Parental Myopia Research Articles

Incidence and Progression of Myopia in Early Adulthood

Myopia incidence and progression has been described extensively in children. However, few data exist regarding myopia incidence and progression in early adulthood. To describe the 8-year incidence of myopia and change in ocular biometry in young adults and their association with the known risk factors for childhood myopia. The Raine Study is a prospective single-center cohort study. Baseline and follow-up eye assessments were conducted from January 2010 to August 2012 and from March 2018 to March 2020. The data were analyzed from June to July 2021. A total of 1328 participants attended the baseline assessment, and 813 participants attended the follow-up assessment. Refractive information from both visits was available for 701 participants. Participants with keratoconus, previous corneal surgery, or recent orthokeratology wear were excluded. Participants' eyes were examined at ages 20 years (baseline) and 28 years. Incidence of myopia and high myopia; change in spherical equivalent (SE) and axial length (AL). A total of 516 (261 male [50.6%]) and 698 (349 male [50.0%]) participants without myopia or high myopia at baseline, respectively, were included in the incidences analyses, while 691 participants (339 male [49%]) were included in the progression analysis. The 8-year myopia and high myopia incidence were 14.0% (95% CI, 11.5%-17.4%) and 0.7% (95% CI, 0.3%-1.2%), respectively. A myopic shift (of 0.50 diopters [D] or greater in at least 1 eye) occurred in 261 participants (37.8%). Statistical significance was found in longitudinal changes in SE (-0.04 D per year; P < .001), AL (0.02 mm per year; P <.001), and lens thickness (0.02 mm per year; P < .001). Incident myopia was associated with self-reported East Asian vs White race (odds ratio [OR], 6.13; 95% CI, 1.06-35.25; P = .04), female vs male sex (OR, 1.81; 95% CI, 1.02-3.22; P = .04), smaller conjunctival ultraviolet autofluorescence area (per 10-mm2 decrease, indicating less sun exposure; OR, 9.86; 95% CI, 9.76-9.97; P = <.009), and parental myopia (per parent; OR, 1.57; 95% CI, 1.03-2.38; P = <.05). Rates of myopia progression and axial elongation were faster in female participants (estimate: SE, 0.02 D per year; 95 % CI, 0.01-0.02 and AL, 0.007 mm per year, 95 % CI, 0.00.-0.011; P ≤ .001) and those with parental myopia (estimate per parent: SE, 0.01 D per year; 95% CI, 0.00-0.02 and AL, 95% CI, 0.002-0.008; P ≤ .001). Education level was not associated with myopia incidence or progression. These findings suggest myopia progression continues for more than one-third of adults during the third decade of life, albeit at lower rates than during childhood. The protective effects of time outdoors against myopia may continue into young adulthood.

Annual Incidences and Progressions of Myopia and High Myopia in Chinese Schoolchildren Based on a 5-Year Cohort Study.

PurposeTo determine the annual incidences and rates of progression of myopia and high myopia in Chinese schoolchildren from grade 1 to grade 6 and explore the possible cause-specific risk factors for myopia.MethodsFrom 11 randomly selected primary schools in Anyang city, central China, 2835 grade 1 students were examined with annual follow ups for 5 years. Students were invited to undergo a comprehensive examination, including cycloplegic autorefraction, ocular biometry, and standardized questionnaires.ResultsThe mean spherical equivalent refraction decreased substantially from +0.94 ± 1.03 diopter (D) in grade 1 to −1.37 ± 2.08 D in grade 6, with rapid annual myopic shifts, especially for students in grades 3 through 6 (−0.51 to −0.59 D). The prevalence of myopia increased substantially, with the yearly incidence of myopia increasing from 7.8% in grade 1 and 2 to 25.3% in grades 5 and 6, and the incidence of high myopia increased from 0.1% to 1.0%. The 5-year incidence of myopia was lowest among children who has a baseline spherical equivalent refraction of greater than +2.00 D (4.4%), and increased to nearly 92.0% among children whose baseline spherical equivalent refraction was 0.00 to −0.50 D. The incidence of myopia was higher in children who had less hyperopic baseline refraction, two myopic parents, longer axial length, deeper anterior chamber, higher axial length–corneal radius of curvature ratio, and thinner lenses.ConclusionsBoth the annual incidence and progression rates of myopia and high myopia were high in Chinese schoolchildren, especially after grade 3. Hyperopic refraction of children should be monitored before primary school as hyperopia reserve to prevent the onset of myopia and high myopia.

