Myopia In Adolescents Research Articles

The association between anthocyanin intake and myopia in adolescents: a cross-sectional study of NHANES

AimThe study aimed to explore the relationship of anthocyanin and its subtypes with myopia in adolescents aged 12–17 years.MethodsAdolescents data for this cross-sectional study were extracted from the National Health and Nutrition Examination Survey (NHANES) 2007–2008. Anthocyanin and subtypes were obtained using the Nutrient Database for Dietary Studies codes. Myopia was defined as a spherical equivalent of −1.0 diopters or less. The relationships between anthocyanin and subtypes intake and myopia were determined utilizing weighted univariate and multivariate logistic regression models. The relationships were also explored in gender, leisure time, physical activity, sedentary activity, BMI, and serum cotinine subgroups.ResultsA total of 839 adolescents were included for further analysis, among them 245 have myopia. Malvidin (34.98%) was the subtype with the largest anthocyanin intake, followed by cyanidin (22.94%). Compared to adolescents without anthocyanin intake, total anthocyanin intake was related to a lower incidence of myopia (OR = 0.69, 95%CI: 0.51–0.92). Higher intake of cyanidin (OR = 0.69, 95%CI: 0.52–0.92), petunidin (OR = 0.64, 95%CI: 0.42–0.97), and delphinidin (OR = 0.71, 95%CI: 0.51–0.99) were associated with lower odds of myopia in adolescents. Higher total anthocyanin intake was related to lower odds of myopia in those females, leisure time physical activity ≥60 min/day, sedentary time <8 h/day, overweight or obese, and serum cotinine ≥0.05 ng/ml.ConclusionHigher total anthocyanin intake, particularly cyanidin, petunidin, and delphinidin, was related to a lower incidence of myopia in adolescents. Increasing dietary anthocyanin intake may be an effective prevention strategy for ocular health.

Association between dietary inflammatory index and adolescent myopia based on the National Health and Nutrition Examination Survey.

The prevalence of adolescent myopia is remarkably increasing. Previous studies have indicated that an unhealthy diet is a risk factor for myopia. However, the link between diet-related inflammation and myopia is unclear. To explore their correlation, we used dietary inflammation index (DII) that is a parameter to quantify the inflammatory potential of diet, to reveal the relationship between DII and myopia in adolescents. We extracted sociodemographic data, information of diets and eye refractive status of adolescents from National Health and Nutrition Examination Survey (NHANES) for period 1999-2008. Dietary intake data was used to calculate DII scores, which were then categorized into quartiles. Multivariable regression models and subgroup analyses were conducted to investigate the association between DII and myopia. Subsequently, smoothed curve analyses were conducted to discern the trend of correlation between DII and myopia across diverse population. A total of 7191 juveniles aged at 12 to 18 years with complete information were included in our study, consisting 3367 participants with diagnosis of myopia. Among these participants, a trend towards an increasing prevalence of myopia was observed with a higher DII. After adjusting for all covariates, stratified logistic regression analyses showed that among the population aged in 16 to 18 years old or with 9-11th grade educational level, the prevalence of myopia was significantly increased with higher DII score (OR = 1.06, 95% CI = 1.01, 1.11, P = 0.006; OR = 1.06, 95% CI = 1.01, 1.11, P = 0.010). In the two subgroups, participants in the highest quartile of DII had a 31.00% higher risk of myopia and a higher 27.00% risk of myopia respectively, compared to those in the lowest quartile of DII. Our results revealed an increasing trend in the prevalence of myopia with increased DII score in adolescents. Particularly, DII was positively associated with the risk of myopia among the population aged in 16 to 18 years old and with 9-11th grade educational level.

