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Zhu M, Liu Y, Fang D, Li M, Fu T, Yao K, Wang P, Sun X, Xiang Y. Safety of repeated low-level red-light therapy for children with myopia. Photodiagnosis Photodyn Ther 2024; 47:104198. [PMID: 38729232 DOI: 10.1016/j.pdpdt.2024.104198] [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: 03/05/2024] [Revised: 05/05/2024] [Accepted: 05/06/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUD To investigate the safety of repetitive low-level red-light therapy (RLRLT) in children with myopia. METHODS Children with myopia were assigned to the RLRL and control groups. Axial length (AL) and spherical equivalent refraction (SER) were followed up at 3-, 6-, and 12-month. To evaluate the safety of RLRLT, at 6 and 12 months in the RLRL group, multifocal electroretinography (mfERG) and contrast sensitivity were recorded. Furthermore, optical coherence tomography was used to measure the relative reflectance of the ellipsoid zone (rEZR), photoreceptor outer segment (rPOSR), and retinal pigment epithelium (rRPER). RESULTS A total of 108 children completed the trial (55 in the RLRL group and 53 in the control group). After 3, 6, and 12 months, AL was shorter and SER less myopic in the RLRL group than in the control group. Regarding the safety of the RLRLT, the response density and amplitude of the P1 wave of the first ring of the mfERG increased significantly at 6 months (P = 0.001 and P = 0.017, respectively). At 6 and 12 months, contrast sensitivity at the high spatial frequency increased. Moreover, the rEZR increased significantly at 6 months (P = 0.029), the rPOSR increased significantly at 6 and 12 months (both P < 0.001), and the increase in rPOSR was greater with greater AL regression. CONCLUSIONS Based on retinal function and structure follow-up, RLRLT was safe within 12 months. However, rEZR and rPOSR increased, the effects of this phenomenon requires further observation.
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Affiliation(s)
- Mengxia Zhu
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong, University of Science and Technology, Wuhan, 430030, China
| | - Ying Liu
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong, University of Science and Technology, Wuhan, 430030, China
| | - Dengqin Fang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong, University of Science and Technology, Wuhan, 430030, China
| | - Mu Li
- Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong, University of Science and Technology, Wuhan, 430030, China
| | - Ting Fu
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong, University of Science and Technology, Wuhan, 430030, China
| | - KeJun Yao
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong, University of Science and Technology, Wuhan, 430030, China
| | - Ping Wang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong, University of Science and Technology, Wuhan, 430030, China
| | - Xufang Sun
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong, University of Science and Technology, Wuhan, 430030, China
| | - Yan Xiang
- Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong, University of Science and Technology, Wuhan, 430030, China.
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Chen KS, Au Eong JTW, Au Eong KG. Changing paradigm in the management of childhood myopia. Eye (Lond) 2024; 38:1027-1028. [PMID: 37968518 PMCID: PMC11009256 DOI: 10.1038/s41433-023-02831-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 10/28/2023] [Accepted: 11/06/2023] [Indexed: 11/17/2023] Open
Affiliation(s)
- Krystal S Chen
- International Eye Cataract Retina Centre, Mount Elizabeth Medical Centre and Farrer Park Medical Centre, Singapore, Singapore
| | - Jonathan T W Au Eong
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Kah-Guan Au Eong
- International Eye Cataract Retina Centre, Mount Elizabeth Medical Centre and Farrer Park Medical Centre, Singapore, Singapore.
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
- Department of Ophthalmology and Visual Sciences, Khoo Teck Puat Hospital, Singapore, Singapore.
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3
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Wang X, Wang Q, Li Z, Chen M, Guo M, Kong L, Chen L, Li X, Li J, Cao Q, Luo Z, Xiong Z, Zhao D. Reliability and validity of the Chinese version of the sunlight exposure questionnaire. Front Public Health 2024; 12:1281301. [PMID: 38550315 PMCID: PMC10972874 DOI: 10.3389/fpubh.2024.1281301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 02/22/2024] [Indexed: 04/02/2024] Open
Abstract
Objective This study aimed to translate and validate the reliability and validity of the Chinese version of the Philippines Sunlight Exposure Questionnaire. Methods A total of 392 Chinese individuals aged at least 18 years, residing in various cities in Sichuan province for at least 1 year, were recruited. The reliability of the Chinese version of the questionnaire was measured through internal consistency, split-half reliability, and retest reliability, while validity was determined using the content validity index and the structure validity index. Results The Chinese version of the Sunlight Exposure Questionnaire, which includes 19 items covering 5 factors, demonstrated McDonald's omega coefficient of 0.788. The split-half reliability of the questionnaire was 0.823, and the retest reliability was 0.940. The content validity index (S-CVI) was 0.952. The five-factor structure, supported by eigenvalues, explained 66.2% of the total variance. Confirmatory factor analysis indicated favorable model fit. Results The chi-square value degrees of freedom ratio (χ2/df) = 1.852, the goodness-of-fit index (GFI) = 0.938, the normed fit index (NFI) = 0.922, the incremental fit index (IFI) = 0.962, the comparative fit index (CFI) = 0.962, the Tucker-Lewis index (TLI) = 0.952, and root mean square error of approximation (RMSEA) = 0.047. The indicators of the fit of the model were within reasonable bounds. Conclusion The Chinese version of the Sunlight Exposure Questionnaire shows validity and good reliability for assessing sun exposure among adults in a Chinese cultural context.
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Affiliation(s)
- Xiaoxia Wang
- School of Nursing, Chengdu Medical College, Chengdu, China
| | - Qin Wang
- School of Nursing, Chengdu Medical College, Chengdu, China
- School of Health and Medicine, Polus International College, Chengdu, China
| | - Zhe Li
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
- Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China
| | - Mengjie Chen
- School of Nursing, Chengdu Medical College, Chengdu, China
| | - Maoting Guo
- School of Nursing, Chengdu Medical College, Chengdu, China
| | - Laixi Kong
- School of Nursing, Chengdu Medical College, Chengdu, China
| | - Liyuan Chen
- Xindu Hospital of Traditional Chinese Medicine •The First Affiliated Hospital of Traditional Chinese Medicine, Chengdu Medical College, Chengdu, China
| | - Xiaolong Li
- Xindu Hospital of Traditional Chinese Medicine •The First Affiliated Hospital of Traditional Chinese Medicine, Chengdu Medical College, Chengdu, China
| | - Junjun Li
- School of Nursing, Chengdu Medical College, Chengdu, China
| | - Qieyan Cao
- Second Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Zhenhua Luo
- Xindu Hospital of Traditional Chinese Medicine •The First Affiliated Hospital of Traditional Chinese Medicine, Chengdu Medical College, Chengdu, China
| | - Zhenzhen Xiong
- School of Nursing, Chengdu Medical College, Chengdu, China
- Nursing Key Laboratory of Sichuan Province, Chengdu, China
| | - Dan Zhao
- School of Nursing, Chengdu Medical College, Chengdu, China
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4
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Domsa P, Bankó ÉM, Körtvélyes J, Meigen C, Széchey R, Lantos K, Nagy ZZ, Csutak A. Astigmatism and maternal myopia as important factors affecting success rate of DIMS lens treatment. BMJ Open Ophthalmol 2024; 9:e001499. [PMID: 38453262 PMCID: PMC10921505 DOI: 10.1136/bmjophth-2023-001499] [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: 09/17/2023] [Accepted: 01/28/2024] [Indexed: 03/09/2024] Open
Abstract
OBJECTIVE To assess the efficacy of myopia control spectacle lenses (defocus incorporated multiple segments/DIMS) in slowing myopia progression among a diverse Central European paediatric population and investigate the contribution of baseline parameters on treatment outcomes. METHODS AND ANALYSIS This retrospective observational study included 62 individuals aged 4-17 years (mean±SD: 10.21±2.70) with progressing myopia but without ocular pathology with a range of -0.88 to -8.25 D spherical equivalent refraction (SER) (-3.73±1.56), coupled with astigmatism up to -3.25 D cylindrical. All participants were prescribed DIMS (Hoya MiyoSmart) spectacles. Key outcome variables were cycloplegic SER, measured for all participants and axial length (AL), assessed in a subset of patients, recorded at baseline, 6 months and 12 months. Quality of life assessments were conducted at baseline, at 2 weeks, and 3, 6, 9 and 12 months. Additionally, parental myopic dioptre was recorded when applicable. RESULTS At the 12-month mark, myopia progression in patients (mean±SE: -0.40±0.05) mirrored findings from prior European DIMS studies, but with 50% of patients showing no progression. A multivariate analysis of covariance model revealed that baseline astigmatism and younger age adversely affected therapy outcomes in both SER and AL, while severe maternal myopia led to greater SER progression. In contrast, only young age but not astigmatism was associated with AL increase in a comparable group of children with myopia, part of the LIFE Child Study, wearing single-vision spectacles. Patients reported consistent satisfaction with treatment, with minimal side effects, which diminished over the year. CONCLUSION In the European population, astigmatism, young age and severe maternal myopia are risk factors for suboptimal outcomes following DIMS therapy. Further research is necessary to elucidate the impact of astigmatism on myopic defocus therapy.
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Affiliation(s)
- Patricia Domsa
- Non Plus Ultra Vision Centre, Budapest, Hungary
- Department of Ophthalmology, University of Pécs Medical School, Pecs, Hungary
| | - Éva M Bankó
- HUN-REN Research Centre for Natural Sciences, Budapest, Hungary
| | - Judit Körtvélyes
- Non Plus Ultra Vision Centre, Budapest, Hungary
- Heim Pál National Pediatric Institute, Budapest, Hungary
| | - Christof Meigen
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Germany
| | - Rita Széchey
- Non Plus Ultra Vision Centre, Budapest, Hungary
- Semmelweis University of Medicine, Budapest, Hungary
| | - Krisztina Lantos
- Department of Ophthalmology, University of Pécs Medical School, Pecs, Hungary
| | - Zoltán Zsolt Nagy
- Department of Ophthalmology, Semmelweis University of Medicine, Budapest, Hungary
| | - Adrienne Csutak
- Department of Ophthalmology, University of Pécs Medical School, Pecs, Hungary
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Chawla O, Singh A, Kumawat D, Chowdhury N, Kumar B. Systematic Review of Sleep Duration and Development of Myopia. Cureus 2024; 16:e56216. [PMID: 38618360 PMCID: PMC11016326 DOI: 10.7759/cureus.56216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2024] [Indexed: 04/16/2024] Open
Abstract
There is a knowledge gap in the relationship between sleep duration and myopia. Since sleep duration is a modifiable risk factor, its association with the development and progression of myopia has implications for public health. This review was conducted in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The bibliographic databases of PubMed and Scopus were searched for published studies on the association between sleep duration and myopia. These databases were searched in December 2023 with no date or study design limits. The relevant literature was extracted and met the priori determined population (children, adolescents, and adults suffering from myopia with or without corrective glasses), intervention/exposure (sleep), and the outcome (various indicators of sleep especially sleep duration/bedtime/wake time and sleep quality). Data were gathered by gender, age, and refraction technique and standardized to the definition of myopia as refractive error ≥0.50 diopter. The relevant literature was extracted from these electronic databases using the keywords "sleep," "sleep duration," "bedtime," and "myopia." English language articles related to the topic were included. Articles that have discussed the role of risk factors for myopia but did not mention any relation to sleep were excluded. Sixteen studies were included after reviewing the relevant literature, and only six studies have shown a significant relationship between shorter duration of sleep and the development of myopia. This review suggests that apart from other environmental factors, sleep duration may have a role in developing myopia. Thus, increasing awareness about optimum sleep duration has a potential utility to reduce the development and progression of myopia.
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Affiliation(s)
- Omna Chawla
- Department of Physiology, Government Doon Medical College, Dehradun, IND
| | - Anupam Singh
- Department of Ophthalmology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Devesh Kumawat
- Department of Ophthalmology, All India Institute of Medical Sciences, New Delhi, New Delhi, IND
| | - Nilotpal Chowdhury
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
| | - Barun Kumar
- Department of Cardiology, All India Institute of Medical Sciences, Rishikesh, Rishikesh, IND
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6
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Biswas S, El Kareh A, Qureshi M, Lee DMX, Sun CH, Lam JSH, Saw SM, Najjar RP. The influence of the environment and lifestyle on myopia. J Physiol Anthropol 2024; 43:7. [PMID: 38297353 PMCID: PMC10829372 DOI: 10.1186/s40101-024-00354-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 01/05/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Myopia, commonly known as near-sightedness, has emerged as a global epidemic, impacting almost one in three individuals across the world. The increasing prevalence of myopia during early childhood has heightened the risk of developing high myopia and related sight-threatening eye conditions in adulthood. This surge in myopia rates, occurring within a relatively stable genetic framework, underscores the profound influence of environmental and lifestyle factors on this condition. In this comprehensive narrative review, we shed light on both established and potential environmental and lifestyle contributors that affect the development and progression of myopia. MAIN BODY Epidemiological and interventional research has consistently revealed a compelling connection between increased outdoor time and a decreased risk of myopia in children. This protective effect may primarily be attributed to exposure to the characteristics of natural light (i.e., sunlight) and the release of retinal dopamine. Conversely, irrespective of outdoor time, excessive engagement in near work can further worsen the onset of myopia. While the exact mechanisms behind this exacerbation are not fully comprehended, it appears to involve shifts in relative peripheral refraction, the overstimulation of accommodation, or a complex interplay of these factors, leading to issues like retinal image defocus, blur, and chromatic aberration. Other potential factors like the spatial frequency of the visual environment, circadian rhythm, sleep, nutrition, smoking, socio-economic status, and education have debatable independent influences on myopia development. CONCLUSION The environment exerts a significant influence on the development and progression of myopia. Improving the modifiable key environmental predictors like time spent outdoors and engagement in near work can prevent or slow the progression of myopia. The intricate connections between lifestyle and environmental factors often obscure research findings, making it challenging to disentangle their individual effects. This complexity underscores the necessity for prospective studies that employ objective assessments, such as quantifying light exposure and near work, among others. These studies are crucial for gaining a more comprehensive understanding of how various environmental factors can be modified to prevent or slow the progression of myopia.