Risk Factors for Myopia in 2 Hong Kong School Systems: A Pilot Study.

Myopia has reached "epidemic" proportions, especially in several East Asian countries. Most myopia emerges during childhood, particularly during the school years. The aim of this study was to investigate myopia prevalence and compare risk factors of myopia among Hong Kong Chinese primary school children under 2 different educational systems. Cross-sectional study. Visual assessments were conducted in 1 government-funded primary school (n = 159) and 1 international school (n = 223) in Hong Kong in September and October 2018, respectively. Measurements were performed on children aged 8 to 10 years old. Noncycloplegic refraction and axial length were measured, respectively. A validated questionnaire focusing on demographic information, nonscreen time (eg, reading and writing on paper materials), screen time (ie, smartphones and tablets usage), time spent on outdoor activities, and other myopia risk factors was completed by parents of participants. The prevalence of myopia [37.5% vs 12.8%, P < 0.001; spherical equivalent refraction (SER) ≤ -1.00 diopter (D)] and refractive astigmatism [25.0% vs 7.2%, P < 0.001; cylinder (Cyl) ≥ 1.00 diopter cylinder (DC)] were significantly higher in the local school than in the international school. Students in the local school were slightly older than those attending the international school (9.17 ± 0.82 years vs 8.95 ± 0.85 years, P = 0.046), and there was no significant difference in gender distribution between the 2 schools (P = 0.51). There were significant differences in the demographic information including parental myopia (P < 0.001), family income (P < 0.001), and parents' educational level (P < 0.001) between the 2 schools. Multiple regression analysis showed that parental myopia history and continuous near work was associated with myopia in the local school, while the father's educational level was related to myopia in the international school. In this pilot study, despite the much higher prevalence of parental myopia and high myopia in the international school, the myopia prevalence among the students is lower in this school than in the local school, suggesting that environmental factors other than genetics might have a stronger protective effect in this school population.

Prevalence and risk factors of myopia amongst Grade 8 learners in the Vhembe district, South Africa

Background: Myopia is the most common cause of refractive errors in both adults and children in many countries. However, it is not a simple refractive error but sometimes and eyesight-threatening disorder. The disorder has a great impact on public health and the socio-economic well-being of people, particularly children.Aim: The study aimed to assess the prevalence of myopia amongst secondary school learners.Setting: The study was conducted in the Vhembe District, South Africa.Methods: A cross-sectional study was carried out amongst 297 Grade 8 students of 13 to 14 years of age. The students were selected using a multi-stage-stratified cluster sampling technique from three secondary schools. Two public secondary schools and one private secondary school. The learners’ socioeconomic background, type of school and parental myopia were assessed by a questionnaire before visual acuity assessment. Learners with visual acuity of less than or equal to 6/12 in the worse eye, who showed vision improvement with pinhole, underwent non-cycloplegic retinoscopy and subjective refraction were selected. Myopia was defined as a spherical equivalent of less than or equal to −0.50 dioptre (D). Data were analysed using descriptive statistics.Results: A total of 289 learners completed the study (156 aged 14 years and 133 aged 13 years). A total of 30 learners were identified to have myopic refractive error making the prevalence of 10.4%. Of the 154 females, 14 (47.0%) had myopia, whilst 16 (53.0%) of the 135 males had myopia making males slightly more myopic than females. From the total learners diagnosed to have refractive error (n = 40), myopia constituted 30/40 (75.0%) of the learners indicating that it is the commonest type of refractive error amongst secondary learners. Myopia was more common amongst older age children (14 years; 57.0%). About 18 (60.0%) participants were from the urban area. A total of 17 (57%) of the myopic learners attended private school and about 63% of the participants’ parents were myopic.Conclusion: Spending more time indoor and continuous reading without resting are risk factors of myopia whilst increased outdoor activities were observed as protective environmental factors against myopia in secondary school learners. Doing more outdoors activities may be beneficial to protect against myopia onset.

Dietary intake and associations with myopia in Singapore children.

