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Sah RP, Narra PK, Ostrin LA. A novel wearable sensor for objective measurement of distance and illumination. Ophthalmic Physiol Opt 2025. [PMID: 40318162 DOI: 10.1111/opo.13523] [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: 01/27/2025] [Revised: 04/23/2025] [Accepted: 04/25/2025] [Indexed: 05/07/2025]
Abstract
PURPOSE To evaluate the rangefinding and light sensing capabilities of a novel wearable sensor, the Visual Environment Evaluation Tool (VEET) developed for myopia research. METHODS The VEET 1.0 (Meta, LLC) is a temple-integrated system mounted on a spectacle frame. Both the left and right temples house four sensors each, angled straight ahead and 20° downward/4° nasal, respectively. For validation, VEET-mounted spectacles were placed on a mannequin head. An infrared camera was used to capture the spatial characteristics of the rangefinding beam. Distance measurements were collected against a wall for 5-400 cm. The accuracy of distance measurements for different target types, sizes and tilt was assessed. Ambient illumination was captured in different indoor and outdoor settings and compared to a lux meter. RESULTS All devices (N = 20) were capable of capturing distances for the full range evaluated, 5-400 cm, against a wall. There was a strong relationship between the actual and measured distances, with a slope of 1.01 ± 0.003 and 0.95 ± 0.007, for the left and right temples, respectively. Distance measurements were repeatable across different target types, including paper and tablet. Mean beam diameter of five tested devices was 52.2° ± 7.5°. The VEET effectively measured distances across different target sizes, ranging from 2 × 2 cm and larger and target tilt ±60°. Illumination measurements across different indoor and outdoor settings demonstrated a strong linear relationship with lux meter readings (R2 = 0.99 and 0.78 for the left and right temples, respectively), effectively distinguishing indoor (<1000 lux) and outdoor (≥1000 lux) illumination levels. CONCLUSION The VEET provides accurate quantification of real-time distances across different target types and sizes and is capable of effectively distinguishing indoor and outdoor illumination levels. The VEET will be valuable in studies evaluating risk factors for myopia to gain a better understanding of the role of near work and light exposure.
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Affiliation(s)
| | | | - Lisa A Ostrin
- University of Houston College of Optometry, Houston, Texas, USA
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Palumaa T, Linntam D, Rebane R, Harak K, Tamsalu M, Sõnajalg K, Ülper K, Belova S, Keller T, Tammaru M, Palumaa K. Assessment of potential myopia risk factors, including chronotype, in Estonian adolescents: a cross-sectional study. BMC Ophthalmol 2024; 24:486. [PMID: 39501181 PMCID: PMC11539277 DOI: 10.1186/s12886-024-03747-5] [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: 08/18/2024] [Accepted: 10/25/2024] [Indexed: 11/08/2024] Open
Abstract
BACKGROUND Myopia is a growing healthcare concern worldwide. Increasing evidence suggests that sleep and circadian rhythms may be associated with myopia. Furthermore, the risk factors of myopia have not been studied in the Estonian population to date. This study aimed to evaluate chronotype, lifestyle factors, and parental myopia in relation to myopia in Estonian secondary school students. METHODS Grade 10 students from three secondary schools in Tallinn, each with distinct focuses: one science-oriented, one arts-oriented, and one sports-oriented, were invited to participate. They underwent a comprehensive ocular examination, including cycloplegic autorefraction and ocular biometry. Chronotype was evaluated with the Morningness - Eveningness Questionnaire. Participants reported parental myopia and replied to a set of questions, separately for schooldays and free days, to indicate the amount of time they spent outdoors, doing near work and intermediate distance activities. Myopia was defined as cycloplegic SER ≤ - 0.50 D. Logistic regression analysis was performed to assess the association of the studied factors with myopia. RESULTS A total of 123 students (57% female) participated in the study, with a mean age of 16.71 years (standard deviation 0.41). In a multivariable regression model, having two myopic parents was associated with higher odds of myopia (OR 3.78, 95% CI 1.15 - 12.42). We found no association between myopia and chronotype. Notably, time spent outdoors and doing near work or intermediate distance work did not affect the likelihood of having myopia. We observed that students attending the sports-oriented school had lower odds of myopia than those attending the science-oriented school (OR 0.12, 95% CI 0.03-0.51). CONCLUSION Chronotype was not associated with myopia in our study sample. Consistent with previous reports, we identified parental myopia as a myopia risk factor. Interestingly, there was no association between myopia and time spent outdoors or near work. However, the odds of myopia varied depending on the school attended by the participants, which may reflect the educational load or lifestyle of participants in earlier childhood.
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Affiliation(s)
- Teele Palumaa
- Eye Clinic, East Tallinn Central Hospital, Ravi 18, Tallinn, 10138, Estonia.
- Institute of Genomics, University of Tartu, Tartu, Estonia.
- Department of Ophthalmology, Emory University, Atlanta, USA.
| | - Delis Linntam
- Eye Clinic, East Tallinn Central Hospital, Ravi 18, Tallinn, 10138, Estonia
| | - Reili Rebane
- Eye Clinic, East Tallinn Central Hospital, Ravi 18, Tallinn, 10138, Estonia
| | - Kristel Harak
- Eye Clinic, East Tallinn Central Hospital, Ravi 18, Tallinn, 10138, Estonia
| | - Mari Tamsalu
- Eye Clinic, East Tallinn Central Hospital, Ravi 18, Tallinn, 10138, Estonia
| | - Katrin Sõnajalg
- Eye Clinic, East Tallinn Central Hospital, Ravi 18, Tallinn, 10138, Estonia
| | - Karina Ülper
- Eye Clinic, East Tallinn Central Hospital, Ravi 18, Tallinn, 10138, Estonia
| | - Svetlana Belova
- Eye Clinic, East Tallinn Central Hospital, Ravi 18, Tallinn, 10138, Estonia
| | - Triin Keller
- Eye Clinic, East Tallinn Central Hospital, Ravi 18, Tallinn, 10138, Estonia
| | - Marika Tammaru
- Research Department, East Tallinn Central Hospital, Tallinn, Estonia
| | - Kadi Palumaa
- Eye Clinic, East Tallinn Central Hospital, Ravi 18, Tallinn, 10138, Estonia
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Gibaldi A, Harb EN, Wildsoet CF, Banks MS. A Child-Friendly Wearable Device for Quantifying Environmental Risk Factors for Myopia. Transl Vis Sci Technol 2024; 13:28. [PMID: 39422897 PMCID: PMC11498637 DOI: 10.1167/tvst.13.10.28] [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: 03/28/2024] [Accepted: 08/20/2024] [Indexed: 10/19/2024] Open
Abstract
Purpose In the past few decades, the prevalence of myopia, where the eye grows too long, has increased dramatically. The visual environment appears to be critical to regulating the eye growth. Thus, it is very important to determine the properties of the environment that put children at risk for myopia. Researchers have suggested that the intensity of illumination and range of distances to which a child's eyes are exposed are important, but this has not been confirmed. Methods We designed, built, and tested an inexpensive, child-friendly, head-mounted device that can measure the intensity and spectral content of illumination approaching the eyes and can also measure the distances to which the central visual field of the eyes are exposed. The device is mounted on a child's bicycle helmet. It includes a camera that measures distances over a substantial range and a six-channel spectral sensor. The sensors are hosted by a light-weight, battery-powered microcomputer. We acquired pilot data from children while they were engaged in various indoor and outdoor activities. Results The device proved to be comfortable, easy, and safe to wear, and able to collect very useful data on the statistics of illumination and distances. Conclusions The designed device is an ideal tool to be used in a population of young children, some of whom will later develop myopia and some of whom will not. Translational Relevance Such data would be critical for determining the properties of the visual environment that put children at risk for becoming myopic.
