AIM:To investigate the prevalence and characteristics of myopia in school-aged students and effects of environmental and genetic factors on the progression of myopia.METHODS:A total of 2422 students aged between 5 and...AIM:To investigate the prevalence and characteristics of myopia in school-aged students and effects of environmental and genetic factors on the progression of myopia.METHODS:A total of 2422 students aged between 5 and 18y from nine schools in Baiyun District of Guangzhou,China were sampled using a stratified sampling method in 2020.Among them,1066 students participated in the follow-up survey the following year.Data were obtained based on ocular examinations and a questionnaire survey conducted during two visits.Factors potentially influencing the progression of myopia were analyzed.RESULTS:During the year assessed in this study,the percentage of students with myopia increased from 58.4%to 64.8%(P=0.002).Spherical equivalent(SE)progressed from-1.44±1.91 diopters(D)at baseline to-1.66±1.10 D(P=0.005).A generalized estimating equation(GEE)model revealed that age[adjusted odds ratio(aOR)=1.298,P<0.001],residential students(aOR=2.428,P=0.018),parental myopia(one myopic parent:aOR=1.553,both parents myopic:aOR=2.609,P<0.001),frequent reading of books or viewing of screens in direct sunlight(aOR=3.502,P=0.023),using only overhead lighting for reading and writing at night(aOR=1.633,P=0.011),parental restrictions on exercise time(aOR=2.286,P=0.012),and having less than 2h of outdoor exercise per day during the past week(aOR=1.584,P=0.019)were all identified as independent risk factors for progression of myopia.CONCLUSION:Our findings in this study indicate that age,residential students,parental myopia,indoor lighting environment,and physical activity have significant effects on the progression of myopia,providing evidence for further in-depth mechanistic interpretation and efficient intervention strategies for school-age children in this area.展开更多
AIM:To investigate the progression of myopia and risk factors among university students in central China.METHODS:A total of 7359 first-year undergraduate students at Huazhong University of Science and Technology in ce...AIM:To investigate the progression of myopia and risk factors among university students in central China.METHODS:A total of 7359 first-year undergraduate students at Huazhong University of Science and Technology in central China were recruited to the study and invited to a centralized clinic for medical examination,including optometry,and re-examined after one year.Correlation analyses were performed to assess the associations between one-year myopia progression and various parameters.RESULTS:The spherical equivalent refraction for the overall population was-3.14±2.28 D at baseline.The rate of myopia progression over 0.50 D after one year was 41.9%,and the 1-year progression of myopia was-0.47±0.58 D.There was no difference of mean 1-year myopia progression between male and female or difference among age group.The myopia progression of original myopia was severer than progression of new-onset myopia.There was also difference of mean myopia progression among different degrees of myopia at baseline.The under corrected eyes had a higher percentage of myopia progression than well corrected eyes(χ^(2)=7.90,P<0.01).There was no correlation between myopia progression and height,weight,body mass index,hemoglobin(Spearman correlation,ρ=-0.078,-0.152,-0.170,-0.096,respectively,all P>0.05).CONCLUSION:Myopes still progress in undergraduate students,especially in high myopes.展开更多
Myopia is a huge health problem due to its high frequency,vision losses and public health cost.According to the World Health Organization,at least 2.2 billion people have vision impairment.Although myopia can be contr...Myopia is a huge health problem due to its high frequency,vision losses and public health cost.According to the World Health Organization,at least 2.2 billion people have vision impairment.Although myopia can be controlled at its early and middle stages,unfortunately,no cure can be achieved so far.Among the methods to control myopia,atropine,a muscarinic receptor antagonist,is the oldest but still the most effective for retardation of myopia progression.Despite such a fact,standard protocols have not been established for clinicians to use atropine for treatment of myopia.In this article,a concise and up to date summary of myopia epidemiology and pathogenesis and summarized therapeutic effects and side effects,possible mechanisms and application methods of atropine were provided in hope for clinical doctors to effectively control this problematic disease.At present,the protocol is recommend:use higher dose(1%)of atropine intermittently to effectively slowdown myopia progression in schoolchildren for 2y,and to significantly reduce side effects of atropine by decrease of atropine frequency for 1y and inhibit myopic rebound by withdrawal of topical atropine gradually for 1y.Application of a lower dose(0.05%)atropine regime should also be considered due to its effectiveness and application at regular basis.展开更多