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Affiliation(s)
- Sayantan Biswas
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Antonio El Kareh
- Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon
| | - Mariyem Qureshi
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
| | | | - Chen-Hsin Sun
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Janice S H Lam
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Seang-Mei Saw
- Singapore Eye Research Institute, Singapore, Singapore
- Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Raymond P Najjar
- Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
- Singapore Eye Research Institute, Singapore, Singapore.
- Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore.
- Department of Biomedical Engineering, College of Design and Engineering, National University of Singapore, Singapore, Singapore.
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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: 0] [Impact Index Per Article: 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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Alvarez-Peregrina C, Ruiz-Pomeda A, Martinez-Perez C, Prieto-Garrido FL, Villa-Collar C, Gonzalez-Perez M, Gonzalez-Abad A, Sanchez-Tena MA. Subjective behavioral measures in myopic and pre-myopic children before and after the COVID lockdown. Front Med (Lausanne) 2023; 10:1308423. [PMID: 38155664 PMCID: PMC10753851 DOI: 10.3389/fmed.2023.1308423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/28/2023] [Indexed: 12/30/2023] Open
Abstract
Background There are environmental factors that may contribute to the onset of myopia. This study aims to evaluate the children's lifestyle changes before and after the COVID-19 lockdown and how they can influence their vision. Methods The same questionnaire was administered to children aged between 5 and 7 in Spain every year in September before (2017-2019) and after the COVID-19 lockdown (2020-2021). All the children also passed a vision exam consisting of the measurement of visual acuity (VA) and determination of objective and subjective refraction. Children were classified as myopes, pre-myopes, or hyperopes. The cut-off points to define the refractive error were established according to the value of the spherical equivalent (SE): hyperopia (SE > +0,75D), myopia (SE ≤ -0,5D), or pre-myopia (-0.5D < SE ≥ +0.75D). Data analysis is performed with the SPSS 27.0 software (SPSS Inc., Chicago, Illinois). Results In the pre-COVID period, the pre-myopes were the ones who spent the longest time outdoors, and after the COVID lockdown, there were no differences between groups. There neither were any differences in the time spent doing near-work activities between the groups in both periods (p > 0.05). Regarding the spherical equivalent, in the pre-COVID period, the mean value was 0.75 ± 2.09D and after the COVID lockdown, it was 0.47 ± 1.88D (p < 0.001). Conclusion Pre-myopes spent more time outdoors than myopes in the pre-COVID period, while myopes spent more time using digital devices. All these differences do not exist after the COVID lockdown, with a general increase in the time spent outdoors and a decrease in the use of digital devices. Further studies are needed to know if these lifestyle changes remain and how they influence the onset of myopia.
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Affiliation(s)
- Cristina Alvarez-Peregrina
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Alicia Ruiz-Pomeda
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | | | - Francisco Luis Prieto-Garrido
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
- Fundación para la Investigación e Innovación Biomédica del Hospital Universitario del Henares (FIIB HHEN), Madrid, Spain
| | - Cesar Villa-Collar
- Faculty of Biomedical and Health Science, Universidad Europea de Madrid, Madrid, Spain
| | - Mariano Gonzalez-Perez
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
- Training and Development Department, Alain Afflelou Óptico, Madrid, Spain
| | - Ana Gonzalez-Abad
- Training and Development Department, Alain Afflelou Óptico, Madrid, Spain
| | - Miguel Angel Sanchez-Tena
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
- ISEC LISBOA-Instituto Superior de Educação e Ciências, Lisbon, Portugal
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9
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Tapasztó B, Flitcroft DI, Aclimandos WA, Jonas JB, De Faber JTHN, Nagy ZZ, Kestelyn PG, Januleviciene I, Grzybowski A, Vidinova CN, Guggenheim JA, Polling JR, Wolffsohn JS, Tideman JWL, Allen PM, Baraas RC, Saunders KJ, McCullough SJ, Gray LS, Wahl S, Smirnova IY, Formenti M, Radhakrishnan H, Resnikoff S, Németh J. Myopia management algorithm. Annexe to the article titled Update and guidance on management of myopia. European Society of Ophthalmology in cooperation with International Myopia Institute. Eur J Ophthalmol 2023:11206721231219532. [PMID: 38087768 DOI: 10.1177/11206721231219532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
Myopia is becoming increasingly common in young generations all over the world, and it is predicted to become the most common cause of blindness and visual impairment in later life in the near future. Because myopia can cause serious complications and vision loss, it is critical to create and prescribe effective myopia treatment solutions that can help prevent or delay the onset and progression of myopia. The scientific understanding of myopia's causes, genetic background, environmental conditions, and various management techniques, including therapies to prevent or postpone its development and slow its progression, is rapidly expanding. However, some significant information gaps exist on this subject, making it difficult to develop an effective intervention plan. As with the creation of this present algorithm, a compromise is to work on best practices and reach consensus among a wide number of specialists. The quick rise in information regarding myopia management may be difficult for the busy eye care provider, but it necessitates a continuing need to evaluate new research and implement it into daily practice. To assist eye care providers in developing these strategies, an algorithm has been proposed that covers all aspects of myopia mitigation and management. The algorithm aims to provide practical assistance in choosing and developing an effective myopia management strategy tailored to the individual child. It incorporates the latest research findings and covers a wide range of modalities, from primary, secondary, and tertiary myopia prevention to interventions that reduce the progression of myopia.
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Affiliation(s)
- Beáta Tapasztó
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
- Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
| | - Daniel Ian Flitcroft
- Temple Street Children's Hospital, Dublin, Ireland
- Centre for Eye Research Ireland (CERI) Technological University, Dublin, Ireland
| | | | - Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Zoltán Zsolt Nagy
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | | | | | - Andrzej Grzybowski
- Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznan, Poland
| | - Christina Nicolaeva Vidinova
- Department of Ophthalmology, Military Medical Academy, Sofia, Bulgaria
- Department of Optometry, Sofia University "St. Kliment Ohridski", Sofia, Bulgaria
| | | | - Jan Roelof Polling
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Optometry and Orthoptics, University of Applied Science, Utrecht, The Netherlands
| | - James S Wolffsohn
- Optometry and Vision Science Research Group, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - J Willem L Tideman
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department Ophthalmology, Martini Hospital, Groningen, The Netherlands
| | - Peter M Allen
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Rigmor C Baraas
- National Centre for Optics, Vision and Eye Care, University of South-Eastern Norway, Kongsberg, Norway
| | - Kathryn J Saunders
- Centre for Optometry and Vision Science, Ulster University, Coleraine, UK
| | - Sara J McCullough
- Centre for Optometry and Vision Science, Ulster University, Coleraine, UK
| | | | - Siegfried Wahl
- Institute for Ophthalmic Research, University Tübingen, Tübingen, Germany
- Carl Zeiss Vision International GmbH, Tübingen, Germany
| | | | - Marino Formenti
- Department of Physics, School of Science, University of Padova, Padova, Italy
| | - Hema Radhakrishnan
- Division of Pharmacy and Optometry, University of Manchester, Manchester, UK
| | - Serge Resnikoff
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
- Brien Holden Vision Institute, Sydney, Australia
| | - János Németh
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
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Liao S, Li X, Bai N, Wu D, Yang W, Wang F, Ji HZ. An empirical study on the effect of outdoor illumination and exercise intervention on Children's vision. Front Public Health 2023; 11:1270826. [PMID: 38155899 PMCID: PMC10754518 DOI: 10.3389/fpubh.2023.1270826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/28/2023] [Indexed: 12/30/2023] Open
Abstract
Objective To explore the relationship between outdoor lighting and sports and the development of myopia, and to analyze the effects of outdoor lighting and exercise on the diopter of children with normal vision and myopia, so as to provide guidance for the prevention and treatment of myopia in children and adolescents in the future. Methods A total of 201 children were divided into two groups according to myopia or not. Each group was randomly divided into 4 groups: outdoor exercise group, outdoor control group, indoor exercise group and indoor control group. Among them, the outdoor exercise group and indoor exercise group received moderate and high intensity aerobic exercise 3 times a week for 60 min each time for 12 months, while the outdoor control group and indoor control group had normal study and life during the corresponding period of time. No additional exercise intervention. At the end of the experiment, the diopter of each group was compared. Results The diopter of all groups with normal vision and myopia decreased significantly after the experiment (p < 0.01). There were significant differences in diopter between outdoor exercise group and indoor control group (p < 0.01), between outdoor exercise group and indoor control group (p < 0.05), and between indoor exercise group and indoor control group (p < 0.01). There were significant differences in diopter between indoor exercise group and indoor control group (p < 0.01). The differences among myopic children after the experiment showed that there was significant difference in diopter between outdoor exercise group and indoor exercise group (p < 0.05), between outdoor exercise group and indoor control group (p < 0.01), and between outdoor control group and indoor control group (p < 0.05). There were significant differences in the changes of diopter between the outdoor control group and the indoor exercise group with normal vision and myopia before and after the experiment (p < 0.05). Conclusion Outdoor light and exercise intervention can have a beneficial effect on children's vision, but because of whether children are myopic or not, the effect is different, outdoor light and exercise have a better effect on reducing the diopter of children with normal vision.
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Affiliation(s)
- Shuaixiong Liao
- Inner Mongolia University of Science and Technology, Baotou, China
| | - Xueying Li
- Inner Mongolia University of Science and Technology, Baotou, China
| | - Nan Bai
- Inner Mongolia University of Science and Technology, Baotou, China
| | | | - Wenliang Yang
- Inner Mongolia University of Science and Technology, Baotou, China
| | - Feng Wang
- Inner Mongolia University of Science and Technology, Baotou, China
| | - Hao Zong Ji
- Chongqing Liangjiang Yucai Middle School, Chongqing, China
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11
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Xu Q, Wang X, Bai Y, Zheng Y, Duan J, Du J, Wu X. Trends of non-melanoma skin cancer incidence in Hong Kong and projection up to 2030 based on changing demographics. Ann Med 2023; 55:146-154. [PMID: 36519234 PMCID: PMC9762823 DOI: 10.1080/07853890.2022.2154382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To assess the trends in non-melanoma skin cancer (NMSC) incidence in Hong Kong from 1990 to 2019 and the associations of age, calendar period, and birth cohort, to make projections to 2030, and to examine the drivers of NMSC incidence. METHODS We assessed the age, calendar period, and birth cohort effects of NMSC incidence in Hong Kong between 1990 and 2019 using an age-period-cohort model. Using Bayesian age-period-cohort analysis with integrated nested Laplace approximations, we projected the incidence of NMSC in Hong Kong to 2030. RESULTS From 1990 to 2019, the age-standardized incidence rate of NMSC increased from 6.7 per 100,000 population to 8.6 per 100,000 population in men and from 5.4 per 100,000 to 5.9 per 100,000 population in women, among the 19,568 patients in the study (9812 male patients [50.14%]). The annual net drift was 2.00% (95% confidence interval [CI]: 1.50-2.50%) for men and 1.53% (95% CI: 0.95-2.11%) for women. Local drifts increased for both sexes above the 35-39-year age group. The period and cohort risk of developing NMSC tended to rise but slowed gradually in the most recent period and post-1975 birth cohort. From 2019 to 2030, it is projected that the number of newly diagnosed NMSC cases in Hong Kong will increase from 564 to 829 in men and from 517 to 863 in women. Population aging, population growth, and epidemiologic changes contributed to the increase in incident NMSCs, with population aging being the most significant contributor. CONCLUSION The slowing of the period and cohort effects suggests that the rising incidence of NMSC is partly attributable to increased awareness and diagnosis. The increasing prevalence of NMSC among the elderly and an aging population will significantly impact the clinical workload associated with NMSC for the foreseeable future.
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Affiliation(s)
- Qingqiang Xu
- Institute of Dermatology, Shaanxi Institution of Traditional Chinese Medicine, Shaanxi Traditional Chinese Medicine Hospital, Xi'an, Shaanxi, China
| | - Xiaoyan Wang
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yan Bai
- School of Continuing Education, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yan Zheng
- Department of Dermatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Junbo Duan
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Jianqiang Du
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xiaoming Wu
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi, China
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Chen CS, Lin CF, Chou YL, Lee DY, Tien PT, Wang YC, Chang CY, Lin ES, Chen JJ, Wu MY, Ku H, Gan D, Chang YM, Lin HJ, Wan L. Acupuncture modulates development of myopia by reducing NLRP3 inflammasome activation via the dopamine-D1R signaling pathway. Acupunct Med 2023; 41:364-375. [PMID: 37211683 DOI: 10.1177/09645284231170886] [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] [Indexed: 05/23/2023]
Abstract
BACKGROUND Dopamine has been suggested to be a stop signal for eye growth and affects the development of myopia. Acupuncture is known to increase dopamine secretion and is widely used to treat myopia clinically. OBJECTIVE The aim of this study was to determine if acupuncture inhibits myopia progression in form deprived Syrian hamsters by inducing rises in dopamine content that in turn suppress inflammasome activation. METHODS Acupuncture was applied at LI4 and Taiyang every other day for 21 days. The levels of molecules associated with the dopamine signaling pathway, inflammatory signaling pathway and inflammasome activation were determined. A dopamine agonist (apomorphine) was used to evaluate if activation of the dopaminergic signaling pathway suppresses myopia progression by inhibiting inflammasome activation in primary retinal pigment epithelial (RPE) cells. A dopamine receptor 1 (D1R) inhibitor (SCH39166) was also administered to the hamsters. RESULTS Acupuncture inhibited myopia development by increasing dopamine levels and activating the D1R signaling pathway. Furthermore, we also demonstrated that nucleotide-binding oligomerization domain (NOD)-, leucine-rich repeat (LRR)- and pyrin domain-containing protein 3 (NLR) family pyrin domain-containing 3 (NLRP3) inflammasome activation was inhibited by activation of the D1R signaling pathway. CONCLUSION Our findings suggest that acupuncture inhibits myopia development by suppressing inflammation, which is initiated by activation of the dopamine-D1R signaling pathway.
