Rural-urban differences in prevalence of and risk factors for refractive errors among school children and adolescents aged 6–18 years in Dalian, China

Wang, Yachen; Liu, Lei; Lu, Zuliang; Qu, Yiyin; Ren, Xianlong; Wang, Jiaojiao; Lu, Yan; Liang, Wei; Yue, Xin; Zhang, Nan; Lin, Jenshan; Wang, Lijing; Song, Jian; J, Yu; Zhao, Lifeng; Ma, Xiang; Zhang, Lijun

doi:10.3389/fpubh.2022.917781

Cited by 17 publications

(11 citation statements)

References 45 publications

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“…Considering the 47.8% overall prevalence of refractive error (17.1% in boys and 30.6% in girls), our screened population had a considerably higher prevalence. This difference verifies the findings of previous studies, which reported different prevalence rates within countries and even among people of the same ethnic background [4][5][6]. Furthermore, it indicates the importance of vision screening programs among various communities or areas in the same country to discover the actual magnitude of this avoidable and prevalent cause of visual impairment [3].…”

Section: Discussionsupporting

confidence: 86%

“…Using the same definition, myopia accounted for 63.2% of students with refractive errors in the present study, which is significantly less than that in the screened population. This indicates the difference in the prevalence rate of the type of refractive error within countries and even among people of the same ethnic background [4][5][6].…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of myopia, hyperopia, and astigmatism among Chinese preschool children in Changsha is 2.94%, 13.8%, and 17.6%, respectively [4]. The prevalence of myopia and anisometropia in Dalian, northeast China, differs significantly between urban (82.71 and 7.27%, respectively) and rural (71.76% and 5.41%, respectively) students because of differences in sociodemographic and physiologic factors [5]. The prevalence of myopia in 6 -7-year-old Chinese children from Sydney is significantly lower compared to those from Singapore (3.3% versus 29.1%) [6].…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of refractive errors among school children in Wangsa Maju, Kuala Lumpur, Malaysia

Ismail¹,

Sukumaran²

2022

Med Hypothesis Discov Innov Optom

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Background: Uncorrected refractive error is the most common cause of vision impairment and the second leading cause of blindness worldwide. Its prevalence differs among and within countries. This study was aimed at exploring the pattern and prevalence of refractive error among school children in the Wangsa Maju Township, Kuala Lumpur, Malaysia. Methods: A stratified, multistage, cluster random sampling in a geographically defined area was employed, and 245 school children, aged 8–12 years, from two primary schools in Wangsa Maju Township, Kuala Lumpur, were recruited. The cross-sectional study employed interviewing, measuring uncorrected distance visual acuity (UCDVA) using the Snellen chart, cycloplegic refraction under a streak retinoscope refined subjectively, and a detailed slit-lamp examination to assess the anterior and posterior segments. Myopia, hyperopia, and astigmatism were defined as spherical equivalent (SE) greater than or equal to - 0.50, SE greater than or equal to + 2.00, and cylindrical greater than or equal to 0.75 D, respectively. Reduced UCDVA was defined as an unaided visual acuity < 6/9. Results: The mean (standard deviation) age of the participants was 10.42 (1.22) years. The overall prevalence of refractive error was 47.8%. Of 245 screened school children, including 42 (35.9%) boys and 75 (64.1%) girls, 117 had refractive error, with a prevalence of refractive error of 17.1% and 30.6% in boys and girls, respectively. Myopia was the most common type (30.2%), followed by astigmatism (16.3%) and hyperopia (1.2%). The prevalence of reduced UCDVA was 36.3% among the screened school children, attributable to refractive error with a significantly high positive correlation (r = +.721; P < 0.01). Among those with refractive errors, sex differences in the magnitude of refractive errors were not statistically significant in the three types of refractive errors (all P > 0.05). Conclusions: The prevalence of refractive error among primary school children in Wangsa Maju Township, Kuala Lumpur, Malaysia was 47.8%; girls outnumbered boys, but the magnitude of refractive errors showed no sex differences. The prevalence of reduced UCDVA was 36.3%, attributable to refractive error. Irrespective of sex, myopia had the highest prevalence compared to other refractive errors, and its prevalence increased with age. Future population-based studies are required to address the limitations concerning environmental risk factors for refractive error and the impact of ethnic or familial backgrounds on their prevalence in a similar but larger population using the same protocol.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prevalence of refractive errors among school children in Wangsa Maju, Kuala Lumpur, Malaysia

Ismail¹,

Sukumaran²

2022

Med Hypothesis Discov Innov Optom

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“… 15 For example, Wang et al reported myopia prevalence of 82.71% and 72.76% among students aged 6–18 years in urban Dalian city and rural areas of China, respectively. 16 Similarly, Peng et al found that the prevalence of myopia in urban and rural regions in Anhui was 68.1% and 63.7%, 17 respectively.…”