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Affiliation(s)
- Agostino Gibaldi
- Herbert Wertheim School of Optometry and Vision Science, University of California at Berkeley, Berkeley, CA, USA
- Department of Engineering “Enzo Ferrari,” University of Modena and Reggio Emilia, Modena, Italy
| | - Elise N. Harb
- Herbert Wertheim School of Optometry and Vision Science, University of California at Berkeley, Berkeley, CA, USA
| | - Christine F. Wildsoet
- Herbert Wertheim School of Optometry and Vision Science, University of California at Berkeley, Berkeley, CA, USA
| | - Martin S. Banks
- Herbert Wertheim School of Optometry and Vision Science, University of California at Berkeley, Berkeley, CA, USA
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Xu TT, Wu X, Luo ZB, Tang LD, Gao JY, Zang LS. Light intensity differentially mediates the life cycle of lepidopteran leaf feeders and stem borers. PEST MANAGEMENT SCIENCE 2024; 80:4216-4222. [PMID: 38619050 DOI: 10.1002/ps.8125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 03/02/2024] [Accepted: 04/15/2024] [Indexed: 04/16/2024]
Abstract
BACKGROUND Leaf feeders, such as Spodoptera frugiperda and Spodoptera litura, and stem borers Ostrinia furnacalis and Chilo suppressalis, occupy two different niches and are well adapted to their particular environments. Borer larvae burrow and inhabit the interior of stems, which are relatively dark. By contrast, the larvae of leaf feeders are exposed to sunlight during feeding. We therefore designed series of experiments to evaluate the effect of light intensity (0, 2000, and 10 000 lx) on these pests with different feeding modes. RESULTS The development of all four pests was significantly delayed at 0 lx. Importantly, light intensity affected the development of both male and female larvae of borers, but only significantly affected male larvae of leaf feeders. Furthermore, the proportion of female offspring of leaf feeders increased with increasing light intensity (S. frugiperda: 33.89%, 42.26%, 57.41%; S. litura: 38.90%, 51.75%, 65.08%), but no significant differences were found in stem borers. This research also revealed that the survival rate of female leaf feeders did not vary across light intensities, but that of males decreased with increasing light intensity (S. frugiperda: 97.78%, 85.86%, 61.21%; S. litura: 95.83%, 73.54%, 58.99%). CONCLUSION These results improve our understanding of how light intensity affects sex differences in important lepidopteran pests occupying different feeding niches and their ecological interactions with abiotic factors in agroecosystems. © 2024 Society of Chemical Industry.
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Affiliation(s)
- Ting-Ting Xu
- National Key Laboratory of Green Pesticide, Key Laboratory of Green Pesticide and Agricultural Bioengineering, Ministry of Education, Guizhou University, Guiyang, China
| | - Xian Wu
- National Key Laboratory of Green Pesticide, Key Laboratory of Green Pesticide and Agricultural Bioengineering, Ministry of Education, Guizhou University, Guiyang, China
| | - Zhen-Bao Luo
- Bijie Tobacco Company of Guizhou Province, Bijie, China
| | - Liang-De Tang
- National Key Laboratory of Green Pesticide, Key Laboratory of Green Pesticide and Agricultural Bioengineering, Ministry of Education, Guizhou University, Guiyang, China
| | - Jun-Yi Gao
- Bijie Tobacco Company of Guizhou Province, Bijie, China
| | - Lian-Sheng Zang
- National Key Laboratory of Green Pesticide, Key Laboratory of Green Pesticide and Agricultural Bioengineering, Ministry of Education, Guizhou University, Guiyang, China
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Chang DJ, P. L. S, Jeong J, Saw SM, Sevdalis N, Najjar RP. Light Therapy for Myopia Prevention and Control: A Systematic Review on Effectiveness, Safety, and Implementation. Transl Vis Sci Technol 2024; 13:31. [PMID: 39167378 PMCID: PMC11343011 DOI: 10.1167/tvst.13.8.31] [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: 05/13/2024] [Accepted: 07/15/2024] [Indexed: 08/23/2024] Open
Abstract
Purpose This systematic review focuses on the effectiveness, safety, and implementation outcomes of light therapy as an intervention to prevent or control myopia in children. Methods A systematic literature search was performed in PubMed, EMBASE, CINAHL, SCOPUS, and Web of Science up to January 27, 2024. Effectiveness outcomes included myopia incidence, and changes in axial length (AL), spherical equivalent refraction (SER), and choroidal thickness (CT). Safety outcomes relating to retinal health or damage and implementation outcomes including compliance rates and loss to follow-up were extracted. ROBINS-I, ROB 2, and ROB-2 CRT were used to assess risk of bias. Results Nineteen interventional studies were included. Increased outdoor time (n = 3), red-light therapy (n = 13), and increased classroom lighting (n = 1) had a significant effect on myopia incidence, and changes in AL, SER, and CT. Violet-light therapy (n = 2) was only effective in children aged 8 to 10 years and children without eyeglasses with less than 180 minutes of near-work time daily. Two studies using red-light therapy reported adverse effects. For all studies, only compliance rates and loss to follow-up were reported on implementation effectiveness. Conclusions Evidence is compelling for the effectiveness of red-light therapy and outdoors time; more data are needed to confirm safety. Robust data are still needed to prove the effectiveness of violet-light and increased classroom lighting. Clearer implementation strategies are needed for all light therapies. Translational Relevance Light therapy has emerged as effective for myopia prevention and control. This systematic review summarizes the state of knowledge and highlights gaps in safety and implementation for these strategies.
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Affiliation(s)
- Dylan James Chang
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Sriram P. L.
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jooyeon Jeong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Seang-Mei Saw
- Singapore Eye Research Institute, Singapore
- Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Nick Sevdalis
- Centre for Behavioural and Implementation Science Interventions (BISI), Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Centre for Holistic Initiatives for Learning and Development, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Raymond P. Najjar
- Singapore Eye Research Institute, Singapore
- Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School, Singapore
- Eye N' Brain Research Group, Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Biomedical Engineering, College of Design and Engineering, National University of Singapore, Singapore
- Centre for Innovation & Precision Eye Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Rodriguez NG, Claici AO, Ramos-Castaneda JA, González-Zamora J, Bilbao-Malavé V, de la Puente M, Fernandez-Robredo P, Garzón-Parra SJ, Garza-Leon M, Recalde S. Conjunctival ultraviolet autofluorescence as a biomarker of outdoor exposure in myopia: a systematic review and meta-analysis. Sci Rep 2024; 14:1097. [PMID: 38212604 PMCID: PMC10784576 DOI: 10.1038/s41598-024-51417-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024] Open
Abstract
Outdoor exposure is considered the primary modifiable risk factor in preventing the development of myopia. This effect is thought to be attributed to the light-induced synthesis and release of dopamine in the retina. However, until recent years, there was no objective quantifiable method available to measure the association between time spent outdoors and myopia. It is only recently that the conjunctival ultraviolet autofluorescence (CUVAF) area, serving as a biomarker for sun exposure, has begun to be utilized in numerous studies. To provide a comprehensive summary of the relevant evidence pertaining to the association between the CUVAF area and myopia across different geographic regions and age groups, a systematic review and meta-analysis were conducted. The search encompassed multiple databases, including MEDLINE, SCIENCE DIRECT, GOOGLE SCHOLAR, WEB OF SCIENCE, and SCOPUS, and utilized specific search terms such as "conjunctival ultraviolet autofluorescence", "CUVAF", "UVAF", "objective marker of ocular sun exposure", "myopia", "degenerative myopia", and "high myopia". The bibliographic research included papers published between the years 2006 and 2022. A total of 4051 records were initially identified, and after duplicates were removed, 49 articles underwent full-text review. Nine articles were included in the systematic review. These studies covered myopia and outdoor exposure across different regions (Australia, Europe and India) with a total population of 3615 individuals. They found that myopes generally had smaller CUVAF areas compared to non-myopes. The meta-analysis confirmed this, revealing statistically smaller CUVAF areas in myopic patients, with a mean difference of - 3.30 mm2 (95% CI - 5.53; - 1.06). Additionally, some studies showed a positive correlation between more outdoor exposure and larger CUVAF areas. In terms of outdoor exposure time, myopic patients reported less time outdoors than non-myopic individuals, with a mean difference of - 3.38 h/week (95% CI - 4.66; - 2.09). Overall, these findings highlight the connection between outdoor exposure, CUVAF area and myopia, with regional variations playing a significant role. The results of this meta-analysis validate CUVAF as a quantitative method to objectively measure outdoor exposure in relation with myopia development.