AIM:To investigate the effects of school-basedcomprehensive intervention on myopia development inelementary school children.METHODS:As a part of the Wenzhou Epidemiologyof Refraction Error Study,there were 1524 partic...AIM:To investigate the effects of school-basedcomprehensive intervention on myopia development inelementary school children.METHODS:As a part of the Wenzhou Epidemiologyof Refraction Error Study,there were 1524 participatingelementary students(730 girls,47.9%)in grades 1 to3 from three campuses of one school,aged 7.3±0.9y,who were examined twice every year for a 2.5y follow upperiod.Comprehensive intervention and other reminderswere given at school every semester for the interventiongroup.The control group did not receive comprehensiveintervention and did not have reminders of it.RESULTS:There were 651 students in the interventiongroup[mean age 7.3±0.9y;294(45.2%)girls]and 737students in the control group[mean age 7.2±0.9y;346(46.9%)girls].Overall mean myopia progression duringthe 2.5y follow-up was-0.49±1.04 diopters(D)in theintervention group and-0.65±1.08 D in the control group(P=0.004).The majority that not get myopia at baselinespherical equivalent(SE≤-1.0 D).Their mean myopiaprogression during the 2.5y follow-up was-0.37±0.89 Din the intervention group and-0.51±0.93 D in the controlgroup(27.5%reduction,P=0.009);Overall,mean axiallength elongation was less in the intervention group(0.56±0.32 mm)than in the control group(0.61±0.38 mm,10.5%reduction,P=0.009).The percentage of close reading distance(<30 cm)in the intervention group was less than in the control group(73.4%vs 76.2%,P<0.001),the percentage of everyday perform eye exercises in the intervention group was more than in the control group(27.8%vs 20.7%,P<0.001)30mo later.CONCLUSION:The comprehensive intervention program at elementary school has a significant alleviating effect on myopia progression for children during the 2.5y follow-up,especially for those non-myopia at baseline.展开更多
Background:Axial myopia is the most common type of myopia.However,due to the high incidence of myopia in Chinese children,few studies estimating the physiological elongation of the ocular axial length(AL),which does n...Background:Axial myopia is the most common type of myopia.However,due to the high incidence of myopia in Chinese children,few studies estimating the physiological elongation of the ocular axial length(AL),which does not cause myopia progression and differs from the non-physiological elongation of AL,have been conducted.The purpose of our study was to construct a machine learning(ML)-based model for estimating the physiological elongation of AL in a sample of Chinese school-aged myopic children.Methods:In total,1011 myopic children aged 6 to 18 years participated in this study.Cross-sectional datasets were used to optimize the ML algorithms.The input variables included age,sex,central corneal thickness(CCT),spherical equivalent refractive error(SER),mean K reading(K-mean),and white-to-white corneal diameter(WTW).The output variable was AL.A 5-fold cross-validation scheme was used to randomly divide all data into 5 groups,including 4 groups used as training data and one group used as validation data.Six types of ML algorithms were implemented in our models.The best-performing algorithm was applied to predict AL,and estimates of the physiological elongation of AL were obtained as the partial derivatives of AL_(predicted)-age curves based on an unchanged SER value with increasing age.Results:Among the six algorithms,the robust linear regression model was the best model for predicting AL,with a R^(2) value of 0.87 and relatively minimal averaged errors between the predicted AL and true AL.Based on the partial derivatives of the AL_(predicted)-age curves,the estimated physiological AL elongation varied from 0.010 to 0.116 mm/year in male subjects and 0.003 to 0.110 mm/year in female subjects and was influenced by age,SER and K-mean.According to the model,the physiological elongation of AL linearly decreased with increasing age and was negatively correlated with the SER and the K-mean.Conclusions:The physiological elongation of the AL is rarely recorded in clinical data in China.In cases of unavailable clinical dat,an ML algorithm could provide practitioners a reasonable model that can be used to estimate the physiological elongation of AL,which is espedally useful when monitoring myopia progression in orthokeratology lens wearers.展开更多
