Progression of myopia in a natural cohort of Chinese children during COVID-19 pandemic

Ma, Dandan; Wei, Shifei; Li, Shiming; Yang, Xiaohui; Cao, Kai; Hu, Jianping; Fan, Sujie; Zhang, Lihua; Wang, Ke

doi:10.1007/s00417-021-05305-x

Cited by 51 publications

(88 citation statements)

References 34 publications

(41 reference statements)

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“…The mean SER for 8-year-old Tibetan children was +0.59 ± 1.08D, which is significantly higher compared to the children in Hong Kong [10] of the same age (0.10 ± 1.38D and 0.04 ± 1.36D, pre-and post-epidemic). This comparison is also similar to that of other provinces in China like Shandong [4] (−0.59∼−0.31D), Zhejiang [1] (−0.7 ± 1.6D), He Bei [11] (−0.50 ± 1.25D), and Shanghai [12](−1.86 ± 0.76D). Most children are still in a state of mild hyperopia even after the COVID-19 epidemic in Lhasa.…”

Section: Discussionsupporting

confidence: 87%

Distribution, Progression, and Associated Factors of Refractive Status of Children in Lhasa, Tibet, after COVID-19 Quarantine

Yao

Liu

et al. 2022

Ophthalmic Res

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Introduction Uncorrected refractive error is one of the major causes of visual impairment in children and adolescents worldwide. During the COVID-19(Coronavirus Disease 2019) epidemic,home isolation is considered a boost to the progression of children's myopia. Under geographical conditions of high altitude and strong sunshine, the Tibetan plateau is the main residence of the Tibetan population, where little information is available about the refractive status and developmental trajectory.Therefore,this article aimed to evaluate the distribution,progression,and associated factors of the refractive status in second grade children in Lhasa after COVID-19 quarantine. Materials and Methods Students from 7 elementary schools completed comprehensive ocular examinations in the Lhasa Childhood Eye Study. Data regarding cycloplegic refraction and corneal biometry parameters, including axial length (AL),corneal power,anterior chamber depth(ACD),and other demographic factors,were analyzed. Results A total of 1,819 students were included, with a mean age of 7.9±0.5 years, of which 961 were boys (52.8%), and 95.1% were Tibetan. The prevalence of myopia, emmetropia, mild hyperopia and hyperopia was 10.94%, 24.02%, 60.80% and 4.24%, respectively. Besides, the average cycloplegic spherical equivalent refraction(SER) was +1.07±0.92D before the COVID-19 quarantine and +0.59±1.08D after the quarantine, with a growth rate of 7%. Moreover, the prevalence of hyperopia in girls was significantly higher than that of boys. Nonetheless, the proportion of myopia and emmetropia was similar. Meanwhile, children in suburban schools had a significantly lower proportion of myopia. The average AL, ACD, lens power (LP) and axial length-to-corneal radius(AL/CR) ratio were 22.79±0.78mm, 3.54±0.21mm, 25.12±1.48D and 2.93±0.08, respectively. The result of AL,ACD,and AL/CR for girls were significantly lower than for boys while the result of LP is the opposite. Finally, multivariate regression analysis revealed that SER was negatively correlated with AL, LP, and AL-to-CR ratio, while positively correlated with CR and ACD. Conclusion This study found that after the COVID-19 confinement, myopia progressed faster in Lhasa children but was still significantly lower than that of plain cities in China. Compared to short-term confinement, this acceleration was more likely related to the growth and general trend of myopia in children. Collectively, these findings help to explore the differences in ocular growth and development among children of different ethnic groups.