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Grants
- 01/0022-23 Doctoral fellowship funded by Miniciencias Bogotá, Colombia.
- PI20/00251 Instituto de Salud Carlos III through the project Co-funded by European Regional Development Fund "A way to make Europe"
- CUN 2019 Multiópticas
- (RD21/0017/0027) Redes de Investigación Cooperativa Orientadas al Resultado en Salud (RICORS) de Terapias avanzadas , Enfermedades Inflamatorias and Enfermedades vasculares cerebrales , Ministerio de Ciencia, Innovación y Universidades, Instituto de Salud Carlos III
- (RD21/0002/0010) Redes de Investigación Cooperativa Orientadas al Resultado en Salud (RICORS) de Terapias avanzadas , Enfermedades Inflamatorias and Enfermedades vasculares cerebrales , Ministerio de Ciencia, Innovación y Universidades, Instituto de Salud Carlos III
- (RD21/0006/0008) Redes de Investigación Cooperativa Orientadas al Resultado en Salud (RICORS) de Terapias avanzadas , Enfermedades Inflamatorias and Enfermedades vasculares cerebrales , Ministerio de Ciencia, Innovación y Universidades, Instituto de Salud Carlos III
- 01-20/21 Fundación Jesús Gangoiti Barrera
- Instituto de Salud Carlos III through the project Co-funded by European Regional Development Fund “A way to make Europe”
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Affiliation(s)
- Natali Gutierrez Rodriguez
- Grupo de Investigación en Optometría-Facultad de Optometría de la Universidad Antonio Nariño, Bogotá, Colombia
| | - Aura Ortega Claici
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Clinica Universidad de Navarra, Pamplona, Spain
- Faculty of Medicine, Universidad de Navarra, Pamplona, Spain
| | - Jorge A Ramos-Castaneda
- Research Group Innovación y Cuidado, Faculty of Nursing, Universidad Antonio Nariño, Neiva, Colombia
| | - Jorge González-Zamora
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Clinica Universidad de Navarra, Pamplona, Spain
- Department of Ophthalmology, Clínica Universidad de Navarra, Madrid, Spain
- Navarra Institute for Health Research, IdiSNA, Pamplona, Spain
| | - Valentina Bilbao-Malavé
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Clinica Universidad de Navarra, Pamplona, Spain
- Department of Ophthalmology, Bellvitge University Hospital, Barcelona, Spain
| | - Miriam de la Puente
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Clinica Universidad de Navarra, Pamplona, Spain
- Department of Ophthalmology, Clínica Universidad de Navarra, Madrid, Spain
- Navarra Institute for Health Research, IdiSNA, Pamplona, Spain
| | - Patricia Fernandez-Robredo
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Clinica Universidad de Navarra, Pamplona, Spain
- Department of Ophthalmology, Clínica Universidad de Navarra, Madrid, Spain
- Navarra Institute for Health Research, IdiSNA, Pamplona, Spain
| | - Sandra Johanna Garzón-Parra
- Grupo de Investigación en Optometría-Facultad de Optometría de la Universidad Antonio Nariño, Bogotá, Colombia
| | - Manuel Garza-Leon
- Clinical Science Department, Science of Health Division, University of Monterrey, San Pedro Garza García, Nuevo León, México
| | - Sergio Recalde
- Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Clinica Universidad de Navarra, Pamplona, Spain.
- Department of Ophthalmology, Clínica Universidad de Navarra, Madrid, Spain.
- Navarra Institute for Health Research, IdiSNA, Pamplona, Spain.
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Shneor E, Gordon-Shaag A, Doron R, Benoit JS, Ostrin LA. Utility of the Actiwatch Spectrum Plus for detecting the outdoor environment and physical activity in children. JOURNAL OF OPTOMETRY 2024; 17:100483. [PMID: 37797567 PMCID: PMC10551654 DOI: 10.1016/j.optom.2023.100483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 05/24/2023] [Accepted: 06/25/2023] [Indexed: 10/07/2023]
Abstract
PURPOSE To describe the performance of the Actiwatch Spectrum Plus (Philips, Respironics) for determining real world indoor and outdoor environments and physical activity in children. METHODS Children wore the device while performing 10 different activities, ranging from sedentary to vigorous physical-activity, and under different indoor and outdoor conditions. Repeated measures ANOVA was implemented via mixed effects modeling to determine illuminance (lux) and physical activity (counts per 15 s, CP15) across conditions. Receiver operator characteristics (ROC) analysis assessed the accuracy to detect indoor versus outdoor settings. RESULTS Illuminance was found to be statistically different across indoor (793 ± 348 lux) and outdoor (4,413 ± 518 lux) conditions (P<.0001), with excellent diagnostic accuracy to detect indoor versus outdoor settings (Area under the ROC Curve, AUC 0.94); 1088 lux was identified as the optimal threshold for outdoor illuminance (sensitivity: 93.0%; specificity: 85.0%). Using published activity ranges, we found that when children were sitting, 94% of the physical-activity readings were classified as sedentary or light. When children were walking, 88% of readings were classified as light, and when children were running, 77% of readings were classified as moderate or vigorous. CONCLUSION The Actiwatch Spectrum Plus performed well during real world activities in children, showing excellent diagnostic accuracy at 1088 lux as a threshold to detect indoor versus outdoor environments and in categorizing physical activity.
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Affiliation(s)
- Einat Shneor
- Department of Optometry, Hadassah Academic College, Jerusalem 9101001, Israel.
| | - Ariela Gordon-Shaag
- Department of Optometry, Hadassah Academic College, Jerusalem 9101001, Israel
| | - Ravid Doron
- Department of Optometry, Hadassah Academic College, Jerusalem 9101001, Israel
| | - Julia S Benoit
- College of Optometry, University of Houston, Houston, TX 77004, USA; Texas Institute for Measurement, Evaluation, and Statistics, University of Houston, Houston, TX 77004, USA
| | - Lisa A Ostrin
- College of Optometry, University of Houston, Houston, TX 77004, USA
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Hönekopp A, Weigelt S. Using Light Meters to Investigate the Light-Myopia Association - A Literature Review of Devices and Research Methods. Clin Ophthalmol 2023; 17:2737-2760. [PMID: 37743889 PMCID: PMC10517690 DOI: 10.2147/opth.s420631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/18/2023] [Indexed: 09/26/2023] Open
Abstract
With the increasing prevalence of myopia, evaluating its relationship with objective light exposure as a potential adjustable environmental factor in myopia development has been an emerging research field in recent years. From a thorough literature search, we identify ten wearable light meters from human studies on light exposure and myopia and present an overview of their parameters, thereby demonstrating the wide between-device variability and discussing its implications. We further identify 20 publications, including two reanalyses, reporting investigations of light-myopia associations with data from human subjects wearing light meters. We thoroughly review the publications with respect to general characteristics, aspects of data collection, participant population, as well as data analysis and interpretation, and also assess potential patterns regarding the absence or presence of light-myopia associations in their results. In doing so, we highlight areas in which more research is needed as well as several aspects that warrant consideration in the study of light exposure and myopia.
