for all). Additionally, none of the nutrients (p ≥ 0.004 for all) or food groups (p ≥ 0.006 for all) were associated with SE or AL. CONCLUSIONS Our study findings of no significant association between specific nutrients or food groups and incident myopia or SE or AL suggest that diet may not be associated with myopia in children aged 9 years. Well-conducted prospective studies in other populations may clarify the association.
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Affiliation(s)
- Mijie Li
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,Myopia Research Group, Singapore Eye Research Institute, Singapore, Singapore
| | - Chuen-Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Li-Lian Foo
- Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore.,Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Ray Sugianto
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Jia Ying Toh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Chen-Hsin Sun
- Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| | - Fabian Yap
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Charumathi Sabanayagam
- Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore.,Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
| | - Foong-Fong Mary Chong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - Seang-Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,Myopia Research Group, Singapore Eye Research Institute, Singapore, Singapore.,Ophthalmology and Visual Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
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Five-Year cumulative Incidence and Progression of Myopic Maculopathy in a German population – results from the Gutenberg Health Study. Ophthalmology 2021; 129:562-570. [DOI: 10.1016/j.ophtha.2021.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 12/19/2021] [Accepted: 12/21/2021] [Indexed: 11/17/2022] Open
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Yang BY, Li S, Zou Z, Markevych I, Heinrich J, Bloom MS, Luo YN, Huang WZ, Xiao X, Gui Z, Bao WW, Jing J, Ma J, Ma Y, Chen Y, Dong GH. Greenness Surrounding Schools and Visual Impairment in Chinese Children and Adolescents. ENVIRONMENTAL HEALTH PERSPECTIVES 2021; 129:107006. [PMID: 34704791 PMCID: PMC8549527 DOI: 10.1289/ehp8429] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 09/26/2021] [Accepted: 09/28/2021] [Indexed: 05/22/2023]
Abstract
BACKGROUND Evidence concerning the effects of greenness on childhood visual impairment is scarce. OBJECTIVES We aimed to assess whether greenness surrounding schools was associated with visual impairment prevalence and visual acuity levels in Chinese schoolchildren and whether the associations might be explained by reduced air pollution. METHODS In September 2013, we recruited 61,995 children and adolescents 6-18 years of age from 94 schools in seven provinces/municipalities in China. Greenness exposure was assessed using the normalized difference vegetation index (NDVI) and the soil-adjusted vegetation index (SAVI) from July to August 2013. Visual impairment was defined as at least one visual acuity level (dimensionless) lower than 4.9 (Snellen 5/6 equivalent). Three-year annual averages of particulate matter (PM) with an aerodynamic diameter of ≤1μm (PM1) and nitrogen dioxide (NO2) at each school were assessed using machine learning methods. We used generalized linear mixed models to estimate the associations between greenness and prevalent visual impairment and visual acuity levels and used mediation analyses to explore the potential mediating role of air pollution. RESULTS In the adjusted model, an interquartile range increase in NDVI500m was associated with lower odds of prevalent visual impairment [odds ratio (OR)=0.95; 95% confidence interval (CI): 0.93, 0.97]. The same increase in NDVI500m was also associated with 0.012 (95% CI: 0.008, 0.015) and 0.011 (95% CI: 0.007, 0.015) increases in visual acuity levels for left- and right-eye, respectively. Our results also suggested that PM1 and NO2 significantly mediated the association between NDVI500m and visual impairment. Similar effect estimates were observed for SAVI500m, and our estimates were generally robust in several sensitivity analyses. DISCUSSION These findings suggest higher greenness surrounding schools might reduce the risk of visual impairment, possibly owing in part to lower PM1 and NO2 in vegetated areas. Further longitudinal studies with more precise greenness assessment are warranted to confirm these findings. https://doi.org/10.1289/EHP8429.
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Affiliation(s)
- Bo-Yi Yang
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Zhiyong Zou
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Iana Markevych
- Institute of Psychology, Jagiellonian University, Krakow, Poland
| | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig-Maximilians-Universität München (LMU) Munich, Munich, Germany
- Comprehensive Pneumology Center Munich, LMU Munich, Munich, Germany
- German Center for Lung Research, LMU Munich, Munich, Germany
| | - Michael S Bloom
- Department of Global and Community Health, George Mason University, Fairfax, Virginia, USA
| | - Ya-Na Luo
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wen-Zhong Huang
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiang Xiao
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zhaohuan Gui
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Wen-Wen Bao
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jin Jing
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Yinghua Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Yajun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Guang-Hui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
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Burke N, Butler JS, Flitcroft I, Loughman J. The relationship between serum zinc levels and myopia. Clin Exp Optom 2021; 104:28-34. [PMID: 32266755 DOI: 10.1111/cxo.13069] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
CLINICAL SIGNIFICANCE Nutritional status influences growth and development, including that of the eye. However, little attention has been given to possible dietary influences in myopia. This study demonstrates that serum zinc has no relationship with myopia development. BACKGROUND Myopia is inherently associated with eye growth and thereby possibly amenable to nutritional influence. A number of Asian studies have reported lower levels of serum zinc in myopic children. This study was designed to assess the relationship between serum zinc and myopia in the Korean population - using a subsample of participants from nationally representative data. METHODS Data from the fifth Korea National Health and Nutrition Examination Survey (KNHANES) 2010 were used to explore zinc status in relation to refraction. A total of 304 participants were analysed, ranging in age from 12 to 19-years. Serum zinc levels were measured using inductively coupled plasma mass spectrometry, while refractive error was determined by non-cycloplegic autorefraction. Multivariate analysis was used to examine the association. RESULTS A significant majority of participants (n = 255; 84 per cent) were myopic. There was no significant difference in serum zinc levels between myopic and non-myopic children (p = 0.81). In multivariate logistic regression, serum zinc was not significantly associated with myopia after adjustment for age, gender, residence, body mass index, family income and recreational activity. Similarly, no relationship was observed between spherical equivalent refraction and serum zinc within the myopic group (p = 0.46). CONCLUSION In a subset of 12-19-year-old participants from the population-representative KNHANES study, no association was found between serum zinc and myopia. However, the lack of a sensitive biomarker for zinc status remains a major limitation in this, and all current studies.
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Affiliation(s)
- Niamh Burke
- Centre for Eye Research Ireland, School of Physics, Clinical and Optometric Sciences, College of Sciences and Health, Technological University Dublin , Dublin, Ireland
| | - John S Butler
- Centre for Eye Research Ireland, School of Physics, Clinical and Optometric Sciences, College of Sciences and Health, Technological University Dublin , Dublin, Ireland.,School of Mathematical Sciences, College of Sciences and Health, Technological University Dublin , Dublin, Ireland
| | - Ian Flitcroft
- Centre for Eye Research Ireland, School of Physics, Clinical and Optometric Sciences, College of Sciences and Health, Technological University Dublin , Dublin, Ireland.,Ophthalmology Department, Temple Street Children's University Hospital , Dublin, Ireland
| | - James Loughman
- Centre for Eye Research Ireland, School of Physics, Clinical and Optometric Sciences, College of Sciences and Health, Technological University Dublin , Dublin, Ireland
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Characterizing Astigmatism in the United States. J Cataract Refract Surg 2021; 48:519-527. [PMID: 34417780 DOI: 10.1097/j.jcrs.0000000000000786] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 08/07/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE To study astigmatism and astigmatism rule by 1) determining changes in prevalence in the United States between 1971-1975 and 1999-2008 and 2) identifying associations with demographic factors. SETTING National survey. DESIGN Retrospective cross-sectional study. METHODS Participants of the 1971-1975 and 1999-2008 National Health and Nutrition Examination Survey (NHANES) aged 20-74 years representing the United States population. The 1971-1975 NHANES measured astigmatism in individuals using an algorithm based on presenting visual acuity, lensometry and objective refraction. We implemented similar methods using 1999-2008 NHANES data for comparison. We identified prevalence of clinically significant astigmatism (≥1.0 D) and used logistic regression models to assess demographic associations with rule of astigmatism. RESULTS Main outcomes were prevalence estimates of astigmatism and odds ratios estimating associations with demographic characteristics. There was an increase in astigmatism from the 1970's to 2000's [14% (95% CI: 13.2-14.5) vs. 24% (22.8-24.6)], which was more pronounced in men [12% (10.8-12.7) vs. 23% (21.9-24.2)] than women [16% (14.9-16.8) vs. 24% (23.0-25.7)]. In adjusted analysis of the 2000's cohort, myopes had 8.34 (CI: 7.30-9.54) times greater odds of astigmatism than non-myopes. In the 2000's, there was increased odds of ATR astigmatism in males (OR, 1.4; 95% CI: 1.1-1.8) compared to females, non-myopes (OR, 2.3; 95% CI: 1.7-3.1) compared to myopes, and 60-74 year olds (OR, 3.7; 95% CI: 2.7-5.1) compared to 20-39 year olds. CONCLUSIONS There is greater prevalence of astigmatism and against-the-rule astigmatism in 1999-2008 compared to 30 years prior. Factors associated with against-the-rule astigmatism were being male, white, and nonmyopic.
