Development pattern of ocular biometric parameters and refractive error in young Chinese adults: a longitudinal study of first-year university students

Abstract

Background The increase in the prevalence of myopia has become a matter of serious public health concern, and few studies to date have examined the ocular biometric parameters of myopia in young Chinese adults. This study aimed to investigate the longitudinal ocular biometric and refractive development of first-year university students and the influence of near work. Methods This study included 526 first-year university students from Tianjin Medical University (mean age, 18.34 years; 313 females and 213 males). From 2016 to 2018, participants underwent ocular biometry measurements and subjective refraction annually. Near-work activities such as the use of electronic devices, online games, reading, and writing as well as demographic data were recorded by questionnaires. Results The prevalence of myopia in this population from 2016 to 2018 was 92.40%, 92.59%, and 92.97%, respectively. Importantly, the prevalence of high myopia increased significantly from 20.91% to 28.33% (P < .001). The spherical equivalent refraction was significantly more myopic by approximately − 0.38 D (from − 4.18 ± 2.44 to − 4.56 ± 2.57 D; P < .001) during the period. The axial length, central corneal thickness, and lens thickness became significantly different (all P < .05), and the axial length significantly increased by 0.12 mm during 2 years (P < .001). Using binary logistic regression analysis, the data indicated that spending more time on online games (odds ratio, 2.09; 95% confidence interval, 1.33–3.29) could speed up the progression of myopia (P < .05). Conclusions This study showed that the prevalence of high myopia continued to increase in undergraduate students over 2 years. Baseline myopia correlated with myopic shift, the time spent on online games, and parental myopia were significantly associated with an increase in myopia in these young adult populations.

The association between time spent on screens and reading with myopia, premyopia and ocular biometric and anthropometric measures in 6‐ to 7‐year‐old schoolchildren in Ireland

“…The association between more time spent reading, longer AL and a more myopic SER found in 7‐ to 9‐year‐olds in Singapore contrast with the present study, where no association between ocular biometric parameters and time spent reading was found 39 . However, more recent studies demonstrated that increased screentime and time spent engaged in online gaming was associated with a longer AL and myopic SER in 18‐year‐olds 40 . Moreover, the association between increased screentime, a higher AL/CR and more myopic SER found in the present study aligns with objectively measured smartphone use in Dutch 13‐year‐olds, 16 where continuous use during schooldays was positively associated with AL/CR and negatively associated with SER.…”

“…39 However, more recent studies demonstrated that increased screentime and time spent engaged in online gaming was associated with a longer AL and myopic SER in 18-year-olds. 40 Moreover, the association between increased screentime, a higher AL/CR and more myopic SER found in the present study aligns with objectively measured smartphone use in Dutch 13-year-olds, 16 where continuous use during schooldays was positively associated with AL/CR and negatively associated with SER.…”

Prevalence of myopia among senior students in Fenghua, Eastern China, before and during the COVID-19 pandemic

“…The prevalence myopia among students in eastern cities is generally higher, with two cities in Jiangsu Province reporting prevalence rates of 86.8% for high school students (11,30). The prevalence of myopia among adolescents in some northern cities was even above 90%, with the prevalence of high myopia reaching more than 20% (32,33,36,37). In contrast, myopia prevalence is relatively low in some western and minority regions such as Xinjiang, with 80.5% of adolescents aged 14 to 18 (38).…”

Prevalence and risk factors for refractive error in older adults in eight ethnicities in China: The China National Health Survey (CNHS)

“…Asia [4]. The prevalence of high myopia in university students in East Asia was 16%-28% in recent studies [39,40]. Preventing moderate myopia progression to high myopia has become an important research issue [18].…”