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Affiliation(s)
- Chih-Sheng Chen
- Department of Food Nutrition and Health Biotechnology, Asia University, Taichung
- Division of Chinese Medicine, Asia University Hospital, Taichung
| | - Chi-Fong Lin
- PhD Program for Health Science and Industry, China Medical University, Taichung
| | - Yung-Lan Chou
- School of Chinese Medicine, China Medical University, Taichung
| | - Der-Yen Lee
- Graduate Institute of Integrated Medicine, China Medical University, Taichung
| | - Peng-Tai Tien
- Eye Center, China Medical University Hospital, Taichung
| | - Yao-Chien Wang
- Department of Emergency Medicine, Taichung Tzu Chi Hospital, Taichung
| | - Ching-Yao Chang
- Department of Medical Laboratory Science and Biotechnology, Asia University, Taichung
| | - En-Shyh Lin
- Department of Beauty Science, National Taichung University of Science and Technology, Taichung
| | | | - Ming-Yen Wu
- Eye Center, China Medical University Hospital, Taichung
| | - Hsiangyu Ku
- Department of Ophthalmology and Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Dekang Gan
- Department of Ophthalmology and Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Yung-Ming Chang
- The School of Chinese Medicine for Post Baccalaureate, I-Shou University, Kaohsiung
- Department of Chinese Medicine, 1PT Biotechnology Co., Ltd., Taichung
| | - Hui-Ju Lin
- School of Chinese Medicine, China Medical University, Taichung
- Graduate Institute of Integrated Medicine, China Medical University, Taichung
| | - Lei Wan
- School of Chinese Medicine, China Medical University, Taichung
- Department of Medical Laboratory Science and Biotechnology, Asia University, Taichung
- Department of Obstetrics and Gynecology, China Medical University Hospital, Taichung
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Xu S, Jiang J, Yu M, Gao J, Wang M, Kuang L, Hu Y, Kee CS, Yang X, He M. Effect of COVID-19 home confinement on the efficacy of orthokeratology, 0.01% atropine and combined treatment. Acta Ophthalmol 2023. [PMID: 37983888 DOI: 10.1111/aos.15818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/08/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023]
Abstract
PURPOSE To investigate the effect of COVID-19 home confinement on the efficacy of the interventions for controlling myopia, and to select effective therapies to control myopia during COVID-19 confinement. METHOD Children (n = 164) aged 8-12 years with spherical equivalent refraction of -1.00 to -6.00 diopters were stratified into two age subgroups and randomly allocated into the control, 0.01% atropine, orthokeratology (ortho-k) and atropine combined ortho-k (ACO) groups. Axial length (AL) was measured at baseline, 6-, 12-, 18- and 24-month visits. The follow-up spanned the period before the COVID-19 outbreak, the period of the home confinement, and the period of the school reopening. Hence, the AL change in different periods was collected and compared. Data analysis was performed following the criteria of intention to treat (ITT). RESULTS All 164 children were involved in the ITT analysis. Compared to control, all interventions can still reduce the AL elongation during the COVID-19 home confinement period (all p < 0.05). However, the efficacy was compromised: individuals experienced more AL elongation during the COVID-19 home confinement period in the control, 0.01% atropine and ACO groups (all p < 0.05). Interestingly, in the ortho-k group, the difference was insignificant (p = 0.178), and the interaction between the intervention type (control vs. ortho-k) and the confinement severity was significant (p for interaction = 0.041), which is different from the atropine (p for interaction = 0.248) or ACO group (p for interaction = 0.988). These results were stable after being adjusted by other variables based on the multivariable regression model. CONCLUSION Ortho-k was less affected by the COVID-19 home confinement, which is potentially a better therapy for children in this high-risk environment. Further investigations are warranted to validate this issue.
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Affiliation(s)
- Shengsong Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Jinyun Jiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Mengting Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Jiajia Gao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Mengyi Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Longhao Kuang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Yin Hu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Chea-Su Kee
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Xiao Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Mingguang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Victoria, Australia
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Hansen NC, Hvid-Hansen A, Møller F, Bek T, Larsen DA, Jacobsen N, Kessel L. Safety and efficacy of 0.01% and 0.1% low-dose atropine eye drop regimens for reduction of myopia progression in Danish children: a randomized clinical trial examining one-year effect and safety. BMC Ophthalmol 2023; 23:438. [PMID: 37904082 PMCID: PMC10614417 DOI: 10.1186/s12886-023-03177-9] [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: 06/19/2023] [Accepted: 10/14/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND To investigate the efficacy and safety of 0.1% and 0.01% low-dose atropine eye drops in reducing myopia progression in Danish children. METHODS Investigator-initiated, placebo-controlled, double-masked, randomized clinical trial. Ninety-seven six- to twelve-year old myopic participants were randomized to 0.1% loading dose for six months followed by 0.01% for six months (loading dose group, Number (N) = 33), 0.01% for twelve months (0.01% group, N = 32) or vehicle for twelve months (placebo, N = 32). Primary outcomes were axial length and spherical equivalent refraction. Secondary outcomes included adverse events and reactions, choroidal thickness and ocular biometry. Outcomes were measured at baseline and three-month intervals. Data was analyzed with linear-mixed model analysis according to intention-to-treat. RESULTS Mean axial elongation was 0.10 mm less (95% confidence interval (CI): 0.17; 0.02, adjusted-p = 0.06) in the 0.1% loading dose and 0.07 mm less (95% CI: 0.15; 0.00, adjusted-p = 0.16) in the 0.01% group at twelve months compared to placebo. Mean spherical equivalent refraction progression was 0.24 D (95% CI: 0.05; 0.42) less in the loading dose and 0.19 D (95% CI: 0.00; 0.38) less in the 0.01% groups at twelve months, compared to placebo (adjusted-p = 0.06 and 0.14, respectively). A total of 108 adverse events were reported during the initial six-month loading dose period, primarily in the loading dose group, and 14 were reported in the six months following dose switching, all deemed mild except two serious adverse events, unrelated to the intervention. CONCLUSIONS Low-dose atropine eye drops are safe over twelve months in otherwise healthy children. There may be a modest but clinically relevant reduction in myopia progression in Danish children after twelve months treatment, but the effect was statistically non-significant after multiple comparisons adjustment. After dose-switching at six months the loading dose group approached the 0.01% group, potentially indicating an early "rebound-effect". TRIAL REGISTRATION this study was registered in the European Clinical Trials Database (EudraCT, number: 2018-001286-16) 05/11/2018 and first posted at www. CLINICALTRIALS gov (NCT03911271) 11/04/2019, prior to initiation.
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Affiliation(s)
- Niklas Cyril Hansen
- Department of Ophthalmology, Copenhagen University Hospital - Rigshospitalet-Glostrup, Valdemar Hansens Vej 1-23, DK-2600, Glostrup, Denmark.
| | - Anders Hvid-Hansen
- Department of Ophthalmology, Copenhagen University Hospital - Rigshospitalet-Glostrup, Valdemar Hansens Vej 1-23, DK-2600, Glostrup, Denmark
| | - Flemming Møller
- Department of Ophthalmology, University Hospital of Southern Denmark - Vejle Hospital, Beriderbakken 4, DK-7100, Vejle, Denmark
| | - Toke Bek
- Department of Ophthalmology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 167, DK-8200, Aarhus, Denmark
| | - Dorte Ancher Larsen
- Department of Ophthalmology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 167, DK-8200, Aarhus, Denmark
| | - Nina Jacobsen
- Department of Ophthalmology, Copenhagen University Hospital - Rigshospitalet-Glostrup, Valdemar Hansens Vej 1-23, DK-2600, Glostrup, Denmark
| | - Line Kessel
- Department of Ophthalmology, Copenhagen University Hospital - Rigshospitalet-Glostrup, Valdemar Hansens Vej 1-23, DK-2600, Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3b 33.5, DK-2200, Copenhagen, Denmark
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Tariq F, Mobeen R, Wang X, Lin X, Bao Q, Liu J, Gao H. Advances in myopia prevention strategies for school-aged children: a comprehensive review. Front Public Health 2023; 11:1226438. [PMID: 37655278 PMCID: PMC10466414 DOI: 10.3389/fpubh.2023.1226438] [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: 05/21/2023] [Accepted: 07/24/2023] [Indexed: 09/02/2023] Open
Abstract
Myopia has significantly risen in East and Southeast Asia, and the pathological outcomes of this condition, such as myopic maculopathy and optic neuropathy linked to high myopia, have emerged as leading causes of irreversible vision loss. Addressing this issue requires strategies to reduce myopia prevalence and prevent progression to high myopia. Encouraging outdoor activities for schoolchildren and reducing near-work and screen time can effectively prevent myopia development, offering a safe intervention that promotes healthier habits. Several clinical approaches can be employed to decelerate myopia progression, such as administering low-dose atropine eye drops (0.05%), utilizing orthokeratology lenses, implementing soft contact lenses equipped with myopia control features, and incorporating spectacle lenses with aspherical lenslets. When choosing an appropriate strategy, factors such as age, ethnicity, and the rate of myopia progression should be considered. However, some treatments may encounter obstacles such as adverse side effects, high costs, complex procedures, or limited effectiveness. Presently, low-dose atropine (0.05%), soft contact lenses with myopia control features, and orthokeratology lenses appear as promising options for managing myopia. The measures mentioned above are not necessarily mutually exclusive, and researchers are increasingly exploring their combined effects. By advocating for a personalized approach based on individual risk factors and the unique needs of each child, this review aims to contribute to the development of targeted and effective myopia prevention strategies, thereby minimizing the impact of myopia and its related complications among school-aged children in affected regions.
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Affiliation(s)
- Farheen Tariq
- Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Rabia Mobeen
- School of Optometry and Vision Science, UNSW Sydney, Sydney, NSW, Australia
| | - Xinhai Wang
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Xiao Lin
- Shandong University of Traditional Chinese Medicine, Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Qingdong Bao
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Jinhui Liu
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- School of Ophthalmology, Shandong First Medical University, Jinan, China
| | - Hua Gao
- Eye Hospital of Shandong First Medical University (Shandong Eye Hospital), Jinan, China
- School of Ophthalmology, Shandong First Medical University, Jinan, China
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Eye Institute of Shandong First Medical University, Qingdao, China
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Huang CY, Chen CM, Chang CK. Decision Behavior and Influential Factors of Spectacle Prescription for Schoolchildren in Taiwan. CLINICAL OPTOMETRY 2023; 15:159-166. [PMID: 37551197 PMCID: PMC10404432 DOI: 10.2147/opto.s424678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 07/27/2023] [Indexed: 08/09/2023]
Abstract
Purpose The prevalence of children myopia in Taiwan is among the highest in the world. The study aimed to understand the status of the final prescription of the spectacle prescribed by the Taiwan optometrists when they conducted the visual inspection of elementary school, middle school and high school students, and to evaluate the influencing factors of their decision-making behavior. Methods Among the attendants of the continuing education course activities held by optometrist associations in Taiwan, an anonymous questionnaire survey was given on the spot to optometrists who have passed the national examination. This study received 442 questionnaire surveys, including 174 optometrists and 268 assistant optometrists. The data were analyzed by using chi-square test in IBM SPSS. Results There are statistically significant differences in the decision-making of spectacle prescription for myopia of -1.00D~-1.50D and -2.25D~-2.50D in the primary school stage between optometrists and assistant optometrists. There are also significant differences for myopia of -2.25D and above in the middle school students. By the time of high school, there are significant differences for myopia from -0.75D to -3.25D and above. The higher the grade, the greater the difference in the final prescription of the spectacles given. As for the judgment factors of the final prescription, only children among elementary school and junior high school show a statistically significant difference in professional judgment between optometrists and assistant optometrists. There is no significant difference in the judgment factors for high school children. Depending on the educational level of optometrists and assistant optometrists and their distribution area, the prescription decisions are also different. Conclusion The optometrists prefer to prescribe full correction for schoolchildren, while the assistant optometrists mostly prescribe under-correction in prescriptions for low-degree myopia and lower grades. Further investigation is needed to study its impact on children's visual health.
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Affiliation(s)
- Ching Yao Huang
- Department of Optometry, Da-Yeh University, Changhua, Taiwan
| | - Chih Ming Chen
- Department of Optometry, Da-Yeh University, Changhua, Taiwan
| | - Chao Kai Chang
- Department of Optometry, Da-Yeh University, Changhua, Taiwan
- Nobel Eye Institute, Taipei, Taiwan
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Peng W, Zhang Z, Wang F, Sun S, Sun Y. Association of educational environment with the prevalence of myopia: a cross-sectional study in central China. Front Public Health 2023; 11:1188198. [PMID: 37397761 PMCID: PMC10308441 DOI: 10.3389/fpubh.2023.1188198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/01/2023] [Indexed: 07/04/2023] Open
Abstract
Purposes This study was to estimate the prevalence of myopia among primary school students in Hefei, China, and evaluate the association of educational environment with myopia. Methods This study was a cross-sectional study, and recruited primary school students in grades 1-6. Children underwent a stepwise ophthalmic examination, which included visual acuity and objective cycloplegic refraction to identify children with myopia. Under the guidance of parents, children completed a questionnaire, including gender, region, grade and several indicators related to education. The study analyzed the risk factors by using a logistic regression and assessed feature importance by using a random forest algorithm. Results A total of 3,596 primary school students were involved in this analysis, and the overall prevalence of myopia was 27.1%. Gender, grade, education level of the father, education level of the mother, academic level of children, hours of homework per day on weekends, number of after-school tutoring per week and frequency of extracurricular reading were significantly associated with myopia. There was no significant association between the amount of homework per day on school days and myopia after adjusting for covariates. In terms of educational environment, the top 3 factors were academic level of children, homework on weekends and after-school tutoring. Conclusions Educational environment with high educational loads was associated with the high prevalence of myopia. Reducing the burden of studying, especially that after class, was an effective way to prevent myopia.
