Effect of outdoor activity on myopia onset and progression in school-aged children in northeast china: the sujiatun eye care study

Abstract

BackgroundDue to its high prevalence and associated sight-threatening pathologies, myopia has emerged as a major health issue in East Asia. The purpose was to test the impact on myopia development of a school-based intervention program aimed at increasing the time student spent outdoors.MethodsA total of 3051 students of two primary (grades 1-5, aged 6-11) and two junior high schools (grades 7-8, aged 12-14) in both urban and rural Northeast China were enrolled. The intervention group (n = 1735) unlike the control group (n = 1316) was allowed two additional 20-min recess programs outside the classroom. A detailed questionnaire was administered to parents and children. Uncorrected visual acuity (UCVA) was measured using an E Standard Logarithm Vision Acuity Chart (GB11533-2011) at baseline, 6-month and 1-year intervals. A random subsample (n = 391) participated in the clinic visits and underwent cycloplegia at the beginning and after 1 year.ResultsThe mean UCVA for the entire intervention group was significantly better than the entire control group after 1 year (P < 0.001). In the subgroup study, new onset of myopia and changes in refractive error towards myopia were direction during the study period was significantly lower in the intervention group than in the control group (3.70 % vs. 8.50 %, P = 0.048; -0.10 ± 0.65 D/year vs. -0.27 ± 0.52 D/year, P = 0.005). Changes in axial length and IOP were also significantly lower following the intervention group (0.16 ± 0.30 mm/year vs. 0.21 ± 0.21 mm/year, P = 0.034; -0.05 ± 2.78 mmHg/year vs. 0.67 ± 2.21 mmHg/year, P = 0.006).ConclusionsIncreasing outdoor activities prevented myopia onset and development, as well as axial growth and elevated IOP in children.Trial registrationCurrent controlled trials NCT02271373.Electronic supplementary materialThe online version of this article (doi:10.1186/s12886-015-0052-9) contains supplementary material, which is available to authorized users.

Time spent in outdoor activities in relation to myopia prevention and control: a meta‐analysis and systematic review

“…; Jin et al. ). For the cross‐sectional studies, if the exposure variable was defined as hours per day, results were standardized to hours per week by dividing the log(OR) and SE by 7 (Sherwin et al.…”

“…() and Jin et al. (), the additional time outdoors in the intervention group was considered the increase in time between the intervention and control groups, whereas in that by Wu et al. () the exposure was assumed from the time children were not allowed to stay in their classrooms.…”

Dopamine signaling and myopia development: What are the key challenges

“…Recent epidemiological studies indicate that outdoor activity (with increasing light exposure) affects mainly the onset of myopia but not the progression of myopia development in children, indicating a possible effect of DA signaling on initiation of myopia (Guo et al, 2013; He et al, 2015; Jin et al, 2015). Data from mouse models with retinal pathway defects that result in decreased dopamine turnover and increased myopia susceptibility would also support the hypothesis that DA release alters myopia induction (Figure 2).…”

Violet Light Exposure Can Be a Preventive Strategy Against Myopia Progression

“…The etiology of myopia remains unknown, but some epidemiological studies have suggested that increased near vision tasks such as reading, using computers and smartphones are possible risk factors (Ip et al, 2008). Recently, the time spent outdoors was proposed as a protective factor (French et al, 2013a, French et al, 2013b, Guggenheim et al, 2012, Ip et al, 2008, Jin et al, 2015, Jones-Jordan et al, 2014, Jones et al, 2007, Read et al, 2014, Rose et al, 2008), and the beneficial effect of high ambient light for the protection of myopia has been confirmed in chicks, mice, and monkeys (Karouta and Ashby, 2015, Norton and Siegwart, 2013, Smith et al, 2012, Stone et al, 2013, Tkatchenko et al, 2013). Additionally, some clinical trials indicated that increased outdoor activity of students had an anti -myopia effect (He et al, 2015, Jin et al, 2015, Wu et al, 2013).…”