Shanghai Time Outside to Reduce Myopia trial: design and baseline data

He, Xiangui; Sankaridurg, Padmaja; Xiong, Shuyu; Li, Wayne; Zhang, Bo; Weng, Rebecca; Zhu, Jianfeng; Naduvilath, Thomas; Resnikoff, Serge; Zou, Haidong; Xu, Xun

doi:10.1111/ceo.13391

Cited by 30 publications

(23 citation statements)

References 13 publications

(30 reference statements)

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“…This trial (the Shanghai Time Outside to Reduce Myopia trial) was approved by the Shanghai General Hospital Ethics Committee and adhered to the tenets of the Declaration of Helsinki (ClinicalTrials.gov Identifier: NCT02980445). Detailed information on the study design has been published previously 19 . A total of 6295 children (2949 girls, 46.8%), aged between 6 to 9 years (7.2 ± 0.7 years) at baseline, from 24 schools across eight districts in Shanghai, were enrolled.…”

Section: Methodsmentioning

confidence: 99%

“…At baseline, data were available for 6042 participants (mean age 7.36 ± 0.60 years; female 2835, 46.93%), amongst which there were 409 cases of myopia and the prevalence was 6.77% (409/6024). Detailed baseline sample descriptive data can be found in a previous publication 19 . After 2 years, at the 24-month visit, data were available for 5355 participants and myopes accounted for 27.64% (1480/5355) of the study sample.…”

Section: Study Sample Characteristicsmentioning

confidence: 99%

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Sleeping late is a risk factor for myopia development amongst school-aged children in China

Liu

Naduvilath

Wang

et al. 2020

Sci Rep

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Myopia, a leading cause of distance vision impairment, is projected to affect half of the world’s population in 30 years. We analysed the relationship between certain demographic, environmental, and behavioural factors and myopia from a 2-year school-based, prospective trial conducted in Shanghai, China. This trial enrolled 6295 school-aged children at baseline and followed them up for 24 months. The relationship between abovementioned factors and myopia was examined and the role of sleep in childhood myopia development was highlighted. Our results suggest that ‘sleeping late’ is a risk factor for myopia prevalence at baseline (odds ratio [OR] = 1.55, p = 0.04), 2-year myopia incidence (odds ratio [OR] = 1.44, p = 0.02) and progression over 24 months (p = 0.005), after adjusting for residency area, age, gender, sleep duration, and time spent outdoors. The identification and consistency of results with late sleepers being a susceptible group to both myopia onset and progression suggests a complex relationship between circadian rhythm, indoor environment, habitual indoor activities and myopia development and progression. These results can offer new insights to future myopia aetiology studies as well as aid in decision-making of myopia prevention strategies.

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Section: Methodsmentioning

confidence: 99%

Section: Study Sample Characteristicsmentioning

confidence: 99%

Sleeping late is a risk factor for myopia development amongst school-aged children in China

Liu

Naduvilath

Wang

et al. 2020

Sci Rep

Self Cite

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“…A total of 6,295 children were randomized into a control group ( n = 2,037), test group I ( n = 2,329, 40 minutes outdoor time/day), or test group II ( n = 1,929, 80 minutes outdoor time/day). The study failed to demonstrate any significant association between the time spent outdoor and myopia development or progression [ 20 ]. Jones-Jordan et al did not observe any retardation in myopia development in children who spent more time outdoors, as reported by He et al [ 12 , 20 ].…”

Section: Outdoor Time and Near Workmentioning

confidence: 99%

Myopia: Mechanisms and Strategies to Slow Down Its Progression

Russo

Boldini

Romano

et al. 2022

Journal of Ophthalmology

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This topical review aimed to update and clarify the behavioral, pharmacological, surgical, and optical strategies that are currently available to prevent and reduce myopia progression. Myopia is the commonest ocular abnormality; reinstated interest is associated with high and increasing prevalence, especially but not, in the Asian population and progressive nature in children. The growing global prevalence seems to be associated with both genetic and environmental factors such as spending more time indoor and using digital devices, particularly during the coronavirus disease 2019 pandemic. Various options have been assessed to prevent or reduce myopia progression in children. In this review, we assess the effects of several types of measures, including spending more time outdoor, optical interventions such as the bifocal/progressive spectacle lenses, soft bifocal/multifocal/extended depth of focus/orthokeratology contact lenses, refractive surgery, and pharmacological treatments. All these options for controlling myopia progression in children have various degrees of efficacy. Atropine, orthokeratology/peripheral defocus contact and spectacle lenses, bifocal or progressive addition spectacles, and increased outdoor activities have been associated with the highest, moderate, and lower efficacies, respectively.

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“…One hypothesis that has earned a current consensus is the suggestion that a change in the lighting environment of modern society is the cause of myopia (9,10). Consistent with this, outdoor activity has a protective effect on myopia development (9,11,12), though the main reason for this effect is still under debate (7,12,13). One explanation is that bright outdoor light can promote the synthesis and release of dopamine in the eye, a myopia-protective neuromodulator (14)(15)(16).…”

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confidence: 96%

Violet light suppresses lens-induced myopia via neuropsin (OPN5) in mice

Jiang

Pardue

Mori

et al. 2021

Proc. Natl. Acad. Sci. U.S.A.

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Myopia has become a major public health concern, particularly across much of Asia. It has been shown in multiple studies that outdoor activity has a protective effect on myopia. Recent reports have shown that short-wavelength visible violet light is the component of sunlight that appears to play an important role in preventing myopia progression in mice, chicks, and humans. The mechanism underlying this effect has not been understood. Here, we show that violet light prevents lens defocus–induced myopia in mice. This violet light effect was dependent on both time of day and retinal expression of the violet light sensitive atypical opsin, neuropsin (OPN5). These findings identify Opn5-expressing retinal ganglion cells as crucial for emmetropization in mice and suggest a strategy for myopia prevention in humans.

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Shanghai Time Outside to Reduce Myopia trial: design and baseline data

Abstract: Myopia prevalence was high at nearly 8 to 9% in school children aged 7 years in Shanghai, China. The current trial will help evaluate if increased time outdoors has a role to play in reducing the incidence of myopia and/or slow the progression of myopia.

Cited by 30 publications

References 13 publications

Sleeping late is a risk factor for myopia development amongst school-aged children in China

Sleeping late is a risk factor for myopia development amongst school-aged children in China

Myopia: Mechanisms and Strategies to Slow Down Its Progression

Violet light suppresses lens-induced myopia via neuropsin (OPN5) in mice

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