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Németh J, Tapasztó B, Aclimandos WA, Kestelyn P, Jonas JB, De Faber JTHN, Januleviciene I, Grzybowski A, Nagy ZZ, Pärssinen O, Guggenheim JA, Allen PM, Baraas RC, Saunders KJ, Flitcroft DI, Gray LS, Polling JR, Haarman AEG, Tideman JWL, Wolffsohn JS, Wahl S, Mulder JA, Smirnova IY, Formenti M, Radhakrishnan H, Resnikoff S. Update and guidance on management of myopia. European Society of Ophthalmology in cooperation with International Myopia Institute. Eur J Ophthalmol 2021; 31:853-883. [PMID: 33673740 PMCID: PMC8369912 DOI: 10.1177/1120672121998960] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/04/2021] [Indexed: 12/13/2022]
Abstract
The prevalence of myopia is increasing extensively worldwide. The number of people with myopia in 2020 is predicted to be 2.6 billion globally, which is expected to rise up to 4.9 billion by 2050, unless preventive actions and interventions are taken. The number of individuals with high myopia is also increasing substantially and pathological myopia is predicted to become the most common cause of irreversible vision impairment and blindness worldwide and also in Europe. These prevalence estimates indicate the importance of reducing the burden of myopia by means of myopia control interventions to prevent myopia onset and to slow down myopia progression. Due to the urgency of the situation, the European Society of Ophthalmology decided to publish this update of the current information and guidance on management of myopia. The pathogenesis and genetics of myopia are also summarized and epidemiology, risk factors, preventive and treatment options are discussed in details.
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Affiliation(s)
- János Németh
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Beáta Tapasztó
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
- Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
| | | | | | - Jost B Jonas
- Department of Ophthalmology, Heidelberg University, Mannheim, Germany
| | | | | | - Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland
- Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznan, Poland
| | - Zoltán Zsolt Nagy
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Olavi Pärssinen
- Gerontology Research Centre and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | | | - Peter M Allen
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Rigmor C Baraas
- National Centre for Optics, Vision and Eye Care, University of South-Eastern Norway, Kongsberg, Norway
| | - Kathryn J Saunders
- Centre for Optometry and Vision Science research, Ulster University, Coleraine, UK
| | - Daniel Ian Flitcroft
- Temple Street Children’s Hospital, Dublin, Ireland
- Centre for Eye Research Ireland (CERI) Technological University Dublin, Ireland
| | | | - Jan Roelof Polling
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Optometry and Orthoptics, Hogeschool Utrecht, University of Applied Science, Utrecht, The Netherlands
| | - Annechien EG Haarman
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - J Willem L Tideman
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - James Stuart Wolffsohn
- Optometry and Vision Science, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Siegfried Wahl
- Institute for Ophthalmic Research, University Tübingen, Tübingen, Germany
- Carl Zeiss Vision International GmbH, Tübingen, Germany
| | - Jeroen A Mulder
- Department of Optometry and Orthoptics, Hogeschool Utrecht, University of Applied Science, Utrecht, The Netherlands
| | | | - Marino Formenti
- Department of Physics, School of Science, University of Padova, Padova, Italy
| | | | - Serge Resnikoff
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
- Brien Holden Vision Institute, Sydney, Australia
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22
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Asano S, Yamashita T, Asaoka R, Fujino Y, Murata H, Terasaki H, Yoshihara N, Kakiuchi N, Sakamoto T. Retinal vessel shift and its association with axial length elongation in a prospective observation in Japanese junior high school students. PLoS One 2021; 16:e0250233. [PMID: 33886637 PMCID: PMC8062002 DOI: 10.1371/journal.pone.0250233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 04/04/2021] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To investigate retinal vessel shift (RVS) and its association with axial length (AL) elongation in junior high school students. METHODS Total 161 eyes of 161 healthy junior high school students were prospectively studied. Optical AL and anterior chamber depth (ACD) measurements, and fundus photography were performed in the first and third grades. Eyes of subjects in the first and third grade that had perfect matching among all the retinal vessels were allocated to the RVS(-) group, otherwise allocated to the RVS(+) group. In the RVS(+) group, the peripapillary retinal arteries angle (PRAA) was measured for quantitative analysis of RVS; the angle between the major retinal arteries. The variables related to PRAA were identified using model selection with the corrected Akaike information criterion. RESULTS Forty-two eyes (26.1%) were allocated to the RVS(+) group. There were seven patterns in the RVS of those in the RVS(+) group, including clockwise shift in the supra temporal area (5 eyes), infra temporal area (7 eyes), and nasal area (9 eyes); anticlockwise shift in the supra temporal area (7 eyes), infra temporal area (5 eyes), and nasal area (2 eyes); and distal shift in the temporal area (7 eyes). The optimal model for the PRAA narrowing included larger AL and body weight in the first grade, and greater AL elongation. CONCLUSION Various (seven) RVS patterns were observed in about 25% of the junior high school students within two years. RVS was associated with AL elongation, and useful to reveal the mechanism of myopic retinal stretch.
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Affiliation(s)
- Shotaro Asano
- Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
| | - Takehiro Yamashita
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Ryo Asaoka
- Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Shizuoka, Japan
- Seirei Christopher University, Shizuoka, Japan
- Nanovision Research Division, Research Institute of Electronics, Shizuoka University, Shizuoka, Japan
- The Graduate School for the Creation of New Photonics Industries, Shizuoka, Japan
- * E-mail:
| | - Yuri Fujino
- Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
| | - Hiroshi Murata
- Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
| | - Hiroto Terasaki
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Naoya Yoshihara
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Naoko Kakiuchi
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Taiji Sakamoto
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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23
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Patasova K, Khawaja AP, Tamraz B, Williams KM, Mahroo OA, Freidin M, Solebo AL, Vehof J, Falchi M, Rahi JS, Hammond CJ, Hysi PG. Association Between Medication-Taking and Refractive Error in a Large General Population-Based Cohort. Invest Ophthalmol Vis Sci 2021; 62:15. [PMID: 33591358 PMCID: PMC7900881 DOI: 10.1167/iovs.62.2.15] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Refractive errors, particularly myopia, are common and a leading cause of blindness. This study aimed to explore associations between medications and refractive error in an aging adult cohort and to determine whether childhood-onset refractive errors predict future medication use to provide novel insights into disease mechanisms. Methods The study compared the spherical equivalent values measured in 102,318 UK Biobank participants taking the 960 most commonly used medications. The strengths of associations were evaluated against the self-reported age of spectacle wear. The causality of refractive error changes was inferred using sensitivity and Mendelian randomization analyses. Results Anti-glaucoma drugs were associated with 1 to 2 diopters greater myopic refraction, particularly in subjects who started wearing correction in the first two decades of life, potentially due to the association of higher intraocular pressure since early years with both myopia and, later in life, glaucoma. All classes of pain-control medications, including paracetamol, opiates, non-steroidal antiinflammatory drugs, and gabapentinoids, were associated with greater hyperopia (+0.68–1.15 diopters), after correction for deprivation, education, and polypharmacy and sensitivity analyses for common diagnoses. Oral hypoglycemics (metformin, gliburonide) were associated with myopia, as was allopurinol, and participants using bronchodilators (ipratropium and salbutamol) were more hyperopic. Conclusions This study finds for the first time, to our knowledge, that medication use is associated with refractive error in adults. The novel finding that analgesics are associated with hyperopic refraction, and the possibility that multisite chronic pain predisposes to hyperopia, deserves further research. Some drugs, such as antihyperglycemic or bronchodilators, may directly alter refractive error. Intraocular pressure appears causative for myopia.
