Carla Lanca1,2, Jason C Yam3, Wen-Jun Jiang4, Yih-Chung Tham1,5, Mohammad Hassan Emamian6, Chuen-Seng Tan7, Yin Guo8, Hu Liu9, Hua Zhong10, Dan Zhu11, Yuan-Yuan Hu12, Rohit Saxena13, Hassan Hashemi14, Li-Jia Chen2, Tien-Yin Wong1,5,15,16, Ching-Yu Cheng1,5,15, Chi-Pui Pang3, Hui Zhu9, Chen-Wei Pan17, Yuan Bo Liang18, Akbar Fotouhi19, Hong-Sheng Bi4, Jost B Jonas20, Seang-Mei Saw1,5,7. 1. Singapore Eye Research Institute, Singapore, Singapore. 2. Comprehensive Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal. 3. Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR, Hong Kong. 4. Eye Institute of Shandong University of Traditional Chinese Medicine, Jinan, China. 5. Ophthalmology and Visual Science Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore. 6. Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran. 7. Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore. 8. Tongren Eye Care Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China. 9. Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China. 10. Department of Ophthalmology, the First Affiliated Hospital of Kunming Medical University, Kunming, China. 11. The Affiliated Hospital of Inner Mongolia Medical University, Huhhot, China. 12. Affiliated Eye Hospital of Shandong, University of Traditional Chinese Medicine, Jinan, China. 13. Pediatric Ophthalmology, Strabismus and Neuro-Ophthalmology Section, Dr. R P Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. 14. Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran. 15. Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. 16. Singapore National Eye Centre, Singapore, Singapore. 17. School of Public Health, Medical College of Soochow University, Suzhou, China. 18. Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China. 19. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. 20. Department of Ophthalmology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
Abstract
PURPOSE: To examine the association between near work, screen time including TV and outdoor time with myopia in children from the Sunflower Myopia Asian Eye Epidemiology Consortium (AEEC). METHODS: We analysed AEEC cross-sectional data (12 241 children) on risk factors (near work, screen time including TV and outdoor time) and myopia of six population-based studies (China, Hong Kong and Singapore). Cycloplegic refraction and axial length (AL) measurements were included. Risk factors were determined using questionnaires. Data were pooled from each study, and multivariable regression analysis was performed to evaluate the associations between risks factors and myopia, spherical equivalent (SE) and AL. RESULTS: Among the included children, 52.1% were boys, 98.1% were Chinese and 69.7% lived in urban areas. Mean±standard deviation (SD) for age was 8.8 ± 2.9 years, for SE was -0.14 ± 1.8 D and for AL was 23.3 ± 1.1 mm. Myopia prevalence was 30.6%. In multivariate analysis, more reading and writing (OR = 1.17; 95% CI, 1.11-1.24), more total near work (OR = 1.05; 95% CI, 1.02-1.09) and less outdoor time (OR = 0.82, 95% CI, 0.75-0.88) were associated with myopia (p's < 0.05). These factors were similarly associated with SE and AL (p's < 0.05), except for total near work and AL (p = 0.15). Screen time including TV was not significantly associated with myopia (p = 0.49), SE (p = 0.49) or AL (p = 0.83). CONCLUSION: In this study, increased reading and writing and decreased outdoor time were associated with myopia. Screen time may be a surrogate factor of near work or outdoor time, but further research is needed to assess its role as an independent risk factor for myopia.
PURPOSE: To examine the association between near work, screen time including TV and outdoor time with myopia in children from the Sunflower Myopia Asian Eye Epidemiology Consortium (AEEC). METHODS: We analysed AEEC cross-sectional data (12 241 children) on risk factors (near work, screen time including TV and outdoor time) and myopia of six population-based studies (China, Hong Kong and Singapore). Cycloplegic refraction and axial length (AL) measurements were included. Risk factors were determined using questionnaires. Data were pooled from each study, and multivariable regression analysis was performed to evaluate the associations between risks factors and myopia, spherical equivalent (SE) and AL. RESULTS: Among the included children, 52.1% were boys, 98.1% were Chinese and 69.7% lived in urban areas. Mean±standard deviation (SD) for age was 8.8 ± 2.9 years, for SE was -0.14 ± 1.8 D and for AL was 23.3 ± 1.1 mm. Myopia prevalence was 30.6%. In multivariate analysis, more reading and writing (OR = 1.17; 95% CI, 1.11-1.24), more total near work (OR = 1.05; 95% CI, 1.02-1.09) and less outdoor time (OR = 0.82, 95% CI, 0.75-0.88) were associated with myopia (p's < 0.05). These factors were similarly associated with SE and AL (p's < 0.05), except for total near work and AL (p = 0.15). Screen time including TV was not significantly associated with myopia (p = 0.49), SE (p = 0.49) or AL (p = 0.83). CONCLUSION: In this study, increased reading and writing and decreased outdoor time were associated with myopia. Screen time may be a surrogate factor of near work or outdoor time, but further research is needed to assess its role as an independent risk factor for myopia.
Authors: Arumugam R Muralidharan; Carla Lança; Sayantan Biswas; Veluchamy A Barathi; Low Wan Yu Shermaine; Saw Seang-Mei; Dan Milea; Raymond P Najjar Journal: Ther Adv Ophthalmol Date: 2021-12-19