Interventions recommended for myopia prevention and control among children and adolescents in China: a systematic review

Zhu, Zhuoting; Chen, Yanxian; Tan, Zachary; Xiong, Ruilin; McGuinness, Myra; Müller, Andreas

doi:10.1136/bjophthalmol-2021-319306

Cited by 48 publications

(25 citation statements)

References 82 publications

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“…On the basis of considering the model uncertainty, we used the Bayesian model averaging method to analyze the factors that affect the eyesight of primary school students, junior middle school students and senior middle school students. We found that exercise is the robust influencing factor that affects the eyesight of (junior and senior) middle school students, which has been consistent with previous studies (4,(37)(38)(39)(40). However, few studies have identified the school stages (primary, junior or senior middle school) in the association between physical activities and myopia.…”

Section: Discussionsupporting

confidence: 92%

Exercise is the dominant factor affecting the development of teenagers' eyesight—Based on the Bayesian model averaging

Liu

Zhao

et al. 2022

Front. Public Health

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ObjectiveThe model uncertainty may result in inconsistency about the environmental factors of myopia among students, and the Bayesian model average (BMA) is an effective way to eliminate it. We aimed to explore the influencing factors of myopia in primary and middle school students by BMA.MethodsThe data came from the 2021 National Surveillance of Common Diseases and Health Influencing Factors of students. By stratified random cluster sampling, the physical and mental health status of students in Tianjin and the factors affecting their physical health, such as diet, exercise, mental stress, school bullying, sleep time, and internet use, were investigated. The sample consisted of 8,457 primary school students, 8,191 junior middle school students, and 5,901 senior middle school students. Besides the physical examination, we used computer optometry (non-ciliary paralysis) to screen myopia. And we used BMA to select the risk factors through the BMS package in R.ResultsThe exercise was the only factor that affected the eyesight of junior and senior middle schoolers by BMA, with the posterior probability of 0.9736 and 0.9762, but not for the primary students. And we failed to select variables that affected eyesight in grades 4–6 of primary school.ConclusionThe exercise was a strong influencing factor for the eyesight of students in Tianjin's junior and senior middle schools.

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Section: Discussionsupporting

confidence: 92%

Exercise is the dominant factor affecting the development of teenagers' eyesight—Based on the Bayesian model averaging

Liu

Zhao

et al. 2022

Front. Public Health

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“…A variety of studies investigated lifestyle (mainly including outdoor, near work, and screen use) [51][52][53][54] , but how these factors work together and lead to myopia or promote myopia progression is intricated. Though many efforts have been tried to reduce the incidence of myopia and the effect of myopia prevention was checked 55 , most of them implemented only a few intervention measures which may not be suitable for every single person in practice. In addition, how to identify target population with high risk of early-onset myopia is another signi cant important issue 56 because delivery of accurate early intervention could be twice as effective.…”

Section: Discussionmentioning

confidence: 99%

Influence of Lifestyle Patterns On Myopia In Students Aged 9 To 18 In Tianjin, China: A Latent Class Analysis

Cui

Cao

Liu

et al. 2022

Preprint

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Purpose: This study aims to determine influence of lifestyle patterns on myopia and spherical equivalent refraction (SE) in school-aged children in Tianjin.Methods: Students aged 9 to 18 in grade 4 to 12 were recruited. Non-cycloplegic SE was obtained. A self-administration questionnaire was used to collect demographic and lifestyle information.Results: The overall prevalence of myopia of 8651 students was 81.5% and that of high myopia was 8.88%. Myopia and high myopia rate increased dramatically with grade (p<0.001). Students were classified into 3 groups based on latent class analysis (LCA). Students in class 2 had the lowest myopia rate of 74.1% and those in class 1 had the highest rate of 82.8%. Binary logistic regression analysis showed that class 1 and 3 had a higher risk for myopia compared to class 2 (OR= 1.68, p<0.001; OR= 1.46, p=0.004). The risk for high myopia of Class 1 and 3 were also higher compared to that of class2 (OR= 2.41, p<0.001; OR= 2.13, p=0.006). General linear model showed that SE of students in class 1 and 3 was lower than that of students in class 2 (β=-0.82, p<0.001; β=-0.68, p<0.001).Conclusion: Lifestyle is associated with myopia and SE value.

