Prediction of Juvenile-Onset Myopia

Zadnik, Karla; Sinnott, Loraine T.; Cotter, Susan A.; Jones‐Jordan, Lisa A.; Kleinstein, Robert N.; Manny, Ruth E.; Twelker, J. Daniel; Mutti, Donald O.

doi:10.1001/jamaophthalmol.2015.0471

Cited by 214 publications

(240 citation statements)

References 32 publications

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“…Zadnik et al. () did not found an association between time outdoors and risk of myopia onset in multivariate models (data not shown), while the other three studies observed a protective association (Peckham et al. ; Onal et al.…”

Section: Resultsmentioning

confidence: 93%

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Time spent in outdoor activities in relation to myopia prevention and control: a meta‐analysis and systematic review

Xiong

Sankaridurg

Naduvilath

et al. 2017

Acta Ophthalmologica

400

372

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Outdoor time is considered to reduce the risk of developing myopia. The purpose is to evaluate the evidence for association between time outdoors and (1) risk of onset of myopia (incident/prevalent myopia); (2) risk of a myopic shift in refractive error and c) risk of progression in myopes only. A systematic review followed by a meta‐analysis and a dose–response analysis of relevant evidence from literature was conducted. PubMed, EMBASE and the Cochrane Library were searched for relevant papers. Of the 51 articles with relevant data, 25 were included in the meta‐analysis and dose–response analysis. Twenty‐three of the 25 articles involved children. Risk ratio (RR) for binary variables and weighted mean difference (WMD) for continuous variables were conducted. Mantel–Haenszel random‐effects model was used to pool the data for meta‐analysis. Statistical heterogeneity was assessed using the I 2 test with I 2 ≥ 50% considered to indicate high heterogeneity. Additionally, subgroup analyses (based on participant's age, prevalence of myopia and study type) and sensitivity analyses were conducted. A significant protective effect of outdoor time was found for incident myopia (clinical trials: risk ratio (RR) = 0.536, 95% confidence interval (CI) = 0.338 to 0.850; longitudinal cohort studies: RR = 0.574, 95% CI = 0.395 to 0.834) and prevalent myopia (cross‐sectional studies: OR = 0.964, 95% CI = 0.945 to 0.982). With dose–response analysis, an inverse nonlinear relationship was found with increased time outdoors reducing the risk of incident myopia. Also, pooled results from clinical trials indicated that when outdoor time was used as an intervention, there was a reduced myopic shift of −0.30 D (in both myopes and nonmyopes) compared with the control group (WMD = −0.30, 95% CI = −0.18 to −0.41) after 3 years of follow‐up. However, when only myopes were considered, dose–response analysis did not find a relationship between time outdoors and myopic progression (R 2 = 0.00064). Increased time outdoors is effective in preventing the onset of myopia as well as in slowing the myopic shift in refractive error. But paradoxically, outdoor time was not effective in slowing progression in eyes that were already myopic. Further studies evaluating effect of outdoor in various doses and objective measurements of time outdoors may help improve our understanding of the role played by outdoors in onset and management of myopia.

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Section: Resultsmentioning

confidence: 93%

“…; Zadnik et al. ); exposure measured as a categorical variable (six studies; Onal et al. ; Wu et al.…”

Section: Resultsmentioning

confidence: 99%

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Time spent in outdoor activities in relation to myopia prevention and control: a meta‐analysis and systematic review

Xiong

Sankaridurg

Naduvilath

et al. 2017

Acta Ophthalmologica

400

372

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“…Therefore, finding risk factors of myopia for children is especially important. Cohort studies such as Singapore Cohort Study of the Risk Factors for Myopia, Orinda Longitudinal Study of Myopia, Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error, Sydney Myopia Study, Guangzhou Twins Eye Study and many others provided evidence to understand possible risk factors of myopia, such as parental myopia, near work and outdoor activity . However, in China, with a high prevalence of myopia in teenagers, there are limited number of cohort studies with relatively long follow‐up in young schoolchildren.…”