To evaluate associations of dietary factors with myopia, spherical equivalent refractive error (SE) and axial length (AL) in children at age 9 from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort. We included 467multi-ethnic children (933 eyes) who participated in the GUSTO prospective birth cohort and were delivered in two major hospitals in Singapore (2009-2010). At the 9-year visit, we assessed the 6-year incidence of myopia (between ages 3 to 9), cycloplegic SE and AL in children without myopia (SE≤-0.5D in either eye) at the 3-year visit. Using a validated 112-item food frequency questionnaire, parents reported each child's average daily intake of dietary factors (nutrients and food groups) in the past month. Paired eyes were analysed using Generalised Estimating Equations with multivariable logistic or linear regression. Bonferroni corrections were applied, correcting for multiple comparisons between the 13 nutrients (p<0.004) or 8 food groups (p<0.006) and each outcome. In children aged 9years (51.0% boys; 56.3% Chinese), the 6-year incidence of myopia was 35.5%. Overall, the mean (SD) SE and AL were -0.3 (1.7)D and 23.4 (1.0)mm, respectively. In multivariable regression, macronutrients or micronutrients were not associated with incident myopia (p≥0.004 for all), adjusting for total energy, gender, ethnicity, time outdoors, near-work and the number of myopic parents (additionally child's height for outcome AL). Similarly, all food groups (including refined grains, sugar-sweetened beverages, protein foods, fruits and vegetables) were not associated with incident myopia (p≥0.006 for all). Additionally, none of the nutrients (p≥0.004 for all) or food groups (p≥0.006 for all) were associated with SE or AL. Our study findings of no significant association between specific nutrients or food groups and incident myopia or SE or AL suggest that diet may not be associated with myopia in children aged 9years. Well-conducted prospective studies in other populations may clarify the association.

Prevalence and risk factors of myopia amongst Grade 8 learners in the Vhembe district, South Africa

Background: Myopia is the most common cause of refractive errors in both adults and children in many countries. However, it is not a simple refractive error but sometimes and eyesight-threatening disorder. The disorder has a great impact on public health and the socio-economic well-being of people, particularly children. Aim: The study aimed to assess the prevalence of myopia amongst secondary school learners. Setting: The study was conducted in the Vhembe District, South Africa. Methods: A cross-sectional study was carried out amongst 297 Grade 8 students of 13 to 14 years of age. The students were selected using a multi-stage-stratified cluster sampling technique from three secondary schools. Two public secondary schools and one private secondary school. The learners’ socioeconomic background, type of school and parental myopia were assessed by a questionnaire before visual acuity assessment. Learners with visual acuity of less than or equal to 6/12 in the worse eye, who showed vision improvement with pinhole, underwent non-cycloplegic retinoscopy and subjective refraction were selected. Myopia was defined as a spherical equivalent of less than or equal to −0.50 dioptre (D). Data were analysed using descriptive statistics. Results: A total of 289 learners completed the study (156 aged 14 years and 133 aged 13 years). A total of 30 learners were identified to have myopic refractive error making the prevalence of 10.4%. Of the 154 females, 14 (47.0%) had myopia, whilst 16 (53.0%) of the 135 males had myopia making males slightly more myopic than females. From the total learners diagnosed to have refractive error ( n = 40), myopia constituted 30/40 (75.0%) of the learners indicating that it is the commonest type of refractive error amongst secondary learners. Myopia was more common amongst older age children (14 years; 57.0%). About 18 (60.0%) participants were from the urban area. A total of 17 (57%) of the myopic learners attended private school and about 63% of the participants’ parents were myopic. Conclusion: Spending more time indoor and continuous reading without resting are risk factors of myopia whilst increased outdoor activities were observed as protective environmental factors against myopia in secondary school learners. Doing more outdoors activities may be beneficial to protect against myopia onset.

