Jacob Megreli1,2, Adiel Barak3,4, Maxim Bez1, Dana Bez1,2, Hagai Levine5. 1. Medical Corps, Israel Defense Forces, Ramat-Gan, Israel. 2. Hebrew University-Hadassah Faculty of Medicine, Braun School of Public Health and Community Medicine, P.O Box 12272, 9112002, Jerusalem, Israel. 3. Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. 4. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. 5. Hebrew University-Hadassah Faculty of Medicine, Braun School of Public Health and Community Medicine, P.O Box 12272, 9112002, Jerusalem, Israel. hagai.levine@gmail.com.
Abstract
BACKGROUND: Myopia is a leading cause of visual impairment worldwide, and its increasing incidence is of public health concern. Cognitive function was associated with myopia among children, but evidence for adolescents is scarce. The purpose of this study was to determine whether myopia is associated with cognitive function, and which cognitive ability, verbal or non-verbal, is involved. METHODS: We conducted a population-based cross-sectional study of 1,022,425 Israeli candidates for military service aged 16.5-18 years. Participants underwent a comprehensive battery of tests assessing verbal and non-verbal intelligence, which yields a summarized cognitive function score (CFS). In addition, subjective visual acuity examination followed by objective non-cycloplegic refraction was carried out for each participant. Association between myopia and cognitive function was evaluated by multivariable logistic regression models adjusted for gender, age, country of origin, socioeconomic status, years of education, body mass index, height and year of examination. RESULTS: Compared to the intermediate CFS of the entire cohort, participants who had the highest CFS had 1.85-fold (95% CI, 1.81 to 1.89; P < .001) higher odds of having myopia and 2.73-fold (95% CI, 2.58 to 2.88; P < .001) higher odds of high myopia, while participants with the lowest CFS had 0.59-fold (95% CI, 0.57 to 0.61, P < .001) lower odds of having myopia. The verbal components of the cognitive function assessment had stronger associations with myopia than the non-verbal components (P < .001, for all). CONCLUSIONS: Cognitive function, especially verbal intelligence, is strongly and consistently associated with myopia among adolescents.
BACKGROUND:Myopia is a leading cause of visual impairment worldwide, and its increasing incidence is of public health concern. Cognitive function was associated with myopia among children, but evidence for adolescents is scarce. The purpose of this study was to determine whether myopia is associated with cognitive function, and which cognitive ability, verbal or non-verbal, is involved. METHODS: We conducted a population-based cross-sectional study of 1,022,425 Israeli candidates for military service aged 16.5-18 years. Participants underwent a comprehensive battery of tests assessing verbal and non-verbal intelligence, which yields a summarized cognitive function score (CFS). In addition, subjective visual acuity examination followed by objective non-cycloplegic refraction was carried out for each participant. Association between myopia and cognitive function was evaluated by multivariable logistic regression models adjusted for gender, age, country of origin, socioeconomic status, years of education, body mass index, height and year of examination. RESULTS: Compared to the intermediate CFS of the entire cohort, participants who had the highest CFS had 1.85-fold (95% CI, 1.81 to 1.89; P < .001) higher odds of having myopia and 2.73-fold (95% CI, 2.58 to 2.88; P < .001) higher odds of high myopia, while participants with the lowest CFS had 0.59-fold (95% CI, 0.57 to 0.61, P < .001) lower odds of having myopia. The verbal components of the cognitive function assessment had stronger associations with myopia than the non-verbal components (P < .001, for all). CONCLUSIONS: Cognitive function, especially verbal intelligence, is strongly and consistently associated with myopia among adolescents.