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Chen D, Du Y, Liu Y, Hong J, Yin X, Zhu Z, Wang J, Zhang J, Chen J, Zhang B, Du L, Yang J, He X, Xu X. Development and validation of a smartwatch algorithm for differentiating physical activity intensity in health monitoring. Sci Rep 2024; 14:9530. [PMID: 38664457 PMCID: PMC11045869 DOI: 10.1038/s41598-024-59602-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
To develop and validate a machine learning based algorithm to estimate physical activity (PA) intensity using the smartwatch with the capacity to record PA and determine outdoor state. Two groups of participants, including 24 adults (13 males) and 18 children (9 boys), completed a sequential activity trial. During each trial, participants wore a smartwatch, and energy expenditure was measured using indirect calorimetry as gold standard. The support vector machine algorithm and the least squares regression model were applied for the metabolic equivalent (MET) estimation using raw data derived from the smartwatch. Exercise intensity was categorized based on MET values into sedentary activity (SED), light activity (LPA), moderate activity (MPA), and vigorous activity (VPA). The classification accuracy was evaluated using area under the ROC curve (AUC). The METs estimation accuracy were assessed via the mean absolute error (MAE), the correlation coefficient, Bland-Altman plots, and intraclass correlation (ICC). A total of 24 adults aged 21-34 years and 18 children aged 9-13 years participated in the study, yielding 1790 and 1246 data points for adults and children respectively for model building and validation. For adults, the AUC for classifying SED, MVPA, and VPA were 0.96, 0.88, and 0.86, respectively. The MAE between true METs and estimated METs was 0.75 METs. The correlation coefficient and ICC were 0.87 (p < 0.001) and 0.89, respectively. For children, comparable levels of accuracy were demonstrated, with the AUC for SED, MVPA, and VPA being 0.98, 0.89, and 0.85, respectively. The MAE between true METs and estimated METs was 0.80 METs. The correlation coefficient and ICC were 0.79 (p < 0.001) and 0.84, respectively. The developed model successfully estimated PA intensity with high accuracy in both adults and children. The application of this model enables independent investigation of PA intensity, facilitating research in health monitoring and potentially in areas such as myopia prevention and control.
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Affiliation(s)
- Daixi Chen
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 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, 200080, China
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, National Clinical Research Center for Eye Diseases, Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai, 200030, China
| | - Yuchen Du
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, National Clinical Research Center for Eye Diseases, Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai, 200030, China
| | - Yuan Liu
- Key Laboratory of Adolescent Health Assessment and Exercise Intervention of the Ministry of Education, East China Normal University, Shanghai, 200241, China
| | - Jun Hong
- Key Laboratory of Adolescent Health Assessment and Exercise Intervention of the Ministry of Education, East China Normal University, Shanghai, 200241, China
| | - Xiaojian Yin
- College of Economics and Management, Shanghai Institute of Technology, Shanghai, 201418, China
| | - Zhuoting Zhu
- Centre for Eye Research Australia, Ophthalmology, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Jingjing Wang
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, National Clinical Research Center for Eye Diseases, Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai, 200030, China
| | - Junyao Zhang
- Centre for Eye Research Australia, Ophthalmology, University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Jun Chen
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, National Clinical Research Center for Eye Diseases, Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai, 200030, China
| | - Bo Zhang
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, National Clinical Research Center for Eye Diseases, Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai, 200030, China
| | - Linlin Du
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, National Clinical Research Center for Eye Diseases, Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai, 200030, China
| | - Jinliuxing Yang
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, National Clinical Research Center for Eye Diseases, Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai, 200030, China
| | - Xiangui He
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 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, 200080, China.
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, National Clinical Research Center for Eye Diseases, Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai, 200030, China.
| | - Xun Xu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 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, 200080, China.
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, National Clinical Research Center for Eye Diseases, Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai, 200030, 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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Tong L, Chen J, Liu L, Kang M, Liao X, Ying P, Ling Q, Zou J, Wei H, Wang Y, Shao Y. Temporal effects of an original myopia song on school children's myopia and awareness: a 3-year prospective study. Clin Exp Optom 2023:1-7. [PMID: 37989320 DOI: 10.1080/08164622.2023.2251975] [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: 03/22/2023] [Accepted: 08/22/2023] [Indexed: 11/23/2023] Open
Abstract
CLINICAL RELEVANCE Raising children's myopia prevention awareness and behaviour tends to exhibits a protective effect against myopia among schoolchildren. BACKGROUND To investigate the effect of an original myopia song in raising school children's awareness of healthier eye use behaviour and on myopia prevention. METHODS In this prospective randomised control study, two groups of students from one primary schools in Jiangxi, China, were enrolled and monitored from grade 3 to grade 6 (2016-2019). The primary outcome was the change in axial length (AL) after the intervention. Secondary outcomes included changes in spherical equivalent refraction (SER), near work and outdoor time, corrected near and distant visual acuity, visual discomfort score (VDS) and accommodative lag. RESULTS Four hundred students (193 females, 48.25%) aged 9.3 (range 8-10) years with emmetropia to moderate myopia were enrolled. Children in the myopia song group had a significantly shorter AL and less myopic refractive change than those in the control group (p = 0.04 and 0.02, respectively). Compared with the control group, children in the myopia song group spent less time on near work and more time outdoors (p = 0.04 and 0.04, respectively). At the final follow-up, the proportion of children with myopia was significantly lower in the myopia song group (30.5%) than in the control group (41%) (p = 0.03). No significant differences were found for the secondary outcomes, including corrected near and distant visual acuity, VDS and accommodative lag. CONCLUSIONS An original myopia song performed twice daily in primary schools appeared to have a modest effect on myopia control among school-aged children by changing their lifestyles in the long term.