Multifocal Rigid Gas Permeable Contact Lenses with Multi-Tangential Positioning and Corrected Spherical Aberration for Myopia Control

Slowing the progression of myopia has become an extensive concern for parents of children with myopia. According to research findings in animals, eye growth is primarily influenced by the peripheral retina. Treatment options such as orthokeratology, daytime bifocal or multifocal soft contact lens usage are available because they can induce relative myopia in the periphery. In this work, a new multifocal rigid gas permeable (MFRGP) contact lens for myopia prevention and control in adolescents was designed specifically for preventing and controlling myopia in adolescents. This lens features a multi-tangent alignment curve, smaller spherical aberration, and transition defocus. FocalPoints and UPC 100 Vision were used for lens design and lathing, respectively. The lens structure and power profile were measured using IS830 and CONTEST 2, respectively. The elimination of lens aberrations was achieved through design optimization using ZEMAX with ray tracing. Lens fitting was evaluated using slit-lamp microscopy and corneal topography.

Prevalence and risk factors of myopia among children and adolescents in Hangzhou.

To analyze the prevalence and influencing factors of myopia among children and adolescents in Hangzhou city, and provide ideas for the formulation of myopia prevention and control measures. A cross-sectional school-based study using stratified cluster random sampling method was used to select 31,880 students from 113 schools in Hangzhou city. Myopia screening and questionnaires on the influencing factors of poor visual acuity were carried out. Univariate and multivariate logistic regression were used to screen possible risk factors of myopia. The overall prevalence of myopia was found to be 55.3% (17,630/31,880), with the myopia rates observed among students in kindergarten, primary school, junior high school, and senior high school, at 5.8%, 34.9%, 74.2%, and 85.0%, respectively. As the academic year progresses, there has been an observable increase in the prevalence of myopia (χ2 = 8676.748, P<0.001), low myopia (χ2 = 5444.040, P<0.001) and high myopia (χ2 = 2171.073, P<0.001) among students, with the difference between the three groups being statistically significant. The myopia prevalence in girls is higher than that in boys (χ2 = 119.917, P<0.001); the prevalence of myopia in urban students is higher than that in suburban students (χ2 = 4.603, P = 0.032). The time spent on homework after school, the correctness of reading and writing postures, the duration of exposure to electronic screens, and the use of lighting in an appropriate manner all have an impact on the development of myopia (all P<0.05). The overall prevalence of myopia and high myopia in schools in eastern China, is notably high. The prevalence of myopia and high myopia increases with grade or age. Myopia is associated with increased age, parental myopia, extended periods of homework after school, poor reading and writing posture, prolonged exposure to electronic screens and inappropriate lighting. In light of the findings of the present survey, it is recommended that a comprehensive prevention and control intervention model for myopia in children and adolescents based on society-hospital-school-family-individual students with a view to preventing and controlling myopia.

Myopia and systemic manifestation of tissue hyperlaxity: A population-based cross-sectional study.

Whether non-syndromic connective tissue hyperlaxity is associated with myopia is unknown. The aim of this study was to examine the association between systemic signs of tissue hyperlaxity and myopia among adolescents. Included were adolescents assessed before mandatory military service at the age of 16-18 years between 2011 and 2022. Diagnoses of hernias, pes planus, genu varus, genu valgum, and scoliosis, as well as joint injuries were used as surrogate markers for tissue hyperlaxity. The prevalence of these events among adolescents with myopia was evaluated and compared to the non-myopic population. Included were 920 806 adolescents. The mean age was 17.4 ± 1.4 years and 58.6% were men. Myopia was diagnosed in 290 759 adolescents (31.6%) and high myopia in 24 069 adolescents (2.6%). The prevalence of hernias was higher among adolescents with myopia, (2.76%, 95% confidence interval (95% CI): 2.69%-2.82% vs. 2.60%, 95% CI: 2.57%-2.65%), as were pes planus (14.92%, 95% CI: 14.79-15.05 vs. 13.51%, 95% CI: 13.42-13.59) and scoliosis (9.14%, 95% CI: 9.03-9.24 vs. 7.69%, 95%CI: 7.62-7.76). The prevalence of joint injuries was clinically similar between groups (less than 0.1% difference for ankle, shoulder, and knee injuries), as were genu varum and genu valgum (0.66%, 95%CI: 0.64%-0.69% vs. 0.68%, 95% CI: 0.66-0.70, respectively). Adjusted for possible confounders results remained consistent. Among a large sample of Israeli adolescents, those with myopia had a higher prevalence of hernias, pes planus, and scoliosis. These results could suggest a propensity for systemic conditions related to tissue laxity among myopic adolescents.