Effects of eye exercises on axial eye elongation in junior students

Objective: To evaluate the association between the eye exercises and one-year axial eye elongation in grade 7 students in Beijing. Methods: Sampling was performed using a multistage random cluster approach, and 1 443 students of grade 7 were selected from 9 middle schools in 6 districts for the baseline survey. Data were collected by questionnaires and axial length measurement. Multiple linear regression analysis was used to evaluate the association between eye exercises and excessive axial eye elongation. Results: Among 1 197 (82.95%) students with complete information, the median (QR) age was 12.00 (1.00) years old, girls accounted for 44.28%, and the median (QR) axial eye elongation was 0.22 (0.18) mm. In the multiple linear regression analysis, the frequency of eye exercises was significantly correlated with excessive axial eye elongation in boys (β=-0.135, 95%CI:-0.253--0.018) but not in girls (β=-0.075, 95%CI:-0.207- 0.058) after adjusting for sex, age, body height, the number of myopic parents, time spent outdoors and time spent on reading and writing outside class; while the seriousness of eye exercises was not significantly associated with axial eye elongation in boys (β=-0.028, 95%CI: -0.114-0.058) and girls (β=-0.035, 95%CI: -0.134-0.064). Conclusion: The increased frequency of eye exercises is beneficial to control the axial eye elongation in boys in Beijing.

Prevalence of myopia in children and adults in Europe and North America

Purpose. The prevalence of myopia varies highly between different ethnic groups. Especially in East and Southeast Asia the prevalence of myopia is very high. In addition to ethnic factors, the prevalence of myopia is determined by genetic factors. The aim of the literature review is to determine the prevalence of myopia among children and adults of Caucasian origin in Europe and North America. Material and Methods. A systematic literature review was performed for the prevalence of myopia in Europe, Middle East, North America, and Australia. For the evaluation of the results, the methodological requirements of an epidemiologi- cal study of myopia prevalence were formulated. A threshold of -0.50 D and retinoscopy should be standard. Results. The prevalence of myopia is not increased among Caucasians with 30 % from a statistical point of view. In children, the prevalence of myopia can be assumed to be 15 %. The risk of myopia is increased threefold in children with myopic parents compared to children with nonmyopic pa- rents. Refraction determination with autorefractometers and omission of cycloplegia leads to a significant overestimation of the prevalence of myopia. Conclusion. An increase in myopia prevalence can not ne- cessarily be inferred from the observed prevalence of 30% among Caucasians. A reliable determination of myopia pre- valence requires standardized examination methods and thresholds for myopia. Keywords myopia, ethnicity, genetics, children, prevalence

Influence of the interaction between parental myopia and poor eye habits when reading and writing and poor reading posture on prevalence of myopia in school students in Urumqi, China

BackgroundTo evaluate the prevalence of myopia in school students in Urumqi, China, and explore the influence of the interaction between parental myopia and poor reading and writing habits on myopia to identify the at-risk population and provide evidence to help school students avoid developing myopia.MethodsA cross-sectional survey was conducted with 6,883 school students aged 7–20 years in Urumqi in December 2019. The Standard Eye Chart and mydriatic optometry were used to determine whether students had myopia. Falconer’s method was used to calculate the heritability of parental myopia. Multivariate unconditional logistic regression models were used to analyze the risk factors for myopia and the additive and multiplicative interaction of parental myopia and poor reading and writing habits.ResultsAfter standardizing the age of the 6,883 students, the overall prevalence rate of myopia was 47.50 %. The heritability of parental myopia was 66.57 % for boys, 67.82 % for girls, 65.02 % for the Han group, and 52.71 % for other ethnicities. There were additive interactions between parental myopia and poor reading and writing habits; among them, parental myopia and poor eye habits when reading and writing (the distance between the eyes and book is less than 30 cm when reading and writing, fingers block the sight of one eye while holding the pen, and leaning one’s body when reading and writing; habit 1) increased the risk of myopia by 10.99 times (odds ratio [OR] = 10.99, 95 % confidence interval [CI] = 8.33–14.68), parental myopia and poor reading posture (reading while lying down, walking, or in the car; habit 2) increased the risk of myopia by 5.92 times (OR = 5.92, 95 % CI = 4.84–7.27). There was no multiplicative interaction between parental myopia and habit 1 or habit 2 (OR = 0.69, 95 % CI = 0.44–1.08; OR = 0.89, 95 % CI = 0.66–1.21, respectively).ConclusionThe prevalence of myopia among students in Urumqi, Xinjiang is relatively high. The risk of developing myopia is affected by parental myopia and poor reading and writing habits. In addition, parental myopia amplifies the harm caused by poor reading and writing habits, thereby increasing the risk of myopia. Students with parents who have myopia should be targeted during myopia prevention efforts.

Familial Aggregation and Heritability of Myopia: A Local Population Survey in Shanxi, China.