Background:To characterize the axial and off-axis refraction across four meridians of the retina in myopic eyes before and after Orthokeratology(OK)and LASIK surgery.Methods:Sixty right eyes with a spherical equivalen...Background:To characterize the axial and off-axis refraction across four meridians of the retina in myopic eyes before and after Orthokeratology(OK)and LASIK surgery.Methods:Sixty right eyes with a spherical equivalent(M)between−0.75 to−5.25 D(cylinder<−1.00 D)underwent LASIK(n=26)or OK(n=34)to treat myopia.Axial and off-axis refraction were measured with an open-field autorefractometer before and after stabilized treatments.Off-axis measurements were obtained for the horizontal(35°nasal and temporal retina)and vertical(15°superior and inferior retina)meridians,and for two oblique directions(45–225°and 135–315°)up to 20°of eccentricity.The refractive profile was addressed as relative peripheral refractive error(RPRE).Results:OK and LASIK post-treatment results showed an increase of myopic relative refraction at several eccentric locations.At the four meridians evaluated,the M component of the pre-treatment RPRE values was not statistically different(p>0.05)from the post-treatment RPRE within 30°and 20°of the central visual field after LASIK and OK,respectively.These results demonstrated that the treatment zone warrants an optimal central field of vision.Conclusions:The present study gives an overview of RPRE after refractive corneal reshaping treatments(OK and LASIK)across vertical,horizontal and two oblique meridians together.This allows a 3D representation of RPRE at the retina and shows that the myopic shift induced by both treatments is more relevant in horizontal directions.展开更多
Purpose:To measure axial and off-axis refraction patterns in myopic eyes with spectacle lenses correction and lens free emmetropes in young healthy subjects at different target distances from 2.00 m(0.50 D)to 0.20 m(5...Purpose:To measure axial and off-axis refraction patterns in myopic eyes with spectacle lenses correction and lens free emmetropes in young healthy subjects at different target distances from 2.00 m(0.50 D)to 0.20 m(5.00 D)in terms of sphere,astigmatism,and spherical equivalent refraction.Methods:Refraction was measured at the center,20 and 40 degrees from the line of sight both nasally and temporally in 15 emmetropic and 25 myopic young healthy subjects with an open field,binocular,infrared autorefractor(Grand Seiko WAM-5500,Hiroshima,Japan).Fixation target was a Maltese cross set at 2.00,0.50,0.33 and 0.20 m from the corneal plane.Changes in off-axis refraction with accommodation level were normalized with respect to distance axial values and compared between myopic eyes with spectacle lenses correction and lens free emmetropes.Results:Off-axis refraction in myopic eyes with spectacle lenses correction was significantly more myopic in the temporal retina compared to lens free emmetropes except for the closest target distance.Relative off-axis refractive error changed significantly with accommodation when compared to axial refraction particularly in the myopic group.This change in the negative direction was due to changes in the spherical component of refraction that became more myopic relative to the center at the 0.20 m distance as the J0 component of astigmatism was significantly reduced in both emmetropes and myopes for the closest target.Conclusion:Accommodation to very near targets(up to 0.20 m)makes the off-axis refraction of myopes wearing their spectacle correction similar to that of lens free emmetropes.A significant reduction in off-axis astigmatism was also observed for the 0.20 m distance.展开更多
基金Supported by the Guangzhou Health Science and Technology Project(No.20221A010077)the Guangdong Provincial Medical Science and Technology Research Fund Project(No.A2020146).
