Generational Difference of Refractive Error and Risk Factors in the Handan Offspring Myopia Study

Abstract

Citation: Lin Z, Gao TY, Vasudevan B, et al. Generational difference of refractive error and risk factors in the Handan Offspring Myopia Study. Invest Ophthalmol Vis Sci. 2014;55:5711-5717. DOI:10.1167/ iovs.13-13693 PURPOSE. To report the refractive error difference (RED) between parents and their children, and its risk factors, in a rural area of China.METHODS. Children (6-17 years) and their parents (36.2 6 4.1 years) from the Handan Offspring Myopia Study (HOMS) were enrolled. Cycloplegic autorefraction (cyclopentolate 1%, Topcon KR8800) of the children and noncycloplegic autorefraction of their parents were assessed. A detailed vision-based questionnaire was also completed. Refractive error difference was defined as the difference between the parental spherical equivalent (SE) and their children's SE. Generational myopic shift was defined as the estimated RED when a child would be 18 years old according to a prediction model. RESULTS.Three hundred fifty-six pairs of parents and 585 children were enrolled. The RED (median, quartiles) increased from À1.33 (À1.99, À0.98) diopters (D) in children aged 6 to 7 years to 0.81 (À0.16, 2.28) D in children aged 16 to 17 years. The children's SE was predicted to approach the parental SE at 14 years of age. Moreover, the children's estimated myopic shift would be 1.03 D. Multiple linear regression revealed that older children (b ¼ 0.23 D/y, P < 0.0001) and girls (b ¼ 0.24, P ¼ 0.01) tended to have a higher RED.CONCLUSIONS. In this rural Chinese population, the children's refraction was estimated to be similar to the parental refraction at 14 years of age. Moreover, the generational myopic shift was estimated to be approximately 1 D at 18 years of age. These data suggest that the generational difference reflects the increasing prevalence of myopia in the younger generation, which is likely due to changes in environmental exposure.

Prevalence of Myopia in Schoolchildren in Ejina: The Gobi Desert Children Eye Study

“…All these studies, including investigations assessing differences in refractive error between parents and their children, agree on the considerable increase in the prevalence of myopia. 28 As in previous studies, factors associated with myopia in our study were older age, parental myopia, and time spent outdoors. [29][30][31] Interestingly, the prevalence of high myopia (refractive error À6.00 and À8 D) was not significantly associated with the time spent outdoors in our study.…”

Myopigenic Activity Change and Its Risk Factors in Urban Students in Beijing: Three-Year Report of Beijing Myopia Progression Study

“…[1][2][3][4][5][6] In the baseline report of the Beijing Myopia Progression Study (BMPS), we demonstrated that the generational myopic shift from parents to their children was approximately 2 diopters (D) and 1D in urban and rural Chinese students, respectively. 7,8 These data provide support that lifestyle and exposure to environmental factors contribute to the development of myopia. Among the environmental factors, daily activities such as near work and outdoor activities are generally thought to be key factors associated with myopic onset and/or its progression.…”

Eye exercises of acupoints: their impact on myopia and visual symptoms in Chinese rural children

“…In the current study, the rural students who performed the eye exercises in school had less myopic refractive error as compared to the urban students (-0.40D vs. -1.70D). Moreover, as compared to urban students, the rural students are exposed to relatively low risk factors for myopia, such as spending less time on near work and more time on outdoor activities, having a more open and spacious living environment, and having fewer myopic parents [21–24]. Lastly, urban student’s myopia and related near oculomotor imbalance may be more “embedded” in those with intensive near work demands, and thus less susceptible to any remediation/intervention [25].…”