Purpose To further determine the roles of environmental and genetic factors in the development of myopia, a comprehensive survey was performed. The guidance for myopia-susceptible people is established which might help prevent or delay the onset and development of myopia. Methods 1,852 students were recruited using the multistage sampling approach from the Gaoping county in Shanxi. The refractive status of students was examined using an autorefractometer, and the refractive status of students' first-degree relatives was collected using a well-designed questionnaire. Family aggregation of myopia was analyzed according to the myopic status of the students (nonmyopic or myopic group). The prevalence and heritability of myopia in students and their first-degree relatives were further explored by subdividing into mild, moderate, and high myopia groups. Significance analysis among each group was performed by the χ2 test using SPSS 25.0 software. Falconer's method was used to calculate the inheritability of myopia. Results A total of 1,852 subjects were recruited in this study, and 1,813 subjects were finally included. The family aggregation of myopia in the myopic student group (34.7%) was significantly higher than that in the nonmyopic group (8.5%). The prevalence of mild, moderate, and high myopia in children (students and siblings) was higher than that in their parents. The rate of high myopia (6.33%) was significantly higher among students with one or both myopic parents than those without myopic parents (3.85%). The heritability of mild, moderate, and high myopia among parents-offspring was 3.72%, 20.47%, and 48.00%, respectively. The heritability of mild, moderate, and high myopia among siblings was 17.50%, 86.09%, and 78.75%, which is significantly higher than that among parents-offspring. In addition to genetic factors, extensive near-work time, higher education pressure, and minimal outdoor activities contribute significantly to mild and moderate myopia. Conclusions Myopia is of high risk due to familial aggregation. Students with a family history of myopia are more likely to have high myopia than those without family history. The occurrence and development of high myopia are affected by both the genetic and environmental factors, which could either weaken or strengthen myopia. Therefore, students with a family history of myopia should pay close attention to their eye health to avoid the occurrence of myopia and the deepening of diopter, which may lead to high myopia and its related complications.

Environmental and Behavioral Factors with Refractive Error in Israeli Boys.

Evidence supporting the contributions of near work in myopia is equivocal. Findings from this pilot study suggest that a high prevalence of myopia in ultra-Orthodox boys may be attributed to intense near work at school and learning to read in preschool at an early age. This study aimed to assess factors that may influence myopia in three groups of Jewish boys with different educational demands. Healthy ultra-Orthodox, religious, and secular Jewish boys (n = 36) aged 8 to 12 years participated. Refractive status, education, time spent reading and writing, and electronic device use were assessed using a questionnaire, and time outdoors and physical activity were assessed objectively using an Actiwatch. Data were analyzed with χ2 and Kruskal-Wallis tests with Bonferroni post hoc comparisons. Ultra-Orthodox (n = 14) and religious (n = 13) children had greater myopia prevalence compared with secular children (n = 9; P = .01), despite no differences in parental myopia. Actigraph data showed that there were no differences in activity (P = .52) or time spent outdoors (P = .48) between groups. Ultra-Orthodox children learned to read at a younger age and spent more hours at school (P < .001 for both). All groups engaged in a similar amount of near work while not in school (P = .52). However, ultra-Orthodox boys had less electronic device use than did religious (P = .007) and secular children (P < .001). This pilot study demonstrates that ultra-Orthodox, religious, and secular children have distinct educational demands but similar time outdoors, physical activity, and near work while not in school. The findings suggest that near work at school and/or learning to read in preschool at an early age may contribute to previously reported differences in refractive error between groups. However, conclusions should be confirmed in a larger sample size.

Associations of near work time, watching TV, outdoors time, and parents' myopia with myopia among school children based on 38-year-old historical data.