文摘AIM:To investigate the prevalence and characteristics of myopia in school-aged students and effects of environmental and genetic factors on the progression of myopia.METHODS:A total of 2422 students aged between 5 and 18y from nine schools in Baiyun District of Guangzhou,China were sampled using a stratified sampling method in 2020.Among them,1066 students participated in the follow-up survey the following year.Data were obtained based on ocular examinations and a questionnaire survey conducted during two visits.Factors potentially influencing the progression of myopia were analyzed.RESULTS:During the year assessed in this study,the percentage of students with myopia increased from 58.4%to 64.8%(P=0.002).Spherical equivalent(SE)progressed from-1.44±1.91 diopters(D)at baseline to-1.66±1.10 D(P=0.005).A generalized estimating equation(GEE)model revealed that age[adjusted odds ratio(aOR)=1.298,P<0.001],residential students(aOR=2.428,P=0.018),parental myopia(one myopic parent:aOR=1.553,both parents myopic:aOR=2.609,P<0.001),frequent reading of books or viewing of screens in direct sunlight(aOR=3.502,P=0.023),using only overhead lighting for reading and writing at night(aOR=1.633,P=0.011),parental restrictions on exercise time(aOR=2.286,P=0.012),and having less than 2h of outdoor exercise per day during the past week(aOR=1.584,P=0.019)were all identified as independent risk factors for progression of myopia.CONCLUSION:Our findings in this study indicate that age,residential students,parental myopia,indoor lighting environment,and physical activity have significant effects on the progression of myopia,providing evidence for further in-depth mechanistic interpretation and efficient intervention strategies for school-age children in this area.
文摘AIM:To investigate the progression of myopia and risk factors among university students in central China.METHODS:A total of 7359 first-year undergraduate students at Huazhong University of Science and Technology in central China were recruited to the study and invited to a centralized clinic for medical examination,including optometry,and re-examined after one year.Correlation analyses were performed to assess the associations between one-year myopia progression and various parameters.RESULTS:The spherical equivalent refraction for the overall population was-3.14±2.28 D at baseline.The rate of myopia progression over 0.50 D after one year was 41.9%,and the 1-year progression of myopia was-0.47±0.58 D.There was no difference of mean 1-year myopia progression between male and female or difference among age group.The myopia progression of original myopia was severer than progression of new-onset myopia.There was also difference of mean myopia progression among different degrees of myopia at baseline.The under corrected eyes had a higher percentage of myopia progression than well corrected eyes(χ^(2)=7.90,P<0.01).There was no correlation between myopia progression and height,weight,body mass index,hemoglobin(Spearman correlation,ρ=-0.078,-0.152,-0.170,-0.096,respectively,all P>0.05).CONCLUSION:Myopes still progress in undergraduate students,especially in high myopes.
基金Supported by the Basic Research Fund for Science and Technology Department of Yunnan Province and Kunming Medical University(No.202401AY070001-289).
文摘Myopia is a huge health problem due to its high frequency,vision losses and public health cost.According to the World Health Organization,at least 2.2 billion people have vision impairment.Although myopia can be controlled at its early and middle stages,unfortunately,no cure can be achieved so far.Among the methods to control myopia,atropine,a muscarinic receptor antagonist,is the oldest but still the most effective for retardation of myopia progression.Despite such a fact,standard protocols have not been established for clinicians to use atropine for treatment of myopia.In this article,a concise and up to date summary of myopia epidemiology and pathogenesis and summarized therapeutic effects and side effects,possible mechanisms and application methods of atropine were provided in hope for clinical doctors to effectively control this problematic disease.At present,the protocol is recommend:use higher dose(1%)of atropine intermittently to effectively slowdown myopia progression in schoolchildren for 2y,and to significantly reduce side effects of atropine by decrease of atropine frequency for 1y and inhibit myopic rebound by withdrawal of topical atropine gradually for 1y.Application of a lower dose(0.05%)atropine regime should also be considered due to its effectiveness and application at regular basis.