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Affiliation(s)
- Liyang Tong
- Department of Ophthalmology, The Affiliated Ningbo Eye Hospital of Wenzhou Medical University, Ningbo, Zhejiang, China
| | - Jun Chen
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Liqi Liu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Min Kang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Xulin Liao
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Shatin, China
| | - Ping Ying
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Qian Ling
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Jie Zou
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Hong Wei
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yixin Wang
- School of optometry and vision science, Cardiff University, Cardiff, Wales, UK
| | - Yi Shao
- Department of Ophthalmology, The Affiliated Ningbo Eye Hospital of Wenzhou Medical University, Ningbo, Zhejiang, China
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China
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Horvat-Gitsels LA, Cortina-Borja M, Solebo AL, Rahi JS. Impaired vision and physical activity in childhood and adolescence: findings from the Millennium Cohort Study. Br J Ophthalmol 2023; 107:588-594. [PMID: 34758961 DOI: 10.1136/bjophthalmol-2021-320315] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/26/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIMS Investigate if impaired vision is associated with reduced levels and differences in types of physical activity (PA) to identify barriers or enablers to achieving healthy PA levels. METHODS Data from the Millennium Cohort Study of children born in the UK in 2000-2001 and followed-up to age 14 years (n=11 571). Using parental report on eye conditions coded by clinicians, children were categorised as having no, unilateral or bilateral impaired vision. Outcomes included objective accelerometer-derived time spent in moderate-to-vigorous physical activity (MVPA), and 16 PA types reported by parents, teachers and/or participants, covering physical education (PE), organised sports, self-organised sports and hobbies. RESULTS Overall, 50% of 7-year-olds and subsequently 41% as 14-year-olds achieved the internationally recommended level of ≥60 MVPA min/day, irrespective of vision status, and mainly attributable to PE and organised sports. Bilateral impaired vision (vs none) was associated with parent-reported difficulties with PE (adjusted OR, 4.67; 95% CI, 2.31 to 9.41), self-rated poor ability in PE (3.21; 1.44 to 7.15) and not enjoy indoor PA (0.48; 0.26 to 0.88). Unilateral impaired vision was associated with both parent-rated difficulties (1.80; 1.26 to 2.59) and teachers' perception of low ability in PE (2.27; 1.57 to 3.28), and reduced odds of high participation in organised sports (0.77; 0.59 to 0.99). Age-related trajectories showed suboptimal PA in childhood tracked into adolescence, with no difference by vision status. CONCLUSION Population-wide programmes to increase PA levels in children should pay special attention to those with impaired vision and include early interventions to encourage participation and confidence in PE and organised sports, starting in primary school and maintained afterwards.
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Affiliation(s)
- Lisanne Andra Horvat-Gitsels
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health Population Policy and Practice, London, UK
- Ulverscroft Vision Research Group, UCL Great Ormond Street Institute of Child Health Population Policy and Practice, London, UK
| | - Mario Cortina-Borja
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health Population Policy and Practice, London, UK
| | - Ameenat Lola Solebo
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health Population Policy and Practice, London, UK
- Ulverscroft Vision Research Group, UCL Great Ormond Street Institute of Child Health Population Policy and Practice, London, UK
- Ophthalmology, Great Ormond Street Hospital for Children, London, UK
| | - Jugnoo Sangeeta Rahi
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health Population Policy and Practice, London, UK
- Ulverscroft Vision Research Group, UCL Great Ormond Street Institute of Child Health Population Policy and Practice, London, UK
- Ophthalmology, Great Ormond Street Hospital for Children, London, UK
- Institute of Ophthalmology, UCL, London, UK
- NIHR Moorfields Biomedical Research Centre, London, UK
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Zhou H, Bai X. A Review of the Role of the School Spatial Environment in Promoting the Visual Health of Minors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1006. [PMID: 36673762 PMCID: PMC9859487 DOI: 10.3390/ijerph20021006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 12/28/2022] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
Rising childhood myopia rate has detrimental health consequences that pose a considerable challenge to health systems. The school spatial environment, which is where students are for the longest period of time, has a high health value for myopia systematic intervention. While research has demonstrated associations between physical daylight environments, medical gene and visual health, the literature currently lacks a synthesis of evidence that will act as a spatially-organized resource for school designers. This study is based on literature from the period 2000-2022 and has been taken from the Web of Science, scopus, Medline and CNKI core collection database. Collaboration, literature co-citation and quantitative and qualitative analysis, in addition to keyword co-occurrence are adopted to conduct a visual health research review. The results indicate that intensive near work activity (as a risk factor) and longer time spent outdoors (as a protective factor), are involved in visual health factors. Two main research themes are obtained and relate to: (1) The environment of visual work behavior (especially the near work learning environment) and adaptable multimedia learning environment; and (2) the environment of outdoor exposure behavior. Furthermore, with the variation of educational demands, models and concepts, there are different demands for near work behavior, and this study makes an important contribution by pointing to two future research directions, including the accurate and controllable environment of near work behavior, which operate in accordance with various educational mode requirements and the active design of the environment of outdoor exposure behavior. In referring to differences between regions and countries, as well as the development of the educational environment, it provides insight into how these demands can be controlled.
