Increase in Myopia Prevalence in Clinic-Based Populations Across a Century

Hrynchak, Patricia K.; Mittelstaedt, Andrea; Machan, Carolyn M.; Bunn, Carla; Irving, Elizabeth L.

doi:10.1097/opx.0000000000000069

Cited by 37 publications

(55 citation statements)

References 49 publications

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“…The incidence of myopia is increasing worldwide (Hrynchak et al, 2013; Sun et al, 2012). In addition, myopia is a major risk factor for eye disease, (Burton, 1989; Saw et al, 2005; Vongphanit et al, 2002; Zadnik, 2001) and has significant negative effects on the quality of life.…”

Section: Discussionmentioning

confidence: 99%

The wavelength composition and temporal modulation of ambient lighting strongly affect refractive development in young tree shrews

Gawne

Siegwart

Ward

et al. 2017

Experimental Eye Research

105

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Shortly after birth, the eyes of most animals (including humans) are hyperopic because the short axial length places the retina in front of the focal plane. During postnatal development, an emmetropization mechanism uses cues related to refractive error to modulate the growth of the eye, moving the retina toward the focal plane. One possible cue may be longitudinal chromatic aberration (LCA), to signal if eyes are getting too long (long [red] wavelengths in better focus than short [blue]) or too short (short wavelengths in better focus). It could be difficult for the short-wavelength sensitive (SWS, “blue”) cones, which are scarce and widely spaced across the retina, to detect and signal defocus of short wavelengths. We hypothesized that the SWS cone retinal pathway could instead utilize temporal (flicker) information. We thus tested if exposure solely to long-wavelength light would cause developing eyes to slow their axial growth and remain refractively hyperopic, and if flickering short-wavelength light would cause eyes to accelerate their axial growth and become myopic. Four groups of infant northern tree shrews (Tupaia glis belangeri, dichromatic mammals closely related to primates) began 13 days of wavelength treatment starting at 11 days of visual experience (DVE). Ambient lighting was provided by an array of either long-wavelength (red, 626±10 nm) or short-wavelength (blue, 464±10 nm) light-emitting diodes placed atop the cage. The lights were either steady, or flickering in a pseudo-random step pattern. The approximate mean illuminance (in human lux) on the cage floor was red (steady, 527 lux; flickering, 329 lux), and blue (steady, 601 lux; flickering, 252 lux). Refractive state and ocular component dimensions were measured and compared with a group of age-matched normal animals (n=15 for refraction (first and last days); 7 for ocular components) raised in broad spectrum white fluorescent colony lighting (100-300 lux). During the 13 day period, the refraction of the normal animals decreased from (mean±SEM) 5.8±0.7 diopters (D) to 1.5±0.2 D as their vitreous chamber depth increased from 2.77±0.01mm to 2.80±0.03 mm. Animals exposed to red light (both steady and flickering) remained hyperopic throughout the treatment period so that the eyes at the end of wavelength treatment were significantly hyperopic (7.0±0.7 D, steady; 4.7±0.8 D, flickering) compared with the normal animals (p<0.01). The vitreous chamber of the steady red group (2.65±0.03 mm) was significantly shorter than normal (p<0.01). On average, steady blue light had little effect; the refractions paralleled the normal refractive decrease. In contrast, animals housed in flickering blue light increased the rate of refractive decrease so that the eyes became significantly myopic (−2.9±1.3 D) compared with the normal eyes and had longer vitreous chambers (2.93±0.04 mm). Upon return to colony lighting, refractions in all groups gradually returned toward emmetropia. These data are consistent both with the hypothesis that LCA can be an important visual...

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Section: Discussionmentioning

confidence: 99%

The wavelength composition and temporal modulation of ambient lighting strongly affect refractive development in young tree shrews

Gawne

Siegwart

Ward

et al. 2017

Experimental Eye Research

105

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“…Hyrnchak and colleagues 40 at the University of Waterloo collected refractive error data on all patients of all ages seen at their clinic in 2007. The result is a wonderful figure depicting the increase in the prevalence of myopia in the young, followed by the increase in the prevalence of hyperopia and decrease in the prevalence of myopia after age 50.…”

Section: No Substitutes For Patient-based Datamentioning

confidence: 99%

“…The result is a wonderful figure depicting the increase in the prevalence of myopia in the young, followed by the increase in the prevalence of hyperopia and decrease in the prevalence of myopia after age 50. 40 The exact numbers may be in question because the data are from a clinical sample rather than a population-based one, but the general trends have been borne out in longitudinal data sets over shorter spans of ages. The authors also noted an increase in the prevalence of myopia when their data were compared with three older data sets, consistent with reports from Asia and from the United States.…”

Section: No Substitutes For Patient-based Datamentioning

confidence: 99%

Myopia—Yesterday, Today, and Tomorrow

Mutti

Gwiazda

Norton

et al. 2013

Optometry and Vision Science

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“…The net optical consequence is that images of distant objects fall in front of the retina for the uncorrected eye. 1 Myopia is estimated to affect 22% of the world's population (1.5 billion people) 2 and its prevalence continues to rise, precipitously so in East Asia, 3,4 with significant increases also reported in the United States, 5 Canada, 6 and Europe. 7 Apart from these changing prevalence statistics, of additional concern is the fact that the age of myopia onset has significantly decreased.…”

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confidence: 99%

A Bioengineering Approach to Myopia Control Tested in a Guinea Pig Model

Garcia

Jha

Healy

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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PurposeTo investigate the biocompatibility of an injectable hydrogel and its ability to control myopia progression in guinea pigs.MethodsThe study used a hydrogel synthesized from acrylated hyaluronic acid with a conjugated cell-binding peptide and enzymatically degradable crosslinker. Seven-day-old guinea pigs were first form deprived (FD) with diffusers for 1 week. One group was kept as an FD-only control; two groups received a sub-Tenon's capsule injection of either hydrogel or buffer (sham surgery) at the posterior pole of the eye. Form deprivation treatments were then continued for 3 additional weeks. Treatment effects were evaluated in terms of ocular axial length and refractive error. Safety was evaluated via intraocular pressure (IOP), visual acuity, flash electroretinograms (ERG), and histology.ResultsBoth hydrogel and sham surgery groups showed significantly reduced axial elongation and myopia progression compared to the FD-only group. For axial lengths, net changes in interocular difference (treated minus control) were 0.04 ± 0.06, 0.02 ± 0.09, and 0.24 ± 0.08 mm for hydrogel, sham, and FD-only groups, respectively (P = 0.0006). Intraocular pressures, visual acuities, and ERGs of treated eyes were not significantly different from contralateral controls. Extensive cell migration into the implants was evident. Both surgery groups showed noticeable Tenon's capsule thickening.ConclusionsSub-Tenon's capsule injections of both hydrogel and buffer inhibited myopia progression, with no adverse effects on ocular health. The latter unexpected effect warrants further investigation as a potential novel myopia control therapy. That the hydrogel implant supported significant cell infiltration offers further proof of its biocompatibility, with potential application as a tool for drug and cell delivery.

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Increase in Myopia Prevalence in Clinic-Based Populations Across a Century

Abstract: In the last 100 years, there appears to have been a myopic shift in clinic-based populations and myopia prevalence appears to follow a predictable pattern with age.

Cited by 37 publications

References 49 publications

The wavelength composition and temporal modulation of ambient lighting strongly affect refractive development in young tree shrews

The wavelength composition and temporal modulation of ambient lighting strongly affect refractive development in young tree shrews

Myopia—Yesterday, Today, and Tomorrow

A Bioengineering Approach to Myopia Control Tested in a Guinea Pig Model

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