The influence of near work on myopic refractive change in urban students in Beijing: a three-year follow-up report

Zhong, Lin; Vasudevan, Balamurali; Mao, Guang Yun; Ciuffreda, Kenneth J.; Jhanji, Vishal; Li, Xiao Xia; Zhou, Hong; Wang, Ning Li; Liang, Yuan Bo

doi:10.1007/s00417-016-3440-9

Cited by 52 publications

(55 citation statements)

References 28 publications

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“…Pseudomyopia is due to an intermittent spasm of the ciliary muscle, classically thought to be due to an overactive or excessive accommodative response that primarily occurs after sustained near work in children and young adults. Several longitudinal studies have supported the role of near work and myopic progression . In the present sample, it was also found that children who spent more time performing near work were associated with greater myopic progression .…”

Section: Discussionsupporting

confidence: 80%

“…Several longitudinal studies have supported the role of near work and myopic progression . In the present sample, it was also found that children who spent more time performing near work were associated with greater myopic progression . However, and somewhat unexpectedly, the DSE was not found to be associated with the amount of near work time in this sample.…”

Section: Discussionsupporting

confidence: 60%

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The difference between cycloplegic and non‐cycloplegic autorefraction and its association with progression of refractive error in Beijing urban children

Zhong

Vasudevan

Ciuffreda

et al. 2017

Ophthalmic Physiologic Optic

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Purpose To investigate the difference between cycloplegic and non‐cycloplegic autorefraction and its association with the progression of refractive error in Beijing urban children. Methods A total of 386 children aged 6–17 years were enrolled in the baseline investigation of the Beijing Myopia Progression Study in 2010. They were invited for follow‐up vision examinations in the years 2011, 2012, and 2013, including cycloplegic (cyclopentolate 1%, three times) autorefraction. We investigated the difference between the cycloplegic spherical equivalent (SE) and the non‐cycloplegic SE (DSE) provided by autorefraction and its association with refractive error progression. The progression of refractive error was defined as the difference between the cycloplegic SE at follow‐up and at baseline. Results Two hundred and nineteen children (57%) with completed refractive data (mean ± standard deviation: −1.36 ± 2.44 D at baseline) were ultimately enrolled. The DSE reduced from 0.51 ± 0.72 D at baseline to 0.19 ± 0.43 D in the third year of follow‐up (p = 0.01). The baseline DSE was positively associated with the children's baseline cycloplegic refraction (β = 0.193 dioptre dioptre−1, p < 0.001). After further divided by refractive status, the DSE was consistently higher in the hyperopic group than in either the emmetropic or myopic groups at each follow‐up (all p < 0.001). In the multivariate regression analysis, the myopic children with larger baseline DSE (β = −0.404 dioptre dioptre−1, p = 0.01) exhibited more myopic refractive change. However, baseline DSE was not found to be a significant risk factor (relative risk, 95% confidence interval: 1.06, 0.79–1.41) for those with newly developed myopia. Conclusion In this sample, the children's DSE was found to be increased as the hyperopic refraction increased. Furthermore, greater the DSE was associated with the progression of refractive error among the myopic children, but not with the onset of myopia.

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Section: Discussionsupporting

confidence: 80%

Section: Discussionsupporting

confidence: 60%

The difference between cycloplegic and non‐cycloplegic autorefraction and its association with progression of refractive error in Beijing urban children

Zhong

Vasudevan

Ciuffreda

et al. 2017

Ophthalmic Physiologic Optic

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“…17 Both of the two studies measured non-cycloplegic refraction data, which will be inaccurate in evaluating young children's refractive status. 18 Other studies, such as the Guangzhou Twins Eye Study and the Beijing Myopia Progression Study, 13,19 measuring cycloplegic refraction, suggested risk factors such as long near work time, parental myopia and short outdoor time were associated with myopia; however, the Beijing Myopia Progression Study did not observe relationship between outdoor and myopia. 19 In another study performed by our study group in Jiading District, Shanghai, the 1-year cohort results suggested that in addition to time outdoor and near work, near work related behaviours were also associated with incident myopia in schoolchildren.…”

Section: Introductionmentioning

confidence: 99%

“…18 Other studies, such as the Guangzhou Twins Eye Study and the Beijing Myopia Progression Study, 13,19 measuring cycloplegic refraction, suggested risk factors such as long near work time, parental myopia and short outdoor time were associated with myopia; however, the Beijing Myopia Progression Study did not observe relationship between outdoor and myopia. 19 In another study performed by our study group in Jiading District, Shanghai, the 1-year cohort results suggested that in addition to time outdoor and near work, near work related behaviours were also associated with incident myopia in schoolchildren. 20 The present study followed primary schoolchildren for 4 years (from 2010 to 2014) in Baoshan District, another suburb area in Shanghai, and measured their cycloplegic refractive parameters aiming to describe incidence of myopia, change of refraction and refractive components, to explore possible risk factors for myopia incidence and to try to building models to predict myopia incidence.…”

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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“…9 Longitudinal studies in students of Beijing also found that close near work, less time on outdoor activities, and more time on indoor activities was significantly associated with more myopia progression. [10][11][12] Although daily activities are important environmental risk factors for myopic onset and its progression, [13][14][15][16] few studies have assessed the change of children's daily activities over time and their associated risk factors. French and co-authors reported that children in the Sydney Adolescent and Vascular Eye Study (SAVES) had significant decrease in amount of time on outdoor activities, and also had significant increase in near work time, in both 6-and 12-year-old cohorts, when re-examined 5 years later.…”

Section: Introductionmentioning

confidence: 99%

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

Zhong

Vasudevan

Ciuffreda

et al. 2017

Ophthalmic Epidemiology

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The influence of near work on myopic refractive change in urban students in Beijing: a three-year follow-up report

Abstract: In this cohort, children with a greater near work load at baseline exhibited more myopic refractive change and were also more likely to develop myopia. The protective effect of outdoor activity on myopic refractive change was not observed.

Cited by 52 publications

References 28 publications

The difference between cycloplegic and non‐cycloplegic autorefraction and its association with progression of refractive error in Beijing urban children

The difference between cycloplegic and non‐cycloplegic autorefraction and its association with progression of refractive error in Beijing urban children

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

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

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