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Affiliation(s)
- Astrid Hönekopp
- Department of Rehabilitation Sciences, Research Unit Vision, Visual Impairments & Blindness, TU Dortmund University, Dortmund, Germany
| | - Sarah Weigelt
- Department of Rehabilitation Sciences, Research Unit Vision, Visual Impairments & Blindness, TU Dortmund University, Dortmund, Germany
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Dhakal R, Rudrapankte JR, Chittajallu HSNS, Lawrenson JG, Huntjens B, Shah R, Verkicharla PK. Development and validation of a 'MyLyt' wearable light tracking device. Ophthalmic Physiol Opt 2023; 43:132-140. [PMID: 36271902 DOI: 10.1111/opo.13061] [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: 04/28/2022] [Revised: 09/23/2022] [Accepted: 09/23/2022] [Indexed: 12/27/2022]
Abstract
PURPOSE We developed a clip-on light tracker (MyLyt) for estimating light exposure in real time. This study aimed at validating and investigating the feasibility of using MyLyt in children and adults. METHOD The study was conducted in two phases. Phase 1 involved validation against a factory-calibrated digital lux meter in three separate conditions: controlled environmental set-up, outdoors and indoors where intra-test (two measurements by the same tracker), inter-test (measurements among trackers) and inter-device (MyLyt tracker and lux meter) validations were conducted. Phase 2 involved a feasibility study where MyLyt was used in a real-world setting by 21 adults and 8 children. Participants were asked to log their real-time movements in an 'activity diary', which were correlated with the lux levels measured by the tracker. RESULTS A strong positive correlation and non-significant difference in the recorded mean illuminance levels were observed during intra-test (inter-class correlation: 1.00, p = 0.99), inter-test (0.91-1.00, p > 0.15) and inter-device (0.91-1.00, p > 0.56) validation in all three testing conditions (p > 0.49), except the indoor location. While the lux level measured by MyLyt was significantly higher than that of the lux meter (p < 0.01) in the indoor locations, differences were minimal and clinically insignificant. A Bland-Altman plot showed a minimal mean difference (95% limits of agreement) between the MyLyt tracker and lux meter in all three conditions (controlled environmental set-up: 641 [-949, 2230], outdoor: 74 [-2772, 2920] and indoor: -35 [-151, 80] lux). Phase 2 validation showed an expected illuminance level against the corresponding location with high sensitivity (97.8%) and specificity (99%) to accurately differentiate between outdoor and indoor locations. CONCLUSION The MyLyt tracker showed good repeatability, strong correlation and comparable values with the lux meter in the three tested conditions, making it suitable for tracking light exposure patterns for both research and clinical purposes.
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Affiliation(s)
- Rohit Dhakal
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India.,Infor Myopia Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, India.,Centre for Applied Vision Research, School of Health Sciences, City, University of London, London, UK
| | | | | | - John G Lawrenson
- Centre for Applied Vision Research, School of Health Sciences, City, University of London, London, UK
| | - Byki Huntjens
- Centre for Applied Vision Research, School of Health Sciences, City, University of London, London, UK
| | - Rakhee Shah
- Centre for Applied Vision Research, School of Health Sciences, City, University of London, London, UK
| | - Pavan K Verkicharla
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India.,Infor Myopia Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Hyderabad, India
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Wen L, Cheng Q, Cao Y, Li X, Pan L, Li L, Zhu H, Mogran I, Lan W, Yang Z. The Clouclip, a wearable device for measuring near-work and outdoor time: validation and comparison of objective measures with questionnaire estimates. Acta Ophthalmol 2021; 99:e1222-e1235. [PMID: 33729708 DOI: 10.1111/aos.14785] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 10/26/2020] [Accepted: 01/12/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE To validate a novel wearable device that can measure both viewing distance and light exposure, Clouclip, and compare questionnaire estimates regarding near-work and outdoor time with the objective measures obtained using Clouclip. METHODS Fifteen Clouclips were selected to measure different distances and levels of illuminance. With each Clouclip, five measurements at different distances and light intensities were measured and recorded. Eighty participants wore Clouclips for a week and completed an activity questionnaire afterwards. RESULTS The intra- and inter-Clouclip coefficients were 1.00 and 0.99 for measuring distance and 1.00 and 1.00 for illuminance, respectively. Within the measurement limit, the maximum relative error was 2.07% for distance and 2.23% for illuminance. Assuming that <30 cm was the typical distance for near-work activities and >1000 Lux was the typical cut-off for outdoor environments, the questionnaire showed a trend of overestimation for both. The greatest overestimation of near-work occurred during the school period [Questionnaire: 4.73 hr (4.73, 5.07) versus Clouclip: 2.16 hr (1.74, 2.78); p < 0.01]. The greatest overestimation of outdoor activity also occurred during the school period [Questionnaire: 1.60 hr (1.33, 1.85) versus Clouclip: 1.21 hr (0.96, 1.50); p < 0.01]. Based on Clouclip, the total time spent outdoors was estimated to be 1.55 hr on school days, of which 0.34 hr occurred after school. For weekend days, however, the duration was only 0.17 hr. CONCLUSIONS Clouclip had excellent precision and accuracy. Although the agreement between the questionnaire and Clouclip was relatively poor, they were able to complement each other to provide a more logical and feasible assessment of exposure to near-work and outdoor activity. Indoor-oriented lifestyles were found to predominate in Chinese children.
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Affiliation(s)
- Longbo Wen
- Aier School of Ophthalmology Central South University Hunan China
| | - Qian Cheng
- State Key Laboratory of Software Development Environment Beihang University Beijing China
| | - Yingpin Cao
- Aier School of Ophthalmology Central South University Hunan China
| | - Xiaoning Li
- Aier School of Ophthalmology Central South University Hunan China
- Aier School of Optometry and Vision Science Hubei University of Science and Technology Hubei China
| | - Lun Pan
- Aier School of Ophthalmology Central South University Hunan China
- Aier School of Optometry and Vision Science Hubei University of Science and Technology Hubei China
| | - Lei Li
- State Key Laboratory of Software Development Environment Beihang University Beijing China
| | - Haogang Zhu
- Guangzhou Aier Eye Hospital Jinan University Guangdong China
| | - Ian Mogran
- Research School of Biology Australia National University Canberra ACT Australia
| | - Weizhong Lan
- Aier School of Ophthalmology Central South University Hunan China
- Aier School of Optometry and Vision Science Hubei University of Science and Technology Hubei China
- Guangzhou Aier Eye Hospital Jinan University Guangdong China
| | - Zhikuan Yang
- Aier School of Ophthalmology Central South University Hunan China
- Aier School of Optometry and Vision Science Hubei University of Science and Technology Hubei China
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11
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Wearable Sensors for Measurement of Viewing Behavior, Light Exposure, and Sleep. SENSORS 2021; 21:s21217096. [PMID: 34770402 PMCID: PMC8587946 DOI: 10.3390/s21217096] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/29/2021] [Accepted: 10/21/2021] [Indexed: 11/25/2022]
Abstract
The purpose of this study was to compare two wearable sensors to each other and to a questionnaire in an adult population. For one week, participants aged 29.2 ± 5.5 years (n = 25) simultaneously wore a Clouclip, a spectacle-mounted device that records viewing distance and illuminance, and an Actiwatch, a wrist-worn device that measures illuminance and activity. Participants maintained a daily log of activities and completed an activity questionnaire. Objective measures of time outdoors, near (10–< 60 cm) and intermediate (60–100 cm) viewing, and sleep duration were assessed with respect to the daily log and questionnaire. Findings showed that time outdoors per day from the questionnaire (3.2 ± 0.3 h) was significantly greater than the Clouclip (0.9 ± 0.8 h) and Actiwatch (0.7 ± 0.1 h, p < 0.001 for both). Illuminance from the Actiwatch was systematically lower than the Clouclip. Daily near viewing duration was similar between the questionnaire (5.7 ± 0.6 h) and Clouclip (6.1 ± 0.4 h, p = 0.76), while duration of intermediate viewing was significantly different between methods (p < 0.001). In conclusion, self-reported time outdoors and viewing behaviors were different than objective measures. The Actiwatch and Clouclip are valuable tools for studying temporal patterns of behavioral factors such as near work, light exposure, and sleep.