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Affiliation(s)
- Huihui Zhou
- School of Architecture and Urban Planning, Huazhong University of Science and Technology, Wuhan 430074, China
- Hubei Engineering and Technology Research Center of Urbanization, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Xiaoxia Bai
- School of Architecture and Urban Planning, Huazhong University of Science and Technology, Wuhan 430074, China
- Hubei Engineering and Technology Research Center of Urbanization, Huazhong University of Science and Technology, Wuhan 430074, China
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Does Physical Activity Moderate the Relationship between Myopia and Functional Status in Children 9-11 Years of Age? J Clin Med 2022; 11:jcm11195672. [PMID: 36233536 PMCID: PMC9572250 DOI: 10.3390/jcm11195672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/15/2022] [Accepted: 09/21/2022] [Indexed: 11/17/2022] Open
Abstract
Although previous studies have reported an association between physical activity (PA) and myopia in school-aged children, little is known about the link between myopia and children’s functional status. The purpose of this study was to investigate dynamic balance control in relation to the daily PA levels of myopic schoolchildren aged 9−11 years (n = 52) versus a non-myopic control group (n = 53). A single leg stance test performed on the instability platform of the Biodex Balance System was used to assess balance control. The overall stability index (OSI), anterior-posterior stability index (APSI) and medial-lateral stability index (MLSI) were analyzed. PA levels were calculated using the World Health Organization European Childhood Obesity Surveillance Initiative family record form. Myopes and non-myopes were separated into three subgroups based on PA level (low, moderate and high). Myopia significantly affected OSI (F = 40.46, p < 0.001), APSI (F = 33.93, p < 0.001) and MLSI (F = 49.51, p < 0.001). There were significant differences (p < 0.001) between myopic and non-myopic children with low and moderate levels of PA, whilst there were no differences between compared children with high levels of PA. High PA levels had a positive impact on balance control in myopes. Our results showed that PA levels moderate the relationship between myopia and children’s functional status.
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Chen Y, Zhu Z, Wang W, Shang X, He M, Li J. Association of Myopia With Risk of Incident Metabolic Syndrome: Findings From the UK Biobank Study Cohort of 91,591 Participants. Front Med (Lausanne) 2022; 9:872013. [PMID: 35652067 PMCID: PMC9150791 DOI: 10.3389/fmed.2022.872013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/04/2022] [Indexed: 12/18/2022] Open
Abstract
Purpose To investigate the association between myopia and risk of metabolic syndrome (MetS) in a prospective cohort from the UK Biobank Study. Methods Volunteers (aged 40 years and above) free of baseline MetS and cataract included from the UK Biobank Study, a prospective follow-up cohort. Myopia was defined using uncycloplegic autorefraction, self-report-myopia, and medical records for refractive error at baseline. MetS as well as components of MetS were diagnosed based on health records, blood biochemistry, and questionnaires. Questionnaires determined the status of smoking, drinking, physical activity and dietary supplements, as well as ethnicity and education. Results A total of 91,591 participants were available in the analysis, with a mean age of 55.37 ± 8.07 years at baseline and a median follow-up years of 11.16 years. The proportion of myopia was 49.7%, and a total of 937 (1.0%) participants were identified as having incident MetS (0.09/100 person years). Subjects with myopia were more likely to have MetS compared with non-myopic subjects (0.82 vs. 0.21%, Log-rank test P < 0.001). Mopes had greater risk of incident MetS (Hazard ratio [HR] = 4.19, 95% confidence interval [CI] 3.57-4.93, P < 0.001) adjusting for baseline age, gender, education and ethnicity. After further controlling for lifestyle factors (smoking, drinking, physical activity, and fish oil supplement) or baseline metabolic disorders, the risk of incident MetS were 3.88- and 4.06-fold greater in myopic subjects than those without myopia, respectively (P < 0.001 for both models). The severity of myopia was not significantly correlated to incident MetS in multivariate-adjusted models. Conclusions An increased risk of incident MetS among the elderly is associated with myopia, but not the degree of myopia. These findings highlighted the need of prevention of MetS among older adults with myopia.