Epidemiology of Myopia: Prevalence, Risk Factors and Effects of Myopia.

Myopia is the most common cause of visual impairment in children and young adults. In order to assess the consequences for society, it is necessary to know temporal trends in prevalence, incidence and associated factors in childhood and adolescence, as well as the rate of myopia progression, as based on epidemiological research. This paper presents a literature review of publications from 2020 up to March 2024, supplemented by other relevant publications. The prevalence of myopia in children and adolescents in Germany is almost stable and is significantly lower than in Asia. The development of myopia is influenced by outdoor activity, parental myopia, genetics and near work, while insufficient time spent outdoors in childhood is a significant and controllable risk factor for myopia-related complications such as myopic maculopathy, glaucoma, and retinal detachment.

Influence of daily eye care on the prevention and control of Myopia in adolescents

Influence of daily eye care on the prevention and control of Myopia in adolescents

Analysis of Risk Factors for Myopia in Adolescents in Urban Environments

Analysis of Risk Factors for Myopia in Adolescents in Urban Environments

Prevalence, sociodemographic risk factors, and coverage of myopia correction among adolescent students in the central region of Portugal

BackgroundKnowing the prevalence of myopia at school age is essential to implement preventive measures and appropriate interventions, ensure access to vision care, promote a healthier educational environment and improve academic performance. The purpose of this study was to determine the prevalence of myopia and its associated sociodemographic risk factors, as well as to estimate the coverage of myopia correction among adolescents in center of Portugal.MethodsThis cross-sectional study evaluated 1115 adolescents from the 5th to the 9th year of school, with an average of 12.9 years (SD = 1.5) ranging from 10.0 to 18.0 years. Optometric evaluations were carried out in a school environment and consisted of the evaluation of distance visual acuity, assessed using a logarithmic visual acuity chart (ETDRS charts 1 and 2) at 4 m, and measured by refractive error with a pediatric autorefractometer (Plusoptix), by non-cycloplegic. Myopia was defined as spherical equivalent (SE ≤ -0.50 diopter (D)) and uncorrected visual acuity (UVA ≤ 95VAR). Adjusted logistic regression analysis was applied to investigate risk factors.ResultsWe found a myopia rate of 21.5% and a high myopia rate of 1.4%. Higher school level and attendance at urban schools were associated with myopia, but no association was found with age or sex. Only 34.6% of myopic adolescents use the best optical correction and 26.4% do not use any type of optical correction.ConclusionsData on the prevalence of refractive problems in Portugal are scarce and heterogeneous. This study, although regional, provides a valuable contribution with a clear and reproducible methodology, following international guidelines and filling gaps in the existing literature. The results show that the rate of myopia in this age group is similar to reports from other European studies. The high rate of adolescents with uncorrected or under-corrected myopia in Portugal is a problem that deserves attention.

Study on the relationship between adolescent myopia and gut microbiota via 16S rRNA sequencing

Myopia has become a global public health problem, with a high incidence among adolescents. In recent years, the correlation between gut microbiota and various diseases has become a research hotspot. This paper analyzes the relationship between myopia and gut microbiota in adolescents based on 16S rRNA sequencing, opening up a new avenue for the prevention and control of myopia. 80 adolescents aged 6–15 years were included; fecal samples were collected to compare their diversity and species differences. There was no significant difference in α diversity when considering richness and evenness at the same time (P > 0.05). While the group difference in β diversity reached a significant level (R2 = 0.022, P < 0.05). The absolute quantification and relative abundance of phylum level Firmicutes and Actinobacteriota are different; among the top 30 genera, myopic group only one genus decreased in absolute quantification, while 13 genera decreased in relative quantification; so LEfSe analysis was performed, and the result showed that microbial community composition changed under Linear discriminant analysis (LDA) score, the top ten changes are shown in the figure; the Wilcoxon Rank sum test also found some significant changes in the absolute abundance of differential microbiota among different groups, at the phylum level, one bacterial phylum decreased and three bacterial phyla increased; at the genus level, 2 bacteria genera decreased and 29 bacteria genera increased. Functional pathways prediction found many myopic-related pathways were functionally enhanced in myopic patients (P < 0.05). Multivariate logistic regression analysis results showed that the area under the curve (AUC) of myopic patients predicted was close to or equal to 1. In conclusion, adolescent myopia is closely related to the gut microbiota, and the characteristic gut microbiota can distinguish myopia from healthy controls to a large extent. Therefore, it can be considered to regulate these characteristic gut microbiota to prevent and control myopia.