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Affiliation(s)
- Karina Patasova
- Section of Ophthalmology, School of Life Course Sciences, King's College London, United Kingdom.,Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, United Kingdom
| | - Anthony P Khawaja
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and the UCL Institute of Ophthalmology, London, United Kingdom
| | - Bani Tamraz
- Department of Clinical Pharmacy, University of California San Francisco, San Francisco, California, United States
| | - Katie M Williams
- Section of Ophthalmology, School of Life Course Sciences, King's College London, United Kingdom.,Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, United Kingdom.,NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and the UCL Institute of Ophthalmology, London, United Kingdom.,Department of Ophthalmology, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.,Institute of Ophthalmology, University College London, London, United Kingdom
| | - Omar A Mahroo
- Section of Ophthalmology, School of Life Course Sciences, King's College London, United Kingdom.,Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, United Kingdom.,NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and the UCL Institute of Ophthalmology, London, United Kingdom.,Department of Ophthalmology, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.,Institute of Ophthalmology, University College London, London, United Kingdom
| | - Maxim Freidin
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, United Kingdom
| | - Ameenat L Solebo
- UCL Great Ormond Street Hospital Institute of Child Health, London, United Kingdom
| | - Jelle Vehof
- Section of Ophthalmology, School of Life Course Sciences, King's College London, United Kingdom.,Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, United Kingdom.,University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Mario Falchi
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, United Kingdom
| | - Jugnoo S Rahi
- Institute of Ophthalmology, University College London, London, United Kingdom.,Ulverscroft Vision Research Group, University College London, London, United Kingdom
| | - Chris J Hammond
- Section of Ophthalmology, School of Life Course Sciences, King's College London, United Kingdom.,Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, United Kingdom
| | - Pirro G Hysi
- Section of Ophthalmology, School of Life Course Sciences, King's College London, United Kingdom.,Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, United Kingdom.,UCL Great Ormond Street Hospital Institute of Child Health, London, United Kingdom
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24
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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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25
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Pan M, Guan Z, Reinach PS, Kang L, Cao Y, Zhou D, Srinivasalu N, Zhao F, Qu J, Zhou X. PPARγ modulates refractive development and form deprivation myopia in Guinea pigs. Exp Eye Res 2020; 202:108332. [PMID: 33152389 DOI: 10.1016/j.exer.2020.108332] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 10/20/2020] [Accepted: 10/22/2020] [Indexed: 12/26/2022]
Abstract
Form deprivation myopia (FDM) is characterized by loss of choroidal thickness (ChT), reduced choroidal blood perfusion (ChBP), and consequently scleral hypoxia. In some tissues, changes in levels of peroxisome proliferator-activated receptor γ (PPARγ) expression modulate hypoxia-induced pathological responses. We determined if PPARγ modulates FDM through changes in ChT, ChBP, scleral hypoxia-inducible transcription factor (HIF-1α) that in turn regulate scleral collagen type 1 (COL1) expression levels in guinea pigs. Myopia was induced by occluding one eye, while the fellow eye served as control. They received daily peribulbar injections of either the PPARγ antagonist GW9662, or the GW1929 agonist, with or without ocular occlusion for 4 weeks. Ocular refraction and biometric parameters were estimated at baseline, 2 and 4 weeks post-treatment. ChT and ChBP were measured at the 2- and 4-week time points. Western blot analysis determined the expression levels of scleral HIF-1α and COL1. GW9662 induced a myopic shift in unoccluded eyes. Conversely, GW1929 inhibited FDM progression without affecting the refraction in unoccluded eyes. GW9662 reduced both ChT and ChBP in unoccluded eyes, while GW1929 inhibited their declines in occluded eyes. Scleral HIF-1α expression rose in GW9662-treated unoccluded eyes whereas GW1929 reduced HIF-1α upregulation in occluded eyes. GW9662 downregulated scleral COL1 expression in unoccluded eyes, while GW1929 reduced their decreases in occluded eyes. Therefore, PPARγ modulates collagen expression levels and FDM through an inverse relationship between changes in PPARγ and HIF-1α expression levels.
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Affiliation(s)
- Miaozhen Pan
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; State Key Laboratory of Optometry, Ophthalmology, and Vision Science, Wenzhou, Zhejiang, China
| | - Zhenqi Guan
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; State Key Laboratory of Optometry, Ophthalmology, and Vision Science, Wenzhou, Zhejiang, China
| | - Peter S Reinach
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; State Key Laboratory of Optometry, Ophthalmology, and Vision Science, Wenzhou, Zhejiang, China
| | - Lin Kang
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; State Key Laboratory of Optometry, Ophthalmology, and Vision Science, Wenzhou, Zhejiang, China
| | - Yuqing Cao
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; State Key Laboratory of Optometry, Ophthalmology, and Vision Science, Wenzhou, Zhejiang, China
| | - Dengke Zhou
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; State Key Laboratory of Optometry, Ophthalmology, and Vision Science, Wenzhou, Zhejiang, China
| | - Nethrajeith Srinivasalu
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; State Key Laboratory of Optometry, Ophthalmology, and Vision Science, Wenzhou, Zhejiang, China
| | - Fei Zhao
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; State Key Laboratory of Optometry, Ophthalmology, and Vision Science, Wenzhou, Zhejiang, China
| | - Jia Qu
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; State Key Laboratory of Optometry, Ophthalmology, and Vision Science, Wenzhou, Zhejiang, China.
| | - Xiangtian Zhou
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; State Key Laboratory of Optometry, Ophthalmology, and Vision Science, Wenzhou, Zhejiang, China; Research Unit of Myopia Basic Research and Clinical Prevention and Control, Chinese Academy of Medical Sciences (2019RU025), China.
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26
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Berticat C, Mamouni S, Ciais A, Villain M, Raymond M, Daien V. Probability of myopia in children with high refined carbohydrates consumption in France. BMC Ophthalmol 2020; 20:337. [PMID: 32811458 PMCID: PMC7433090 DOI: 10.1186/s12886-020-01602-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 08/06/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Evaluate risk factors for paediatric myopia in a contemporary French cohort taking into account consumption of refined carbohydrates (starches and sugars). METHODS An epidemiological cross-sectional study was conducted between May 2017 and May 2018. Two hundred sixty-four children aged 4 to 18 years attending the Centre Hospitalier Universitaire Gui de Chauliac in Montpellier were recruited. Ophthalmologic or optometric cycloplegic refraction were measured. Evaluated risk factors for myopia were collected, including family history of myopia, outdoor time, reading time, screen time, physical activity, and consumption of refined carbohydrates. Association between the probability of at least one eye showing myopia (defined as < 0 D) and frequency of refined carbohydrates consumption adjusted for risk factors and control factors was tested. RESULTS Overall, 86/264 (32.6%) children investigated showed myopia in at least one eye. We included 180 children exhibiting refraction < 3 D in both eyes: 88 (48.9%) girls and 92 (51.1%) boys. The consumption of refined carbohydrates significantly increased the probability of myopia for girls (odds ratio [OR] = 1.07; 95% confidence interval [CI], 1.02-1.13; P = 0.009) but decreased it for boys (OR = 0.94; 95% CI, 0.89-0.98; P = 0.011). The probability of myopia was marginally increased with increased screen time (OR = 2.32; 95% CI, 0.94-6.47; P = 0.083). Outdoor time seemed marginally protective (OR = 0.74; 95% CI, 0.54-1.01; P = 0.057). CONCLUSION Refined carbohydrates consumption could be associated with child myopia, with increased probability for girls and unexpected reduced probability for boys, possibly due to the fact that frequency of carbohydrates consumption do not really capture boy's chronic hyperglycemia, boys being more physically active than girls at all ages. Some known risk/protective factors of myopia were marginally significant: screen time (risk) and outdoor time (protective). This study reinforces the belief that modifiable risk factors for myopia could be targets for future public health actions.
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Affiliation(s)
- Claire Berticat
- ISEM, University of Montpellier, CNRS, EPHE, IRD, Montpellier cedex 05, France.
| | - Sonia Mamouni
- Department of Ophthalmology, Gui De Chauliac Hospital, Montpellier, France
| | - Angelique Ciais
- Department of Orthoptist, Gui De Chauliac Hospital, Montpellier, France
| | - Max Villain
- Department of Ophthalmology, Gui De Chauliac Hospital, Montpellier, France
| | - Michel Raymond
- ISEM, University of Montpellier, CNRS, EPHE, IRD, Montpellier cedex 05, France
| | - Vincent Daien
- Department of Ophthalmology, Gui De Chauliac Hospital, Montpellier, France.,Neuropsychiatry: Epidemiological & Clinical Research, University of Montpellier, INSERM, Montpellier, France
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27
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Ostrin LA, Read SA, Vincent SJ, Collins MJ. Sleep in Myopic and Non-Myopic Children. Transl Vis Sci Technol 2020; 9:22. [PMID: 32879778 PMCID: PMC7442863 DOI: 10.1167/tvst.9.9.22] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 06/07/2020] [Indexed: 12/16/2022] Open
Abstract
Purpose To examine differences in sleep between myopic and non-myopic children. Methods Objective measurements of sleep, light exposure, and physical activity were collected from 91 children, aged 10 to 15 years, for two 14-day periods approximately 6 months apart. Sleep parameters were analyzed with respect to refractive error, season, day of the week, age, and sex. Results Myopic children exhibited differences in sleep duration by day of the week (P < 0.001) and season (P = 0.007). Additionally, myopic children exhibited shorter sleep latency than non-myopic children (P = 0.04). For all children, wake time was later (P < 0.001) and sleep duration was longer (P = 0.03) during the cooler season compared with the warmer season. On weekends, children went to bed later (P < 0.001), woke up later (P < 0.001), and had increased sleep duration (P < 0.001) than on weekdays. Younger children exhibited earlier bedtime (P = 0.005) and wake time (P = 0.01) than older children. Time spent outdoors was positively associated with sleep duration (P = 0.03), and daily physical activity was negatively associated with wake time (P < 0.001). Conclusions Myopic children tended to have more variable sleep duration and shorter latency than non-myopic children. Sleep patterns were influenced by season, day of the week, age, time outdoors, and activity. Translational Relevance Myopic children tended to have more variable sleep duration and shorter latency than non-myopic children, which may reflect previously reported differences in environmental and behavioral factors between refractive error groups.