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Affiliation(s)
- Yanxian Chen
- Department of Ophthalmology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China
| | - Zhuoting Zhu
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xianwen Shang
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China.,Centre for Eye Research Australia, Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
| | - Mingguang He
- Department of Ophthalmology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China.,Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China.,State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.,Centre for Eye Research Australia, Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, VIC, Australia
| | - Jinying Li
- Department of Ophthalmology, Peking University Shenzhen Hospital, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China
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Mirhajianmoghadam H, Piña A, Ostrin LA. Objective and Subjective Behavioral Measures in Myopic and Non-Myopic Children During the COVID-19 Pandemic. Transl Vis Sci Technol 2021; 10:4. [PMID: 34473223 PMCID: PMC8419879 DOI: 10.1167/tvst.10.11.4] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 08/09/2021] [Indexed: 12/12/2022] Open
Abstract
Purpose The coronavirus disease 2019 (COVID-19) pandemic required a shift to electronic devices for education and entertainment, with children more confined to home, which may affect eye growth and myopia. Our goal was to assess behaviors during COVID-19 in myopic and non-myopic children. Methods Parents completed a questionnaire for their children (ages 8.3 ± 2.4 years, n = 53) regarding visual activity in summer 2020, during the COVID-19 pandemic, as well as during school time and the summer before COVID-19. Children also wore an Actiwatch for 10 days in summer 2020 for objective measures of light exposure, activity, and sleep. Data were analyzed with repeated-measures analysis of variance. Results Subjective measures showed that during COVID-19, children exhibited increased electronic device use and decreased activity and time outdoors (P < 0.05 for all), while time spent doing near work was not different than during a typical school or summer session before COVID-19 (P > 0.05). Objective measures during COVID-19 showed that myopic children exhibited lower daily light exposure (P = 0.04) and less activity (P = 0.04) than non-myopic children. Conclusions Children demonstrated increased electronic device use and decreased activity and time outdoors during COVID-19, with myopic children exhibiting lower light exposure and activity than non-myopes. Long-term follow-up is needed to understand if these behavioral changes ultimately contribute to myopia progression. Translational Relevance Children's behaviors changed during the COVID-19 pandemic, which may have implications in eye growth and myopia.
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Affiliation(s)
| | - Amanda Piña
- University of Houston College of Optometry, Houston, TX, USA
| | - Lisa A. Ostrin
- University of Houston College of Optometry, Houston, TX, USA
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Howell CM, McCullough SJ, Doyle L, Murphy MH, Saunders KJ. Reliability and validity of the Actiwatch and Clouclip for measuring illumination in real-world conditions. Ophthalmic Physiol Opt 2021; 41:1048-1059. [PMID: 34387902 DOI: 10.1111/opo.12860] [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] [Received: 12/09/2020] [Revised: 06/09/2021] [Accepted: 06/09/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE To compare real-world measures of illumination obtained with the Actiwatch-2 and Clouclip-M2 with 'gold standard' photometry measures and to evaluate the ability of Actiwatch-2 to correctly identify photometer-defined conditions: scotopic (≤0.01 lux), mesopic (0.02-3 lux), indoor photopic (>3-1,000 lux) and outdoor photopic (>1,000 lux); and Clouclip to correctly identify photometer-defined conditions within its operating range (>1 lux). Inter-device reliability of Clouclip for illumination and viewing distance measures was also investigated. METHODS A Hagner-S2 photometer was used as reference. Measures of illumination were obtained from a range of real-world conditions. To investigate inter-device reliability, five Clouclips were simultaneously exposed to varied light conditions and object distances. RESULTS Strong correlations existed between illumination measured with the photometer and both Actiwatch-2 (ρ = 0.99, p < 0.0001) and Clouclip (ρ = 0.99, p < 0.0001). However, both devices underestimated illumination compared to the photometer; disparity increased with increasing illumination and was greater for Actiwatch-2 than Clouclip measures. Actiwatch-2 successfully categorised illumination level (scotopic, mesopic, indoor and outdoor photopic) in 71.2% of cases. Clouclip successfully categorised illumination levels as scotopic/mesopic (≤3 lux) and indoor and outdoor photopic in 100% of cases. Mean differences and limits of agreement (LOA) were 430.92 ± 1,828.74 and 79.35 ± 407.33 lux, between the photometer and Actiwatch-2 and photometer and Clouclip, respectively. The Intra-class Correlation Coefficients for illumination and viewing distance measured with five Clouclips were 0.85 and 0.96, respectively. CONCLUSION These data illustrate that different Clouclip devices produce comparable measures of viewing distance and illumination in real-world settings. Both Actiwatch-2 and Clouclip underestimate illumination in the field compared to gold standard photometer measures. The disparity increases at higher levels of illumination and the discrepancy was greater for Actiwatch-2 measures. For researchers interested in categorising light exposure, Clouclip classifies illumination levels >2 lux more accurately than Actiwatch-2 but cannot discriminate between scotopic and low mesopic light.