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“…Moreover, early-onset myopia among preschoolers has become more prevalent in recent years in China ( 3 ), indicating longer duration of myopia progression and more likely to have high myopia in the future ( 4 , 5 ). Consequently, the Chinese Ministry of Education issued the Comprehensive Plan to Prevent Nearsightedness among Children and Teenagers (CPPNCT) in aim to reduce the incidence of myopia and control myopic progression in China in 2018 ( 6 ). Though numerous items are included in the CPPNCT, increasing time outdoors and reducing near-work time are the key content ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

“…Consequently, the Chinese Ministry of Education issued the Comprehensive Plan to Prevent Nearsightedness among Children and Teenagers (CPPNCT) in aim to reduce the incidence of myopia and control myopic progression in China in 2018 ( 6 ). Though numerous items are included in the CPPNCT, increasing time outdoors and reducing near-work time are the key content ( 6 ). For example, mandatory outdoor time has already been implemented as part of myopia prevention programs in cities of mainland China.…”

Section: Introductionmentioning

confidence: 99%

Effect of atropine 0.01% on myopia control in children aged 6–13 years during the 2022 lockdown in Shanghai

Jiang

Chen

2023

Front. Public Health

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PurposeTo compare the myopic progression in children treated with 0. 01% atropine and those who discontinued atropine during the 2022-home quarantine in Shanghai.MethodsIn this retrospective study, children aged 6–13 years with follow-up visits before (between January 2022 and February 2022) and after the lockdown (between July 2022 and August 2022) were included. Cycloplegic refraction and axial length (AL) were measured at both visits. The atropine group had continuous medication during the lockdown while the control group discontinued. The 0.01% atropine eyedrops were administered daily before bedtime. The types of spectacle lens were recorded: single vision (SV) spectacles or defocus incorporated multiple segments lenses (DIMS).ResultsIn total, 41 children (81 eyes) in the atropine group and 32 children (64 eyes) in the control group were enrolled. No significant difference was found in the demographic characteristics, spherical diopter, spherical equivalent (SE), AL, and follow-up time between the two groups before the lockdown in 2022 (all p > 0.1). After the home confinement, a greater myopia progression was observed in the control group (−0.46 ± 0.42 D) compared to atropine group (−0.26 ± 0.37 D; p = 0.0023). Axial elongation was also longer in the control group than that in children sustained with atropine (0.21 ± 0.17 vs. 0.13 ± 0.15 mm, p = 0.0035). Moreover, there was no significant change of spherical diopter and SE during lockdown in the atropine + DIMS combined subgroup (0.03 ± 0.033 D for spherical diopter, p = 0.7261 and 0.08 ± 0.27 D for SE, p = 0.2042, respectively). However, significant myopic shift was observed in the atropine + SV subgroup during the quarantine time (−0.31 ± 0.39 D for SE and 0.15 ± 0.16 mm for AL, both p < 0.001).ConclusionChildren treated with 0.01% atropine had slower myopia progression during the lockdown period in Shanghai compared with children discontinued. Moreover, the effect of atropine on myopic prevention can be strengthened with DIMS lenses.

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Interventions recommended for myopia prevention and control among children and adolescents in China: a systematic review

Cited by 48 publications

References 82 publications

Exercise is the dominant factor affecting the development of teenagers' eyesight—Based on the Bayesian model averaging

Exercise is the dominant factor affecting the development of teenagers' eyesight—Based on the Bayesian model averaging

Influence of Lifestyle Patterns On Myopia In Students Aged 9 To 18 In Tianjin, China: A Latent Class Analysis

Effect of atropine 0.01% on myopia control in children aged 6–13 years during the 2022 lockdown in Shanghai

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