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Battersby K, Koy L, Phillips N, Sim J, Wilk J, Schmid KL. Analysis of physical activity in emmetropic and myopic university students during semester and holiday periods: a pilot study. Clin Exp Optom 2021; 98:547-54. [DOI: 10.1111/cxo.12327] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 05/19/2015] [Accepted: 06/04/2015] [Indexed: 11/28/2022] Open
Affiliation(s)
- Katherine Battersby
- School of Optometry and Vision Science, Faculty of Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - Linda Koy
- School of Optometry and Vision Science, Faculty of Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - Nicola Phillips
- School of Optometry and Vision Science, Faculty of Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - Joanna Sim
- School of Optometry and Vision Science, Faculty of Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - Jay Wilk
- School of Optometry and Vision Science, Faculty of Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia,
| | - Katrina L Schmid
- School of Optometry and Vision Science, Faculty of Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia,
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13
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Ramamurthy D, Lin chua SY, Saw S. A review of environmental risk factors for myopia during early life, childhood and adolescence. Clin Exp Optom 2021; 98:497-506. [DOI: 10.1111/cxo.12346] [Citation(s) in RCA: 94] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2015] [Revised: 08/16/2015] [Accepted: 08/20/2015] [Indexed: 01/01/2023] Open
Affiliation(s)
- Dharani Ramamurthy
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore,
| | | | - Seang‐mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore,
- Myopia Unit, Singapore Eye Research Institute, Singapore,
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14
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Mutti DO, Mulvihill SP, Orr DJ, Shorter PD, Hartwick ATE. The Effect of Refractive Error on Melanopsin-Driven Pupillary Responses. Invest Ophthalmol Vis Sci 2020; 61:22. [PMID: 33091116 PMCID: PMC7594593 DOI: 10.1167/iovs.61.12.22] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Human and animal studies suggest that light-mediated dopamine release may underlie the protective effect of time outdoors on myopia development. Melanopsin-containing retinal ganglion cells may be involved in this process by integrating ambient light exposure and regulating retinal dopamine levels. The study evaluates this potential involvement by examining whether melanopsin-driven pupillary responses are associated with adult refractive error. Methods Subjects were 45 young adults (73% female, 24.1 ± 1.8 years) with refractive errors ranging from –6.33 D to +1.70 D. The RAPDx (Konan Medical) pupillometer measured normalized pupillary responses to three forms of square-wave light pulses alternating with darkness at 0.1 Hz: alternating long wavelength (red, peak at 608 nm) and short wavelength (blue, peak at 448 nm), followed by red only and then blue only. Results Non-myopic subjects displayed greater pupillary constriction in the blue-only condition and slower redilation following blue light offset than subjects with myopia (P = 0.011). Pupillary responses were not significantly different between myopic and non-myopic subjects in the red-only condition (P = 0.15). More hyperopic/less myopic refractive error as a continuous variable was linearly related to larger increases in pupillary constriction in response to blue-only stimuli (r = 0.48, P = 0.001). Conclusions Repeated light exposures to blue test stimuli resulted in an adaptation in the pupillary response (more constriction and slower redilation), presumably due to increased melanopsin-mediated input in more hyperopic/less myopic adults. This adaptive property supports a possible role for these ganglion cells in the protective effects of time outdoors on myopia development.
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Affiliation(s)
- Donald O Mutti
- The Ohio State University College of Optometry, Columbus, Ohio, United States
| | | | - Danielle J Orr
- The Ohio State University College of Optometry, Columbus, Ohio, United States
| | - Patrick D Shorter
- Optical Radiation Bioeffects Branch, Tri-Service Research Laboratory, Fort Sam Houston, Texas, United States
| | - Andrew T E Hartwick
- The Ohio State University College of Optometry, Columbus, Ohio, United States
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15
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Bhandari KR, Ostrin LA. Validation of the Clouclip and utility in measuring viewing distance in adults. Ophthalmic Physiol Opt 2020; 40:801-814. [PMID: 33002229 DOI: 10.1111/opo.12735] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 08/20/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE To validate the Clouclip, a continuously measuring objective rangefinder, and examine viewing behaviours during various near tasks in non-myopic and myopic adults. METHODS In experiment 1, five Clouclip devices were utilised. An infrared camera was used to visualise and measure infrared beam size and angle. Repeatability for distance tracking was assessed from 5 to 120 cm in 5 cm increments. Accuracy of distance tracking was investigated for paper and iPad targets, spatial integration was calculated, effects of target tilt were determined and light measurements were compared to a lux meter. In experiment 2, viewing behaviour was assessed in 41 subjects (21 non-myopic, 20 myopic) during four 15-min near tasks; (1) passive reading of printed material, (2) active writing on printed material, (3) passive viewing on an electronic device and (4) active engagement on an electronic device. Working distance was compared between tasks and refractive error groups. RESULTS Clouclip distance tracking showed good repeatability, with a mean difference of 0.34 cm and limits of agreement of ±2.0 cm. Clouclip-measured and actual distances were highly correlated for paper and electronic targets from 5 to 120 cm, with mean differences and limits of agreement of 3.96 ± 13.78 cm and 4.48 ± 8.92 cm, respectively; variability increased for distances >100 cm. Tracking ability increased with larger target sizes; tracking was accurate when the target occupied 1.5%-20.3% of tracking beam area, depending on distance and with target tilt up to ±60 degrees. Clouclip- and lux meter-measured ambient illumination were highly correlated for a wide range of intensities (r = 0.96, p < 0.001), but with greater variability for intensities >20 000 lux. The Clouclip infrared beam was measured to have a diameter of 25.6 ± 2.2° and a downward angle of 10.3 ± 0.5°. For subject testing, viewing distance was significantly closer for active and passive printed tasks (29.5 ± 6.7 cm and 33.2 ± 8.8 cm, respectively) than for active and passive electronic tasks (35.4 ± 8.0 cm and 40.8 ± 10.4 cm, respectively), with no differences between refractive error groups (p = 0.88). CONCLUSIONS The Clouclip performed well in measuring near and intermediate distances and could distinguish between indoor (<1000 lux) and outdoor (>1000 lux) illumination. A closer working distance was observed for printed tasks compared to those on an iPad, with no difference in viewing distance between non-myopic and myopic adults.
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Affiliation(s)
| | - Lisa A Ostrin
- University of Houston College of Optometry, Houston, USA
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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: 115] [Impact Index Per Article: 19.2] [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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17
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Wolffsohn JS, Kollbaum PS, Berntsen DA, Atchison DA, Benavente A, Bradley A, Buckhurst H, Collins M, Fujikado T, Hiraoka T, Hirota M, Jones D, Logan NS, Lundström L, Torii H, Read SA, Naidoo K. IMI - Clinical Myopia Control Trials and Instrumentation Report. Invest Ophthalmol Vis Sci 2019; 60:M132-M160. [PMID: 30817830 DOI: 10.1167/iovs.18-25955] [Citation(s) in RCA: 109] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The evidence-basis based on existing myopia control trials along with the supporting academic literature were reviewed; this informed recommendations on the outcomes suggested from clinical trials aimed at slowing myopia progression to show the effectiveness of treatments and the impact on patients. These outcomes were classified as primary (refractive error and/or axial length), secondary (patient reported outcomes and treatment compliance), and exploratory (peripheral refraction, accommodative changes, ocular alignment, pupil size, outdoor activity/lighting levels, anterior and posterior segment imaging, and tissue biomechanics). The currently available instrumentation, which the literature has shown to best achieve the primary and secondary outcomes, was reviewed and critiqued. Issues relating to study design and patient selection were also identified. These findings and consensus from the International Myopia Institute members led to final recommendations to inform future instrumentation development and to guide clinical trial protocols.