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Affiliation(s)
- Colleen M Howell
- Optometry and Vision Science Research Group, School of Biomedical Sciences, Ulster University, Coleraine, UK
| | - Sara J McCullough
- Optometry and Vision Science Research Group, School of Biomedical Sciences, Ulster University, Coleraine, UK
| | - Lesley Doyle
- Optometry and Vision Science Research Group, School of Biomedical Sciences, Ulster University, Coleraine, UK
| | - Marie H Murphy
- Sport and Exercise Sciences Research Institute, School of Sport, Ulster University, Jordanstown, UK
| | - Kathryn J Saunders
- Optometry and Vision Science Research Group, School of Biomedical Sciences, Ulster University, Coleraine, UK
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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: 1.3] [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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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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12
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Foreman J, Crowston JG, Dirani M. Is physical activity protective against myopia? Br J Ophthalmol 2020; 104:1329-1330. [PMID: 32620685 DOI: 10.1136/bjophthalmol-2020-316173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 06/06/2020] [Indexed: 12/29/2022]
Affiliation(s)
- Joshua Foreman
- Ophthalmology, Department of Surgery, The University of Melbourne, Melbourne, Australia .,Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | - Jonathan G Crowston
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia.,Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - Mohamed Dirani
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia.,Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore
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13
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Comparison of Solar Radiation and Myopia Occurrence in South Korean Children. J Ophthalmol 2019; 2019:7643850. [PMID: 31281670 PMCID: PMC6590540 DOI: 10.1155/2019/7643850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 04/28/2019] [Accepted: 05/02/2019] [Indexed: 11/17/2022] Open
Abstract
PURPOSE To investigate the association between regional solar radiation and myopia occurrence in South Korean children. MATERIALS AND METHODS A population-based cross-sectional study using data of 1218 children aged 7-9 years from the Korea National Health and Nutritional Examination Survey was conducted from January 1, 2008, to December 31, 2012. Myopia prevalence and the mean spherical equivalent were estimated; myopia was defined as spherical equivalent refraction <-1.5 D. Data regarding solar radiation and sunshine duration were collected from 21 national monitoring stations in South Korea. Multiple logistic regression analyses and multiple linear regression analyses were used to evaluate the associations. However, the most important covariate, the time spent outdoors, was not measured and could not be used. RESULTS In the entire cohort of 1218 participants, solar radiation and sunshine duration were significantly associated with the mean spherical equivalent (P=0.001 and P=0.014, B = 0.088 and B = 0.069, respectively) and solar radiation was significantly associated with myopia prevalence (P=0.008). And, a negative but not statistically significant association between sunshine duration and myopia prevalence was observed (P=0.064, respectively). CONCLUSIONS Solar radiation and sunshine duration are associated with the mean spherical equivalent and myopia prevalence in South Korean children.
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14
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Mountjoy E, Davies NM, Plotnikov D, Smith GD, Rodriguez S, Williams CE, Guggenheim JA, Atan D. Education and myopia: assessing the direction of causality by mendelian randomisation. BMJ 2018; 361:k2022. [PMID: 29875094 PMCID: PMC5987847 DOI: 10.1136/bmj.k2022] [Citation(s) in RCA: 142] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVES To determine whether more years spent in education is a causal risk factor for myopia, or whether myopia is a causal risk factor for more years in education. DESIGN Bidirectional, two sample mendelian randomisation study. SETTING Publically available genetic data from two consortiums applied to a large, independent population cohort. Genetic variants used as proxies for myopia and years of education were derived from two large genome wide association studies: 23andMe and Social Science Genetic Association Consortium (SSGAC), respectively. PARTICIPANTS 67 798 men and women from England, Scotland, and Wales in the UK Biobank cohort with available information for years of completed education and refractive error. MAIN OUTCOME MEASURES Mendelian randomisation analyses were performed in two directions: the first exposure was the genetic predisposition to myopia, measured with 44 genetic variants strongly associated with myopia in 23andMe, and the outcome was years in education; and the second exposure was the genetic predisposition to higher levels of education, measured with 69 genetic variants from SSGAC, and the outcome was refractive error. RESULTS Conventional regression analyses of the observational data suggested that every additional year of education was associated with a more myopic refractive error of -0.18 dioptres/y (95% confidence interval -0.19 to -0.17; P<2e-16). Mendelian randomisation analyses suggested the true causal effect was even stronger: -0.27 dioptres/y (-0.37 to -0.17; P=4e-8). By contrast, there was little evidence to suggest myopia affected education (years in education per dioptre of refractive error -0.008 y/dioptre, 95% confidence interval -0.041 to 0.025, P=0.6). Thus, the cumulative effect of more years in education on refractive error means that a university graduate from the United Kingdom with 17 years of education would, on average, be at least -1 dioptre more myopic than someone who left school at age 16 (with 12 years of education). Myopia of this magnitude would be sufficient to necessitate the use of glasses for driving. Sensitivity analyses showed minimal evidence for genetic confounding that could have biased the causal effect estimates. CONCLUSIONS This study shows that exposure to more years in education contributes to the rising prevalence of myopia. Increasing the length of time spent in education may inadvertently increase the prevalence of myopia and potential future visual disability.