Section: Introductionmentioning

confidence: 99%

Cohort study with 4‐year follow‐up of myopia and refractive parameters in primary schoolchildren in Baoshan District, Shanghai

Zou

Lin

et al. 2018

Clinical Exper Ophthalmology

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ImportanceCohort studies could not only reveal associations between change of refractive components and onset/progression of myopia, but also risk factors, which is important for understanding mechanism and providing strategies.BackgroundPrevalence of myopia is high in Shanghai, being reported to be 52.2% in children aged 10 years old.DesignCohort study.ParticipantsA total of 1856 students from six randomly selected primary schools in Baoshan District, Shanghai.MethodsChildren underwent comprehensive ocular measurement, including axial length (AL), corneal curvature radius and cycloplegic auto‐refraction. Questionnaires about eye usage time were collected. Grade 1 students were followed for 4 years, and grade 2 and 3 students for 2 years.Main Outcome Measures(i) Change of spherical equivalent (SE) and AL and (ii) risk factors for progression and incidence of myopia.ResultsThe average 2‐year progress of SE was 0.91D, 0.91D and 1.11D for grade 1, 2 and 3, respectively, and the average elongation of AL was 0.70 mm, 0.64 mm and 0.71 mm, respectively. Only parental myopia, but not near work time, near work diopter time, outdoor activity time or attending tutoring classes, was associated with myopia incidence and progression in the present population. Using baseline SE could be a simple and effective indicator for myopia prediction.Conclusions and RelevanceIncidence and progression of myopia is relatively high in schoolchildren in Shanghai compared with children of Western countries, East Asia and other parts of China. Effective strategies to control myopia prevalence are in urgent need.

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“…However the association between near-work and myopia is inconsistent4041, and importantly refraction in young children, prior to the experience of intensive education and near-work, can significantly predict those who will later become myopic4243. The possibility that increased time studying can increase an individual’s IQ has been largely discounted; there is no robust evidence that a large effect on IQ can be achieved by such an intervention44.…”

Section: Discussionmentioning

confidence: 99%

Phenotypic and genotypic correlation between myopia and intelligence

Williams

Hysi

Yonova-Doing

et al. 2017

Sci Rep

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Myopia, or near-sightedness, is our most common eye condition and the prevalence is increasing globally. Visual impairment will occur if uncorrected, whilst high myopia causes sight-threatening complications. Myopia is associated with higher intelligence. As both are heritable, we set out to examine whether there is a genetic correlation between myopia and intelligence in over 1,500 subjects (aged 14–18 years) from a twin birth cohort. The phenotypic correlation between refractive error and intelligence was −0.116 (p < 0.01) - the inverse correlation due to the fact that myopia is a negative refractive error. Bivariate twin modeling confirmed both traits were heritable (refractive error 85%, intelligence 47%) and the genetic correlation was −0.143 (95% CI −0.013 to −0.273). Of the small phenotypic correlation the majority (78%) was explained by genetic factors. Polygenic risk scores were constructed based on common genetic variants identified in previous genome-wide association studies of refractive error and intelligence. Genetic variants for intelligence and refractive error explain some of the reciprocal variance, suggesting genetic pleiotropy; in the best-fit model the polygenic score for intelligence explained 0.99% (p = 0.008) of refractive error variance. These novel findings indicate shared genetic factors contribute significantly to the covariance between myopia and intelligence.

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Prediction of Juvenile-Onset Myopia

Cited by 214 publications

References 32 publications

Time spent in outdoor activities in relation to myopia prevention and control: a meta‐analysis and systematic review

Time spent in outdoor activities in relation to myopia prevention and control: a meta‐analysis and systematic review

Cohort study with 4‐year follow‐up of myopia and refractive parameters in primary schoolchildren in Baoshan District, Shanghai

Phenotypic and genotypic correlation between myopia and intelligence

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