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Affiliation(s)
- Wei Peng
- Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China
- University of Science and Technology of China, Hefei, China
| | - Zikang Zhang
- Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China
- University of Science and Technology of China, Hefei, China
| | - Fei Wang
- The Second Hospital of Anhui Medical University, Hefei, China
| | - Shaoming Sun
- Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China
- CAS Hefei Institute of Technology Innovation, Hefei, China
| | - Yining Sun
- Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, China
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18
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Manoharan MK, Thakur S, Dhakal R, Gupta SK, Priscilla JJ, Bhandary SK, Srivastava A, Marmamula S, Poigal N, Verkicharla PK. Myopia progression risk assessment score (MPRAS): a promising new tool for risk stratification. Sci Rep 2023; 13:8858. [PMID: 37258536 DOI: 10.1038/s41598-023-35696-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 05/22/2023] [Indexed: 06/02/2023] Open
Abstract
Timely identification of individuals "at-risk" for myopia progression is the leading requisite for myopia practice as it aids in the decision of appropriate management. This study aimed to develop 'myopia progression risk assessment score' (MPRAS) based on multiple risk factors (10) to determine whether a myope is "at-risk" or "low-risk" for myopia progression. Two risk-score models (model-1: non-weightage, model-2: weightage) were developed. Ability of MPRAS to diagnose individual "at-risk" for myopia progression was compared against decision of five clinicians in 149 myopes, aged 6-29 years. Using model-1 (no-weightage), further 7 sub-models were created with varying number of risk factors in decreasing step-wise manner (1a: 10 factors to 1g: 4 factors). In random eye analysis for model-1, the highest Youden's J-index (0.63-0.65) led to the MPRAS cut-off score of 41.50-43.50 for 5 clinicians with a sensitivity ranging from 78 to 85% and specificity ranging from 79 to 87%. For this cut-off score, the mean area under the curve (AUC) between clinicians and the MPRAS model ranged from 0.89 to 0.90. Model-2 (weighted for few risk-factors) provided similar sensitivity, specificity, and AUC. Sub-model analysis revealed greater AUC with high sensitivity (89%) and specificity (94%) in model-1g that has 4 risk factors compared to other sub-models (1a-1f). All the MPRAS models showed good agreement with the clinician's decision in identifying individuals "at-risk" for myopia progression.
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Affiliation(s)
- Manoj K Manoharan
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India
- Infor Myopia Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Swapnil Thakur
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India
| | - Rohit Dhakal
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India
- Infor Myopia Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Satish K Gupta
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India
| | - Jacinth J Priscilla
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India
| | - Shashank K Bhandary
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India
| | - Alok Srivastava
- L V Prasad Eye Institute, Hyderabad, Telangana, India
- Sri Innovation and Research Foundation, Ghaziabad, Uttar Pradesh, India
| | - Srinivas Marmamula
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Nitish Poigal
- L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Pavan K Verkicharla
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Brien Holden Institute of Optometry and Vision Sciences, L V Prasad Eye Institute, Kallam Anji Reddy Campus, Hyderabad, Telangana, 500034, India.
- Infor Myopia Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India.
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19
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Lou L, Ostrin LA. The outdoor environment affects retinal and choroidal thickness. Ophthalmic Physiol Opt 2023; 43:572-583. [PMID: 36779486 PMCID: PMC10081136 DOI: 10.1111/opo.13107] [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: 11/21/2022] [Revised: 01/27/2023] [Accepted: 01/28/2023] [Indexed: 02/14/2023]
Abstract
PURPOSE Accumulating evidence suggests that time outdoors is protective against myopia development and that the choroid may be involved in this effect. The goal of this study was to examine the effect of 2 h of time outdoors in sunlight on retinal and choroidal thickness in adults. METHODS Twenty adults, ages 23-46 years, each participated in three experimental sessions on different days, consisting of 2 h of exposure to (1) indoor illumination (350 lux), (2) darkness (<0.1 lux) or (3) outdoor environment (6000-50,000 lux). Spectral-domain optical coherence tomography (SD-OCT) imaging was conducted at baseline, after 1 and 2 h of exposure, and after 1 and 2 h of follow-up. Choroidal, total retinal, photoreceptor outer segment + retinal pigment epithelium (RPE) and photoreceptor inner segment thicknesses were determined. RESULTS At 2 h, the choroid was significantly thinner during the outdoor compared with the indoor and dark conditions (p < 0.01) but was not significantly different at follow-up. Total retinal thickness was significantly thicker during and after the outdoor compared with the indoor and dark conditions. The outer segment + RPE was significantly thinner during the outdoor compared with the indoor condition but was not significantly different at follow-up. The inner segment was significantly thicker during the outdoor compared with the indoor and dark conditions during exposure and follow-up. CONCLUSIONS Spending 2 h outdoors under high-intensity sunlight resulted in an unexpected thinning of the choroid, which recovered post-exposure. Retinal thickness showed different responses to the outdoor and indoor environments and was sensitive to the duration of exposure.
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Affiliation(s)
- Linjiang Lou
- College of Optometry, University of Houston, Houston, Texas, USA
| | - Lisa A. Ostrin
- College of Optometry, University of Houston, Houston, Texas, USA
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20
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Dhakal R, Huntjens B, Shah R, Lawrenson JG, Verkicharla PK. Influence of location, season and time of day on the spectral composition of ambient light: Investigation for application in myopia. Ophthalmic Physiol Opt 2023; 43:220-230. [PMID: 36637143 DOI: 10.1111/opo.13085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 01/14/2023]
Abstract
PURPOSE Given the possible role of spectral composition of light and myopia, this study aimed at investigating the variation in the spectral composition of ambient light in different (a) outdoor/indoor locations, (b) time of a day and (c) seasons. METHODS The spectral power distribution (SPD), categorised into short (380-500 nm), middle (505-565 nm) and long wavelengths (625-780 nm), was recorded using a handheld spectrometer at three outdoor locations ('open playground', 'under shade of tree' and 'canopy') and three indoor locations ('room with multiple windows', 'closed room' and 'closed corridor'). Readings were taken at five different time points (3-h intervals between 6:30 and 18:00 hours) on two days, each during the summer and monsoon seasons. RESULTS The overall median SPD (IQR [25th-75th percentile] W/nm/m2 ) across the three outdoor locations (0.11 [0.09, 0.12]) was 157 times higher than that of the indoor locations (0.0007 [0.0001, 0.001]). Considerable locational, diurnal and seasonal variation was observed in the distribution of the median SPD value, with the highest value being recorded in the 'open playground' (0.27 [0.21, 0.28]) followed by 'under shade of tree' (0.083 [0.074, 0.09]), 'canopy' (0.014 [0.012, 0.015]) and 'room with multiple windows' (0.023 [0.015, 0.028]). The relative percentage composition of short, middle and long wavelengths was similar in both the outdoor and indoor locations, with the proportion of middle wavelengths significantly higher (p < 0.01) than short and long wavelengths in all the locations, except 'canopy'. CONCLUSION Irrespective of variation in SPD values with location, time, day and season, outdoor locations always exhibited significantly higher spectral power than indoor locations. The relative percentage composition of short, middle and long wavelengths of light was similar across all locations. These findings establish a foundation for future research to understand the relationship between spectral power and the development of myopia.
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Affiliation(s)
- Rohit Dhakal
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Infor Myopia Centre, L V Prasad Eye Institute, Hyderabad, India.,Centre for Applied Vision Research, School of Health Sciences, City University of London, London, UK
| | - Byki Huntjens
- Centre for Applied Vision Research, School of Health Sciences, City University of London, London, UK
| | - Rakhee Shah
- Centre for Applied Vision Research, School of Health Sciences, City University of London, London, UK
| | - John G Lawrenson
- Centre for Applied Vision Research, School of Health Sciences, City University of London, London, UK
| | - Pavan K Verkicharla
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, Infor Myopia Centre, L V Prasad Eye Institute, Hyderabad, India
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21
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Jawaid I, Wacogne ID, Abbott J. Increased short-sightedness in younger children associated with home schooling and confinement. Arch Dis Child Educ Pract Ed 2023; 108:51-52. [PMID: 34493598 DOI: 10.1136/archdischild-2021-322574] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Imran Jawaid
- Department of Paediatric Ophthalmology, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
| | - Ian D Wacogne
- Department of Paediatric Ophthalmology, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
| | - Joseph Abbott
- Department of Paediatric Ophthalmology, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK
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22
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Zhu Z, Chen Y, Tan Z, Xiong R, McGuinness MB, Müller A. Interventions recommended for myopia prevention and control among children and adolescents in China: a systematic review. Br J Ophthalmol 2023; 107:160-166. [PMID: 34844916 DOI: 10.1136/bjophthalmol-2021-319306] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 11/09/2021] [Indexed: 01/25/2023]
Abstract
In 2018, a consortium of government bodies in China led by the Ministry of Education released the Comprehensive Plan to Prevent Nearsightedness among Children and Teenagers (CPPNCT), aiming to reduce the incidence of myopia and control myopic progression in China. Recommendations span from home-based to school-based interventions, including time outdoors, physical activity, light exposure, near-work activity, screen time, Chinese eye exercises, diet and sleep. To date, the levels of evidence for this suite of interventions have not been thoroughly investigated. This review has summarised the evidence of the interventions recommended by the CPPNCT in myopia prevention and control. Thus, the following statements are supposed by the evidence: (1) Increasing time outdoors and reducing near-work time are effective in lowering incident myopia in school-aged children. (2) All interventions have a limited effect on myopia progression. Ongoing research may lead to a better understanding of the underlying mechanisms of myopia development, the interaction of different interventions and recommendations, confounding variables and their true effect on myopia prevention, and the identification of those most likely to respond to specific interventions. This field may also benefit from longer-term studies of the various interventions or strategies covered within this review article, to better understand the persistence of treatment effects over time and explore more novel approaches to myopia control.
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Affiliation(s)
- Zhuoting Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yanxian Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Zachary Tan
- Centre for Eye Research Australia, East Melbourne, Victoria, Australia
| | - Ruilin Xiong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Myra Beth McGuinness
- Centre for Eye Research Australia, East Melbourne, Victoria, Australia.,Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Andreas Müller
- Department of Noncommunicable Diseases, World Health Organization, Geneva, Switzerland
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23
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Hashemi H, Khabazkhoob M, Fayaz M, Emamian MH, Yekta A, Iribarren R, Fotouhi A. Refractive Errors and Their Associated Factors in Schoolchildren: A Structural Equation Modeling. Ophthalmic Epidemiol 2023; 30:46-56. [PMID: 35333680 DOI: 10.1080/09286586.2022.2048397] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE To determine the prevalence of myopia and hyperopia in Shahroud schoolchildren and their risk factors. METHODS Optometric examinations including the measurement of uncorrected and corrected visual acuity as well as non-cycloplegic and cycloplegic refraction using retinoscopy were done for students. Generalized Structural Equation Modeling (GSEM) was used to determine direct and indirect effects of independent variables on myopia and hyperopia. RESULTS The data of 5581 students with a mean age of 9.24 ± 1.7 years were used in this study. The prevalence of myopia was 5.0% (95%CI: 4.3-5.7) and the prevalence of hyperopia was 4.8% (95%CI: 4.0 - 5.5) in all schoolchildren. According to the GSEM results, the odds of myopia in rural areas were 0.55 compared to urban areas. A one-unit increase in the ocular AL increased the odds of myopia by 4.91 times. The interaction of sex and age on myopia was significant such that in girls, the odds of myopia increased by 20% for every one-year increase in age while no significant change was seen in boys. A one-unit increase in the ocular AL decreased the odds of hyperopia by 0.49 times. Moreover, the interaction of outdoor activity hours and sex on the prevalence of hyperopia was significant such that increased outdoor activity reduced the odds of hyperopia in girls while no significant correlation was found in boys. CONCLUSION Myopia and hyperopia had moderate prevalence. Axial Length had the largest direct association on myopia and hyperopia. Age and outdoor activity had weak associations on refractive errors.
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Affiliation(s)
- Hassan Hashemi
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Psychiatric Nursing and Management, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahsa Fayaz
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mohammad Hassan Emamian
- Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Abbasali Yekta
- Department of Optometry, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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24
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Althnayan YI, Almotairi NM, Alharbi MM, Alamer HB, Alqahtani HB, Alfreihi S. Myopia Progression Among School-Aged Children in the COVID-19 Distance-Learning Era. Clin Ophthalmol 2023; 17:283-290. [PMID: 36711259 PMCID: PMC9880015 DOI: 10.2147/opth.s381061] [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: 08/28/2022] [Accepted: 01/06/2023] [Indexed: 01/21/2023] Open
Abstract
Objective To investigate the effect of online learning and other environmental factors on myopia progression during the Coronavirus pandemic (COVID-19). Methods A retrospective cohort study from 2018 to 2021. Data from children aged 6-14 were gathered during three visits: pre-pandemic, at the beginning, and during the pandemic. Demographics (hours spent on screens for educational, recreational purposes, outdoors, and type of screen), best-corrected distance visual acuity (BCDVA), uncorrected distance visual acuity (UCDVA), and cycloplegic refraction were gathered. Results Of 150 patients, 70 [47%] were boys. The mean age was 11 (2.4) years. Participants mainly used mobile phones (62%) and had insufficient outdoor play (88%). Of the 300 eyes, 221 (74%) showed myopia progression. A significant difference in spherical equivalent (SE) was found between pre-pandemic and post-pandemic periods (-0.29 (0.23) D vs -0.40 (0.11) D; p =0.023). Additionally, UCDVA showed a difference between the initial and 1st follow-up visits (0.57 (0.37) vs 0.64 (0.36), p =0.001), and the first and 2nd follow-up visits (0.64 (0.36) vs 0.70 (0.36), p =0.001). Significant hazard ratio for change in SE in patients with higher age (>9 years), (HR [95% confidence interval (CI)], 0.71 [0.51-0.84]), greater recreational screen usage (HR [95% CI], 1.26 [1.15-1.66]), and insufficient outdoor time (HR [95% CI], 1.45 [1.35-1.67]). Conclusion Myopia progression was accelerated during the COVID-19 pandemic. Younger age, prolonged screen use, and insufficient outdoor time contributed to increased myopia progression. However, the type of device used had no significant effect.