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Affiliation(s)
- Edward Mountjoy
- MRC Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Neil M Davies
- MRC Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Denis Plotnikov
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Santiago Rodriguez
- MRC Integrative Epidemiology Unit, Bristol Medical School, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Cathy E Williams
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Denize Atan
- Translational Health Sciences, Bristol Medical School, University of Bristol, Biomedical Sciences Building, Bristol BS8 1TD, UK
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15
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Shah RL, Huang Y, Guggenheim JA, Williams C. Time Outdoors at Specific Ages During Early Childhood and the Risk of Incident Myopia. Invest Ophthalmol Vis Sci 2017; 58:1158-1166. [PMID: 28245296 PMCID: PMC5341622 DOI: 10.1167/iovs.16-20894] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose Time outdoors during childhood is negatively associated with incident myopia. Consequently, additional time outdoors has been suggested as a public health intervention to reduce the prevalence of myopia. We investigated whether there were specific ages during early childhood when the time outdoors versus incident myopia association was strongest. Methods Children participating in the Avon Longitudinal Study of Parents and Children (ALSPAC) were studied from age 2 to 15 years. Parentally reported time outdoors and time spent reading were assessed longitudinally in early childhood (ages 2, 3, 4, 5, 7, and 9 years). Noncycloplegic autorefraction was carried out longitudinally in later childhood (ages 10, 11, 12, and 15 years). Information was available for 2833 participants. Cox proportional hazards regression was used to test for association between time outdoors and incident myopia. Results From 3 years of age onward, greater time outdoors was associated with a reduced risk of incident myopia. The hazard ratio for myopia changed progressively from 0.90 (95% CI 0.83–0.98, P = 0.012) at age 3 years, to 0.86 (95% CI 0.78–0.93, P = 0.001) at age 9 years, for each additional SD of time spent outdoors per day. These associations were independent of two major risk factors for myopia: time reading and number of myopic parents. Conclusions Additional time spent outdoors across the 3 to 9 years age range was associated with a reduced incidence of myopia between ages 10 and 15 years. There was a trend for the association to increase toward the older end of the 3 to 9 years range.
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Affiliation(s)
- Rupal L Shah
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, United Kingdom
| | - Yu Huang
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, United Kingdom 2School of Optometry, Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Jeremy A Guggenheim
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, United Kingdom
| | - Cathy Williams
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
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17
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Galvis V, López-Jaramillo P, Tello A, Castellanos-Castellanos YA, Camacho PA, Cohen DD, Gómez-Arbeláez D, Merayo-Lloves J. Is myopia another clinical manifestation of insulin resistance? Med Hypotheses 2016; 90:32-40. [PMID: 27063082 DOI: 10.1016/j.mehy.2016.02.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 02/08/2016] [Indexed: 12/28/2022]
Abstract
Myopia is a multifactorial visual refraction disease, in which the light rays from distant objects are focused in front of retina, causing blurry vision. Myopic eyes are characterized by an increased corneal curvature and/or ocular axial length. The prevalence of myopia has increased in recent decades, a trend that cannot be attributed exclusively to genetic factors. Low and middle income countries have a higher burden of refractive error, which we propose could be a consequence of a shorter exposure time to a westernized lifestyle, a phenomenon that may also explain the rapid increase in cardiometabolic diseases, such as diabetes, among those populations. We suggest that interactions between genetic, epigenetic and a rapidly changing environment are also involved in myopia onset and progression. Furthermore, we discuss several possible mechanisms by which insulin resistance may promote abnormal ocular growth and myopia to support the hypothesis that insulin resistance and hyperinsulinemia are involved in its pathogenesis, providing a link between trends in myopia and those of cardiometabolic diseases. There is evidence that insulin have direct ocular growth promoting effects as well an indirect effect via the induction of insulin-like growth factors leading to decreases insulin-like growth factor-binding protein, also implicated in ocular growth.
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Affiliation(s)
- Virgilio Galvis
- Centro Oftalmológico Virgilio Galvis, Floridablanca, Santander, Colombia; Fundación Oftalmológica de Santander - FOSCAL, Floridablanca, Santander, Colombia
| | - Patricio López-Jaramillo
- Fundación Oftalmológica de Santander - FOSCAL, Floridablanca, Santander, Colombia; Instituto MASIRA, Facultad de Ciencias de la Salud, Universidad de Santander (UDES), Bucaramanga, Santander, Colombia.