基金Supported by National Natural Science Foundation of China(No.81873683)。
文摘AIM:To investigate the effects of school-basedcomprehensive intervention on myopia development inelementary school children.METHODS:As a part of the Wenzhou Epidemiologyof Refraction Error Study,there were 1524 participatingelementary students(730 girls,47.9%)in grades 1 to3 from three campuses of one school,aged 7.3±0.9y,who were examined twice every year for a 2.5y follow upperiod.Comprehensive intervention and other reminderswere given at school every semester for the interventiongroup.The control group did not receive comprehensiveintervention and did not have reminders of it.RESULTS:There were 651 students in the interventiongroup[mean age 7.3±0.9y;294(45.2%)girls]and 737students in the control group[mean age 7.2±0.9y;346(46.9%)girls].Overall mean myopia progression duringthe 2.5y follow-up was-0.49±1.04 diopters(D)in theintervention group and-0.65±1.08 D in the control group(P=0.004).The majority that not get myopia at baselinespherical equivalent(SE≤-1.0 D).Their mean myopiaprogression during the 2.5y follow-up was-0.37±0.89 Din the intervention group and-0.51±0.93 D in the controlgroup(27.5%reduction,P=0.009);Overall,mean axiallength elongation was less in the intervention group(0.56±0.32 mm)than in the control group(0.61±0.38 mm,10.5%reduction,P=0.009).The percentage of close reading distance(<30 cm)in the intervention group was less than in the control group(73.4%vs 76.2%,P<0.001),the percentage of everyday perform eye exercises in the intervention group was more than in the control group(27.8%vs 20.7%,P<0.001)30mo later.CONCLUSION:The comprehensive intervention program at elementary school has a significant alleviating effect on myopia progression for children during the 2.5y follow-up,especially for those non-myopia at baseline.
基金This work was funded by the National Natural Science Foundation of China(Grant No.81870684 and 81421004)the HuaXia Translation Medicine Fund For Young Scholars(Grant No.2017-B-001)+2 种基金the Non-Profit Central Research Institute Fund of the Chinese Academy of Medicine Sciences(Grant No.2019HY320001)the National Key Research and Development Program of China(2017YFE0104200)the National Key Instrumentation Development Project of China(2013YQ030651).
文摘Background:Axial myopia is the most common type of myopia.However,due to the high incidence of myopia in Chinese children,few studies estimating the physiological elongation of the ocular axial length(AL),which does not cause myopia progression and differs from the non-physiological elongation of AL,have been conducted.The purpose of our study was to construct a machine learning(ML)-based model for estimating the physiological elongation of AL in a sample of Chinese school-aged myopic children.Methods:In total,1011 myopic children aged 6 to 18 years participated in this study.Cross-sectional datasets were used to optimize the ML algorithms.The input variables included age,sex,central corneal thickness(CCT),spherical equivalent refractive error(SER),mean K reading(K-mean),and white-to-white corneal diameter(WTW).The output variable was AL.A 5-fold cross-validation scheme was used to randomly divide all data into 5 groups,including 4 groups used as training data and one group used as validation data.Six types of ML algorithms were implemented in our models.The best-performing algorithm was applied to predict AL,and estimates of the physiological elongation of AL were obtained as the partial derivatives of AL_(predicted)-age curves based on an unchanged SER value with increasing age.Results:Among the six algorithms,the robust linear regression model was the best model for predicting AL,with a R^(2) value of 0.87 and relatively minimal averaged errors between the predicted AL and true AL.Based on the partial derivatives of the AL_(predicted)-age curves,the estimated physiological AL elongation varied from 0.010 to 0.116 mm/year in male subjects and 0.003 to 0.110 mm/year in female subjects and was influenced by age,SER and K-mean.According to the model,the physiological elongation of AL linearly decreased with increasing age and was negatively correlated with the SER and the K-mean.Conclusions:The physiological elongation of the AL is rarely recorded in clinical data in China.In cases of unavailable clinical dat,an ML algorithm could provide practitioners a reasonable model that can be used to estimate the physiological elongation of AL,which is espedally useful when monitoring myopia progression in orthokeratology lens wearers.