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Affiliation(s)
- Yasser I Althnayan
- Ophthalmology Division, Department of Surgery, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia,King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia
| | - Nawal M Almotairi
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia,Department of Optometry, College of Applied Medical Science, King Saud University, Riyadh, Riyadh Province, Saudi Arabia
| | - Manal M Alharbi
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia,Department of Optometry, College of Applied Medical Science, King Saud University, Riyadh, Riyadh Province, Saudi Arabia
| | - Hadeel B Alamer
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia,Paediatric Ophthalmology Division, Paediatric Surgery Department, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Hanan B Alqahtani
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia,Department of Optometry, College of Applied Medical Science, King Saud University, Riyadh, Riyadh Province, Saudi Arabia,Paediatric Ophthalmology Division, Paediatric Surgery Department, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
| | - Shatha Alfreihi
- King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia,Paediatric Ophthalmology Division, Paediatric Surgery Department, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia,College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia,Correspondence: Shatha Alfreihi, King Abdullah Specialist Children’s Hospital, P.O. Box 22490, Riyadh, 11426, Saudi Arabia, Tel +966-11-8011111, Fax +966-11-8011000 EXT 53273, 53320, Email
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25
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Liu Z, Wang Q, Zhao Q, Gao F, Jin N, Wang D, Wang B, Du B, Wei R. Association between whole-grain intake and myopia in chinese children: a cross-sectional epidemiological study. BMC Ophthalmol 2023; 23:1. [PMID: 36593443 PMCID: PMC9809013 DOI: 10.1186/s12886-022-02764-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 12/30/2022] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Nutritional status influences the growth and development of the eyes. However, there are few studies on the association between diet, especially whole grains (WG) consumption, and myopia. The study aimed to evaluate the association between WG intake and myopia prevalence among primary school-age children in China. METHODS This cross-sectional epidemiological study conducted between November 2019 and December 2019 included 586 children, aged 6-12 years, attending primary school in Binhai district, Tianjin, China. Ophthalmologic examinations and optometric cycloplegic refraction measurements were conducted. Information was collected on known risks and protective factors for myopia and the consumption of WGs, vegetables, and fruits. This association between the probability of myopia and the proportion of WG consumption (WG proportion was calculated as the mean intake from WG sources divided by total grain intake), adjusted for protective and risk factors, was analysed using crude and multivariable logistic regression. RESULTS Among the study participants, 226/586 (38.57%) children had myopia in at least one eye. WG intake was inversely correlated with the prevalence of myopia. Furthermore, in the multivariate analysis, WG intake of > 50% was identified as a protective factor against myopia after subsequent adjustment for children's age, sex, parental myopia, near-work activity, screen time, reading and writing habits, visual fatigue, outdoor time, and classroom light environment (all P < 0.05). CONCLUSION WG intake (> 50%) was an independent protective factor against myopia. Modifying the form of grains consumed (whole versus refined) could be one of the targets of future public health measures.
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Affiliation(s)
- Zhuzhu Liu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute, School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Qingxin Wang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute, School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Qianyu Zhao
- State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, China
| | - Fei Gao
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute, School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Nan Jin
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute, School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Di Wang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute, School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Biying Wang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute, School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Bei Du
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute, School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.
| | - Ruihua Wei
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute, School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.
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Lanca C, Repka MX, Grzybowski A. Topical Review: Studies on Management of Myopia Progression from 2019 to 2021. Optom Vis Sci 2023; 100:23-30. [PMID: 36705712 DOI: 10.1097/opx.0000000000001947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
SIGNIFICANCE Myopia is a common eye condition that increases the risk of sight-threatening complications. Each additional diopter increases the chance of complications. The purpose of this review was to make an overview of myopia control treatment options for children with myopia progression.In this nonsystematic review, we searched PubMed and Cochrane databases for English-language studies published from 2019 to September 2021. Emphasis was given to selection of randomized controlled trials. Nineteen randomized controlled trials and two retrospective studies were included. Topical atropine and orthokeratology remain the most used treatments, whereas lenses with novel designs are emerging treatments. Overall myopia progression in the treatment groups for low-dose atropine and orthokeratology was lower than in the control groups, and their efficacy was reported in several randomized controlled trials and confirmed by various systematic reviews and meta-analysis. The findings of myopia progression and axial elongation for the MiSight, defocus incorporated multiple segment spectacle lens, highly aspherical lenslets, and diffusion optics technology spectacle lens were comparable. Public health interventions to optimize environmental influences may also be important strategies to control myopia. Optimal choice of management of myopia depends on treatment availability, acceptability to child and parents, and specific patient features such as age, baseline myopia, and lifestyle. Eye care providers need to understand the advantages and disadvantages of each therapy to best counsel parents of children with myopia.
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Affiliation(s)
| | - Michael X Repka
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
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27
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Relatively Stable Prevalence of Myopia among Swedish Children Aged 4 to 7 Years between 2015 and 2020. Optom Vis Sci 2023; 100:91-95. [PMID: 36473085 DOI: 10.1097/opx.0000000000001972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
SIGNIFICANCE The global increase of myopia has caused a lot of debate the last years. Previous research of myopia in the Nordic population has shown diverse results, and only a few Swedish studies have been published in the subject the last two decades. PURPOSE This study aimed to analyze trends in the prevalence of myopia in a population of Swedish children. METHODS A retrospective analysis of medical records for children between 4 and 7 years of age in a region in Sweden was performed. The inclusion criterion was a first glasses prescription for myopia between 2012 and 2020. Children with other eye diseases or syndromes affecting the eye and vision were excluded. Age, sex, uncorrected visual acuity, and cycloplegic refractive values were extracted. The number of myopic children was compared with population data to calculate incidence and estimate prevalence. RESULTS During the study period, 427 children between 4 and 7 years old in an average population of 17,200 children were prescribed glasses for myopia. The incidence for myopia increased from 0.11% in 2012 to 0.39% in 2020 ( P < .05). In 2015 to 2020, the prevalence of myopia for the same age group increased from 0.5 to 1.2% ( P < .05). Linear regression of the prevalence of myopia showed a significant increase in the age group of 7 years ( β = 0.2%, R2 = 0.82, P ≤ .05). CONCLUSIONS This study found a relatively stable prevalence of myopia among Swedish children aged 4 to 7 years between 2015 and 2020. The prevalence of 1.6% among 7-year-old children is not higher than in previous Scandinavian studies.
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Martínez-Pérez C, Villa-Collar C, Santodomingo-Rubido J, Wolffsohn JS. Strategies and attitudes on the management of myopia in clinical practice in Spain. JOURNAL OF OPTOMETRY 2023; 16:64-73. [PMID: 35365431 PMCID: PMC9811371 DOI: 10.1016/j.optom.2022.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/14/2022] [Accepted: 03/06/2022] [Indexed: 06/02/2023]
Abstract
OBJECTIVE In 2019, an international survey was conducted to evaluate strategies and attitudes in the management of myopia in clinical practice worldwide. This study reports on the results found in Spain and how these results compare with those from other regions of the world. METHODS A self-administrated, internet-based questionnaire was distributed to eye care professionals around the world through professional associations. The questions examined were based on the available strategies and their use. RESULTS A total of 173 Spanish optometrists, of the 1,336 practitioners from the five different continents who participated in the study, responded to the online survey. Spain, Asia and South America were found among the regions with the highest concern regarding the increased incidence of myopia (p ≤ 0.001). However, in these regions, the prescription of single-vision spectacles and single-vision contact lenses continues to be the main methods of visual correction prescribed to young myopic patients (p ≤ 0.001). Spanish practitioners, like those from other regions, considered orthokeratology to be the most effective treatment to control myopia progression (p ≤ 0.001). The major reasons why Spanish practitioners were not prescribing myopia control strategies were increased cost, inadequate information and unpredictable outcomes (p < 0.05). CONCLUSIONS The uptake of myopia control methods by Spanish practitioners is relatively low, despite the increase in the prevalence of paediatric myopia as well as increased concern and perceived clinical activity in the area in recent years.
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Affiliation(s)
- Clara Martínez-Pérez
- Optics & Optometry Department, Faculty of Health Sciences, Universidad Europea, Madrid, Spain
| | - César Villa-Collar
- Optics & Optometry Department, Faculty of Health Sciences, Universidad Europea, Madrid, Spain
| | | | - James S Wolffsohn
- College of Health & Life Sciences, Aston University, Birmingham, United Kingdom
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Németh J, Aclimandos WA, Tapasztó B, Jonas JB, Grzybowski A, Nagy ZZ. The impact of the pandemic highlights the urgent need for myopia guidelines: The clinicians' role. Eur J Ophthalmol 2022; 33:11206721221143008. [PMID: 36448253 PMCID: PMC9713518 DOI: 10.1177/11206721221143008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 10/30/2022] [Indexed: 12/05/2022]
Abstract
Myopia is already one of the leading causes of permanent vision impairment, including blindness, and the COVID-19 pandemic has exacerbated the global myopia-related burden among children owing to home confinement, increased screen time (e-learning), and decreased outside activities. To reverse the rising trend of myopia and myopia-related blindness, collaborative efforts are required. There is a wealth of evidence-based medicine (EBM) data on the epidemiology of myopia and effective interventions, but very little has been published on the clinicians' roles and responsibilities. However, this aspect is critical because preventing the onset and progression of myopia necessitates extensive health promotion and advocacy efforts among decision-makers. Only broad medical expert collaboration can bring about the necessary changes in children's lifestyle and education. This article discusses clinicians' critical roles in preventing the onset and progression of myopia.
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Affiliation(s)
- János Németh
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Wagih A Aclimandos
- King's College Hospital, London,
UK
- European Society of Ophthalmology,
Rotterdam, The Netherlands
| | - Beáta Tapasztó
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Jost B Jonas
- Department of Ophthalmology, Heidelberg University, Mannheim, Germany
- Institute of Molecular and Clinical
Ophthalmology Basel, Basel, Switzerland
| | - Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and
Mazury, Olsztyn, Poland
- Institute for Research in
Ophthalmology, Foundation for Ophthalmology Development, Poznan, Poland
| | - Zoltán Zsolt Nagy
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
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A comparative study of the prevalence of myopia and behavioral changes in primary school students. BMC Ophthalmol 2022; 22:370. [PMID: 36115954 PMCID: PMC9482727 DOI: 10.1186/s12886-022-02594-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 09/02/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Objective
To analyze the changes in the prevalence of myopia and its relation to ocular biological parameters, and behaviors among primary school students in China, and understand the prevention and control of myopia.
Methods
Cross-sectional surveys were performed on 7–9-year-old children in the yrs. 2012 and 2019. In addition, spherical equivalent refraction (SER), axial length (AL), and AL/corneal radius ratio (AL/CR ratio) were collected without cycloplegia. Participants completed detailed questionnaires on behavior related to myopia.
Results
Data was collected on 623 children (8.02 ± 0.57 years old) in 2012 and 536 students in 2019 (8.09 ± 0.65 years old). The prevalence of myopia was 37.7% in 2012 and 39.9% in 2019. The SER was -0.25 (0.92) D in 2012 and -0.25 (1.25) in 2019. There was no statistical difference in the prevalence of myopia and SER over the 7 years (all P > 0.05). In 2019, the prevalence of myopia among girls demonstrated an increasing trend (33.8% vs. 37.8%), but there was no statistical difference (P > 0.05). The mean AL and AL/CR ratio of boys were decreasing (all P < 0.05). The proportion of children reading more than 2 h and using digital devices for more than 2 h per day after their classes in the 2019 group both decreased (all P < 0.05). However, the proportion of activities performed outdoors for more than 2 h./day decreased significantly (P = 0.001).
Conclusion
Compared with 2012, the prevalence of myopia in primary school students in 2019 was under control, which may be related to the improvement of children's near-work behavior, but there was the problem of insufficient outdoor activity time. In terms of ocular biological parameters, the risk of myopia for boys in 2019 was lower.
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Shi Y. Effect of Atropine Eye Drops Combined with VR-Based Binocular Visual Function Balance Training for Prevention and Control of Juvenile Myopia. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:4159996. [PMID: 36147642 PMCID: PMC9489366 DOI: 10.1155/2022/4159996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/26/2022] [Accepted: 08/08/2022] [Indexed: 11/20/2022]
Abstract
Purpose This study mainly analyzes the efficacy of 0.01% atropine eye drops (low-dose atropine (LDA)) combined with virtual reality (VR)-based binocular visual function (BVF) balance training in the prevention and control of juvenile myopia. Methods One hundred and thirty-six juvenile myopia patients admitted between November 2018 to November 2021 were selected, including 76 cases (research group) receiving LDA + VR-based BVF balance training and 60 cases (control group) treated by LDA intervention alone. Visual acuity (VA; naked vision), ocular parameters (pupil diameter (PD), axial length (AXL), and diopter), intraocular pressure (IOP), accommodation facility, clinical efficacy, and incidence of adverse reactions were observed, compared, and analyzed in both groups. Results After analysis, it was found that the research group showed significantly higher naked vision and PD while statistically lower D after intervention than the corresponding preinterventional parameters than the control group. While AXL showed no statistical difference between the groups and within groups. The IOP also differed insignificantly between groups, but the post-treatment accommodation facility was better in the research group compared with the baseline (before treatment) and control group. In terms of curative effects, an obviously higher total effective rate was determined in the research group. In addition, the two groups showed no significant difference in the incidence of adverse reactions. Conclusions LDA + VR-based BVF balance training deserves clinical popularization, as it can prevent and control myopia among teenagers, with better adjusting effects on eye function and certain safety.
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Affiliation(s)
- Yuping Shi
- Chengdu Aier Eye Hospital, Chengdu 610041, Sichuan, China
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Cyril Kurupp AR, Raju A, Luthra G, Shahbaz M, Almatooq H, Foucambert P, Esbrand FD, Zafar S, Panthangi V, Khan S. The Impact of the COVID-19 Pandemic on Myopia Progression in Children: A Systematic Review. Cureus 2022; 14:e28444. [PMID: 36176879 PMCID: PMC9512310 DOI: 10.7759/cureus.28444] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 08/25/2022] [Indexed: 11/05/2022] Open
Abstract
Myopia is the most common refractive error among children. The coronavirus disease 2019 (COVID-19) pandemic has affected children's health in many ways. Policy changes due to the COVID-19 pandemic, such as home quarantine and online schooling, have been proposed as causes for the increased risk of myopia progression. During strict home quarantine, children spend less time outdoors and more time using electronic devices which are important risk factors associated with myopia. Our systematic review aims to assess the relationship between myopia progression and these risk factors in children. We did the literature search from PubMed, Google Scholar, and ScienceDirect. A total of 10 research papers were selected for final review using the Preferred Reporting Item for Systematic Review and Meta-Analyses (PRISMA) guidelines. The research articles used had a quality of more than 70%. The quality of these articles was determined using the Joanna Briggs Institute (JBI) tool. Our review included eight cross-sectional and two cohort studies. Most of these studies used questionnaires to assess the risk factors of myopia. Standardized ocular examinations were done in most studies to measure visual acuity, spherical equivalent, and axial lengths. Our study found that the progression of myopia was affected by the reduced time spent outdoors and increased screen time during the pandemic. We also found that children's increased use of electronic devices, such as mobile phones and tablets, has significantly affected myopia progression during the pandemic.
