Myopia Progression during the COVID-19 Era: A Systematic Review and Meta-analysis

Najafzadeh, Mohammad Javad; Zand, Amin; Shafiei, Mohadeseh; Sharifi, Meraj; Nasiri, Naser; Sharifi, Ali

doi:10.1080/08820538.2023.2168490

Cited by 7 publications

(4 citation statements)

References 48 publications

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“…on myopia progression during the COVID-19 era included 33 studies. [ 42 ] Our review specifically studied myopia progression during the COVID-19 pandemic while the aforementioned review included studies on lifestyle and behavioral changes during the pandemic that could affect myopia progression, which was not the primary focus of our review. However, as more studies emerged, an up-to-date review on the impact of the pandemic on myopia is worthy and timely.…”

Section: Discussionmentioning

confidence: 99%

Impact of the coronavirus disease 2019 pandemic on the progression, prevalence, and incidence of myopia: A systematic review

Au Eong,

Chen,

Teo

et al. 2024

Taiwan Journal of Ophthalmology

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We systematically reviewed the literature on the effects of the coronavirus disease 2019 (COVID-19) pandemic on the progression, prevalence, and incidence of myopia. A comprehensive literature search was performed on PubMed, Cochrane Central Register of Controlled Trials, and Scopus databases. Studies included in the review assessed myopia progression, prevalence, and/or incidence as the primary outcome. Of 523 articles yielded in the initial search, 23 studies (6 cross-sectional and 17 cohort) were eligible for inclusion. Sixteen of these were conducted in China and one each in Hong Kong, Turkey, Spain, Israel, India, Korea, and Tibet. Quality appraisals were conducted with the Joanna Briggs Institute Critical Appraisal Checklists. Of the included studies, a large majority reported a greater myopic shift and increase in myopia prevalence during the COVID-19 pandemic compared to the pre-COVID-19 years. All three studies on myopia incidence showed increased incidence during the COVID-19 pandemic. Myopia progression accelerated during the COVID-19 pandemic, even in individuals using low-concentration atropine eye drops in two studies but not in those using orthokeratology treatment in one study. Overall, the studies found that the COVID-19 pandemic and its associated home confinement measures generally increased myopia progression, prevalence, and incidence, even in individuals using low-concentration atropine eye drops.

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Section: Discussionmentioning

confidence: 99%

Impact of the coronavirus disease 2019 pandemic on the progression, prevalence, and incidence of myopia: A systematic review

Au Eong,

Chen,

Teo

et al. 2024

Taiwan Journal of Ophthalmology

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“…1 However, gradual shifts away from outdoor activity and increased screen time, including those caused by the response to COVID, may require an upward revision of prevalence projections. 2 Therefore, the need to understand the mechanisms underlying myopia development and to develop new intervention strategies is more urgent than ever.…”

Section: Introductionmentioning

confidence: 99%

Establishment and comprehensive characterization of a novel dark-reared zebrafish model for myopia studies

Xie,

Goodbourn,

Bui

et al. 2023

Preprint

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PurposeMyopia is predicted to impact approximately 5 billion people by 2050, necessitating mechanistic understanding of its development. Myopia results from dysregulated genetic mechanisms of emmetropization, caused by over-exposure to aberrant visual environments; however, these genetic mechanisms remain unclear. Recent human genome-wide association studies have identified a range of novel myopia-risk genes. To facilitate large-scalein vivomechanistic examination of gene-environment interactions, this study aims to establish a myopia model platform that allows efficient environmental and genetic manipulations.MethodsWe established an environmental zebrafish myopia model by dark-rearing. Ocular biometrics including relative ocular refraction were quantified using optical coherence tomography images. Spatial vision was assessed using optomotor response (OMR). Retinal function was analyzed via electroretinography (ERG). Myopia-associated molecular contents or distributions were examined using RT-qPCR or immunohistochemistry.ResultsOur model produces robust phenotypic changes, showing myopia after 2 weeks of dark-rearing, which were recoverable within 2 weeks after returning animals to normal lighting. 2-week dark-reared zebrafish have reduced spatial-frequency tuning function. ERG showed reduced photoreceptor and bipolar cell function (a- andb-waves) after only 2 days of dark-rearing, which worsened after 2 weeks of dark-rearing. We also found dark-rearing-induced changes to expression of myopia-risk genes, includingegr1, vegfaa, vegfab, rbp3, gjd2aandgjd2b, inner retinal distribution of EFEMP1, TIMP2 and MMP2, as well as transiently reduced PSD95 density in the inner plexiform layer.ConclusionsCoupled with the gene editing tools available for zebrafish, our environmental myopia model provides an excellent platform for large-scale investigation of gene-environment interactions in myopia development.

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“…Human studies showed that children who spent more time outdoors were less likely to develop myopia (Rose et al, 2008). Recent shifts away from outdoor activities and increased screen time may further increase myopia prevalence and promote pathological myopia (Najafzadeh et al, 2023). This points to an urgent need to understand the underlying mechanisms for myopia development, to underpin the development of novel approaches to target these mechanisms.…”

Section: Introductionmentioning

confidence: 99%

EFEMP1 contributes to light-dependent ocular growth in zebrafish

Xie,

Bui,

Goodbourn

et al. 2023

Preprint

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Myopia (short-sightedness) is the most common ocular disorder. It generally develops after over-exposure to aberrant visual environments, disrupting emmetropization mechanisms that should match eye growth with optical power. A pre-screening of strongly associated myopia-risk genes identified through human genome-wide association studies implicatesefemp1in myopia development, but how this gene impacts ocular growth remains unclear. Here, we modifyefemp1expression specifically in the retina of zebrafish. We found that under normal lighting,efemp1mutants developed axial myopia, enlarged eyes, reduced spatial vision and altered retinal function. However, under myopia-inducing dark-rearing, compared to control fish, mutants remained emmetropic and showed changes in retinal function.Efemp1modification changed the expression ofefemp1,egr1,tgfb1a,vegfabandrbp3genes in the eye, and changes the inner retinal distributions of myopia-associated EFEMP1, TIMP2 and MMP2 proteins.Efemp1modification also impacted dark-rearing-induced responses ofvegfabandwnt2bgenes and above-mentioned myopia-associated proteins. Together, we provided robust evidence that light-dependent ocular growth is regulated byefemp1.SummaryThis study shows that retina-specific modification ofefemp1expression in zebrafish results in myopic eye, and impacts responses to myopia-inducing dark-rearing in eye growth, retinal function, and myopia-associated molecular expression and distribution, implicating light-dependent regulation ofefemp1in ocular development.

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Myopia Progression during the COVID-19 Era: A Systematic Review and Meta-analysis

Cited by 7 publications

References 48 publications

Impact of the coronavirus disease 2019 pandemic on the progression, prevalence, and incidence of myopia: A systematic review

Impact of the coronavirus disease 2019 pandemic on the progression, prevalence, and incidence of myopia: A systematic review

Establishment and comprehensive characterization of a novel dark-reared zebrafish model for myopia studies

EFEMP1 contributes to light-dependent ocular growth in zebrafish

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