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Affiliation(s)
- James S Wolffsohn
- Ophthalmic Research Group, Aston University, Birmingham, United Kingdom
| | - Pete S Kollbaum
- Indiana University, School of Optometry, Bloomington, Indiana, United States
| | - David A Berntsen
- The Ocular Surface Institute, College of Optometry, University of Houston, Houston, Texas, United States
| | - David A Atchison
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia
| | | | - Arthur Bradley
- Indiana University, School of Optometry, Bloomington, Indiana, United States
| | - Hetal Buckhurst
- School of Health Professions, Peninsula Allied Health Centre, Plymouth University, Plymouth, United Kingdom
| | - Michael Collins
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia
| | - Takashi Fujikado
- Department of Applied Visual Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takahiro Hiraoka
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan
| | - Masakazu Hirota
- Department of Applied Visual Science, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Debbie Jones
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Nicola S Logan
- Ophthalmic Research Group, Aston University, Birmingham, United Kingdom
| | | | - Hidemasa Torii
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Scott A Read
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia
| | - Kovin Naidoo
- African Vision Research Institute, University of KwaZulu-Natal, Durban, South Africa
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18
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Kearney S, O'Donoghue L, Pourshahidi LK, Richardson P, Laird E, Healy M, Saunders KJ. Conjunctival ultraviolet autofluorescence area, but not intensity, is associated with myopia. Clin Exp Optom 2018; 102:43-50. [PMID: 30114725 DOI: 10.1111/cxo.12825] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 07/08/2018] [Accepted: 07/12/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Conjunctival ultraviolet autofluorescence (CUVAF) has been used as a biomarker of time spent outdoors. Smaller CUVAF area is associated with myopia in southern hemisphere cohorts. Further research is required to determine if this association is replicated in northern latitudes and whether average CUVAF intensity is a valuable metric. This prospective study explored the association between myopia, CUVAF (area and intensity) and additional indicators of sun exposure (vitamin D3 and self-reported sun exposure preferences) across seasons at a location of 55° north. METHODS Young adults (age 18-20) provided blood samples biannually (March/April and September/October) over an 18-month period (four phases) for the assessment of 25-hydroxyvitamin D (25(OH)D3 ) concentrations (liquid chromatography-tandem mass spectrometry). CUVAF (total area, average intensity) and self-reported sun exposure preferences were recorded at each phase. Axial length and corneal radius were measured. Refractive error was measured by autorefractor and spherical equivalent refraction used to classify participants into refractive groups: myopic (spherical equivalent refraction ≤ -0.50 DS) or non-myopic. RESULTS Fifty-four participants (24 myopes, 30 non-myopes) participated. CUVAF area was negatively associated with the presence of myopia (odds ratio = 0.94, 95 per cent confidence interval = 0.90-0.98, p = 0.002). Myopes = 4.5 mm2 (interquartile range [IQR] 0.95-6.4 mm2 ), non-myopes = 7.0 mm2 (IQR = 2.0-10.7 mm2 ). No significant association was found between CUVAF intensity and refractive group (p = 0.17). There was no significant association between sun exposure preferences or serum concentration of 25(OH)D3 and refractive status (all p ≥ 0.21). CUVAF measures were not associated with ocular biometry measures (all p ≥ 0.084). CUVAF area was unaffected by season (all p ≥ 0.45) and variations in CUVAF area over the study period did not exceed the repeatability of the measurement technique. CONCLUSION Myopia was associated with smaller areas of CUVAF indicative of less cumulative ultraviolet-B exposure. These findings suggest that CUVAF measures are a useful, non-invasive biomarker of the time spent outdoors in adults in northern hemisphere populations.
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Affiliation(s)
- Stephanie Kearney
- Department of Optometry and Vision Science, Optometry and Vision Science Research Group, University of Ulster, Coleraine, UK
| | - Lisa O'Donoghue
- Department of Optometry and Vision Science, Optometry and Vision Science Research Group, University of Ulster, Coleraine, UK
| | - Laura K Pourshahidi
- Department of Biomedical Sciences, Nutrition Innovation Centre for Food and Health, University of Ulster, Coleraine, UK
| | - Patrick Richardson
- Department of Optometry and Vision Science, Optometry and Vision Science Research Group, University of Ulster, Coleraine, UK
| | - Eamon Laird
- Department of Biochemistry and Immunology, Trinity College Dublin, Dublin, Ireland
| | - Martin Healy
- School of Medicine, Trinity College Dublin, Dublin, Ireland.,Department of Biochemistry, St James's Hospital, Dublin, Ireland
| | - Kathryn J Saunders
- Department of Optometry and Vision Science, Optometry and Vision Science Research Group, University of Ulster, Coleraine, UK
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Morgan IG, French AN, Ashby RS, Guo X, Ding X, He M, Rose KA. The epidemics of myopia: Aetiology and prevention. Prog Retin Eye Res 2017; 62:134-149. [PMID: 28951126 DOI: 10.1016/j.preteyeres.2017.09.004] [Citation(s) in RCA: 731] [Impact Index Per Article: 91.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 09/11/2017] [Accepted: 09/20/2017] [Indexed: 02/06/2023]
Abstract
There is an epidemic of myopia in East and Southeast Asia, with the prevalence of myopia in young adults around 80-90%, and an accompanying high prevalence of high myopia in young adults (10-20%). This may foreshadow an increase in low vision and blindness due to pathological myopia. These two epidemics are linked, since the increasingly early onset of myopia, combined with high progression rates, naturally generates an epidemic of high myopia, with high prevalences of "acquired" high myopia appearing around the age of 11-13. The major risk factors identified are intensive education, and limited time outdoors. The localization of the epidemic appears to be due to the high educational pressures and limited time outdoors in the region, rather than to genetically elevated sensitivity to these factors. Causality has been demonstrated in the case of time outdoors through randomized clinical trials in which increased time outdoors in schools has prevented the onset of myopia. In the case of educational pressures, evidence of causality comes from the high prevalence of myopia and high myopia in Jewish boys attending Orthodox schools in Israel compared to their sisters attending religious schools, and boys and girls attending secular schools. Combining increased time outdoors in schools, to slow the onset of myopia, with clinical methods for slowing myopic progression, should lead to the control of this epidemic, which would otherwise pose a major health challenge. Reforms to the organization of school systems to reduce intense early competition for accelerated learning pathways may also be important.
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Affiliation(s)
- Ian G Morgan
- Division of Biochemistry and Molecular Biology, Research School of Biology, Australian National University, Canberra, ACT, Australia; State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yatsen University, Guangzhou, China.
| | - Amanda N French
- Discipline of Orthoptics, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Regan S Ashby
- Centre for Research in Therapeutic Solutions, Biomedical Sciences, Faulty of Education, Science, Technology and Mathematics, University of Canberra, Canberra, Australia
| | - Xinxing Guo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yatsen University, Guangzhou, China; Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Xiaohu Ding
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yatsen University, Guangzhou, China
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yatsen University, Guangzhou, China; Centre for Eye Research Australia, University of Melbourne, Parkville, VIC, Australia
| | - Kathryn A Rose
- Discipline of Orthoptics, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia
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20
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Kearney S, O'Donoghue L, Pourshahidi LK, Richardson PM, Saunders KJ. The use of conjunctival ultraviolet autofluorescence (CUVAF) as a biomarker of time spent outdoors. Ophthalmic Physiol Opt 2017; 36:359-69. [PMID: 27350182 DOI: 10.1111/opo.12309] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 05/12/2016] [Indexed: 02/04/2023]
Abstract
PURPOSE Conjunctival ultraviolet autofluorescence (CUVAF) has been used in previous Southern Hemisphere myopia research as a marker for time spent outdoors. The validity of CUVAF as an indicator of time spent outdoors is yet to be explored in the Northern Hemisphere. It is unclear if CUVAF represents damage attributed to UV exposure or dry eye. This cross-sectional study investigated the association between CUVAF measures, self-reported time spent outdoors and measures of dry eye. METHODS Participants were recruited from University staff and students (n = 50, 19-64 years; mean 41). None were using topical ocular medications (with the exception of dry eye treatments). Sun exposure and dry eye questionnaires (Ocular Surface Disease Index and McMonnies) were completed by the participant. Dryness was also assessed using slit lamp biomicroscopy and invasive tear break up time. Images of the temporal and nasal conjunctiva from the right and left eye were captured using a bespoke photography system. The total CUVAF area, average CUVAF pixel intensity per mm(2) and total CUVAF pixel intensity were analysed using MATLAB R2013a (The MathWorks Inc). RESULTS Of the 50 participants, 42% were classified as having dry eye. Self-reported sunglasses use was negatively associated with all CUVAF measures (Kruskal Wallis total CUVAF area, p = 0.04, ptrend = 0.03, average CUVAF pixel intensity p = 0.02, ptrend = 0.02, total CUVAF pixel intensity: p = 0.04, ptrend = 0.02). Time spent outdoors was positively associated with all CUVAF measures (Spearman's correlation coefficients, total CUVAF area: r = 0.37, p = 0.01, average CUVAF pixel intensity: r = 0.36, p = 0.01, total CUVAF pixel intensity: r = 0.37, p = 0.01) and remained significant when sunglasses use was controlled for (partial correlation, total CUVAF area: r = 0.32, p = 0.03, average CUVAF pixel intensity: r = 0.39, p = 0.01, total CUVAF pixel intensity: r = 0.39, p = 0.03). Neither CUVAF area nor intensity measures were associated with any dry eye measure (Ocular Surface Disease Index: all p ≥ 0.41, corneal staining: all p ≥ 0.38, McMonnies: all r ≤ 0.09 all p ≥ 0.52, slit lamp biomicroscopy: all r ≤ 0.20 all p ≥ 0.17, invasive tear break up time: all r ≤ -0.07 all p ≥ 0.31). CONCLUSIONS CUVAF area and intensity were not associated with clinical measures of dry eye. Greater CUVAF area and intensity were associated with wearing sunglasses less frequently and spending more time outdoors. If sunglass wear is accounted for, CUVAF may be a useful biomarker of time spent outdoors in future myopia studies.