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Affiliation(s)
- Lisa A Ostrin
- College of Optometry, University of Houston, Houston, TX, USA
| | - Scott A Read
- Queensland University of Technology (QUT), Centre for Vision and Eye Research, Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Brisbane, Queensland, Australia
| | - Stephen J Vincent
- Queensland University of Technology (QUT), Centre for Vision and Eye Research, Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Brisbane, Queensland, Australia
| | - Michael J Collins
- Queensland University of Technology (QUT), Centre for Vision and Eye Research, Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Brisbane, Queensland, Australia
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Abstract
PURPOSE To investigate the associations of Single Nucleotide Polymorphisms (SNPs) in the SNTB1 gene with high myopia in a Han Chinese population. MATERIALS AND METHODS Based on previous studies, four SNPs from the SNTB1 gene were chosen for genotyping. This is a case-control genetic association study comprising 193 high myopia participants and 135 normal emmetropic controls from a Han Chinese population. Allelic frequencies of the SNPs and haplotypes were compared to assess the associations of the SNPs with high myopia and axial length (AL). RESULTS The SNPs rs7839488 (effect allele: A; OR = 0.685), rs4395927 (effect allele: T; OR = 0.692), and rs6469937 (effect allele: A; OR = 0.683) displayed significant associations with high myopia initially (P = .044, 0.049, and 0.035, respectively), but did not withstand permutation testing (all Ppermutation>0.05). rs6469937 displayed associations with high myopia in the dominant model (AG+AA: OR = 0.609) against GG (reference). rs6469937 was also associated with AL in the dominant model (AG+AA: Beta = -0.58) against GG (reference). The haplotype analysis demonstrated ATGA as the protective haplotype against high myopia, which remained statistically significant in permutation testing (Ppermutation = 0.045). CONCLUSIONS Our findings are suggestive that SNTB1 is associated with high myopia in a Han Chinese population.
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Affiliation(s)
- Kai Xiong Cheong
- Singapore Eye Research Institute, Singapore National Eye Centre , Singapore.,Vision Performance Centre, Military Medicine Institute, Singapore Armed Forces , Singapore
| | - Rita Yu Yin Yong
- DSO National Laboratories, Defence Medical and Environmental Research Institute , Singapore
| | - Mellisa Mei Hui Tan
- Vision Performance Centre, Military Medicine Institute, Singapore Armed Forces , Singapore
| | | | - Bryan Chin Hou Ang
- Vision Performance Centre, Military Medicine Institute, Singapore Armed Forces , Singapore.,National Healthcare Group Eye Institute, Tan Tock Seng Hospital , Singapore
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29
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Abstract
Myopia is one of the most prevalent eye diseases, and its advanced form, high myopia, is a leading cause of subsequent pathologic myopia, which in turn results in an increased risk of retinal diseases. The prevalence of myopia and high myopia is 28.3% and 4.0% of the global population, respectively, and these numbers are estimated to increase to 49.8% for myopia 9.8% for high myopia by 2050, thus making myopia a severe global socioeconomic problem. The eye shape has been receiving increasing attention as a possible biomarker for myopia. Among several modalities, magnetic resonance imaging (MRI) is currently considered to be the best to measure the 3-dimensional eye shape, and one study using MRI revealed that myopic eyes became much larger in all 3 dimensions, but more so in length (0.35 mm/D) than in height (0.19 mm/D) or in width (0.10 mm/D), which fitted in global and axial elongation models. Another recent study reported that emmetropic retinas were oblate but oblateness decreased with myopia progression. According to a study to evaluate eye shapes in high myopia, although all emmetropic eyes had a blunt shape, almost half of the high myopic eyes had a pointed shape. Multiple lines of evidence suggest that abnormal eye shape changes can cause not only simple myopia but also various ocular complications through biomechanical stretching. In this review, we highlight recent findings on eye shape changes in myopic eyes and abnormal eye shapes in pathologic myopia.
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31
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Rozema JJ, Sun W, Wu JF, Jiang WJ, Wu H, Lu TL, Hu YY, Chen R, Guo DD, Wang XR, Dankert S, Jonas JB, Iribarren R, Tian QM, Bi HS. Differences in ocular biometry between urban and rural children matched by refractive error: the Shandong Children Eye Study. Ophthalmic Physiol Opt 2019; 39:451-458. [DOI: 10.1111/opo.12649] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 09/25/2019] [Accepted: 09/26/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Jos J Rozema
- Department of Ophthalmology Antwerp University Hospital EdegemBelgium
- Faculty of Medicine and Health Sciences University of Antwerp Antwerp Belgium
| | - Wei Sun
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine JinanChina
| | - Jian Feng Wu
- School of Ophthalmology and Optometry Shandong University of Traditional Chinese Medicine JinanChina
| | - Wen Jun Jiang
- 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 China
| | - Hui Wu
- 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 China
| | - Tai Liang Lu
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine JinanChina
| | - Yuan Yuan Hu
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine JinanChina
| | - Rong Chen
- Department of Radiology University of Pennsylvania Philadelphia USA
| | - Da Dong Guo
- 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 China
| | - Xing Rong Wang
- 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 China
| | - Sebastian Dankert
- Department of Ophthalmology University of Buenos Aires Buenos Aires Argentina
| | - Jost B Jonas
- Department of Ophthalmology Medical Faculty Mannheim Ruprecht‐Karls‐University Heidelberg Mannheim Germany
| | - Rafael Iribarren
- Laboratory of Ocular Investigations Department of Pathology School of Medicine University of Buenos Aires Argentina
| | - Qing Mei Tian
- Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine JinanChina
- First College of Clinical Medicine Shandong University of Traditional Chinese Medicine Jinan China
| | - Hong Sheng Bi
- 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 China
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High Myopia and Its Associated Factors in JPHC-NEXT Eye Study: A Cross-Sectional Observational Study. J Clin Med 2019; 8:jcm8111788. [PMID: 31731571 PMCID: PMC6912595 DOI: 10.3390/jcm8111788] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 10/22/2019] [Indexed: 11/30/2022] Open
Abstract
The increasing prevalence of high myopia has been noted. We investigated the epidemiological characteristics and the related factors of high myopia in a Japanese adult population. Japan Public Health Center-Based Prospective Study for the Next Generation (JPHC-NEXT) Eye Study was performed in Chikusei-city, a rural area in mid-east Japan, between 2013 and 2015. A cross-sectional observational analysis was conducted to investigate prevalence and related factors of high myopia. A total of 6101 participants aged ≥40 years without a history of ocular surgeries was included. High myopia was defined as a spherical equivalent refraction of ≤−6.00 diopters according to the American Academy of Ophthalmology. Potential high myopia-related factors included intraocular pressure (IOP), corneal structure, corneal endothelial cell density, age, height, body mass index, heart rate, blood pressure, biochemical profile, and current history of systemic and ocular disorders. The odds ratios of high myopia were estimated using the logistic regression models adjusted for the associated factors. The prevalence of high myopia was 3.8% in males and 5.9% in females with a significant difference. Age was inversely associated, IOP was positively associated, and none of other factors were associated with high myopia in both sexes. In conclusion, only age and IOP were associated with high myopia in this community-based sample.
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Abstract
SIGNIFICANCE Significant differences in light exposure were observed between school and summer in children, whereas activity and sleep were similar. Associations between parent and child behaviors suggest a potential mechanism for how myopia is transmitted from parents to children through patterns of environmental exposure, in addition to genetic factors. PURPOSE Objectively measured time outdoors, light exposure, activity, and sleep were examined in children during school and summer and assessed with eye growth. Associations between parent and child behaviors were evaluated. METHODS Children (aged 7.6 ± 1.8 years, n = 60) in Houston, TX, wore an actigraph device for three 2-week sessions (fall school, spring school, summer) to quantify time outdoors, light exposure, activity, and sleep. Cycloplegic autorefraction (WAM-5500; Grand-Seiko, Tokyo, Japan) and axial length (LenStar; Haag-Streit AG, Koeniz, Switzerland) were measured at baseline and 1 year. A subset of parents wore the device during their child's first 2-week session to compare behaviors (n = 33). RESULTS Children spent 94.4 ± 30.6 minutes per day outdoors in spring, 110.6 ± 45.7 minutes in summer, and 72.2 ± 31.0 minutes in fall, with significant differences between sessions (P < .0001). Daily activity and sleep duration were similar across sessions (P = .73 and .06, respectively). Axial growth rate decreased with light exposure, but did not reach significance after adjusting for baseline axial length, age, sex, activity, and parental myopia (P = .073). Parent and child time outdoors and sleep duration were significantly correlated (P = .0002 and 0.026, respectively). CONCLUSIONS Significant differences in light exposure were observed between school and summer, whereas activity and sleep were constant throughout the year. Children's behaviors were associated with their parent's behaviors, which may represent a modifiable component to potential environmental influences on eye growth. However, light exposure was not a significant environmental influence on axial growth in this study.