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Limwattanayingyong J, Amornpetchsathaporn A, Chainakul M, Grzybowski A, Ruamviboonsuk P. The Association Between Environmental and Social Factors and Myopia: A Review of Evidence From COVID-19 Pandemic. Front Public Health 2022; 10:918182. [PMID: 35844861 PMCID: PMC9276954 DOI: 10.3389/fpubh.2022.918182] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/06/2022] [Indexed: 01/20/2023] Open
Abstract
PurposeTo review the association between children's behavioral changes during the restriction due to the pandemic of Coronavirus disease (COVID-19) and the development and progression of myopia.DesignA literature review.MethodWe looked for relevant studies related to 1) children's behavioral changes from COVID-19 restriction and 2) children's myopia progression during COVID-19 restriction by using the following keywords. They were “Behavior,” “Activity,” “COVID-19,” “Lockdown,” “Restriction,” and “Children” for the former; “Myopia,” “COVID-19,” “Lockdown,” “Restriction” for the latter. Titles, abstracts and full texts from the retrieved studies were screened and all relevant data were summarized, analyzed, and discussed.ResultsChildren were less active and more sedentary during COVID-19 restriction. According to five studies from China and six studies, each from Hong Kong, Spain, Israel, South Korea, Turkey and Taiwan included in our review, all countries without myopia preventive intervention supported the association between the lockdown and myopia progression by means of negative SER change ranging from 0.05–0.6 D, more negative SER change (compared post- to pre-lockdown) ranging from 0.71–0.98 D and more negative rate of SER changes (compared post- to pre-lockdown) ranging from 0.05–0.1 D/month. The reported factor that accelerated myopia is an increase in total near work, while increased outdoor activity is a protective factor against myopia progression.ConclusionThe pandemic of COVID-19 provided an unwanted opportunity to assess the effect of the behavioral changes and myopia in the real world. There is sufficient evidence to support the association between an increase in near work from home confinement or a reduction of outdoor activities and worsening of myopia during the COVID-19 lockdown. The findings from this review of data from the real world may help better understanding of myopia development and progression, which may lead to adjustment of behaviors to prevent myopia and its progression in the future.
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Affiliation(s)
- Jirawut Limwattanayingyong
- Department of Ophthalmology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
| | - Anyarak Amornpetchsathaporn
- Department of Ophthalmology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
- *Correspondence: Anyarak Amornpetchsathaporn
| | - Methaphon Chainakul
- Department of Ophthalmology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
| | - Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland
- Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznan, Poland
| | - Paisan Ruamviboonsuk
- Department of Ophthalmology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
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Zhang M, Sun Z, Zhu X, Zhang H, Zhu Y, Yan H. Sports and Myopia: An Investigation on the Prevalence and Risk Factors of Myopia in Young Sports-Related Groups in Tianjin, China. Invest Ophthalmol Vis Sci 2022; 63:27. [PMID: 35758907 PMCID: PMC9248751 DOI: 10.1167/iovs.63.6.27] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Objective To explore the relationship between sports and the prevalence of myopia in young sports-related groups in Tianjin, China. Methods In this cross-sectional study, a cluster sampling method was used to survey professional athletes in Tianjin, students at Tianjin University of Sport, and Tianjin Vocational College of Sports. All participants completed epidemiological questionnaires and ophthalmic examinations. Multivariable logistic regression models were used to explore the potential risk factors of myopia. Results This study recruited 1401 participants. The prevalence of myopia was 50.18%. The prevalence of low, moderate, and high myopia were 52.63%, 37.41%, and 9.96%, respectively. There were no sex-related differences in the prevalence of myopia. The odds of having myopia was 1.788 times higher in the indoor sports group than the outdoor sports group (the adjusted odds ratio [OR], 95% confidence interval [CI], 1.391–2.297). Training time of more than 4 h/d (4–6 h/d: OR, 0.539; 95% CI, 0.310–0.938; >6 h/d: OR, 0.466; 95% CI, 0.257–0.844) resulted in a lower risk of myopia. Participants who often used the electronic screen (OR, 1.406; 95% CI, 1.028–1.923) and/or had a family history of myopia (OR, 2.022; 95% CI, 1.480–2.763) were more likely to suffer from myopia. Conclusions Outdoor sports do not necessarily guarantee to insulate against myopia. Youngsters engaged in outdoor sports had a lower prevalence of myopia than those participating in indoor sports. Electronic screen use, training time, and family history of myopia were also associated with the prevalence of myopia in young sports-related groups.
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Affiliation(s)
- Mingxue Zhang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Heping District, Tianjin, China
| | - Zhiyong Sun
- Department of Ophthalmology, Tianjin Medical University General Hospital, Heping District, Tianjin, China
| | - Xinlei Zhu
- Department of Ophthalmology, Tianjin Medical University General Hospital, Heping District, Tianjin, China.,Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Shinan District, Qingdao, China
| | - Haokun Zhang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Heping District, Tianjin, China
| | - Yun Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Heping District, Tianjin, China
| | - Hua Yan
- Department of Ophthalmology, Tianjin Medical University General Hospital, Heping District, Tianjin, China.,Laboratory of Molecular Ophthalmology, Basic Medical Research Center, Tianjin Medical University, Heping District, Tianjin, China.,School of Medicine, Nankai University, Nankai District, Tianjin, China
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Shan M, Dong Y, Chen J, Su Q, Wang Y. Global Tendency and Frontiers of Research on Myopia From 1900 to 2020: A Bibliometrics Analysis. Front Public Health 2022; 10:846601. [PMID: 35359777 PMCID: PMC8960427 DOI: 10.3389/fpubh.2022.846601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 02/10/2022] [Indexed: 01/29/2023] Open
Abstract
Background:Myopia is one of the most common causes of vision impairment in children and adults and has become a public health priority with its growing prevalence worldwide. This study aims to identify and evaluate the global trends in myopia research of the past century and visualize the frontiers using bibliometric analysis.MethodsThe literature search was conducted on the Web of Science for myopia studies published between 1900 and 2020. Retrieved publications were analyzed in-depth by the annual publication number, prolific countries and institutions, core author and journal, and the number of citations through descriptive statistics. Collaboration networks and keywords burst were visualized by VOSviewer and CiteSpace. Myopia citation network was visualized using CitNetExplorer.ResultsIn total, 11,172 publications on myopia were retrieved from 1900 to 2020, with most published by the United States. Saw SM, from the National University of Singapore, contributed the most publications and citations. Investigative Ophthalmology & Visual Science was the journal with highest number of citations. Journal of Cataract and Refractive Surgery with the maximum number of publications. The top 10 cited papers mainly focused on the epidemiology of myopia. Previous research emphasized myopia-associated experimental animal models, while recent keywords include “SMILE” and “myopia control” with the stronger burst, indicating a shift of concern from etiology to therapy and coincided with the global increment of incidence. Document citation network was clustered into six groups: “prevalence and risk factors of myopia,” “surgical control of myopia,” “pathogenesis of myopia,” “optical interventions of myopia,” “myopia and glaucoma,” and “pathological myopia.”ConclusionsBibliometrics analysis in this study could help scholars comprehend global trends of myopia research frontiers better. Hundred years of myopia research were clustered into six groups, among which “prevalence and risk factors of myopia” and “surgical control of myopia” were the largest groups. With the increasing prevalence of myopia, interventions of myopia control are a potential research hotspot and pressing public health issue.
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Affiliation(s)
- Mengyuan Shan
- School of Medicine, Nankai University, Tianjin, China
| | - Yi Dong
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Nankai University Affiliated Eye Hospital, Tianjin, China
| | - Jingyi Chen
- School of Medicine, Nankai University, Tianjin, China
| | - Qing Su
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
| | - Yan Wang
- School of Medicine, Nankai University, Tianjin, China
- Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Nankai University Affiliated Eye Hospital, Tianjin, China
- *Correspondence: Yan Wang
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Bhandari KR, Shukla D, Mirhajianmoghadam H, Ostrin LA. Objective Measures of Near Viewing and Light Exposure in Schoolchildren during COVID-19. Optom Vis Sci 2022; 99:241-252. [PMID: 35086121 PMCID: PMC8897254 DOI: 10.1097/opx.0000000000001871] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE Wearable sensors provide the opportunity for continuous objective measurement of the visual environment with high resolution. Our findings show that absolute and temporal properties of near viewing and time outdoors vary between myopic and nonmyopic schoolchildren, which are important considerations when studying refractive error pathogenesis. PURPOSE Numerous behavioral factors, including near work, time outdoors, electronic device use, and sleep, have been linked to myopia. The purpose of this study was to assess behaviors using subjective and objective methods in myopic and nonmyopic schoolchildren in the United States. METHODS Forty children (aged 14.6 ± 0.4 years) simultaneously wore two sensors for 1 week, a Clouclip for objective measurement of near viewing and light exposure and an Actiwatch for objective measurement of activity and sleep. Parents completed an activity questionnaire for their child. Near-viewing distance, daily duration, short-duration (>1 minute) and long-duration (>30 minutes) near-viewing episodes, light exposure, time outdoors, electronic device use, and sleep duration were analyzed by refractive error group and day of the week. RESULTS Objectively measured daily near-viewing duration was 6.9 ± 0.3 hours. Myopes spent more time in near + intermediate viewing than nonmyopes (P = .008) and had higher diopter hours (P = .03). Short- and long-duration near-viewing episodes were similar between groups (P < .05 for both). Daily light exposure and time outdoors were significantly lower for myopes (P < .05 for both). Electronic device use (12.0 ± 0.7 hours per day) and sleep duration (8.2 ± 0.2 hours per night) were similar between groups (P > .05 for both). CONCLUSIONS Objective and subjective measures confirm that myopic and nonmyopic schoolchildren exhibit different behaviors. Combining wearable sensors with questionnaires provides a comprehensive description of children's visual environment to better understand factors that contribute to myopia.
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Affiliation(s)
| | - Divya Shukla
- University of Houston College of Optometry, Houston, Texas
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Dhakal R, Shah R, Huntjens B, Verkicharla PK, Lawrenson JG. Time spent outdoors as an intervention for myopia prevention and control in children: an overview of systematic reviews. Ophthalmic Physiol Opt 2022; 42:545-558. [PMID: 35072278 PMCID: PMC9305934 DOI: 10.1111/opo.12945] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 12/02/2021] [Accepted: 12/04/2021] [Indexed: 12/22/2022]
Abstract
PURPOSE Outdoor light exposure is considered a safe and effective strategy to reduce myopia development and aligns with existing public health initiatives to promote healthier lifestyles in children. However, it is unclear whether this strategy reduces myopia progression in eyes that are already myopic. This study aims to conduct an overview of systematic reviews (SRs) reporting time spent outdoors as a strategy to prevent myopia or slow its progression in children. METHODS We searched the Cochrane Library, EMBASE, MEDLINE and CINAHL from inception to 1 November 2020 to identify SRs that evaluated the association between outdoor light exposure and myopia development or progression in children. Outcomes included incident myopia, prevalent myopia and change in spherical equivalent refraction (SER) and axial length (AL) to evaluate annual rates of myopia progression. The methodological quality and risk of bias of included SRs were assessed using the AMSTAR-2 and ROBIS tools, respectively. RESULTS Seven SRs were identified, which included data from 47 primary studies with 63,920 participants. Pooled estimates (risk or odds ratios) consistently demonstrated that time outdoors was associated with a reduction in prevalence and incidence of myopia. In terms of slowing progression in eyes that were already myopic, the reported annual reductions in SER and AL from baseline were small (0.13-0.17 D) and regarded as clinically insignificant. Methodological quality assessment using AMSTAR-2 found that all reviews had one or more critical flaws and the ROBIS tool identified a low risk of bias in only two of the included SRs. CONCLUSION This overview found that increased exposure to outdoor light reduces myopia development. However, based on annual change in SER and AL, there is insufficient evidence for a clinically significant effect on myopia progression. The poor methodological quality and inconsistent reporting of the included systematic reviews reduce confidence in the estimates of effect.
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Affiliation(s)
- Rohit Dhakal
- Myopia Research Lab, Prof. Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, India.,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
| | - Byki Huntjens
- 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
| | - John G Lawrenson
- Centre for Applied Vision Research, School of Health Sciences, City, University of London, London, UK
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Yang J, Ouyang X, Fu H, Hou X, Liu Y, Xie Y, Yu H, Wang G. Advances in biomedical study of the myopia-related signaling pathways and mechanisms. Biomed Pharmacother 2021; 145:112472. [PMID: 34861634 DOI: 10.1016/j.biopha.2021.112472] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/18/2021] [Accepted: 11/23/2021] [Indexed: 11/18/2022] Open
Abstract
Myopia has become one of the most critical health problems in the world with the increasing time spent indoors and increasing close work. Pathological myopia may have multiple complications, such as myopic macular degeneration, retinal detachment, cataracts, open-angle glaucoma, and severe cases that can cause blindness. Mounting evidence suggests that the cause of myopia can be attributed to the complex interaction of environmental exposure and genetic susceptibility. An increasing number of researchers have focused on the genetic pathogenesis of myopia in recent years. Scleral remodeling and excessive axial elongating induced retina thinning and even retinal detachment are myopia's most important pathological manifestations. The related signaling pathways are indispensable in myopia occurrence and development, such as dopamine, nitric oxide, TGF-β, HIF-1α, etc. We review the current major and recent progress of biomedicine on myopia-related signaling pathways and mechanisms.
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Affiliation(s)
- Jing Yang
- School of Life Science and Technology, Weifang Medical University, Weifang 261053, China
| | - Xinli Ouyang
- School of Life Science and Technology, Weifang Medical University, Weifang 261053, China
| | - Hong Fu
- School of Life Science and Technology, Weifang Medical University, Weifang 261053, China
| | - Xinyu Hou
- School of Life Science and Technology, Weifang Medical University, Weifang 261053, China
| | - Yan Liu
- Department of Ophthalmology, Affiliated Hospital of Weifang Medical University, Weifang 261031, China
| | - Yongfang Xie
- School of Life Science and Technology, Weifang Medical University, Weifang 261053, China.
| | - Haiqun Yu
- Department of Ophthalmology, Affiliated Hospital of Weifang Medical University, Weifang 261031, China.
| | - Guohui Wang
- School of Life Science and Technology, Weifang Medical University, Weifang 261053, China.