Gender Difference of the Association Between Sleep Duration and Myopia Among Children and Adolescents.

With girls typically exhibiting higher rates of myopia than boys, however, the mechanisms behind this gender difference remain unclear. This study aims to investigate the gender disparities in the relationship between myopia, sleep duration, physical activity, and BMI. A total of 3138 primary and secondary school students were included. Mplus 8.3 was used to perform the multiple mediation analysis. Sleep duration was indicated to directly affect myopia (β=0.273, 95% CI=0.184-0.356) and through physical activity, BMI, physical activity and BMI three significantly mediation pathways, respectively. In terms of gender, the mediating direct effect of sleep duration on myopia of boys was 66.96%, which is much higher than that of girls' 50.91%. And the mediating indirect effect of sleep duration on myopia through physical activity and BMI are 32.65% and 12.10% respectively among girls, both of which are significantly higher than that of boys. The study found that there are significant differences in the impact of sleep duration on myopia in children and adolescents of different genders. In this regard, while paying attention to the sleep duration of children and adolescents, special attention should also be paid to the indirect impact of girls' physical activity and BMI on myopia, and targeted measures should be formulated according to children of different genders to effectively protect the eye health of children and adolescents.

Developmental characteristics and control effects of myopia and eye diseases in children and adolescents: a school-based retrospective cohort study in Southwest China

ObjectivesTo characterise the prevalence of myopia and eye diseases among school adolescents and children in Southwest China, and to evaluate the effectiveness of myopia control tools.DesignRetrospective cohort study.SettingAcross 95 basic...

Research Progress on the Impact of Outdoor Activities on Myopia in Children and Adolescents

The issue of myopia among children and adolescents has become a global public health concern. Existing research indicates a close correlation between outdoor activities and myopia in children and adolescents, with increased outdoor activity effectively preventing the rise in myopia incidence. This study reviews the impact of outdoor activities on myopia in children and adolescents by searching databases such as CNKI and Web of Science, aiming to explore effective strategies for myopia prevention and control, thereby providing theoretical references for myopia prevention efforts. Currently, scholars have conducted cross-sectional studies, cohort studies, and intervention studies across various countries, confirming that long-term engagement in outdoor activities can improve the average refractive index of children and adolescents, reducing the risk of myopia. However, it has also been found that the protective effect of outdoor activity duration on myopia in children and adolescents has a certain threshold. Additionally, numerous animal and human experiments have investigated the mechanisms by which outdoor activities influence myopia, revealing that outdoor activities can reduce the incidence of myopia by promoting ocular refractive development, stimulating dopamine release, and alleviating eye fatigue. Based on the literature review, this study proposes targeted suggestions for myopia prevention and control from the perspectives of the government, schools, and families.

Prevalence of Myopia Among Schoolchildren and the Impact of Increased Screen Time: A Systematic Review.

Myopia is the most frequent kind of refractive error and affects hundreds of millions of people. Growing evidence suggests that extended exposure to digital screens may exacerbate nearsightedness in children and young people. The purpose of this review is to compile data on the link between too much time in front of a screen and nearsightedness in young people so far. The principles of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guided the methods used and the format of the resulting report. Articles published between January 1, 2000, and June 30, 2023, were found by searching Medline, PubMed, ScienceDirect, Google Scholar, CINAHL, the Cochrane Library, and Scopus. Studies reporting an association between myopia and time spent in front of screens in children and young adults were considered eligible. The initial search yielded a total of 1,251 studies. After eliminating duplicates and reviewing the titles and abstracts, 64 full-text articles were evaluated for eligibility. Ultimately, 15 of these studies were included in the final analysis. The 15 studies involved a total of 59,775 participants and were conducted in various countries, including China, Singapore, and the United States. Overall, the evidence did not support a significant association between screen time and myopia in school children and young adults. There is conflicting evidence on the link between screen time and myopia in children and adolescents. More research is needed to determine whether or not digital screen use is a risk factor for myopia. The complex association between screen time and myopia is not fully understood at this time because of the variability of the included studies. These results have significant public health implications since they may be used to guide recommendations for screen time use in children and the young population.