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Gifford KL, Richdale K, Kang P, Aller TA, Lam CS, Liu YM, Michaud L, Mulder J, Orr JB, Rose KA, Saunders KJ, Seidel D, Tideman JWL, Sankaridurg P. IMI - Clinical Management Guidelines Report. Invest Ophthalmol Vis Sci 2019; 60:M184-M203. [PMID: 30817832 DOI: 10.1167/iovs.18-25977] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Best practice clinical guidelines for myopia control involve an understanding of the epidemiology of myopia, risk factors, visual environment interventions, and optical and pharmacologic treatments, as well as skills to translate the risks and benefits of a given myopia control treatment into lay language for both the patient and their parent or caregiver. This report details evidence-based best practice management of the pre-, stable, and the progressing myope, including risk factor identification, examination, selection of treatment strategies, and guidelines for ongoing management. Practitioner considerations such as informed consent, prescribing off-label treatment, and guides for patient and parent communication are detailed. The future research directions of myopia interventions and treatments are discussed, along with the provision of clinical references, resources, and recommendations for continuing professional education in this growing area of clinical practice.
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Affiliation(s)
- Kate L Gifford
- Private Practice and Queensland University of Technology, Brisbane, Queensland, Australia
| | | | - Pauline Kang
- University of New South Wales, Sydney, New South Wales, Australia
| | - Thomas A Aller
- Private Practice and University of California, Berkeley, United States
| | - Carly S Lam
- The Hong Kong Polytechnic University, Hong Kong
| | - Y Maria Liu
- University of California, Berkeley, California, United States
| | | | - Jeroen Mulder
- University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Janis B Orr
- Aston University, Birmingham, United Kingdom
| | - Kathryn A Rose
- University of Technology Sydney, New South Wales, Australia
| | | | - Dirk Seidel
- Glasgow Caledonian University, Glasgow, United Kingdom
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Saw SM, Matsumura S, Hoang QV. Prevention and Management of Myopia and Myopic Pathology. Invest Ophthalmol Vis Sci 2019; 60:488-499. [PMID: 30707221 DOI: 10.1167/iovs.18-25221] [Citation(s) in RCA: 83] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Myopia is fast becoming a global public health burden with its increasing prevalence, particularly in developed countries. Globally, the prevalence of myopia and high myopia (HM) is 28.3% and 4.0%, respectively, and these numbers are estimated to increase to 49.8% for myopia and 9.8% for HM by 2050 (myopia defined as -0.50 diopter [D] or less, and HM defined as -5.00 D or less). The burden of myopia is tremendous, as adults with HM are more likely to develop pathologic myopia (PM) changes that can lead to blindness. Accordingly, preventive measures are necessary for each step of myopia progression toward vision loss. Approaches to prevent myopia-related blindness should therefore attempt to prevent or delay the onset of myopia among children by increased outdoor time; retard progression from low/mild myopia to HM, through optical (e.g., defocus incorporated soft contact lens, orthokeratology, and progressive-additional lenses) and pharmacological (e.g., low dose of atropine) interventions; and/or retard progression from HM to PM through medical/surgical treatments (e.g., anti-VEGF therapies, macula buckling, and scleral crosslinking). Recent clinical trials aiming for retarding myopia progression have shown encouraging results. In this article, we highlight recent findings on preventive and early interventional measures to retard myopia, and current and novel treatments for PM.
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Affiliation(s)
- Seang-Mei Saw
- Singapore Eye Research Insitute, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,Duke-NUS Medical School, Singapore
| | | | - Quan V Hoang
- Singapore Eye Research Insitute, Singapore.,Duke-NUS Medical School, Singapore.,Singapore National Eye Centre, Singapore.,Department of Ophthalmology, Columbia University Medical Center, New York, New York, United States
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Pan M, Jiao S, Reinach PS, Yan J, Yang Y, Li Q, Srinivasalu N, Qu J, Zhou X. Opposing Effects of PPARα Agonism and Antagonism on Refractive Development and Form Deprivation Myopia in Guinea Pigs. Invest Ophthalmol Vis Sci 2019; 59:5803-5815. [PMID: 30521668 DOI: 10.1167/iovs.17-22297] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To determine if drug-induced peroxisome proliferator-activated receptor α (PPARα) signal pathway modulation affects refractive development and myopia in guinea pigs. Methods Pigmented guinea pigs were randomly divided into normal vision (unoccluded) and form deprivation myopia (FDM) groups. Each group received daily peribulbar injections of either a vehicle or (1) PPARα agonist, GW7647, clofibrate, or bezafibrate or (2) PPARα antagonist, GW6471, for 4 weeks. Baseline and posttreatment refraction and ocular biometric parameters were measured. Immunofluorescent staining of PPARα and two of its downstream readouts, cytosolic malic enzyme 1 (ME1) and apolipoproteinA II (apoA-II), was undertaken in selected scleral sections. Western blot analysis determined collagen type I expression levels. Results GW6471 induced a myopic shift in unoccluded eyes, but had no effect on form-deprived eyes. Conversely, GW7647 inhibited FDM progression without altering unoccluded eyes. Bezafibrate and clofibrate had effects on refraction similar to those of GW7647 in unoccluded and form-deprived eyes. GW6471 downregulated collagen type I expression in unoccluded eyes whereas bezafibrate inhibited collagen type I decreases in form-deprived eyes. GW6471 also reduced the density of ME1- and apoA-II-stained cells in unoccluded eyes whereas bezafibrate increased apoA-II-positive cell numbers in form-deprived eyes. Conclusions As GW7647 and GW6471 had opposing effects on myopia development, PPARα signaling modulation may be involved in this condition in guinea pigs. Fibrates are potential candidates for treating myopia since they reduced both FDM and the associated axial elongation. Bezafibrate also inhibited form deprivation-induced decreases in scleral collagen type I expression and the density of apoA-II expressing cells.
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Affiliation(s)
- Miaozhen Pan
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology, and Vision Science, Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Shiming Jiao
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology, and Vision Science, Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Peter S Reinach
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology, and Vision Science, Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Jiaofeng Yan
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology, and Vision Science, Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Yanan Yang
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology, and Vision Science, Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Qihang Li
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology, and Vision Science, Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Nethrajeith Srinivasalu
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology, and Vision Science, Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Jia Qu
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology, and Vision Science, Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
| | - Xiangtian Zhou
- School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.,State Key Laboratory of Optometry, Ophthalmology, and Vision Science, Affiliated Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China
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Williams R, Bakshi S, Ostrin EJ, Ostrin LA. Continuous Objective Assessment of Near Work. Sci Rep 2019; 9:6901. [PMID: 31061427 PMCID: PMC6503122 DOI: 10.1038/s41598-019-43408-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 04/24/2019] [Indexed: 01/05/2023] Open
Abstract
Evidence regarding the role of near work in myopia is conflicting. We developed the RangeLife, a device for continuous, objective measurement of working distance. Four devices were built, calibrated, and validated. Then, adult subjects wore the device on weekdays and weekend days, while simultaneously wearing an actigraph device for objective measurements of light exposure and activity. Subjects maintained an activity log and answered a visual activity questionnaire. RangeLife data were downloaded and binned into 0.10 m intervals. Objective diopter hours (dh), a weighted measure of near work, were calculated. Diopter hours for all subjects were significantly higher on weekdays (14.73 ± 4.67 dh) compared to weekends (11.90 ± 4.84 dh, p = 0.05). 94 ± 1.85% of near and intermediate viewing distances were recorded when the subjects were exposed to mesopic and indoor photopic light levels (<1000 lux), and 80.03 ± 2.11% during periods of sedentary physical activity (<320 counts per minute). Subjective reports of time viewing near and intermediate distances significantly overestimated objective measures (p = 0.002). The RangeLife was shown to provide reliable measures of viewing distance, and can be further utilized to understand potential influences of viewing behaviors on refractive error.
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Affiliation(s)
- Rachel Williams
- College of Optometry, University of Houston, 4901 Calhoun Rd, Houston, TX 77004, USA
| | - Suyash Bakshi
- Computer Science, University of Houston, 4901 Calhoun Rd, Houston, TX 77004, USA
| | - Edwin J Ostrin
- MD Anderson Cancer Center, University of Texas, 1515 Holcombe Blvd, Houston, TX 77030, USA
| | - Lisa A Ostrin
- College of Optometry, University of Houston, 4901 Calhoun Rd, Houston, TX 77004, USA.
