Myopia: The Evidence for Environmental Factors

Lougheed, Tim

doi:10.1289/ehp.122-a12

Cited by 22 publications

(20 citation statements)

References 31 publications

(34 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Oxidative stress has been shown to impair the release of dopamine from retinal cells [53], which plays a critical role in regulating the axial growth of the eye [1, 8, 54]. Therefore, oxidative stress-related impairment of dopamine release from retinal cells could be one explanation for the impact of air pollution on myopia.…”

Section: Discussionmentioning

confidence: 99%

“…During the past few decades, there has been a notable increase in the global prevalence of myopia, representing an alarming epidemic worldwide [1–4]. Although the reason(s) for this increasing trend are yet to be established, such a rapid increase can be suggestive for a more important contribution of non-genetic and environmental factors in the causation of refractive errors [1, 5, 8]. …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Traffic-related air pollution and spectacles use in schoolchildren

et al. 2017

View full text Add to dashboard Cite

PurposeTo investigate the association between exposure to traffic-related air pollution and use of spectacles (as a surrogate measure for myopia) in schoolchildren.MethodsWe analyzed the impact of exposure to NO2 and PM2.5 light absorbance at home (predicted by land-use regression models) and exposure to NO2 and black carbon (BC) at school (measured by monitoring campaigns) on the use of spectacles in a cohort of 2727 schoolchildren (7–10 years old) in Barcelona (2012–2015). We conducted cross-sectional analyses based on lifelong exposure to air pollution and prevalent cases of spectacles at baseline data collection campaign as well as longitudinal analyses based on incident cases of spectacles use and exposure to air pollution during the three-year period between the baseline and last data collection campaigns. Logistic regression models were developed to quantify the association between spectacles use and each of air pollutants adjusted for relevant covariates.ResultsAn interquartile range increase in exposure to NO2 and PM2.5 absorbance at home was respectively associated with odds ratios (95% confidence intervals (CIs)) for spectacles use of 1.16 (1.03, 1.29) and 1.13 (0.99, 1.28) in cross-sectional analyses and 1.15 (1.00, 1.33) and 1.23 (1.03, 1.46) in longitudinal analyses. Similarly, odds ratio (95% CIs) of spectacles use associated with an interquartile range increase in exposures to NO2 and black carbon at school was respectively 1.32 (1.09, 1.59) and 1.13 (0.97, 1.32) in cross-sectional analyses and 1.12 (0.84, 1.50) and 1.27 (1.03, 1.56) in longitudinal analyses. These findings were robust to a range of sensitivity analyses that we conducted.ConclusionWe observed increased risk of spectacles use associated with exposure to traffic-related air pollution. These findings require further confirmation by future studies applying more refined outcome measures such as quantified visual acuity and separating different types of refractive errors.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Traffic-related air pollution and spectacles use in schoolchildren

et al. 2017

View full text Add to dashboard Cite

show abstract

“…with minor modifications (Dirani et al. ; Lougheed ). Based on this, the authors suggested that outdoor sports had a greater protective effect than indoor sports, because a protective effect was seen for both outdoor sports and outdoor leisure time but less for indoor sports.…”

Section: Discussionmentioning

confidence: 99%

Physical activity in relation to development and progression of myopia – a systematic review

Thykjær

Lundberg

Grauslund

2016

Acta Ophthalmologica

View full text Add to dashboard Cite

On a global scale, myopia is one of the most common causes of visual impairment. Given the increasing prevalence of myopia, it is vital to understand the pathogenesis and to identify potential interventions. Some studies have described physical activity as a potential correlation for myopia. The objective of this study was to make a systematic review regarding the correlation between physical activity and myopia. A total of 263 papers were identified in a systematic database search of PubMed/Medline and Embase. Five steps of screening removed studies of a low evidence quality and animal studies. Studies included had refractive error and physical activity (as measured by questionnaires, accelerometers and cycle ergometers) as separate, well-defined outcomes. Nine studies (six cross-sectional, two cohorts and one case-control study) with a total of 17 634 subjects were included. Six studies demonstrated a reverse association between physical activity and myopia. Three studies supported this, but also attributed the results to time spent outdoors and not physical activity per se. One cross-sectional study found no relation. We could not identify trends among the papers regarding the type of studies, population sizes, ethnicity or age of study subjects. A consistent relationship between more physical activity and less myopia was observed. No evidence of physical activity as an independent risk factor for myopia was seen. Evidence suggests that time outdoors remain the most important factor. Future studies should include objective measurements of physical activity to determine a potential independent effect. Distinction between physical activity and outdoor exposure remains important.

show abstract

“…High outdoor exposure has been recently associated with lower myopia prevalence [79][80][81], and prospective studies in which children are exposed to additional time outdoors have shown that incident myopia can be significantly decreased by this intervention [35,82,83]. In Singapore, where the prevalence of myopia is very high, the government initiated a campaign asking parents to take children outdoors to play [84]. A prospective study of children originally involved in a bifocal trial in Finland provides further evidence for the protective effects of outdoors light, in that it showed that impaired myopic progression was associated with more than three daily hours of outdoor exposure [85].…”

Section: Risk Factors In Myopia Developmentmentioning

confidence: 99%

The Role of Atropine Eye Drops in Myopia Control

Grzybowski¹,

Armesto²,

Szwajkowska³

et al. 2015

CPD

View full text Add to dashboard Cite

High myopia is a major cause of uncorrectable visual impairment. It imposes major challenges and costs for refractive correction, and for the treatment of associated pathological complications. In the last 60 years, there has been a marked increase in the prevalence of high myopia in younger generations in developed countries in East and Southeast Asia, and there are signs of similar, but less pronounced increases in North America and Europe. In some parts of the world, 70-90% of children completing high schools are now myopic, and as many as 20% may be highly myopic. It is now clear that myopia results from excessive axial elongation of the eye, and this greater rate of axial elongation appears to be environmentally driven. Experimental studies have examined the biochemical mechanisms involved in regulation of axial elongation; and, from these studies, some options have emerged for preventing the development of myopia or slowing myopia progression. Atropine eye drops have been quite extensively used in clinical practice in Asian countries. This long-lasting treatment could be beneficial, but has clear limitations and complications. Recent reports suggest that a low concentration of atropine, which has less severe side-effects, is also effective. But, a decision to use an invasive treatment such as atropine drops, even at low doses, requires careful consideration of the risk of myopia progression. A decision to use atropine in pre-myopic patients would require even more careful consideration of the risks. Here, we review the current literature relevant to the prevention of myopia progression with atropine drops.

show abstract

Myopia: The Evidence for Environmental Factors

Cited by 22 publications

References 31 publications

Traffic-related air pollution and spectacles use in schoolchildren

Traffic-related air pollution and spectacles use in schoolchildren

Physical activity in relation to development and progression of myopia – a systematic review

The Role of Atropine Eye Drops in Myopia Control

Contact Info

Product

Resources

About