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Saxena R, Gupta V, Rakheja V, Dhiman R, Bhardawaj A, Vashist P. Lifestyle modification in school-going children before and after COVID-19 lockdown. Indian J Ophthalmol 2021; 69:3623-3629. [PMID: 34827007 PMCID: PMC8837368 DOI: 10.4103/ijo.ijo_2096_21] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose To evaluate the impact of COVID-19 lockdown restrictions on lifestyle of school-going children. Methods This was a questionnaire-based prospective study of 1237 school children aged 9-14 years enrolled from various private and government schools across Delhi in October-December 2020. These children were being followed-up over the previous 2 years (before pandemic) with details of their lifestyle like near/outdoor/reading activities using a questionnaire as a part of another study. The data during the COVID-19 lockdown was collected by telephonic interview. This was compared to similar information collected from this cohort in the pre-Covid period in 2019 when the students had a regular physical school curriculum. Results A significant decline was noted in time spent on outdoor activity (from 8.5 hours/week in pre-COVID-19 time to 1.6 hours/week during COVID-19 lockdown; P < 0.001) and doing homework offline (from 15.3 hour/week to 14 hours/week; P < 0.001). A significant increase was noted in screen time spent on digital devices (from 6.2 hours/week to 19.8 hours/week; P<0.001), and watching television (from 12.2 hours/week to 13.4 hours/week; P < 0.001). The rise in the digital on-screen time was significantly more in boys (P < 0.001) and in students from private schools (P < 0.001). The rise in the duration of watching television was significantly more in girls than boys (P < 0.05). Conclusion COVID-19 lockdown has markedly impacted the lifestyle of school children by significantly decreasing the outdoor activity and increasing the screen time, thereby pre-disposing them to ocular ill-health and myopia. This necessitates the adoption of guidelines for promoting healthy digital habits in children.
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Affiliation(s)
- Rohit Saxena
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Vivek Gupta
- Department of Community Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Vaishali Rakheja
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Rebika Dhiman
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Amit Bhardawaj
- Department of Community Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Praveen Vashist
- Department of Community Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Effect of Violet Light-Transmitting Eyeglasses on Axial Elongation in Myopic Children: A Randomized Controlled Trial. J Clin Med 2021; 10:jcm10225462. [PMID: 34830743 PMCID: PMC8624215 DOI: 10.3390/jcm10225462] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/15/2021] [Accepted: 11/20/2021] [Indexed: 12/27/2022] Open
Abstract
The fact that outdoor light environment is an important suppressive factor against myopia led us to invent violet light-transmitting eyeglasses (VL glasses) which can transmit violet light (VL), 360-400 nm in wavelength, for the suppression of myopia, and can meanwhile block harmful ultraviolet waves from sunlight. The current study is a double-blinded randomized clinical trial to investigate the myopia-suppressive effect of VL glasses compared to conventional eyeglasses (placebo glasses) that do not transmit VL. The subjects were children aged from 6 to 12 years old, the population in which myopia progression is generally accelerated, and the myopia suppressive effect was followed up for two years in a city in Japan. Periodical ophthalmic examinations, interviews, and measurements of reflection and axial length under mydriasis were performed at the initial visit (the baseline) and at 1, 6, 12, 18, and 24 months. The mean change in axial length in the VL glasses group was significantly smaller than in the placebo glasses group when time for near-work was less than 180 min and when the subjects were limited to those who had never used eyeglasses before this trial (p < 0.01); however, this change was not significant without subgrouping. The suppressive rate for axial elongation in the VL glasses group was 21.4% for two years.
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Ahadi M, Ebrahimi A, Rahmani S, Baghban AA. Prevalence of refractive errors and color vision deficiency in a population of industry-workers in Abhar, Iran. Medicine (Baltimore) 2021; 100:e27758. [PMID: 34797301 PMCID: PMC8601269 DOI: 10.1097/md.0000000000027758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 10/28/2021] [Indexed: 01/05/2023] Open
Abstract
Visual impairment due to refractive errors and color vision deficiency (CVD) can affect the visual abilities of workers in workplace. Identifying the prevalence of common visual problems helps us to prevent and treat occupational ocular problems.This study was conducted on 2600 males referring from companies for a routine medical exam to Occupational Medicine Center. In all subjects, visual acuity and refraction were measured. Assessment of color vision was performed by Ishihara color test. In present study, right eyes of subjects were selected to statistical analysis.The mean spherical equivalent was -0.19 ± 1.39 diopter with a range of -11.00 to +10.00 diopter. Whereas 71% of persons were emmetropic, 20% and 9% of them were myopic and hypermetropic, respectively. From a total subjects, 164 of them had CVD with prevalence of color blindness of 6.3%. In comparison with normal subjects, CVD had no significant effect on refractive findings of our subjects (P > .05).Our data present the prevalence of refractive errors and color blindness among Iranian industry-workers. Compared with other studies, our subjects have a lower prevalence of refractive errors, and similar rate of prevalence of color blindness.
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Affiliation(s)
- Masoumeh Ahadi
- Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Saeed Rahmani
- Department of Optometry, School of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Akbarzadeh Baghban
- Proteomics Research Center, Department of Biostatistics, and School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Stafford-Bell N, McVeigh J, Lingham G, Straker L, Eastwood PR, Yazar S, Mackey DA, Lee SSY. Associations of 12-year sleep behaviour trajectories from childhood to adolescence with myopia and ocular biometry during young adulthood. Ophthalmic Physiol Opt 2021; 42:19-27. [PMID: 34676908 DOI: 10.1111/opo.12905] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/15/2021] [Accepted: 09/17/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Cross-sectional studies have variably reported that poor sleep quality may be associated with myopia in children. Longitudinal data, collected over the ages when myopia develops and progresses, could provide new insights into the sleep-myopia paradigm. This study tested the hypothesis that 12-year trajectories of sleep behaviour from childhood to adolescence is associated with myopia during young adulthood. METHODS At the 5-, 8-, 10-, 14- and 17-year follow-ups of the longitudinal Raine Study, which has been following a cohort since their birth in 1989-1992, participants' parents/guardians completed the Child Behaviour Checklist questionnaire (CBCL), which collected information on their child's sleep behaviour and quality. The CBCL includes six questions measuring sleep behaviour, which parents rated as 0 = not true, 1 = somewhat/sometimes true, or 2 = very/often true. Scores were summed at each follow-up to form a composite "sleep behaviour score". Latent Class Growth Analysis (LCGA) was used to classify participants according to their 12-year trajectory of sleep behaviour. At the 20-year follow-up, an eye examination was performed which included cycloplegic autorefraction and axial length measurement. RESULTS The LCGA identified three clusters of participants based on their trajectory of sleep behaviour: those with minimal' (43.6% of the total Raine Study sample), 'declining' (48.9%), or 'persistent' (7.5%) sleep problems. A total of 1194 participants had ophthalmic data and longitudinal sleep data available for analysis (47.2% female, 85.6% Caucasian). No significant differences were observed in regards to age, sex, ethnicity or ocular parameters between trajectory groups. Unadjusted and fully adjusted analyses demonstrated that sleep problem behaviour was not significantly associated with changes in refractive error, axial length or corneal radius. CONCLUSIONS Our findings do not support the hypothesis that there is an association between sleep behaviour and myopia. Future longitudinal studies should explore sleep trajectory data pre- and post-myopia diagnosis to confirm our results.
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Affiliation(s)
- Nicholas Stafford-Bell
- Centre for Ophthalmology and Visual Sciences (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia.,Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Joanne McVeigh
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia.,Movement Physiology Laboratory, School of Physiology, University of Witwatersrand, Johannesburg, South Africa
| | - Gareth Lingham
- Centre for Ophthalmology and Visual Sciences (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
| | - Leon Straker
- Curtin School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Peter R Eastwood
- College of Medicine and Public Health, Flinders Health and Medical Research Institute, Flinders University, Adelaide, South Australia, Australia
| | - Seyhan Yazar
- Garvan-Weizmann Centre for Cellular Genomics, Garvan Institute of Medical Research, Darlinghurst, New South Wales, Australia
| | - David A Mackey
- Centre for Ophthalmology and Visual Sciences (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia.,School of Medicine, Menzies Research Institute Tasmania, University of Tasmania, Hobart, Tasmania, Australia.,Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, Melbourne, Victoria, Australia
| | - Samantha Sze-Yee Lee
- Centre for Ophthalmology and Visual Sciences (incorporating the Lions Eye Institute), University of Western Australia, Perth, Western Australia, Australia
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Foo LL, Ng WY, Lim GYS, Tan TE, Ang M, Ting DSW. Artificial intelligence in myopia: current and future trends. Curr Opin Ophthalmol 2021; 32:413-424. [PMID: 34310401 DOI: 10.1097/icu.0000000000000791] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Myopia is one of the leading causes of visual impairment, with a projected increase in prevalence globally. One potential approach to address myopia and its complications is early detection and treatment. However, current healthcare systems may not be able to cope with the growing burden. Digital technological solutions such as artificial intelligence (AI) have emerged as a potential adjunct for myopia management. RECENT FINDINGS There are currently four significant domains of AI in myopia, including machine learning (ML), deep learning (DL), genetics and natural language processing (NLP). ML has been demonstrated to be a useful adjunctive for myopia prediction and biometry for cataract surgery in highly myopic individuals. DL techniques, particularly convoluted neural networks, have been applied to various image-related diagnostic and predictive solutions. Applications of AI in genomics and NLP appear to be at a nascent stage. SUMMARY Current AI research is mainly focused on disease classification and prediction in myopia. Through greater collaborative research, we envision AI will play an increasingly critical role in big data analysis by aggregating a greater variety of parameters including genomics and environmental factors. This may enable the development of generalizable adjunctive DL systems that could help realize predictive and individualized precision medicine for myopic patients.
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Affiliation(s)
- Li Lian Foo
- Singapore National Eye Centre, Singapore Eye Research Institute
- Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Wei Yan Ng
- Singapore National Eye Centre, Singapore Eye Research Institute
- Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | | | - Tien-En Tan
- Singapore National Eye Centre, Singapore Eye Research Institute
| | - Marcus Ang
- Singapore National Eye Centre, Singapore Eye Research Institute
- Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Daniel Shu Wei Ting
- Singapore National Eye Centre, Singapore Eye Research Institute
- Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
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Progression of myopia in a natural cohort of Chinese children during COVID-19 pandemic. Graefes Arch Clin Exp Ophthalmol 2021; 259:2813-2820. [PMID: 34287693 PMCID: PMC8294263 DOI: 10.1007/s00417-021-05305-x] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 06/16/2021] [Accepted: 06/29/2021] [Indexed: 01/22/2023] Open
Abstract
Purpose To determine myopia progression in children during the COVID-19 and the related factors associated with myopia. Methods All subjects underwent three-timepoint ocular examinations that were measured in July 2019, January, and August 2020. We compared the changes in uncorrected visual acuity (UCVA), mydriatic spherical equivalent (SE), and axial length (AL) between two periods (before and during COVID-19). A questionnaire was performed to investigate risk factors for myopia. Results Compared with before the COVID-19, the mean (S.D.) myopia progression during the COVID-19 was significantly higher in right eyes (− 0.93 (0.65) vs. − 0.33 (0.47) D; p < 0.001). However, the differences in UCVA changes and the axial elongation between two periods were clinically insignificant. Through logistic regressive analysis, we found the difference of the SE changes was associated with the baseline AL (P = 0.028; 95% confidence interval [CI], 1.058, 2.632), online education (P = 0.02; 95% CI, 1.587, 8.665), and time of digital screen (p < 0.005; 95% CI, 1.587, 4.450). Conclusions Children were at higher risk of myopia progression during COVID-19, which was associated with the baseline AL, the longtime online learning, and digital screen reading.
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Pandemic of Childhood Myopia. Could New Indoor LED Lighting Be Part of the Solution? ENERGIES 2021. [DOI: 10.3390/en14133827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The existence of a growing myopia pandemic is an unquestionable fact for health authorities around the world. Different possible causes have been put forward over the years, such as a possible genetic origin, the current excess of children’s close-up work compared to previous stages in history, insufficient natural light, or a multifactorial cause. Scientists are looking for different possible solutions to alleviate it, such as a reduction of time or a greater distance for children’s work, the use of drugs, optometric correction methods, surgical procedures, and spending more time outdoors. There is a growing number of articles suggesting insufficient natural light as a possible cause of the increasing levels of childhood myopia around the globe. Technological progress in the world of lighting is making it possible to have more monochromatic LED emission peaks, and because of this, it is possible to create spectral distributions of visible light that increasingly resemble natural light in the visible range. The possibility of creating indoor luminaires that emit throughout the visible spectrum from purple to infrared can now be a reality that could offer a new avenue of research to fight this pandemic.
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46
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Németh J, Tapasztó B, Aclimandos WA, Kestelyn P, Jonas JB, De Faber JTHN, Januleviciene I, Grzybowski A, Nagy ZZ, Pärssinen O, Guggenheim JA, Allen PM, Baraas RC, Saunders KJ, Flitcroft DI, Gray LS, Polling JR, Haarman AEG, Tideman JWL, Wolffsohn JS, Wahl S, Mulder JA, Smirnova IY, Formenti M, Radhakrishnan H, Resnikoff S. Update and guidance on management of myopia. European Society of Ophthalmology in cooperation with International Myopia Institute. Eur J Ophthalmol 2021; 31:853-883. [PMID: 33673740 PMCID: PMC8369912 DOI: 10.1177/1120672121998960] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/04/2021] [Indexed: 12/13/2022]
Abstract
The prevalence of myopia is increasing extensively worldwide. The number of people with myopia in 2020 is predicted to be 2.6 billion globally, which is expected to rise up to 4.9 billion by 2050, unless preventive actions and interventions are taken. The number of individuals with high myopia is also increasing substantially and pathological myopia is predicted to become the most common cause of irreversible vision impairment and blindness worldwide and also in Europe. These prevalence estimates indicate the importance of reducing the burden of myopia by means of myopia control interventions to prevent myopia onset and to slow down myopia progression. Due to the urgency of the situation, the European Society of Ophthalmology decided to publish this update of the current information and guidance on management of myopia. The pathogenesis and genetics of myopia are also summarized and epidemiology, risk factors, preventive and treatment options are discussed in details.