Section: Introductionmentioning

confidence: 94%

“…Numerous studies have demonstrated varying rates of myopia among populations with comparable genetic backgrounds but varying degrees of urbanisation 15. For example, Wang et al reported myopia prevalence of 82.71% and 72.76% among students aged 6–18 years in urban Dalian city and rural areas of China, respectively 16. Similarly, Peng et al found that the prevalence of myopia in urban and rural regions in Anhui was 68.1% and 63.7%,17 respectively.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of and risk factors for myopia among urban and rural children in Northeast China: protocol for a school-based cross-sectional study

Zheng,

Jiang,

et al. 2024

BMJ Open

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IntroductionThe worldwide prevalence of myopia is high and continues to increase. In this study, a school screening programme for myopia will be implemented using the whole-process information method. The purpose of this study is to investigate the prevalence of myopia in urban and rural areas of Northeast China and to determine the factors related to myopia.Methods and analysisThis is a school-based cross-sectional study. Our study population will include 6000 school-aged children from 2 urban and 2 rural schools in Jinzhou, China. The study will be conducted using our self-developed internet-based intelligent data collection, transmission, storage and analysis system. Examination parameters include uncorrected distance visual acuity, presenting distance visual acuity, non-cycloplegic autorefraction, height, weight, waist circumference, hip circumference, spinal curvature and dental caries. The examination report will be automatically sent to parents, who will complete the questionnaire, and appropriate statistical analysis will be performed. The main outcome is the prevalence of myopia, defined as an equivalent spherical degree ≤−0.5 D.Ethics and disseminationEthical approval was obtained from the Third Affiliated Hospital of Jinzhou Medical University (number: JYDSY-KXYJ-IEC-2023-018). Findings will be published in a peer-reviewed journal. Subjects and their parents (or other authorised agents) give informed consent prior to study participation.Trial registration numberChiCTR2300072893.

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Urban Living Environment and Myopia in Children

Li,

Qin

et al. 2023

JAMA Netw Open

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ImportanceThe global prevalence of myopia has shown a steady increase over recent decades, with urban areas seemingly experiencing a more significant impact.ObjectiveTo assess the association between urbanization and the prevalence, incidence, progression, and severity of myopia.Design, Setting, and ParticipantsThis cohort study included students in grades 1 to 6 in Tianjin, China, who underwent 3 vision examinations conducted over a 2-year period, from March 1, 2021, to March 31, 2023. Participants from grades 1 to 4 completed the 2-year follow-up.ExposuresUrban living environmentMain Outcomes and MeasuresThe association of urbanization with the incidence, progression, prevalence, and severity of myopia. To quantify urbanization, an urban score was constructed using satellite data and an iterative exploratory factor analysis.ResultsOf 177 894 students (51.7% male; mean [SD] age, 10.27 [1.75] years) included in the study, 137 087 students (52.3% male; mean [SD] age, 8.97 [1.21] years) were followed up for 2 years. A positive association was identified between myopia incidence and urbanization. Specifically, each 1-unit increment in the urban score was associated with an increased risk of myopia over a 1-year period (odds ratio [OR], 1.09; 95% CI, 1.01-1.15; P = .02) and a 2-year period (OR, 1.53; 95% CI, 1.50-1.57; P &lt; .001). Conversely, each 1-unit increase in the urban score was associated with a significant decrease in myopia progression at 1 year (OR, 0.84; 95% CI, 0.82-0.86; P &lt; .001) and 2 years (OR, 0.73; 95% CI, 0.70-0.75, P &lt; .001). In a cross-sectional data analysis, the urban score was positively associated with myopia prevalence (OR, 1.62; 95% CI, 1.08-2.42; P = .02) and negatively associated with myopia severity, as indicated by spherical equivalent refraction (OR, 1.46; 95% CI, 1.07-1.99; P = .02).Conclusions and RelevanceThis study exploring urban living environments and myopia revealed dual associations of urban living with both the incidence and the progression of myopia. The observed patterns emphasize the urgency of promptly implementing myopia control strategies in less urbanized regions, where myopia progression may be accentuated.

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Rural-urban differences in prevalence of and risk factors for refractive errors among school children and adolescents aged 6–18 years in Dalian, China

Cited by 17 publications

References 45 publications

Prevalence of refractive errors among school children in Wangsa Maju, Kuala Lumpur, Malaysia

Prevalence of refractive errors among school children in Wangsa Maju, Kuala Lumpur, Malaysia

Prevalence of and risk factors for myopia among urban and rural children in Northeast China: protocol for a school-based cross-sectional study

Urban Living Environment and Myopia in Children

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