To study the prevalence and risk factors of myopia with data from a questionnaire study conducted in 1983 among Finnish school children. School children (n = 4 961) from the 1st, 5th and 8th grades of school (7-, 11- and 15-year-olds) in Central Finland were screened for vision followed by a questionnaire, which was returned by 4 352 (87.7%) participants. Myopia was categorized based on the questionnaire. Items concerned daily time spent on near work and outdoor activities, excluding time spent at school, watching TV and parental myopia and the associations of myopia with these factors were studied. The prevalence of myopia was 3%, 15% and 27% among the 7-, 11- and 15-year-olds, and if daily near work at home was ≤1 hr, myopia prevalence was 0.5%, 3.3% and 17.6%, respectively. The adjusted risk of myopia for each daily near work hour was OR 1.476 (95% confidence interval 1.099-1.984, p = 0.010), OR 1.346 (1.170-1.584, p < 0.001) and OR 1.206 (1.076-1.352, p = 0.001), in the 3 age groups, respectively. The adjusted risk of myopia for each daily hour spent outdoors was OR 0.764 (0.648-0.900, p = 0.001) in the 11-year-olds and OR (0.840, 0.743-0.950, p = 0.005) in the 15-year-olds. Outdoors time prevented myopia at different levels of near work, although less at the highest levels, and near work increased risk of myopia with the level of outdoors time. If the ratio between near work and outdoors time was ≤0. 5 or >1.5, the prevalence of myopia was 1.4% versus 5.6%, 6.3% versus 24.7% and 15.9% versus 36.9%, among the 7-, 11- and 15-year-olds, respectively. The higher prevalence of myopia among the 11- and 15-year-old girls than boys was explained by more near work and less outdoor time among the girls. Having two myopic parents roughly doubled the risk of myopia compared to if one myopic parent in the 11- and 15-year-olds. Myopic parents, greater near work time, less outdoors time, a higher near work/outdoors ratio, and being a girl increased the risk of myopia. Myopia was rare in the 7- and 11-year-olds if daily near work at home did not exceed one hour or if the near work/outdoors ratio was not higher than 0.5. Outdoors time was associated with the prevalence of myopia at all levels of near work, although the association was weaker at the highest level.

Prediction of premyopia and myopia in Chinese preschool children: a longitudinal cohort

BackgroundsMyopia has become a global public health problem. Children with early onset of myopia are at particular risk of complications associated with myopia. Younger children and children with greater initial myopic refractive errors are at a greater risk of myopia progression. Therefore, it is essential to identify subjects at high risk of developing myopia to facilitate myopia prevention in the early stage, especially during the preschool period. The purpose of this study was to determine whether premyopia and myopia in preschool children can be predicted by easily obtainable parameters.MethodsData was collected in a population-based cohort. Comprehensive examinations included height, weight, refraction, axial length (AL), and corneal radius of curvature (CR), with a follow-up of 2 years. Parental myopia history was obtained from a questionnaire. Myopia was defined as spherical equivalent (SE) ≤ − 0.50 D. Premyopia was defined as − 0.50 D < SE ≤ + 0.75 D. Multivariate linear regression models were fitted to determine the associations between these parameters at baseline and future SE. To predict premyopia and myopia, Cox proportional hazard regression analysis coupled with a nomogram was used.ResultsA total of 830 children (433 boys and 397 girls) were included (40.83 ± 3.43 months old at baseline). A significantly negative relationship was observed in the multivariate analysis between baseline AL, AL/CR, two myopic parents, and the future SE after adjusting for age and gender (coefficient = − 0.291, coefficient = − 5.791, coefficient = − 0.273, respectively, both p < 0.001). Higher baseline AL, AL/CR (hazard ratio (HR) = 4.916, HR = 2.979, respectively, comparing the top quartile with the bottom quartile, both p < 0.001) and two myopic parents (HR = 1.756, compared to no myopic parents, p = 0.001) were associated with a higher risk of future onset of premyopia. From the nomogram, AL/CR was found to have the most enormous effect on survival. Different baseline AL and AL/CR values (both Log Rank p < 0.001) had different survival curves.ConclusionsAL and AL/CR could be used as obtainable indicators for identifying subjects at high risk of developing premyopia and myopia in young preschool children.

Association study of the serum 25(OH)D concentration and myopia in Chinese children.