基金Supported in part by a grant to AQ(#SFRH/BD/61768/2009)projects PTDC/SAU-BEB/098391/2008,PTDC/SAU-BEB/098392/2008 and the Strategic Project PEST-C/FIS/UI607/2011 from the Science and Technology Foundation of Portuguese Ministry of Science and Higher Education.
文摘Background:To characterize the axial and off-axis refraction across four meridians of the retina in myopic eyes before and after Orthokeratology(OK)and LASIK surgery.Methods:Sixty right eyes with a spherical equivalent(M)between−0.75 to−5.25 D(cylinder<−1.00 D)underwent LASIK(n=26)or OK(n=34)to treat myopia.Axial and off-axis refraction were measured with an open-field autorefractometer before and after stabilized treatments.Off-axis measurements were obtained for the horizontal(35°nasal and temporal retina)and vertical(15°superior and inferior retina)meridians,and for two oblique directions(45–225°and 135–315°)up to 20°of eccentricity.The refractive profile was addressed as relative peripheral refractive error(RPRE).Results:OK and LASIK post-treatment results showed an increase of myopic relative refraction at several eccentric locations.At the four meridians evaluated,the M component of the pre-treatment RPRE values was not statistically different(p>0.05)from the post-treatment RPRE within 30°and 20°of the central visual field after LASIK and OK,respectively.These results demonstrated that the treatment zone warrants an optimal central field of vision.Conclusions:The present study gives an overview of RPRE after refractive corneal reshaping treatments(OK and LASIK)across vertical,horizontal and two oblique meridians together.This allows a 3D representation of RPRE at the retina and shows that the myopic shift induced by both treatments is more relevant in horizontal directions.
基金supported by Strategic Project PEST-C/FIS/UI607/2011 from the Science and Technology Foundation of Portuguese Ministry of Science and Higher Education.
文摘Purpose:To measure axial and off-axis refraction patterns in myopic eyes with spectacle lenses correction and lens free emmetropes in young healthy subjects at different target distances from 2.00 m(0.50 D)to 0.20 m(5.00 D)in terms of sphere,astigmatism,and spherical equivalent refraction.Methods:Refraction was measured at the center,20 and 40 degrees from the line of sight both nasally and temporally in 15 emmetropic and 25 myopic young healthy subjects with an open field,binocular,infrared autorefractor(Grand Seiko WAM-5500,Hiroshima,Japan).Fixation target was a Maltese cross set at 2.00,0.50,0.33 and 0.20 m from the corneal plane.Changes in off-axis refraction with accommodation level were normalized with respect to distance axial values and compared between myopic eyes with spectacle lenses correction and lens free emmetropes.Results:Off-axis refraction in myopic eyes with spectacle lenses correction was significantly more myopic in the temporal retina compared to lens free emmetropes except for the closest target distance.Relative off-axis refractive error changed significantly with accommodation when compared to axial refraction particularly in the myopic group.This change in the negative direction was due to changes in the spherical component of refraction that became more myopic relative to the center at the 0.20 m distance as the J0 component of astigmatism was significantly reduced in both emmetropes and myopes for the closest target.Conclusion:Accommodation to very near targets(up to 0.20 m)makes the off-axis refraction of myopes wearing their spectacle correction similar to that of lens free emmetropes.A significant reduction in off-axis astigmatism was also observed for the 0.20 m distance.