Regional disparities in the prevalence and correlated factors of myopia in children and adolescents in Gansu, China.

Myopia is a significant public health problem across the globe. This study aimed to examine the regional disparity in prevalence and correlated factors of myopia in children and adolescents in two typical regions, Gannan Tibetan Autonomous Prefecture (Gannan Prefecture for short, a Tibetan residential area) and Wuwei City (a Han residential area) in Gansu Province, China, and to provide a reference for the prevention and control of regional myopia. The study was a cross-sectional study of children and adolescents in Gansu Province, China. A total of 6,187 (Wuwei City: 3,266, Gannan Tibetan Autonomous Prefecture: 2,921) students were selected by stratified cluster sampling. Eye examinations and questionnaires were administered to the participants. Myopia is defined as a condition in which the spherical equivalent refractive error of an eye is less than or equal to -0.50 D when ocular accommodation is relaxed. The χ2 test and multivariate logistic regression analysis were used to analyze the correlated factors of myopia. The myopia rate of 6,187 students was 71.4%, and students had a higher rate of myopia (77.5%) in Wuwei City compared to Gannan Prefecture (64.6%) (p < 0.001). The results of multivariate analysis in Wuwei City showed that girls (odds ratio (OR) = 1.325), junior students (OR = 2.542), senior students(OR = 4.605), distance between eyes and book less than one foot (OR = 1.291), and parents with myopia (one, OR = 2.437; two, OR = 4.453) had higher risks of myopia (all, p < 0.05). For Gannan Prefecture, girls (OR = 1.477), senior students (OR = 1.537), daily time spent doing homework ≥2 h (OR = 1.420), the distance between eyes and book less than one foot (OR = 1.205), mean time continuous eye use (0.25-<0.5 h, OR = 1.345, 0.5-<1 h, OR = 1.317, ≥1 h, OR = 1.313), average daily sleep duration <8 h (OR = 1.399), and parents with myopia (one, OR = 1.852; two, OR = 2.913) had higher risks of myopia (all, p < 0.05). The prevalence of myopia is at a relatively high level in Gansu Province. The prevalence and risk factors for myopia vary by region.

Prevalence and associated factors of myopia among adolescents aged 12–15 in Shandong Province, China: a cross-sectional study

Myopia is a growing concern worldwide, especially among adolescents. This study aimed to investigate the prevalence and associated factors of myopia in adolescents aged 12–15 in Shandong Province, China. This cross-sectional study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines and involved stratified random cluster sampling of 128,678 students from 186 middle schools across 17 cities in Shandong Province. Data collection was conducted from March to April 2024. We excluded students with organic eye diseases, abnormal binocular vision functions, or a history of eye injuries or surgeries. Myopia was assessed using the standard logarithmic visual acuity chart and autorefractor without inducing ciliary muscle paralysis. A comprehensive questionnaire survey was conducted to gather demographic characteristics and daily life behaviors. With the chi-squared test for univariable analysis and multivariable logistic regression for identifying significant factors. This study included 126,375 participants, with a gender distribution of 51.02% male and 48.98% female. The overall prevalence of myopia was 71.34%. Higher prevalence was observed in girls (72.26%) compared to boys (70.45%), and the prevalence increased with age, peaking at 73.12% in 15-year-olds. Urban residents had a higher prevalence (71.86%) than rural (70.39%). Factors such as increased frequency of eye usage while lying down or leaning forward, frequent use of eyes while walking or riding in a car, prolonged screen time, and extended homework duration were associated with higher odds of developing myopia. Conversely, higher frequency of outdoor exercise, maintaining proper posture during reading and writing, greater distance from eyes to screen, and longer sleep duration were associated with lower odds. Additionally, female gender, older age, urban residence, and parental history of myopia increased the risk. The high prevalence of myopia among adolescents in Shandong Province was influenced by a combination of demographic, behavioral, and environmental factors. The study highlighted the importance of lifestyle modifications, such as increasing outdoor activities and maintaining proper visual habits, limiting the duration of screen exposure and homework sessions, and extending sleep duration, to mitigate the risk of developing myopia. These findings underscored the need for targeted public health interventions and educational campaigns to address this significant public health issue.