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Affiliation(s)
- János Németh
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Beáta Tapasztó
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
- Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
| | | | | | - Jost B Jonas
- Department of Ophthalmology, Heidelberg University, Mannheim, Germany
| | | | | | - Andrzej Grzybowski
- Department of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland
- Institute for Research in Ophthalmology, Foundation for Ophthalmology Development, Poznan, Poland
| | - Zoltán Zsolt Nagy
- Department of Ophthalmology, Semmelweis University, Budapest, Hungary
| | - Olavi Pärssinen
- Gerontology Research Centre and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | | | - Peter M Allen
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Rigmor C Baraas
- National Centre for Optics, Vision and Eye Care, University of South-Eastern Norway, Kongsberg, Norway
| | - Kathryn J Saunders
- Centre for Optometry and Vision Science research, Ulster University, Coleraine, UK
| | - Daniel Ian Flitcroft
- Temple Street Children’s Hospital, Dublin, Ireland
- Centre for Eye Research Ireland (CERI) Technological University Dublin, Ireland
| | | | - Jan Roelof Polling
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Optometry and Orthoptics, Hogeschool Utrecht, University of Applied Science, Utrecht, The Netherlands
| | - Annechien EG Haarman
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - J Willem L Tideman
- Department of Ophthalmology and Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - James Stuart Wolffsohn
- Optometry and Vision Science, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Siegfried Wahl
- Institute for Ophthalmic Research, University Tübingen, Tübingen, Germany
- Carl Zeiss Vision International GmbH, Tübingen, Germany
| | - Jeroen A Mulder
- Department of Optometry and Orthoptics, Hogeschool Utrecht, University of Applied Science, Utrecht, The Netherlands
| | | | - Marino Formenti
- Department of Physics, School of Science, University of Padova, Padova, Italy
| | | | - Serge Resnikoff
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
- Brien Holden Vision Institute, Sydney, Australia
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Huang L, Schmid KL, Zhang J, Yang GY, Wu J, Yin XN, He G, Ruan Z, Jiang XQ, Wu CA, Chen WQ. Association between greater residential greenness and decreased risk of preschool myopia and astigmatism. ENVIRONMENTAL RESEARCH 2021; 196:110976. [PMID: 33684414 DOI: 10.1016/j.envres.2021.110976] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/26/2021] [Accepted: 03/02/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Rapid urbanization has led to reduced greenness in many areas, this has been linked to adverse health outcomes. The aim was to determine the association between residential greenness experienced during very early childhood with preschool myopia and astigmatism and to explore the potential mediating role of screen time on any associations. METHOD Information regarding socio-demographic characteristics, home address, screen time during early childhood, and refraction data from vision screenings of 53,575 preschoolers from Longhua Child Cohort Study were collected via questionnaires. Residential greenness was calculated as the average of satellite-derived Normalized Difference Vegetation Index in buffers of 100, 250, and 500 m around each child's home address. Logistic and linear regression models were used to examine the relationships between residential greenness, screen time, and preschool myopia and astigmatism. RESULT The mean (SD) age of the 53,575 preschoolers was 5.0 (0.7) years, and 24,849 (46.4%) were girls. A total of 1236 (2.3%) preschoolers had myopia and 5347 (10.0%) had astigmatism. In the adjusted model, a higher neighborhood greenness level within 100 m buffers around the home address was associated with decreased risk of myopia (adjusted odds ratios (AOR): 0.62, 95% confidence interval (CI): 0.38-0.99), and higher neighborhood greenness levels within 100, 250, and 500 m decreased the risk of astigmatism, and their AORs (95% CIs) were 0.55 (0.43-0.70) for 100 m, 0.59 (0.41-0.83) for 250 m, 0.61 (0.42-0.90) for 500 m, respectively. Greater screen time during early childhood increased the risk of myopia (AOR = 1.33) and astigmatism (AOR = 1.23). Reduction in screen time fully mediated the benefits of greater residential greenness on preschool myopia, but partially mediated that on preschool astigmatism (p < 0.05). CONCLUSION Higher residential greenness reduces the risk of preschool myopia and astigmatism; the benefits of residential greenness were mediated through reduced daily screen time.
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Affiliation(s)
- Lihua Huang
- Department of Epidemiology, Guangzhou Key Laboratory of Environmental Pollution and Health Assessment, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, 510080, Guangzhou, China.
| | - Katrina L Schmid
- Centre for Eye and Vision Research, School of Optometry and Vision Science, Faculty of Health, Queensland University of Technology, Brisbane, 4059, QLD, Australia.
| | - Jingyu Zhang
- Longhua District Maternal and Child Health Hospital, 518109, Shenzhen, China
| | - Gui-You Yang
- Department of Epidemiology, Guangzhou Key Laboratory of Environmental Pollution and Health Assessment, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, 510080, Guangzhou, China
| | - Jianbo Wu
- Department of Epidemiology, Guangzhou Key Laboratory of Environmental Pollution and Health Assessment, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, 510080, Guangzhou, China; Longhua District Maternal and Child Health Hospital, 518109, Shenzhen, China
| | - Xiao-Na Yin
- Longhua District Maternal and Child Health Hospital, 518109, Shenzhen, China
| | - Guanhao He
- Department of Epidemiology, Guangzhou Key Laboratory of Environmental Pollution and Health Assessment, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, 510080, Guangzhou, China
| | - Zengliang Ruan
- Department of Epidemiology, Guangzhou Key Laboratory of Environmental Pollution and Health Assessment, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, 510080, Guangzhou, China
| | - Xiao-Qin Jiang
- Longhua District Maternal and Child Health Hospital, 518109, Shenzhen, China
| | - Chuan-An Wu
- Longhua District Maternal and Child Health Hospital, 518109, Shenzhen, China.
| | - Wei-Qing Chen
- Department of Epidemiology, Guangzhou Key Laboratory of Environmental Pollution and Health Assessment, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, 510080, Guangzhou, China; Department of Information Management, Xinhua College of Sun Yat-sen University, 510080, Guangzhou, China.
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48
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Jonas JB, Ang M, Cho P, Guggenheim JA, He MG, Jong M, Logan NS, Liu M, Morgan I, Ohno-Matsui K, Pärssinen O, Resnikoff S, Sankaridurg P, Saw SM, Smith EL, Tan DTH, Walline JJ, Wildsoet CF, Wu PC, Zhu X, Wolffsohn JS. IMI Prevention of Myopia and Its Progression. Invest Ophthalmol Vis Sci 2021; 62:6. [PMID: 33909032 PMCID: PMC8083117 DOI: 10.1167/iovs.62.5.6] [Citation(s) in RCA: 123] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The prevalence of myopia has markedly increased in East and Southeast Asia, and pathologic consequences of myopia, including myopic maculopathy and high myopia-associated optic neuropathy, are now some of the most common causes of irreversible blindness. Hence, strategies are warranted to reduce the prevalence of myopia and the progression to high myopia because this is the main modifiable risk factor for pathologic myopia. On the basis of published population-based and interventional studies, an important strategy to reduce the development of myopia is encouraging schoolchildren to spend more time outdoors. As compared with other measures, spending more time outdoors is the safest strategy and aligns with other existing health initiatives, such as obesity prevention, by promoting a healthier lifestyle for children and adolescents. Useful clinical measures to reduce or slow the progression of myopia include the daily application of low-dose atropine eye drops, in concentrations ranging between 0.01% and 0.05%, despite the side effects of a slightly reduced amplitude of accommodation, slight mydriasis, and risk of an allergic reaction; multifocal spectacle design; contact lenses that have power profiles that produce peripheral myopic defocus; and orthokeratology using corneal gas-permeable contact lenses that are designed to flatten the central cornea, leading to midperipheral steeping and peripheral myopic defocus, during overnight wear to eliminate daytime myopia. The risk-to-benefit ratio needs to be weighed up for the individual on the basis of their age, health, and lifestyle. The measures listed above are not mutually exclusive and are beginning to be examined in combination.
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Affiliation(s)
- Jost B Jonas
- Department of Ophthalmology, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Marcus Ang
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Department of Ophthalmology and Visual Science, Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Pauline Cho
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong, China
| | - Jeremy A Guggenheim
- School of Optometry & Vision Sciences, Cardiff University, Cardiff, United Kingdom
| | - Ming Guang He
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yatsen University, Guangzhou, China.,Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia
| | - Monica Jong
- Brien Holden Vision Institute, Sydney, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, Australia.,Discipline of Optometry and Vision Science, University of Canberra, Australia
| | - Nicola S Logan
- School of Optometry, Aston University, Birmingham, United Kingdom
| | - Maria Liu
- School of Optometry, University of California, Berkeley, Berkeley, California, United States
| | - Ian Morgan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yatsen University, Guangzhou, China.,Research School of Biology, College of Medicine, Biology and Environment, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Tokyo, Japan
| | - Olavi Pärssinen
- Department of Ophthalmology, Central Hospital of Central Finland, Jyväskylä, Finland.,Gerontology Research Center and Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Serge Resnikoff
- Brien Holden Vision Institute, Sydney, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Padmaja Sankaridurg
- Brien Holden Vision Institute, Sydney, Australia.,School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Seang-Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,Eye & Retina Surgeons, Singapore, Singapore.,Duke-NUS Medical School, Singapore
| | - Earl L Smith
- Brien Holden Vision Institute, Sydney, Australia.,College of Optometry, University of Houston, Houston, Texas, United States
| | - Donald T H Tan
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.,Department of Ophthalmology and Visual Science, Duke-NUS Graduate Medical School, Singapore, Singapore.,Eye & Retina Surgeons, Singapore, Singapore
| | - Jeffrey J Walline
- The Ohio State University College of Optometry, Columbus, Ohio, United States
| | - Christine F Wildsoet
- School of Optometry, University of California, Berkeley, Berkeley, California, United States
| | - Pei-Chang Wu
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Xiaoying Zhu
- Biological and Vision Sciences, State University of New York, College of Optometry, New York, New York, United States
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Flitcroft DI, Harb EN, Wildsoet CF. The Spatial Frequency Content of Urban and Indoor Environments as a Potential Risk Factor for Myopia Development. Invest Ophthalmol Vis Sci 2021; 61:42. [PMID: 32986814 PMCID: PMC7533745 DOI: 10.1167/iovs.61.11.42] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Purpose To examine the hypothesis that the spatial frequency spectra of urban and indoor environments differ from the natural environment in ways that may promote the development of myopia. Methods A total of 814 images were analyzed from three datasets; University of California Berkeley (UCB), University of Texas (UT), and Botswana (UPenn). Images were processed in Matlab (Mathworks Inc) to map the camera color characteristics to human cone sensitivities. From the photopic luminance images generated, two-dimensional spatial frequency (SF) spectra were calculated and converted to one-dimensional spectra by rotational averaging. The spatial filtering profile of a 0.4 Bangerter foil, which has been shown to induce myopia experimentally, was also determined. Results The SF slope for natural scenes followed the recognized 1/fα relationship with mean slopes of −1.08, −0.90, and −1.04 for the UCB, UT and UPenn image sets, respectively. Indoor scenes had a significantly steeper slope (−1.48, UCB; −1.52, UT; P < 0.0001). Urban environments showed an intermediate slope (−1.29, UCB; −1.22, UT) that was significantly different from the slopes derived from the natural scenes (P < 0.0001). The change in SF content between natural outdoor scenes and indoors was comparable to that induced by a 0.4 Bangerter foil, which reduced the SF slope of a natural scene from −0.88 to −1.47. Conclusions Compared to natural outdoor images, man-made outdoor and indoor environments have spatial frequency characteristics similar to those known to induce form-deprivation myopia in animal models. The spatial properties of the man-made environment may be one of the missing drivers of the human myopia epidemic.
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Affiliation(s)
- Daniel Ian Flitcroft
- Ophthalmology, Children's University Hospital, Dublin, Ireland.,Technological University of Dublin, Dublin, Ireland
| | - Elise N Harb
- School of Optometry, University of California, Berkeley, California, United States
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Flanagan SC, Cobice D, Richardson P, Sittlington JJ, Saunders KJ. Elevated Melatonin Levels Found in Young Myopic Adults Are Not Attributable to a Shift in Circadian Phase. Invest Ophthalmol Vis Sci 2021; 61:45. [PMID: 32729910 PMCID: PMC7425780 DOI: 10.1167/iovs.61.8.45] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Purpose To evaluate the relationship between refractive error, circadian phase, and melatonin with consideration of prior light exposure, physical activity, and sleep. Methods Healthy young myopic (spherical equivalent refraction [SER] ≤−0.50DS) and emmetropic adults underwent noncycloplegic autorefraction and axial length (AL) measures. Objective measurements of light exposure, physical activity, and sleep were captured across 7 days by wrist-worn Actiwatch-2 devices. Questionnaires assessed sleep quality and chronotype. Hourly evening saliva sampling during a dim-light melatonin onset (DLMO) protocol evaluated circadian phase, and both morning serum and saliva samples were collected. Liquid chromatography/mass spectrometry quantified melatonin. Results Subjects (n = 51) were aged 21.4 (interquartile range, 20.1−24.0) years. Melatonin was significantly higher in the myopic group at every evening time point and with both morning serum and saliva sampling (P ≤ 0.001 for all). DLMO-derived circadian phase did not differ between groups (P = 0.98). Multiple linear regression analysis demonstrated significant associations between serum melatonin and SER (B = –.34, β = –.42, P = 0.001), moderate activity (B = .009, β = .32, P = 0.01), and mesopic illumination (B = –.007, β = –.29, P = 0.02), F(3, 46) = 7.23, P < 0.001, R2 = 0.32, R2adjusted = .28. Myopes spent significantly more time exposed to “indoor” photopic illumination (3 to ≤1000 lux; P = 0.05), but “indoor” photopic illumination was not associated with SER, AL, or melatonin, and neither sleep, physical activity, nor any other light exposure metric differed significantly between groups (P > 0.05 for all). Conclusions While circadian phase is aligned in adult myopes and emmetropes, myopia is associated with both elevated serum and salivary melatonin levels. Prospective studies are required to ascertain whether elevated melatonin levels occur before, during, or after myopia development.
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