| | - Alejandro Tello
- Centro Oftalmológico Virgilio Galvis, Floridablanca, Santander, Colombia; Departamento de Cirugía, Escuela de Medicina, Facultad de Ciencias de la Salud, Universidad Autónoma de Bucaramanga (UNAB), Bucaramanga, Santander, Colombia
| | | | - Paul Anthony Camacho
- Fundación Oftalmológica de Santander - FOSCAL, Floridablanca, Santander, Colombia
| | - Daniel Dylan Cohen
- Fundación Oftalmológica de Santander - FOSCAL, Floridablanca, Santander, Colombia; Instituto MASIRA, Facultad de Ciencias de la Salud, Universidad de Santander (UDES), Bucaramanga, Santander, Colombia
| | - Diego Gómez-Arbeláez
- Fundación Oftalmológica de Santander - FOSCAL, Floridablanca, Santander, Colombia
| | - Jesús Merayo-Lloves
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, Spain
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18
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Guggenheim JA, Williams C. Childhood febrile illness and the risk of myopia in UK Biobank participants. Eye (Lond) 2016; 30:608-14. [PMID: 26846593 PMCID: PMC4834038 DOI: 10.1038/eye.2016.7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 12/18/2015] [Indexed: 02/03/2023] Open
Abstract
Purpose Historical reports suggest febrile illness during childhood is a risk factor for myopia. The establishment of the UK Biobank provided a unique opportunity to investigate this relationship. Patients and methods We studied a sample of UK Biobank participants of White ethnicity aged 40–69 years old who underwent autorefraction (N=91 592) and were classified as myopic (≤−0.75 Dioptres (D)), highly myopic (≤−6.00 D), or non-myopic (>−0.75 D). Self-reported age at diagnosis of past medical conditions was ascertained during an interview with a nurse at a Biobank assessment centre. Logistic regression analysis was used to calculate the odds ratio (OR) for myopia or high myopia associated with a diagnosis before age 17 years of each of nine febrile illnesses, after adjusting for potential confounders (age, sex, highest educational qualification, and birth order). Results Rubella, mumps, and pertussis were associated with myopia: rubella, OR=1.38, 95% CI: 1.03–1.85, P=0.030; mumps, OR=1.32, 95% CI: 1.07–1.64, P=0.010; and pertussis, OR=1.39, 95% CI 1.03–1.87, P=0.029. Measles, rubella, and pertussis were associated with high myopia: measles, OR=1.48, 95% CI: 1.07–2.07, P=0.019; rubella, OR=1.94, 95% CI: 1.12–3.35, P=0.017; and pertussis, OR=2.15, 95% CI: 1.24–3.71, P=0.006. The evidence did not support an interaction between education and febrile illness in explaining the above risks. Conclusion A history of childhood measles, rubella, or pertussis was associated with high myopia, whereas a history of childhood rubella, mumps, or pertussis was associated with any myopia. The reasons for these associations are unclear.
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Affiliation(s)
- J A Guggenheim
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK
| | - C Williams
- School of Social and Community Medicine, University of Bristol, Bristol, UK
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Rudnicka AR, Kapetanakis VV, Wathern AK, Logan NS, Gilmartin B, Whincup PH, Cook DG, Owen CG. Global variations and time trends in the prevalence of childhood myopia, a systematic review and quantitative meta-analysis: implications for aetiology and early prevention. Br J Ophthalmol 2016; 100:882-890. [PMID: 26802174 PMCID: PMC4941141 DOI: 10.1136/bjophthalmol-2015-307724] [Citation(s) in RCA: 307] [Impact Index Per Article: 38.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 12/01/2015] [Accepted: 01/02/2016] [Indexed: 12/28/2022]
Abstract
The aim of this review was to quantify the global variation in childhood myopia prevalence over time taking account of demographic and study design factors. A systematic review identified population-based surveys with estimates of childhood myopia prevalence published by February 2015. Multilevel binomial logistic regression of log odds of myopia was used to examine the association with age, gender, urban versus rural setting and survey year, among populations of different ethnic origins, adjusting for study design factors. 143 published articles (42 countries, 374 349 subjects aged 1–18 years, 74 847 myopia cases) were included. Increase in myopia prevalence with age varied by ethnicity. East Asians showed the highest prevalence, reaching 69% (95% credible intervals (CrI) 61% to 77%) at 15 years of age (86% among Singaporean-Chinese). Blacks in Africa had the lowest prevalence; 5.5% at 15 years (95% CrI 3% to 9%). Time trends in myopia prevalence over the last decade were small in whites, increased by 23% in East Asians, with a weaker increase among South Asians. Children from urban environments have 2.6 times the odds of myopia compared with those from rural environments. In whites and East Asians sex differences emerge at about 9 years of age; by late adolescence girls are twice as likely as boys to be myopic. Marked ethnic differences in age-specific prevalence of myopia exist. Rapid increases in myopia prevalence over time, particularly in East Asians, combined with a universally higher risk of myopia in urban settings, suggest that environmental factors play an important role in myopia development, which may offer scope for prevention.