To analyze the serum 25 hydroxyvitamin D (25[OH]D) concentration in Chinese children with myopia and explore its correlation with myopia.From July to September in 2019, myopic children were collected from the Myopia Influencing Factors Survey Project. The basic information and vision related behaviors of the subjects were collected by questionnaire. The diopter of the children without dilated pupils was measured by the computerized refractometer. Meanwhile, 5 ml fasting venous blood samples were collected for the determination of serum 25(OH)D concentration.A total of 186 children were included in this study, including 90 males and 96 females, with an average age of 8 ± 3.26 years. The detection rate of serum 25(OH)D deficiency in myopic children was 65.59% (122/186). There was statistical significance in the detection rate of serum 25(OH)D deficiency in children with different myopic degrees (χ2 = 6.635, P = .010). The average serum 25(OH)D concentration in myopic children was 14.86 (10.67–18.96) ng/ml, and the difference of serum 25(OH)D concentration in children with different myopia degrees was statistically significant (Z = 20.23, P < .001). Logistic regression analysis showed that after controlling for gender, parental myopia, after-school class, and outdoor activities, the prevalence of developing moderate and high myopia was 2.051 times (95% confidence interval: 1.272–3.724) higher in the serum 25(OH)D deficiency group than in the serum 25(OH)D sufficiency group. There is a positive correlation between serum 25(OH)D concentration and the equivalent spherical degree of myopic children.The study found that serum 25(OH)D concentration is closely related to the prevalence of myopia in Chinese children. The results further support the conclusion that children with a higher level of serum 25(OH)D have a lower prevalence of moderate to high myopia. The results of this study provide a basis for further research into the relationship between vitamin D and visual development in children and its mechanisms.

Early Age of the First Myopic Spectacle Prescription, as an Indicator of Early Onset of Myopia, Is a Risk Factor for High Myopia in Adulthood.

Purpose The present study investigated the risk factors for high myopia in adulthood, with a focus on the age at which children wore their first spectacles. Methods Adults aged between 20 and 45 years were invited to complete a questionnaire about age, sex, current refractive error, high myopia in parents, early onset of myopia presented by the age of the first myopic spectacle prescription, refractive power of the first spectacles, and life habits at different educational stages. The associations between these factors and high myopia in adulthood were then evaluated and analyzed. Results In total, 331 participants were enrolled. Their average refractive error was −4.03 diopters, and high myopia was noted in 27.5% of the study participants. Only 3.3% of participants had fathers with high myopia, while 6.0% had mothers with high myopia. The participants received their first myopic spectacle prescription at a mean age of 13.35 years, with a mean refractive error of −1.63 diopters. The significant risk factors for developing high myopia in adult life were earlier age of the first spectacles prescribed (p < 0.001), higher refractive power of the first spectacles (p < 0.001), mother with high myopia (p=0.015), and after-school class attendance in senior high school (p=0.018). Those who wore their first spectacles at <9 years of age were more predisposed to high myopia than those who did so at ≧13 years, with an odds ratio of 24.9. Conclusion The present study shows that earlier onset of myopia, which is presented by the age of the first myopic spectacle prescription, higher myopic refraction of the first spectacles, mothers with high myopia, and after-school class attendance in senior high school are risk factors for high myopia in adulthood. It suggests that delaying the onset of myopia in children is important for the prevention of high myopia in later life.

Risk factors for rapid axial length elongation with low concentration atropine for myopia control

Three hundred and twenty-eight myopic children, randomized to use either 0.01% (N = 166) or 0.02% (N = 162) atropine were enrolled in this study. Gender, age, body mass index(BMI), parental myopia status, atropine concentration used, pupil diameter, amplitude of accommodation, spherical equivalent refractive error (SER), anterior chamber depth (ACD) and axial length (AL) were collected at baseline and 1 year after using atropine. Rapid AL elongation was defined as > 0.36 mm growth per year. Univariate analyses showed that children with rapid AL elongation tend to be younger, have a smaller BMI, use of 0.01% atropine, narrow ACD, lower SER, shorter AL, smaller change in pupil diameter between 1 year and baseline (all P < 0.05). Multivariate logistic regression analyses confirmed that rapid AL elongation was associated with children that were younger at baseline (P < 0.0001), use of 0.01% atropine (P = 0.04), a shorter baseline AL (P = 0.03) and a smaller change in pupil diameter between 1 year and baseline (P = 0.04). Younger children with shorter AL at baseline, less change in their pupil diameter with atropine treatment and using the lower of the two atropine concentrations may undergo rapid AL elongation over a 12 months myopia control treatment period.

Prediction of myopia onset with refractive error measured using non-cycloplegic subjective refraction: the WEPrOM Study

Background/aimsTo evaluate the predictive performance of various predictors, including non-cycloplegic refractive error, for risk of myopia onset under pragmatic settings.MethodsThe Wenzhou Medical University Essilor Progression and Onset of Myopia Study...