Effectiveness of low-level red light for controlling progression of Myopia in children and adolescents

ObjectiveTo evaluate the effectiveness of low-level red light (LRL) in controlling the progression of myopia in children and adolescents. MethodsA randomized controlled trial was conducted from March 2022 to June 2022 at the Xuzhou First People's Hospital. A total of 73 children and adolescents with myopia, between the ages of 6 and 14, and meeting the inclusion criteria, were randomly divided into two groups. The experimental group wore single vision spectacles with LRL intervention, while the control group wore single vision spectacles alone. Spherical equivalent refraction (SER), axial length (AL), subfoveal choroidal thickness (SFCT), and best-corrected visual acuity (BCVA) were measured for the participants. Data analysis was performed using chi-square test, independent samples t-test, and Mann-Whitney U test. To compare the changes in SER and AL between groups, we utilized the Generalized Estimating Equations (GEE) model. ResultsThe experimental group was composed of 36 individuals, while the control group had 37. The mean age of the participants was 8.9 ± 2.0 years. No statistically significant distinctions in SER, AL and SFCT were observed between the two groups at baseline (P > 0.05). After 6 months of intervention, the experimental group's increase in SER (-0.01D; 95 % CI: -0.09, 0.06) was higher than that of the control group (-0.41D; 95 % CI: -0.51, -0.32), with a significance level of P < 0.001. Furthermore, the changes over time revealed significant differences between the two groups (Wald χ2group×time: 31.576, P < 0.001). The experimental group's AL increase (-0.02 mm; 95 % CI: -0.07, 0.03) was less than the control group's (0.22 mm; 95 % CI: 0.19, 0.25) (P < 0.001), with a significant difference over time between them (wald χ2group×time: 62.305, P < 0.001). SFCT change after 6 months in the experimental group was significantly greater (29.19 μm; 95 % CI: 18.48, 39.91) compared to that of the control group (-6.59 μm; 95 % CI: -14.28, 1.09) (P < 0.001). No adverse events were observed, and there was no evidence of fundus structural damage on OCT imaging. ConclusionsThe findings suggest that low-level red light can effectively control myopia progression in children and adolescents within 6 months. No adverse reactions were observed.

Myopia Prevalence in Latin American Children and Adolescents: A Systematic Review and Meta-Analysis.

Although myopia is a growing global concern, comprehensive studies on its prevalence among Latin American (LATAM) children and adolescents are still lacking. Thus, we conducted a systematic review and meta-analysis to determine the prevalence of myopia in LATAM children and adolescents aged three to 20. The study conducted a thorough literature search from January 1, 1975, to February 28, 2023, identifying 24 studies on the prevalence of myopia in LATAM that met the inclusion criteria. Quality assessment and standardized data collection were performed. The meta-analysis used a random-effects model due to heterogeneity and calculated prevalence rates. Finally, the analysis of data from 24 eligible studies revealed a myopia prevalence of 8.61% (range 0.80-47.36%, 95% confidence interval (CI): 5.22-13.87%, p < 0.05) among 165,721 LATAM children and adolescents. No significant age-based associations or temporal trends were observed in this study. Studies with non-cycloplegic or objective assessment exhibited a numerically higher, although statistically non-significant, myopia prevalence (10.62%, 95% CI: 4.9-21.6%) compared to studies using cycloplegia (7.17%, 95% CI: 3.40-14.50%). In conclusion, myopia affects approximately one in 11 LATAM children and adolescents. Given the increasing exposure of LATAM youth to known myopia risk factors, such as extensive near-work, online learning, and limited outdoor activities, it is crucial to monitor myopia trends in this region. Further research is imperative to address and prevent myopia in LATAM.