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Affiliation(s)
- Alicja R Rudnicka
- Population Health Research Institute, St George's, University of London, London, UK
| | | | - Andrea K Wathern
- Population Health Research Institute, St George's, University of London, London, UK
| | - Nicola S Logan
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - Bernard Gilmartin
- School of Life and Health Sciences, Aston University, Birmingham, UK
| | - Peter H Whincup
- Population Health Research Institute, St George's, University of London, London, UK
| | - Derek G Cook
- Population Health Research Institute, St George's, University of London, London, UK
| | - Christopher G Owen
- Population Health Research Institute, St George's, University of London, London, UK
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20
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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: 116] [Impact Index Per Article: 11.6] [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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21
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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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Guggenheim JA, Northstone K, McMahon G, Ness AR, Deere K, Mattocks C, Pourcain BS, Williams C. Time outdoors and physical activity as predictors of incident myopia in childhood: a prospective cohort study. Invest Ophthalmol Vis Sci 2012; 53:2856-65. [PMID: 22491403 DOI: 10.1167/iovs.11-9091] [Citation(s) in RCA: 265] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Time spent in "sports/outdoor activity" has shown a negative association with incident myopia during childhood. We investigated the association of incident myopia with time spent outdoors and physical activity separately. METHODS Participants in the Avon Longitudinal Study of Parents and Children (ALSPAC) were assessed by noncycloplegic autorefraction at ages 7, 10, 11, 12, and 15 years, and classified as myopic (≤-1 diopters) or as emmetropic/hyperopic (≥-0.25 diopters) at each visit (N = 4,837-7,747). Physical activity at age 11 years was measured objectively using an accelerometer, worn for 1 week. Time spent outdoors was assessed via a parental questionnaire administered when children were aged 8-9 years. Variables associated with incident myopia were examined using Cox regression. RESULTS In analyses using all available data, both time spent outdoors and physical activity were associated with incident myopia, with time outdoors having the larger effect. The results were similar for analyses restricted to children classified as either nonmyopic or emmetropic/hyperopic at age 11 years. Thus, for children nonmyopic at age 11, the hazard ratio (95% confidence interval, CI) for incident myopia was 0.66 (0.47-0.93) for a high versus low amount of time spent outdoors, and 0.87 (0.76-0.99) per unit standard deviation above average increase in moderate/vigorous physical activity. CONCLUSION Time spent outdoors was predictive of incident myopia independently of physical activity level. The greater association observed for time outdoors suggests that the previously reported link between "sports/outdoor activity" and incident myopia is due mainly to its capture of information relating to time outdoors rather than physical activity.
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Affiliation(s)
- Jeremy A Guggenheim
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, Wales, United Kingdom.
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Abstract
BACKGROUND Myopia, the most common type of refractive error, is a complex trait including both genetic and environmental factors. Numerous studies have tried to elucidate the aetiology of myopia. However, the exact aetiology of myopia is still unclear. PURPOSE To summarize the worldwide patterns and trends for the prevalence of myopia and to evaluate the risk factors for myopia in population-based studies. RECENT FINDINGS The prevalences of myopia vary across populations of different regions and ethnicities. In population-based studies on children, the prevalence of myopia has been reported to be higher in urban areas and Chinese ethnicity. The regional and racial difference is not so obvious in adult populations aged over 40 years. More time spent on near work, less time outdoors, higher educational level and parental history of myopia have been reported to increase the risk of myopia. CONCLUSIONS Environmental factors play a crucial role in myopia development. The effect of gene-environment interaction on the aetiology of myopia is still controversial with inconsistent findings in different studies. A relatively hyperopic periphery can stimulate compensating eye growth in the centre. Longitudinal cohort studies or randomized clinical trials of community-based health behaviour interventions should be conducted to further clarify the aetiology of myopia.
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Affiliation(s)
- Chen-Wei Pan
- Department of Epidemiology and Public Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Read SA, Collins MJ. The short-term influence of exercise on axial length and intraocular pressure. Eye (Lond) 2011; 25:767-74. [PMID: 21423141 DOI: 10.1038/eye.2011.54] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The aim of this study is to investigate the short-term influence of a period of dynamic exercise on axial length (AXL) and intraocular pressure (IOP) in young adult subjects. PATIENTS AND METHODS In all, 20 young adult subjects (10 myopes and 10 emmetropes) participated. Baseline measures of ocular biometrics, IOP and ocular pulse amplitude (OPA) were taken following a 20-min rest period. Subjects then performed 10 min of moderate intensity, low impact dynamic exercise (bicycle ergometry). Measures of ocular biometrics, IOP and OPA were repeated immediately after, and then 5 and 10 min after this exercise task. Systemic blood pressure and pulse rate were also monitored. A repeated measures analysis of variance was used to investigate the changes in the measured parameters. RESULTS Exercise resulted in significant changes in a range of ocular parameters. A small but significant decrease in AXL was observed following exercise (P<0.0001). The largest change in AXL was noted immediately following exercise (mean decrease -17±10 μm). IOP and OPA also decreased significantly following exercise (P<0.0001). A moderate but significant positive association was found between the changes in AXL and the changes in IOP (r(2)=0.36, P<0.0001). There were no significant differences found between the myopic and emmetropic subjects in the magnitude of changes observed in ocular parameters following exercise. CONCLUSION The physiological effects of dynamic exercise lead to changes in a range of ocular parameters, including significant reductions in IOP, OPA and decreases in AXL.
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Affiliation(s)
- S A Read
- Contact Lens and Visual Optics Laboratory, School of Optometry, Queensland University of Technology, Brisbane, Queensland, Australia.
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