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Zhang X, Zhang F, Yang J, Yang W, Liu W, Gao L, Peng Z, Wang Y. Prevalence of overweight and obesity among primary school-aged children in Jiangsu Province, China, 2014-2017. PLoS One 2018; 13:e0202681. [PMID: 30138424 PMCID: PMC6107224 DOI: 10.1371/journal.pone.0202681] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 07/12/2018] [Indexed: 01/22/2023] Open
Abstract
Background Data was limited on prevalence of overweight and obesity among primary school-aged children in Jiangsu Province. We aimed to present the current situation of obesity in Jiangsu Province and explore the relationship between obesity and other common diseases in children. Methods Physical examination among children aged 7 to 14 years in Jiangsu Province was conducted since 2014, and more than one third primary schools were covered annually. The physical measurements included body height, weight, blood pressure, vision, sex, age, and so on. Results The prevalence of overweight and obesity among primary school children was 15.2% (18.7% for male students and 11.0% for female students), and 11.7% (14.5% for male students and 8.2% for female students) respectively. Obesity/overweight prevalence varied by regions. Among them the lowest prevalence was found in the southern region of Jiangsu Province, where residents had the highest average income level. Obesity group had elevated blood pressure comparing with the normal group, and obesity group especially in the male children aged 7 to 12 years had a higher prevalence of uncorrected visual acuity (UCVA) than that of normal group. Conclusion This study found that obesity/overweight prevalence differed by sex, age, and regions in Jiangsu Province. In addition, obese children were closely associated with other common disease. Further studies are needed to explore the basis of biological and statistical theories.
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Affiliation(s)
- Xiyan Zhang
- Department of Child and Adolescent Health Promotion, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.,Public Health Research Institute of Jiangsu Province, Nanjing, China
| | - Fengyun Zhang
- Department of Child and Adolescent Health Promotion, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.,Public Health Research Institute of Jiangsu Province, Nanjing, China
| | - Jie Yang
- Department of Child and Adolescent Health Promotion, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.,Public Health Research Institute of Jiangsu Province, Nanjing, China
| | - Wenyi Yang
- Department of Child and Adolescent Health Promotion, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.,Public Health Research Institute of Jiangsu Province, Nanjing, China
| | - Weina Liu
- Department of Child and Adolescent Health Promotion, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.,Public Health Research Institute of Jiangsu Province, Nanjing, China
| | - Liuwei Gao
- Department of Child and Adolescent Health Promotion, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.,Public Health Research Institute of Jiangsu Province, Nanjing, China
| | - Zhihang Peng
- Department of biostatistics, School of public health, Nanjing medical university, Nanjing, China
| | - Yan Wang
- Department of Child and Adolescent Health Promotion, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China.,Public Health Research Institute of Jiangsu Province, Nanjing, China
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Li L, Zhong H, Li J, Li CR, Pan CW. Incidence of myopia and biometric characteristics of premyopic eyes among Chinese children and adolescents. BMC Ophthalmol 2018; 18:178. [PMID: 30029645 PMCID: PMC6053817 DOI: 10.1186/s12886-018-0836-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 06/25/2018] [Indexed: 11/29/2022] Open
Abstract
Background To determine the one-year incidence and progression rates of myopia and its association with baseline ocular biometric parameters in school-based samples of children and adolescents in China. Methods Two thousand four hundred thirty two grade 1 and 2346 grade 7 students living in the southwest part of China participated in the baseline survey. After 1 year, 2310 (95.0%) grade 1 and 2191 (93.4%) grade 7 students attended the follow-up examination. Refractive error was measured after cycloplegia using the same autorefractor and by the same optometrists in the baseline and follow-up examination. Myopia was defined as spherical equivalent of less than − 0.50 diopter. Results The overall one-year incidence of myopia was 33.6% (95% confidence interval [CI]: 31.7–35.5) among grade 1 students and 54.0% (95% CI: 51.5–56.5) for grade 7 students. The one-year myopia progression rate was − 0.97 D (95% CI: -1.22 to − 0.71) in grade 1 students and − 1.02 D (95% CI: -1.07 to − 0.96) in grade 7 students. Per mm increase in baseline axial lengths increased the risk of myopia onset by 28% among grade 1 students and 22% among grade 7 students after 1 year. The incidence rates of myopia were found to be higher in grade 7 students with thinner premyopic lenses. Conclusions The incidence and progression rates of myopia were very high in Chinese children and adolescents in recent years. Premyopic eyes were characterized with longer axial lengths and thinner lenses. These data had considerable implications for formulating myopia prevention strategies in China.
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Affiliation(s)
- Lan Li
- Department of Ophthalmology, the First People's Hospital of Kunming City, Kunming, China
| | - Hua Zhong
- Department of Ophthalmology, the First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jun Li
- Department of Ophthalmology, the Second People's Hospital of Yunnan Province, Kunming, China
| | - Cai-Rui Li
- Department of Ophthalmology, the First Affiliated Hospital of Dali University, 32 Mangyong Road, Dali, 671003, China.
| | - Chen-Wei Pan
- School of Public Health, Medical College of Soochow University, 199 Ren Ai Road, Suzhou, 215123, China.
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40
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Zhao L, Zhou M. Do only children have poor vision? Evidence from China's One-Child Policy. HEALTH ECONOMICS 2018; 27:1131-1146. [PMID: 29682832 DOI: 10.1002/hec.3661] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 01/30/2018] [Accepted: 03/13/2018] [Indexed: 06/08/2023]
Abstract
This paper examines whether only children have poor vision by exploiting the quasinatural experiment generated by the Chinese One-Child Policy. The results suggest that being an only child increases the incidence of myopia by 9.1 percentage points. We further investigate the mechanisms through which being an only child affects the myopia and find that only children, as the only hope in a household, receive higher expectations in terms of academic performance and future educational attainment and pressure to succeed in life from parents, which contribute to the increased myopia. We also find that the school quality of only children is significantly higher than that of non-only children. This study provides new insights into an important health consequence of One-Child Policy in China.
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Affiliation(s)
- Liqiu Zhao
- School of Labor and Human Resources, Renmin University of China, Beijing, China
| | - Minghai Zhou
- School of Economics, The University of Nottingham Ningbo China and GEP China, Ningbo, China
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41
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Chua SYL, Sabanayagam C, Tan CS, Lim LS, Toh JY, Chong YS, Gluckman PD, Yap F, Cheng CY, Ngo CS, Wong TY, Chong MFF, Saw SM. Diet and risk of myopia in three-year-old Singapore children: the GUSTO cohort. Clin Exp Optom 2018; 101:692-699. [PMID: 29577442 DOI: 10.1111/cxo.12677] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 01/07/2018] [Accepted: 02/11/2018] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND To investigate the relationship between dietary intakes at six, nine and 12 months and risk of myopia in three-year-old children in a birth cohort. METHODS Three hundred and seventeen children from the Growing Up in Singapore Towards Healthy Outcomes (GUSTO) study were included. Dietary intake at six, nine and 12 months of age was ascertained using either 24-hour recalls or three-day food diaries completed by parents. Cycloplegia was achieved with three drops of one per cent cycloplentolate instilled at five minute intervals. Cycloplegic autorefraction and axial length (AL) were measured at three years of age with a table-mounted autorefractor and optical biometer, respectively. Myopia was defined as spherical equivalent (SE) of ≤ -0.50 D. Associations of dietary intake with SE, AL and myopia were examined by single dietary factor models using two multivariable regression models. Model 1 included adjusting for age, gender and total energy intake. Model 2 included additional adjustments for ethnicity, time spent outdoors, maternal education and parental myopia. RESULTS In the single dietary factor adjusted models, dietary intakes at six, nine and 12 months were not associated with SE, AL and myopia. In model 1, protein, fat and carbohydrate intakes were not associated with SE, AL and myopia at any of the three time points (p > 0.05). In model 2, protein, fat and carbohydrate intakes were not associated with SE, AL and myopia at any of the three time points (p > 0.05). CONCLUSIONS In this study, there was no evidence that diet at ages six, nine and 12 months was related to SE, AL or myopia at age three years. Further prospective studies with larger sample sizes are needed to understand the influence of diet on eye development in young children.
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Affiliation(s)
- Sharon Y-L Chua
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Chuen-Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Laurence S Lim
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Jia-Ying Toh
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore.,Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore and National Health System, Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore.,Liggins Institute, The University of Auckland, Auckland, New Zealand
| | - Fabian Yap
- Department of Paediatric Endocrinology, KK Women's and Children's Hospital, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Cheryl S Ngo
- Department of Ophthalmology, National University Hospital, Singapore
| | - Tien-Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore.,Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore
| | - Mary F-F Chong
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore.,Singapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore
| | - Seang-Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore.,Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore
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Undurraga EA, Behrman JR, Emmett SD, Kidd C, Leonard WR, Piantadosi ST, Reyes-García V, Sharma A, Zhang R, Godoy RA. Child stunting is associated with weaker human capital among native Amazonians. Am J Hum Biol 2017; 30. [PMID: 28901592 DOI: 10.1002/ajhb.23059] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 06/19/2017] [Accepted: 08/24/2017] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES We assessed associations between child stunting, recovery, and faltering with schooling and human capital skills in a native Amazonian society of horticulturalists-foragers (Tsimane'). METHODS We used cross-sectional data (2008) from 1262 children aged 6 to 16 years in 53 villages to assess contemporaneous associations between three height categories: stunted (height-for-age Z score, HAZ<-2), moderately stunted (-2 ≤ HAZ≤-1), and nonstunted (HAZ>-1), and three categories of human capital: completed grades of schooling, test-based academic skills (math, reading, writing), and local plant knowledge. We used annual longitudinal data (2002-2010) from all children (n = 853) in 13 villages to estimate the association between changes in height categories between the first and last years of measure and schooling and academic skills. RESULTS Stunting was associated with 0.4 fewer completed grades of schooling (∼24% less) and with 13-15% lower probability of showing any writing or math skills. Moderate stunting was associated with ∼20% lower scores in local plant knowledge and 9% lower probability of showing writing skills, but was not associated with schooling or math and writing skills. Compared with nonstunted children, children who became stunted had 18-21% and 15-21% lower probabilities of showing math and writing skills, and stunted children had 0.4 fewer completed grades of schooling. Stunted children who recovered showed human capital outcomes that were indistinguishable from nonstunted children. CONCLUSIONS The results confirm adverse associations between child stunting and human capital skills. Predictors of growth recovery and faltering can affect human capital outcomes, even in a remote, economically self-sufficient society.