The associations of high academic performance with childhood ametropia prevalence and myopia development in China.

BackgroundTo assess associations of high academic performance with ametropia prevalence and myopia development in Chinese schoolchildren.MethodsThis multicohort observational study was performed in Guangdong, China. We first performed a cross-sectional cohort analysis of students in grades 1 to 9 from Yangjiang to evaluate the relationship between academic performance and refractive status on a yearly basis. We also performed longitudinal analyses of students in Shenzhen to evaluate the trend of academic performance with refractive changes over a period of 33 months. All refractive statuses were measured using noncycloplegic autorefractors.ResultsA total of 32,360 children with or without myopia were recruited in this study (mean age 10.08 years, 18,360 males and 14,000 females). Cross-sectional cohort analyses in Yangjiang showed that the prevalence of hyperopia was associated with lower academic scores in grade one, the year students entered primary school (β=−0.04, P=0.01), whereas the prevalence of myopia was associated with higher academic scores in grade six and grade eight, the years in which students were about to take entrance examinations for junior high school or senior high school (β=0.020, P=0.038; β=0.041, P=0.002). Longitudinal analysis showed that in Shenzhen, faster myopia development was associated with better scores in all grades even after adjustments for BMI, outdoor activity time, screen time, reading time, and parental myopia (grade two at baseline: β=0.026, P<0.001; grade three at baseline: β=0.036, P=0.001; grade four at baseline: β=0.014, P<0.001; grade five at baseline: β=0.039, P<0.001; grade six at baseline: β=0.04, P<0.001).ConclusionsRefractive errors correlated significantly with academic performance among schoolchildren in China. Children with high academic performance were more likely to have faster myopia development.

Sleep time and homework hours/daily are associated with reduced visual acuity among school students aged 9-18 in Shenyang in 2016.

The purpose of this survey was to explore the prevalence of reduced visual acuity and its associated factors among school students in Shenyang in 2016. This was a cross-sectional study using data from the Ministry of Education' Student Physical Fitness (MESPF) monitoring in 2016. A total of 13,642 students aged 9-18 years were surveyed in Shenyang. The unaided distance visual acuity was measured, and questionnaire on lifestyle behaviors that may affect visual acuity was investigated among students. The prevalence of reduced visual acuity and its associated factors were analyzed. The average prevalence of reduced visual acuity among students aged 9-18 years was 65.8%, and severe reduced visual acuity was main (42.9%), and there were statistical effect of age, gender, and region on the prevalence of reduced visual acuity. Binary and multi variable logistic regression results revealed that students sleeping <8 h, homework hours ⩾1 h, and parental myopia had an increased risk of reduced visual acuity. Sleep time <8 h and homework time ⩾1 h may be associated with reduced visual acuity among students in Shenyang. Therefore, it is benefit for student to get enough sleep and decreasing studying time in order to prevent and reduce poor vision.

Time spent outdoors in childhood is associated with reduced risk of myopia as an adult

Myopia (near-sightedness) is an important public health issue. Spending more time outdoors can prevent myopia but the long-term association between this exposure and myopia has not been well characterised. We investigated the relationship between time spent outdoors in childhood, adolescence and young adulthood and risk of myopia in young adulthood. The Kidskin Young Adult Myopia Study (KYAMS) was a follow-up of the Kidskin Study, a sun exposure-intervention study of 1776 children aged 6–12 years. Myopia status was assessed in 303 (17.6%) KYAMS participants (aged 25–30 years) and several subjective and objective measures of time spent outdoors were collected in childhood (8–12 years) and adulthood. Index measures of total, childhood and recent time spent outdoors were developed using confirmatory factor analysis. Logistic regression was used to assess the association between a 0.1-unit change in the time outdoor indices and risk of myopia after adjusting for sex, education, outdoor occupation, parental myopia, parental education, ancestry and Kidskin Study intervention group. Spending more time outdoors during childhood was associated with reduced risk of myopia in young adulthood (multivariable odds ratio [OR] 0.82, 95% confidence interval [CI] 0.69, 0.98). Spending more time outdoors in later adolescence and young adulthood was associated with reduced risk of late-onset myopia (≥ 15 years of age, multivariable OR 0.79, 95% CI 0.64, 0.98). Spending more time outdoors in both childhood and adolescence was associated with less myopia in young adulthood.