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Affiliation(s)
- Stephanie Kearney
- Optometry and Vision Science Research Group, University of Ulster, Coleraine, UK
| | - Lisa O'Donoghue
- Optometry and Vision Science Research Group, University of Ulster, Coleraine, UK
| | - L Kirsty Pourshahidi
- Northern Ireland Centre for Food and Health, University of Ulster, Coleraine, UK
| | - Patrick M Richardson
- Optometry and Vision Science Research Group, University of Ulster, Coleraine, UK
| | - Kathryn J Saunders
- Optometry and Vision Science Research Group, University of Ulster, Coleraine, UK
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21
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Verkicharla PK, Ramamurthy D, Nguyen QD, Zhang X, Pu SH, Malhotra R, Ostbye T, Lamoureux EL, Saw SM. Development of the FitSight Fitness Tracker to Increase Time Outdoors to Prevent Myopia. Transl Vis Sci Technol 2017; 6:20. [PMID: 28660095 PMCID: PMC5477631 DOI: 10.1167/tvst.6.3.20] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 03/19/2017] [Indexed: 11/25/2022] Open
Abstract
Purpose To develop a fitness tracker (FitSight) to encourage children to increase time spent outdoors. To evaluate the wear pattern for this tracker and outdoor time pattern by estimating light illumination levels among children. Methods The development of the FitSight fitness tracker involved the designing of two components: (1) the smartwatch with custom-made FitSight watch application (app) to log the instant light illuminance levels the wearer is exposed to, and (2) a companion smartphone app that synchronizes the time outdoors recorded by the smartwatch to smartphone via Bluetooth communication. Smartwatch wear patterns and tracker-recorded daily light illuminance levels data were gathered over 7 days from 23 Singapore children (mean ± standard deviation age: 9.2 ± 1.4 years). Feedback about the tracker was obtained from 14 parents using a three-level rating scale: very poor/poor/good. Results Of the 14 parents, 93% rated the complete “FitSight fitness tracker” as good and 64% rated its wearability as good. While 61% of 23 children wore the watch on all study days (i.e., 0 nonwear days), 26% had 1 nonwear day, and 4.5% children each had 3, 4, and 5 nonwear days, respectively. On average, children spent approximately 1 hour in light levels greater than 1000 lux on weekdays and 1.3 hours on weekends (60 ± 46 vs. 79 ± 53 minutes, P = 0.19). Mean number of outdoor “spurts” (light illuminance levels >1000 lux) per day was 8 ± 3 spurts with spurt duration of 34 ± 32 minutes. Conclusion The FitSight tracker with its novel features may motivate children to increase time outdoors and play an important role in supplementing community outdoor programs to prevent myopia. Translational Relevance If the developed noninvasive, wearable, smartwatch-based fitness tracker, FitSight, promotes daytime outdoor activity among children, it will be beneficial in addressing the epidemic of myopia.
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Affiliation(s)
| | - Dharani Ramamurthy
- Singapore Eye Research Institute, The Academia, Singapore.,National University of Singapore, Singapore
| | | | - Xinquan Zhang
- Agency for Science, Technology and Research (ASTAR), Singapore
| | - Suan-Hui Pu
- University of Southampton, Malaysia Campus, Johor, Malaysia
| | | | | | | | - Seang-Mei Saw
- Singapore Eye Research Institute, The Academia, Singapore.,National University of Singapore, Singapore
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Rose KA, French AN, Morgan IG. Environmental Factors and Myopia: Paradoxes and Prospects for Prevention. Asia Pac J Ophthalmol (Phila) 2017; 5:403-410. [PMID: 27898443 DOI: 10.1097/apo.0000000000000233] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
The prevalence of myopia in developed countries in East and Southeast Asia has increased to more than 80% in children completing schooling, whereas that of high myopia has increased to 10%-20%. This poses significant challenges for correction of refractive errors and the management of pathological high myopia. Prevention is therefore an important priority. Myopia is etiologically heterogeneous, with a low level of myopia of clearly genetic origins that appears without exposure to risk factors. The big increases have occurred in school myopia, driven by increasing educational pressures in combination with limited amounts of time spent outdoors. The rise in prevalence of high myopia has an unusual pattern of development, with increases in prevalence first appearing at approximately age 11. This pattern suggests that the increasing prevalence of high myopia is because of progression of myopia in children who became myopic at approximately age 6 or 7 because age-specific progression rates typical of East Asia will take these children to the threshold for high myopia in 5 to 6 years. This high myopia seems to be acquired, having an association with educational parameters, whereas high myopia in previous generations tended to be genetic in origin. Increased time outdoors can counter the effects of increased nearwork and reduce the impact of parental myopia, reducing the onset of myopia, and this approach has been validated in 3 randomized controlled trials. Other proposed risk factors need further work to demonstrate that they are independent and can be modified to reduce the onset of myopia.
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Affiliation(s)
- Kathryn Ailsa Rose
- From the *Discipline of Orthoptics, Graduate School of Health, University of Technology Sydney, Ultimo, New South Wales; †Research School of Biology, Australian National University, Canberra, Australian Capital Territory, Australia; and ‡State Key Laboratory of Ophthalmology and Division of Preventive Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
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Liang Y, Song Y, Zhang F, Sun M, Wang N. Effect of a Single Nucleotide Polymorphism in the LAMA1 Promoter Region on Transcriptional Activity: Implication for Pathological Myopia. Curr Eye Res 2016; 41:1379-1386. [PMID: 26862816 DOI: 10.3109/02713683.2015.1118129] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Yanchuang Liang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing, China
- Civil Aviation Medical Center, Civil Aviation Administration of China, Beijing, China
| | - Yanzheng Song
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing, China
| | - Fengju Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing, China
| | - Mingshen Sun
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing, China
| | - Ningli Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Lab, Beijing, China
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Hobday R. Myopia and daylight in schools: a neglected aspect of public health? Perspect Public Health 2015; 136:50-5. [DOI: 10.1177/1757913915576679] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A century ago, it was widely believed that high levels of daylight in classrooms could prevent myopia, and as such, education departments built schools with large windows to try to stop children becoming short-sighted. This practice continued until the 1960s, from which time myopia was believed to be an inherited condition. In the years that followed, less emphasis was placed on preventing myopia. It has since become more common, reaching epidemic levels in east Asia. Recent research strongly suggests that the amount of light children get as they grow determines whether they will develop short sight; however, evidence that daylight in classrooms prevents myopia is lacking. Given the rapid increase in prevalence among school children worldwide, this should be investigated.