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Affiliation(s)
- Eduardo A Undurraga
- School of Government, Pontificia Universidad Católica de Chile, Santiago, Región Metropolitana 7820436, Chile
| | - Jere R Behrman
- Department of Economics and Population Studies Center, University of Pennsylvania, Philadelphia, Pennsylvania 19104
| | - Susan D Emmett
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287.,Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205
| | - Celeste Kidd
- Department of Brain and Cognitive Sciences, University of Rochester, Rochester, New York 14627-0268
| | - William R Leonard
- Department of Anthropology, Northwestern University, Evanston, Illinois 60208
| | - Steven T Piantadosi
- Department of Brain and Cognitive Sciences, University of Rochester, Rochester, New York 14627-0268
| | - Victoria Reyes-García
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona 08010, Spain.,Institut de Ciència i Tecnologia Ambientals, Universitat Autònoma de Barcelona, Bellaterra 08193, Spain
| | - Abhishek Sharma
- Royal Brisbane and Women's Hospital, Brisbane, Queensland 4029, Australia
| | - Rebecca Zhang
- Graduate School of Business, Stanford University, Stanford, California 94305
| | - Ricardo A Godoy
- Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts 02453
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Sedaghat MR, Heravian J, Askarizadeh F, Jabbarvand M, Nematy M, Rakhshandadi T, Amirkalali-Sijavandi MS, Shahsavan F, Narooie-Noori F. Investigation of the effects of Islamic fasting on ocular parameters. J Curr Ophthalmol 2017; 29:287-292. [PMID: 29270476 PMCID: PMC5735232 DOI: 10.1016/j.joco.2017.07.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 06/22/2017] [Accepted: 07/27/2017] [Indexed: 11/02/2022] Open
Abstract
Purpose To investigate the effects of religious fasting during the month of Ramadan on intraocular pressure (IOP), refractive error, corneal tomography and biomechanics, ocular biometry, and tear film layer properties. Methods This prospective study was carried out one week before and in the last week of Ramadan. Ninety-four eyes of 94 healthy adult volunteers (54 males and 40 females) with a mean ± SD age of 35.12 ± 9.07 were enrolled in this study. Patients with any systemic disorder, ocular disease, or a history of previous surgery were excluded. Corneal tomography and biomechanics, ocular biometry, IOP, refractive error, and tear break up time (TBUT) were evaluated in non-fasting and fasting periods by the Pentacam (Oculus), Corvis ST (Oculus), IOL Master (Carl Zeiss), computerized tonometer (Topcon CT-1/CT-1P), auto kerato-refractometer (Topcon KR-1), and Keratograph 5M (Oculus), respectively. Results There was no significant difference in the central corneal thickness (CCT) between the study groups (P = 0.123) using the Pentacam while the Corvis ST showed a significant difference in all participants (P < 0.0001). Moreover, the peak distance (distance of the two surrounding peaks of the cornea at the highest concavity) of male and female participants showed a significant difference between the fasting and non-fasting groups (P = 0.002). The anterior chamber depth (ACD) using the Pentacam decreased in the male group (P = 0.004) in the fasting period. During the fasting period, computerized tonometer showed a decrease in IOP only in males in comparison to the non-fasting group (P = 0.018) while the Corvis ST showed decreased IOP in all participants (P < 0.0001). The steep keratometry (K2) in the corneal posterior surface appeared to be different in males between the study groups (P = 0.034). We were unable to show any significant difference in other ocular parameters between fasting and non-fasting periods. Conclusion This study showed that ACD, IOP, CCT, and peak distance were different between fasting and non-fasting groups while no difference was observed in other ocular parameters. Interpretations of these significant differences should be considered in the clinical setting.
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Affiliation(s)
- Mohamad-Reza Sedaghat
- Cornea Research Center, Khatam-Al-Anbia Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Javad Heravian
- Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Optometry, School of Paramedical Science, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farshad Askarizadeh
- Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Optometry, School of Paramedical Science, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahmoud Jabbarvand
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Nematy
- Department of Nutrition, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Tahereh Rakhshandadi
- Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Optometry, School of Paramedical Science, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Fatemeh Shahsavan
- Nutrition Research Group, Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Foroozan Narooie-Noori
- Refractive Errors Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Optometry, School of Paramedical Science, Mashhad University of Medical Sciences, Mashhad, Iran
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Terasaki H, Yamashita T, Yoshihara N, Kii Y, Sakamoto T. Association of lifestyle and body structure to ocular axial length in Japanese elementary school children. BMC Ophthalmol 2017; 17:123. [PMID: 28697750 PMCID: PMC5506696 DOI: 10.1186/s12886-017-0519-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 07/07/2017] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The purpose of this study is to determine whether the lifestyle and body stature are significantly associated with the axial length (AL) of the eyes of Japanese third grade students. METHODS A prospective, cross sectional, observational study was performed on 122 third grade students consisting of 61 boys and 61 girls ages 8 to 9 years. The AL, body height, body weight, and body mass index (BMI) were measured. The lifestyle was determined by activities such as the daily duration of indoor studying, television viewing, use of computers and smart phones, outdoor activity time, bed time, Japanese or Western dietary habits, and parental myopia were investigated by a questionnaire with three or five grade levels. The relationship between AL and the questionnaire variables were analyzed by Spearman's correlation analyses. RESULTS Westernized dietary habits (r = -0.24, P = 0.01), duration of computer and smart phone use (r = 0.24, P = 0.008), parental myopia (r = 0.39, P < 0.001), body weight (r = 0.26, P = 0.005), and BMI (r = 0.23, P = 0.011) were significantly correlated with the AL. Multiple logistic regression analyses showed that the sex [r = -0.48; 95% confidence interval (CI) -0.80 to -0.17, P = 0.003], body weight (r = 0.04; 95% CI 0.02 to 0.07, P = 0.038), westernized dietary habits (r = -0.30; 95% CI -0.55 to -0.05, P = 0.021), and parental myopia (r = 0.40; 95% CI 0.20 to 0.61, P < 0.001) were significantly and independently correlated with the AL. CONCLUSIONS The body weight and parental myopia and westernized dietary habits are factors significantly associated with myopia. Changing from Japanese food style to westernized food style might increase the risk of progression of school myopia.
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Affiliation(s)
- Hiroto Terasaki
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Takehiro Yamashita
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Naoya Yoshihara
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yuya Kii
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Taiji Sakamoto
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
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45
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Bio-environmental factors associated with myopia: An updated review. ACTA ACUST UNITED AC 2017; 92:307-325. [PMID: 28162831 DOI: 10.1016/j.oftal.2016.11.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 11/27/2016] [Accepted: 11/29/2016] [Indexed: 12/12/2022]
Abstract
Experimental studies in animals, as well as observational and intervention studies in humans, seem to support the premise that the development of juvenile myopia is promoted by a combination of the effect of genetic and environmental factors, with a complex interaction between them. The very rapid increase in myopia rates in some parts of the world, such as Southeast Asia, supports a significant environmental effect. Several lines of evidence suggest that humans might respond to various external factors, such as increased activity in near vision, increased educational pressure, decreased exposure to sunlight outdoors, dietary changes (including increased intake of carbohydrates), as well as low light levels indoors. All these factors could be associated with a higher prevalence of myopia.