Socioeconomic disparities and green space associated with myopia among Chinese school-aged students: A population-based cohort study.

There is increasing evidence on the link between environmental factors and myopia in children and adolescents, yet with inconsistent conclusions. We investigated the associations between socioeconomic inequalities and green space with myopia in school-aged students participating in the Tianjin Child and Adolescent Research of Eye (TCARE) study. We obtained data from a population-based dynamic cohort study conducted in Tianjin, China, in 2021 and followed up in 2022. We included 1 245 271 participants from 16 districts with an average age of 11.6 years (standard deviation = 3.3) in our analysis. We synthesized their area-level SES through a prediction model that combined economic, educational, and health care variables and assessed the greenness levels surrounding the school using the Normalized Difference Vegetation Index (NDVI) based on data obtained through satellite remote sensing. We performed generalised linear mixed effects analyses for each myopia outcome separately, with adjustments for students' sex, years of education completed, and the school's geographical location. We observed that students living in low SES areas had the highest prevalence of myopia (60.7%) in the last screening in 2022, as well as a higher incidence of one-year myopia (26.4%) compared to those residing in middle SES areas (22.7%). With a 0.1 increase in the 250, 500, and 1000 m buffer NDVI, the prevalence of myopia dropped by 6.3% (odds ratio (OR) = 0.937; 95% confidence interval (CI) = 0.915, 0.960), 7.7% (OR = 0.923; 95% CI = 0.900, 0.946), and 8.7% (OR = 0.913; 95% CI = 0.889, 0.937), respectively. The interaction analysis showed that low SES and low greenness exacerbate the prevalence of myopia. Findings from longitudinal analyses consistently demonstrated a correlation between higher values of NDVI and a slower progression of myopia. These findings remained robust across sensitivity analyses, including for variables on parental myopia and students' behaviors. Exposure to green spaces could play a crucial role in slowing the progression of myopia among school-aged students. Myopia control policies should prioritise young populations residing in low SES areas with limited access to green spaces, as they face the highest potential risks.

The association between screen time exposure and myopia in children and adolescents: a meta-analysis

ObjectiveThis study aimed to systematically review epidemiological evidence on associations between screen time exposure and myopia in children and adolescents, and to quantitatively evaluate summary effect estimates from existing literature.MethodThere were three online databases including PubMed, Embase, and Web of Science, for epidemiological studies on screen time exposure and myopia published before June 1, 2023. The risk of bias was assessed by the Newcastle Ottawa Scale (NOS) checklist. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate the correlation between screen time exposure and myopia using random or fixed-effect models by exposure type (categorical/continuous). We also performed subgroup analysis by screen device type, study quality, geographic region, and research period.ResultsWe searched 7,571 records from three databases and identified 19 eligible studies, including 14 high-quality studies and 5 moderate-quality studies. Meta-analyses suggested that there was a statistically significant correlation between screen time (high vs. low) and myopia. The pooled ORs with 95%CIs were respectively 2.24 (1.47–3.42) for cross-sectional studies, and 2.39 (2.07–2.76) for cohort studies. We also found a significant association between continuous exposure to screen time (per 1 h/d increase) and myopia in cohort studies. The pooled ORs with 95%CIs were 1.07 (1.01–1.13). In subgroup analysis stratified by screen device type in cross-sectional studies, screen time exposures from computers (categorical: OR = 8.19, 95%CI: 4.78–14.04; continuous: OR = 1.22, 95%CI: 1.10–1.35) and televisions (categorical: OR = 1.46, 95%CI: 1.02–2.10) were associated with myopia, while smartphones were not. Although publication bias was detected, the pooled results did not show significant changes after adjustment using the trim and fill method.ConclusionOur findings support that screen time exposure was significantly associated with myopia in children and adolescents. Notably, screen time exposure from computers may have the most significant impact on myopia.