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Bernhard MC, Kent ST, Sloan ME, Evans MB, McClure LA, Gohlke JM. Measuring personal heat exposure in an urban and rural environment. ENVIRONMENTAL RESEARCH 2015; 137:410-8. [PMID: 25617601 PMCID: PMC4355189 DOI: 10.1016/j.envres.2014.11.002] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 10/22/2014] [Accepted: 11/03/2014] [Indexed: 05/18/2023]
Abstract
Previous studies have linked heat waves to adverse health outcomes using ambient temperature as a proxy for estimating exposure. The goal of the present study was to test a method for determining personal heat exposure. An occupationally exposed group (urban groundskeepers in Birmingham, AL, USA N=21), as well as urban and rural community members from Birmingham, AL (N=30) or west central AL (N=30) wore data logging temperature and light monitors clipped to the shoe for 7 days during the summer of 2012. We found that a temperature monitor clipped to the shoe provided a comfortable and feasible method for recording personal heat exposure. Ambient temperature (°C) recorded at the nearest weather station was significantly associated with personal heat exposure [β 0.37, 95%CI (0.35, 0.39)], particularly in groundskeepers who spent more of their total time outdoors [β 0.42, 95%CI (0.39, 0.46)]. Factors significantly associated with lower personal heat exposure include reported time indoors [β -2.02, 95%CI (-2.15, -1.89)], reported income>20K [β -1.05, 95%CI (-1.79, -0.30)], and measured % body fat [β -0.07, 95%CI (-0.12, -0.02)]. There were significant associations between income and % body fat with lower indoor and nighttime exposures, but not with outdoor heat exposure, suggesting modifications of the home thermal environment play an important role in determining overall heat exposure. Further delineation of the effect of personal characteristics on heat exposure may help to develop targeted strategies for preventing heat-related illness.
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Affiliation(s)
- Molly C Bernhard
- Department of Environmental Health Sciences, School of Public Health, University of Alabama at Birmingham (UAB), Birmingham, AL 35294, USA
| | - Shia T Kent
- Department of Epidemiology, School of Public Health, UAB, Birmingham, AL 35294, USA
| | | | - Mary B Evans
- Center for the Study of Community Health, School of Public Health, UAB, Birmingham, AL 35294, USA
| | - Leslie A McClure
- Department of Biostatistics, School of Public Health, UAB, Birmingham, AL 35294, USA
| | - Julia M Gohlke
- Department of Environmental Health Sciences, School of Public Health, University of Alabama at Birmingham (UAB), Birmingham, AL 35294, USA
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Jones-Jordan LA, Sinnott LT, Graham ND, Cotter SA, Kleinstein RN, Manny RE, Mutti DO, Twelker JD, Zadnik K. The contributions of near work and outdoor activity to the correlation between siblings in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) Study. Invest Ophthalmol Vis Sci 2014; 55:6333-9. [PMID: 25205866 DOI: 10.1167/iovs.14-14640] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE We determined the correlation between sibling refractive errors adjusted for shared and unique environmental factors using data from the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) Study. METHODS Refractive error from subjects' last study visits was used to estimate the intraclass correlation coefficient (ICC) between siblings. The correlation models used environmental factors (diopter-hours and outdoor/sports activity) assessed annually from parents by survey to adjust for shared and unique environmental exposures when estimating the heritability of refractive error (2*ICC). RESULTS Data from 700 families contributed to the between-sibling correlation for spherical equivalent refractive error. The mean age of the children at the last visit was 13.3 ± 0.90 years. Siblings engaged in similar amounts of near and outdoor activities (correlations ranged from 0.40-0.76). The ICC for spherical equivalent, controlling for age, sex, ethnicity, and site was 0.367 (95% confidence interval [CI] = 0.304, 0.420), with an estimated heritability of no more than 0.733. After controlling for these variables, and near and outdoor/sports activities, the resulting ICC was 0.364 (95% CI = 0.304, 0.420; estimated heritability no more than 0.728, 95% CI = 0.608, 0.850). The ICCs did not differ significantly between male-female and single sex pairs. CONCLUSIONS Adjusting for shared family and unique, child-specific environmental factors only reduced the estimate of refractive error correlation between siblings by 0.5%. Consistent with a lack of association between myopia progression and either near work or outdoor/sports activity, substantial common environmental exposures had little effect on this correlation. Genetic effects appear to have the major role in determining the similarity of refractive error between siblings.
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Affiliation(s)
- Lisa A Jones-Jordan
- The Ohio State University College of Optometry, Columbus, Ohio, United States
| | - Loraine T Sinnott
- The Ohio State University College of Optometry, Columbus, Ohio, United States
| | | | - Susan A Cotter
- Marshall B. Ketchum University, Fullerton, California, United States
| | - Robert N Kleinstein
- University of Alabama at Birmingham School of Optometry, Birmingham, Alabama, United States
| | - Ruth E Manny
- University of Houston College of Optometry, Houston, Texas, United States
| | - Donald O Mutti
- The Ohio State University College of Optometry, Columbus, Ohio, United States
| | - J Daniel Twelker
- University of Arizona Department of Ophthalmology and Vision Science, Tucson, Arizona, United States
| | - Karla Zadnik
- The Ohio State University College of Optometry, Columbus, Ohio, United States
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Read SA, Collins MJ, Vincent SJ. Light exposure and physical activity in myopic and emmetropic children. Optom Vis Sci 2014; 91:330-41. [PMID: 24413273 DOI: 10.1097/opx.0000000000000160] [Citation(s) in RCA: 133] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To objectively assess daily light exposure and physical activity levels in myopic and emmetropic children. METHODS One hundred two children (41 myopes and 61 emmetropes) aged 10 to 15 years old had simultaneous objective measures of ambient light exposure and physical activity collected over a 2-week period during school term, using a wrist-worn actigraphy device (Actiwatch 2). Measures of visible light illuminance and physical activity were captured every 30 seconds, 24 hours a day over this period. Mean hourly light exposure and physical activity for weekdays and weekends were examined. To ensure that seasonal variations did not confound comparisons, the light and activity data of the 41 myopes was compared with 41 age- and gender-matched emmetropes who wore the Actiwatch over the same 2-week period. RESULTS Mean light exposure and physical activity for all 101 children with valid data exhibited significant changes with time of day and day of the week (p < 0.0001). On average, greater daily light exposure occurred on weekends compared to weekdays (p < 0.05), and greater physical activity occurred on weekdays compared to weekends (p < 0.01). Myopic children (n = 41, mean daily light exposure 915 ± 519 lx) exhibited significantly lower average light exposure compared to 41 age- and gender-matched emmetropic children (1272 ± 625 lx, p < 0.01). The amount of daily time spent in bright light conditions (>1000 lx) was also significantly greater in emmetropes (127 ± 51 minutes) compared to myopes (91 ± 44 minutes, p < 0.001). No significant differences were found between the average daily physical activity levels of myopes and emmetropes (p > 0.05). CONCLUSIONS Myopic children exhibit significantly lower daily light exposure, but no significant difference in physical activity compared to emmetropic children. This suggests the important factor involved in documented associations between myopia and outdoor activity is likely exposure to bright outdoor light rather than greater physical activity.
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Affiliation(s)
- Scott A Read
- *PhD, FAAO †PhD Contact Lens and Visual Optics Laboratory, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
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Alvarez AA, Wildsoet CF. Quantifying light exposure patterns in young adult students. JOURNAL OF MODERN OPTICS 2013; 60:1200-1208. [PMID: 25342873 PMCID: PMC4204734 DOI: 10.1080/09500340.2013.845700] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Exposure to bright light appears to be protective against myopia in both animals (chicks, monkeys) and children, but quantitative data on human light exposure are limited. In this study, we report on a technique for quantifying light exposure using wearable sensors. Twenty-seven young adult subjects wore a light sensor continuously for two weeks during one of three seasons, and also completed questionnaires about their visual activities. Light data were analyzed with respect to refractive error and season, and the objective sensor data were compared with subjects' estimates of time spent indoors and outdoors. Subjects' estimates of time spent indoors and outdoors were in poor agreement with durations reported by the sensor data. The results of questionnaire-based studies of light exposure should thus be interpreted with caution. The role of light in refractive error development should be investigated using multiple methods such as sensors to complement questionnaires.
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Affiliation(s)
- Amanda A. Alvarez
- Vision Science Graduate Group, School of Optometry, University of
California, Berkeley 588 Minor Hall, Berkeley, CA 94720-2020, USA
| | - Christine F. Wildsoet
- Vision Science Graduate Group, School of Optometry, University of
California, Berkeley 588 Minor Hall, Berkeley, CA 94720-2020, USA
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