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Section: Discussionsupporting

confidence: 87%

Distribution, Progression, and Associated Factors of Refractive Status of Children in Lhasa, Tibet, after COVID-19 Quarantine

Yao

Liu

et al. 2022

Ophthalmic Res

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“…All of these changes, which could potentially aggravate during and after the COVID-19 pandemic, are associated with the onset and progression of myopia and may affect the visual health of students (11,11,(23)(24)(25)(26). Based on the latest survey of 14,532 students from nine Chinese provinces conducted by the Chinese Ministry of Education, the incidence of myopia has increased by 11.7%, compared with that at the end of 2019.…”

Section: Introductionmentioning

confidence: 99%

“…During the COVID-19, the outdoor activity times decreased by 1.14 h in Grades 1–6 and 1.71 h in Grades 7–12 ( 19 ). The study of Ma et al reported that children were at higher risk of myopia progression during COVID-19, which was associated with longtime online learning and digital screen reading ( 25 ).…”

Section: Introductionmentioning

confidence: 99%

Online Learning-Related Visual Function Impairment During and After the COVID-19 Pandemic

Fan

Wang

Kong

et al. 2021

Front. Public Health

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This study aimed to review the consequences of increased online learning, which was precipitated by the coronavirus disease 2019 (COVID-19), on visual function, as well as the methods for preventing the associated visual impairment. The recent finding implies that a higher incidence of myopia may be observed during the pandemic than that before. The myopia prevalence was 59.35% in COVID-19, which was higher than that in the normal period. COVID-19-related influence of developing myopia among students should be addressed and under control. Online learning precipitated by COVID-19 is likely to increase the global burden of visual function impairment. This review highlighted useful measures to prevent online learning-related visual function impairments, including the following: (1) desktop illumination of no >300 lx, online learning time for primary, and middle-school students of no more than 20–30 min per session; (2) daily video time for preschool children not exceeding 1 h, and for school-age children and adolescents not exceeding 2 h; (3) after every 30–40 min of online learning, moving eyes away from the screen or closed for 10 min; (4) engaging in outdoor activities for ≥ 2 h a day; (5) suitable screen and learning environment settings and correct postures for reading and writing; (6) sufficient sleep and proper nutrition. Preventing online learning-related visual impairment during and after this unprecedented pandemic will facilitate future ophthalmic practice.

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“…This may explain why the difference between DIMS and SVL groups in the current analysis is lower than in the previous study. 27 It is also worth noting that previous longitudinal studies 14 , 15 on refractive error change during the COVID-19 lockdown were targeting whole cohorts (ie, including children with and without myopia). From the current results on children with myopia, we speculate that the drastic change in environmental risk factors during the lockdown period 4 were associated with myopic shift in people without myopia and myopia progression in those with myopia.…”

Section: Discussionmentioning

confidence: 99%

“…Although a previous cross-sectional study 28 revealed an increase in myopia prevalence and incidence during the COVID-19 pandemic compared with historical numbers and some recent studies 14 , 15 longitudinally following up total cohorts of children, the current study leveraged data from longitudinal studies that were prospectively conducted during the pandemic in school-aged children with myopia requiring optical correction. Using exploratory, prespecified analyses, the association of lockdown measures on myopia progression was evaluated, in addition to the performance of DIMS spectacle lenses for control of myopia progression during the COVID-19–induced lockdown period.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of an Optical Defocus Treatment for Myopia Progression Among Schoolchildren During the COVID-19 Pandemic

et al. 2022

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Key Points Question Is an optical defocus treatment associated with slowed myopia progression among schoolchildren experiencing lockdown related to the COVID-19 pandemic? Findings In this exploratory analysis of 2 cohort studies including 171 schoolchildren during COVID-19 lockdown, treatment using a defocus incorporated multiple segments lens was associated with 46% less myopia progression and 34% less axial elongation compared with regular single vision lens treatment. Meaning These findings suggest that an optical defocus treatment may be associated with slower myopia progression, which has been exaggerated during the COVID-19 pandemic, among schoolchildren.

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Progression of myopia in a natural cohort of Chinese children during COVID-19 pandemic

Cited by 51 publications

References 34 publications

Distribution, Progression, and Associated Factors of Refractive Status of Children in Lhasa, Tibet, after COVID-19 Quarantine

Distribution, Progression, and Associated Factors of Refractive Status of Children in Lhasa, Tibet, after COVID-19 Quarantine

Online Learning-Related Visual Function Impairment During and After the COVID-19 Pandemic

Evaluation of an Optical Defocus Treatment for Myopia Progression Among Schoolchildren During the COVID-19 Pandemic

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