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Holden BA, Fricke TR, Wilson DA, Jong M, Naidoo KS, Sankaridurg P, Wong TY, Naduvilath TJ, Resnikoff S. Global Prevalence of Myopia and High Myopia and Temporal Trends from 2000 through 2050. Ophthalmology 2016; 123:1036-42. [PMID: 26875007 DOI: 10.1016/j.ophtha.2016.01.006] [Citation(s) in RCA: 2412] [Impact Index Per Article: 301.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 12/15/2015] [Accepted: 01/05/2016] [Indexed: 10/22/2022] Open
Abstract
PURPOSE Myopia is a common cause of vision loss, with uncorrected myopia the leading cause of distance vision impairment globally. Individual studies show variations in the prevalence of myopia and high myopia between regions and ethnic groups, and there continues to be uncertainty regarding increasing prevalence of myopia. DESIGN Systematic review and meta-analysis. METHODS We performed a systematic review and meta-analysis of the prevalence of myopia and high myopia and estimated temporal trends from 2000 to 2050 using data published since 1995. The primary data were gathered into 5-year age groups from 0 to ≥100, in urban or rural populations in each country, standardized to definitions of myopia of -0.50 diopter (D) or less and of high myopia of -5.00 D or less, projected to the year 2010, then meta-analyzed within Global Burden of Disease (GBD) regions. Any urban or rural age group that lacked data in a GBD region took data from the most similar region. The prevalence data were combined with urbanization data and population data from United Nations Population Department (UNPD) to estimate the prevalence of myopia and high myopia in each country of the world. These estimates were combined with myopia change estimates over time derived from regression analysis of published evidence to project to each decade from 2000 through 2050. RESULTS We included data from 145 studies covering 2.1 million participants. We estimated 1406 million people with myopia (22.9% of the world population; 95% confidence interval [CI], 932-1932 million [15.2%-31.5%]) and 163 million people with high myopia (2.7% of the world population; 95% CI, 86-387 million [1.4%-6.3%]) in 2000. We predict by 2050 there will be 4758 million people with myopia (49.8% of the world population; 3620-6056 million [95% CI, 43.4%-55.7%]) and 938 million people with high myopia (9.8% of the world population; 479-2104 million [95% CI, 5.7%-19.4%]). CONCLUSIONS Myopia and high myopia estimates from 2000 to 2050 suggest significant increases in prevalences globally, with implications for planning services, including managing and preventing myopia-related ocular complications and vision loss among almost 1 billion people with high myopia.
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Affiliation(s)
- Brien A Holden
- Brien Holden Vision Institute, Sydney, Australia; School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | | | - David A Wilson
- Brien Holden Vision Institute, Sydney, Australia; School of Optometry and Vision Science, University of New South Wales, Sydney, Australia; African Vision Research Institute, University of KwaZulu-Natal, Durban, South Africa
| | - Monica Jong
- Brien Holden Vision Institute, Sydney, Australia
| | - Kovin S Naidoo
- Brien Holden Vision Institute, Sydney, Australia; School of Optometry and Vision Science, University of New South Wales, Sydney, Australia; African Vision Research Institute, University of KwaZulu-Natal, Durban, South Africa.
| | - Padmaja Sankaridurg
- Brien Holden Vision Institute, Sydney, Australia; School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Tien Y Wong
- Singapore Eye Research Institute, Singapore National Eye Center, Duke-NUS Medical School, Singapore, Republic of Singapore
| | | | - Serge Resnikoff
- Brien Holden Vision Institute, Sydney, Australia; School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
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Lim LS, Chua S, Tan PT, Cai S, Chong YS, Kwek K, Gluckman PD, Fortier MV, Ngo C, Qiu A, Saw SM. Eye size and shape in newborn children and their relation to axial length and refraction at 3 years. Ophthalmic Physiol Opt 2015; 35:414-23. [PMID: 25958972 DOI: 10.1111/opo.12212] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 04/13/2015] [Indexed: 11/26/2022]
Abstract
PURPOSE To determine if eye size and shape at birth are associated with eye size and refractive error 3 years later. METHODS A subset of 173 full-term newborn infants from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort underwent magnetic resonance imaging (MRI) to measure the dimensions of the internal eye. Eye shape was assessed by an oblateness index, calculated as 1 - (axial length/width) or 1 - (axial length/height). Cycloplegic autorefraction (Canon Autorefractor RK-F1) and optical biometry (IOLMaster) were performed 3 years later. RESULTS Both eyes of 173 children were analysed. Eyes with longer axial length at birth had smaller increases in axial length at 3 years (p < 0.001). Eyes with larger baseline volumes and surface areas had smaller increases in axial length at 3 years (p < 0.001 for both). Eyes which were more oblate at birth had greater increases in axial length at 3 years (p < 0.001). Using width to calculate oblateness, prolate eyes had smaller increases in axial length at 3 years compared to oblate eyes (p < 0.001), and, using height, prolate and spherical eyes had smaller increases in axial length at 3 years compared to oblate eyes (p < 0.001 for both). There were no associations between eye size and shape at birth and refraction, corneal curvature or myopia at 3 years. CONCLUSIONS Eyes that are larger and have prolate or spherical shapes at birth exhibit smaller increases in axial length over the first 3 years of life. Eye size and shape at birth influence subsequent eye growth but not refractive error development.
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Affiliation(s)
| | - Sharon Chua
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore City, Singapore
| | - Pei Ting Tan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore City, Singapore
| | - Shirong Cai
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore City, Singapore
| | - Yap-Seng Chong
- Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore City, Singapore.,Singapore Institute for Clinical Sciences, The Agency for Science, Technology and Research, Singapore City, Singapore
| | - Kenneth Kwek
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore City, Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, The Agency for Science, Technology and Research, Singapore City, Singapore.,Liggins Institute, University of Auckland, Auckland, New Zealand
| | | | - Cheryl Ngo
- Department of Ophthalmology, National University Hospital, Singapore City, Singapore
| | - Anqi Qiu
- Department of Biomedical Engineering, National University of Singapore, Singapore City, Singapore.,Clinical Imaging Research Center, National University of Singapore, Singapore City, Singapore
| | - Seang-Mei Saw
- Singapore Eye Research Institute, Singapore City, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore City, Singapore
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London DS, Beezhold B. A phytochemical-rich diet may explain the absence of age-related decline in visual acuity of Amazonian hunter-gatherers in Ecuador. Nutr Res 2014; 35:107-17. [PMID: 25636674 DOI: 10.1016/j.nutres.2014.12.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Revised: 12/24/2014] [Accepted: 12/28/2014] [Indexed: 11/18/2022]
Abstract
Myopia is absent in undisturbed hunter-gatherers but ubiquitous in modern populations. The link between dietary phytochemicals and eye health is well established, although transition away from a wild diet has reduced phytochemical variety. We hypothesized that when larger quantities and greater variety of wild, seasonal phytochemicals are consumed in a food system, there will be a reduced prevalence of degenerative-based eye disease as measured by visual acuity. We compared food systems and visual acuity across isolated Amazonian Kawymeno Waorani hunter-gatherers and neighboring Kichwa subsistence agrarians, using dietary surveys, dietary pattern observation, and Snellen Illiterate E visual acuity examinations. Hunter-gatherers consumed more food species (130 vs. 63) and more wild plants (80 vs. 4) including 76 wild fruits, thereby obtaining larger variety and quantity of phytochemicals than agrarians. Visual acuity was inversely related to age only in agrarians (r = -.846, P < .001). As hypothesized, when stratified by age (<40 and ≥ 40 years), Mann-Whitney U tests revealed that hunter-gatherers maintained high visual acuity throughout life, whereas agrarian visual acuity declined (P values < .001); visual acuity of younger participants was high across the board, however, did not differ between groups (P > .05). This unusual absence of juvenile-onset vision problems may be related to local, organic, whole food diets of subsistence food systems isolated from modern food production. Our results suggest that intake of a wider variety of plant foods supplying necessary phytochemicals for eye health may help maintain visual acuity and prevent degenerative eye conditions as humans age.
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Affiliation(s)
- Douglas S London
- Adelphi University, One South Street, Garden City, NY 11530, USA.
| | - Bonnie Beezhold
- Benedictine University, 5700 College Drive, Lisle, IL, 60532, USA.
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The relationship of season of birth with refractive error in very young children in eastern China. PLoS One 2014; 9:e100472. [PMID: 24945317 PMCID: PMC4063959 DOI: 10.1371/journal.pone.0100472] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Accepted: 05/23/2014] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To determine the association of season of birth and refractive error in very young Chinese children in China. METHODS We conducted a population-based study of Chinese children aged 0 to 3 years residing in eastern China. Refraction was determined by non-cyclopegic autorefraction using a hand-held autorefractor. Date of birth was retrieved from birth certificate of the individual subjects. A generalized linear regression model was fitted to estimate the regression coefficient and 95% confidence interval (CI) of refractive error for season of birth, adjusting for confounders. RESULTS Of the 1385 children eligible to participate, 1222 (88.2%) were examined. Refractive error data were available for 1219 children. The mean spherical equivalent were 1.21 diopters (D) in children born Spring, 1.24 D in those born in Summer, 1.23 D in those born in Autumn, 1.15 D in Winter. After adjusting for age, sex, father's educational level, birth weight and the number of summers between birth and examination date the children have been exposed to, children born in winter had a 0.12 D more myopic refraction compared with those born in summer (regression coefficient: -0.12; 95% CI, -0.27,-0.06; P = 0.006). The association between season of birth and cylinder power was not statistically significant. CONCLUSIONS In China, children born in winter had a more myopic refraction compared with those born in other seasons. The observed association between season of birth and refractive error was independent of parental educational level and birth weight, suggesting that light level may have a small impact on refractive development in early life.
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Sherwin JC, Mackey DA. Update on the epidemiology and genetics of myopic refractive error. EXPERT REVIEW OF OPHTHALMOLOGY 2014. [DOI: 10.1586/eop.12.81] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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