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BMC Ophthalmology
Published in: BMC Ophthalmology 1/2018

Open Access 01-12-2018 | Research article

Low prevalence of myopia among school children in rural China

Authors: Chen-Wei Pan, Rong-Kun Wu, Jun Li, Hua Zhong

Published in: BMC Ophthalmology | Issue 1/2018

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Abstract

Background

We aim to assess the prevalence of myopia in Chinese school children with low educational pressure and explore which factors could explain the differences in prevalence between generations.

Methods

A school-based epidemiologic study including 2432 grade 1 and 2346 grade 7 students was conducted from 2016 in rural areas of China. Each participant’s refractive status was measured before and after cycloplegia using an autorefractor and axial length (AL) was measured using an IOL Master. The questionnaires were completed by the parents or legal guardians of the children to collect detailed information regarding risk factors. Myopia was defined as spherical equivalent less than − 0.50D.

Results

Grade 7 students had a higher prevalence of myopia (29.4% vs. 2.4%; P < 0.001) and high myopia (0.4% vs. 0.1%; P < 0.001) compared with grade 1 students. Grade 7 students also had longer ALs (23.50 mm vs. 23.37 mm; p = 0.004) after adjusting for the effect of gender, height and other myopia-related risk factors. Adjustment for time spent on reading and writing after school per day led to a reduction in the excess prevalence of myopia in grade 7 students by 15.1%. In addition, adjustment for time outdoors reduced the excess prevalence of myopia in grade 7 students by 33.4%.

Conclusions

We reported a relatively lower prevalence of myopia in school students in rural China, suggesting that Chinese may not have a genetic predisposition to myopia and environmental factors may play a major role in the development of school myopia in Chinese children.
Literature
1.
Pan CW, Ramamurthy D, Saw SM. Worldwide prevalence and risk factors for myopia. Ophthalmic Physiol Opt. 2012;32(1):3–16.CrossRefPubMed
2.
Holden BA, Fricke TR, Wilson DA, Jong M, Naidoo KS, Sankaridurg P, Wong TY, Naduvilath TJ, Resnikoff S. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology. 2016;123(5):1036–42.CrossRefPubMed
3.
4.
Rose KA, Morgan IG, Smith W, Burlutsky G, Mitchell P, Saw SM. Myopia, lifestyle, and schooling in students of Chinese ethnicity in Singapore and Sydney. Arch Ophthalmol. 2008;126(4):527–30.CrossRefPubMed
5.
Wu HM, Seet B, Yap EP, Saw SM, Lim TH, Chia KS. Does education explain ethnic differences in myopia prevalence? A population-based study of young adult males in Singapore. Optom Vis Sci. 2001;78(4):234–9.CrossRefPubMed
6.
Pan CW, Zheng YF, Anuar AR, Chew M, Gazzard G, Aung T, Cheng CY, Wong TY, Saw SM. Prevalence of refractive errors in a multiethnic Asian population: the Singapore epidemiology of eye disease study. Invest Ophthalmol Vis Sci. 2013;54(4):2590–8.CrossRefPubMed
7.
Pan CW, Klein BE, Cotch MF, Shrager S, Klein R, Folsom A, Kronmal R, Shea SJ, Burke GL, Saw SM, et al. Racial variations in the prevalence of refractive errors in the United States: the multi-ethnic study of atherosclerosis. Am J Ophthalmol. 2013;155(6):1129–38. e1121CrossRefPubMedPubMedCentral
8.
9.
Lin Z, Vasudevan B, Jhanji V, Mao GY, Gao TY, Wang FH, Rong SS, Ciuffreda KJ, Liang YB. Near work, outdoor activity, and their association with refractive error. Optometry Vision Sci. 2014;91(4):376–82.CrossRef
10.
Liang YB, Lin Z, Vasudevan B, Jhanji V, Young A, Gao TY, Rong SS, Wang NL, Ciuffreda KJ. Generational difference of refractive error in the baseline study of the Beijing myopia progression study. Brit J Ophthalmol. 2013;97(6):765–9.CrossRef
11.
Zhang Q, Guo X, Xiao X, Jia X, Li S, Hejtmancik JF. A new locus for autosomal dominant high myopia maps to 4q22-q27 between D4S1578 and D4S1612. Mol Vis. 2005;11:554–60.PubMed
12.
Zhang Q, Guo X, Xiao X, Jia X, Li S, Hejtmancik JF. Novel locus for X linked recessive high myopia maps to Xq23-q25 but outside MYP1. J Med Genet. 2006;43(5):e20.CrossRefPubMedPubMedCentral
13.
Tran-Viet KN, Powell C, Barathi VA, Klemm T, Maurer-Stroh S, Limviphuvadh V, Soler V, Ho C, Yanovitch T, Schneider G, et al. Mutations in SCO2 are associated with autosomal-dominant high-grade myopia. Am J Hum Genet. 2013;92(5):820–6.CrossRefPubMedPubMedCentral
14.
Yang Z, Xiao X, Li S, Zhang Q. Clinical and linkage study on a consanguineous Chinese family with autosomal recessive high myopia. Mol Vis. 2009;15:312–8.PubMedPubMedCentral
15.
Ma JH, Shen SH, Zhang GW, Zhao DS, Xu C, Pan CM, Jiang H, Wang ZQ, Song HD. Identification of a locus for autosomal dominant high myopia on chromosome 5p13.3-p15.1 in a Chinese family. Mol Vis. 2010;16:2043–54.PubMedPubMedCentral
16.
Rong SS, Chen LJ, Pang CP. Myopia genetics-the Asia-Pacific perspective. Asia-Pacific journal of ophthalmology. 2016;5(4):236–44.CrossRefPubMed
17.
Pan CW, Qiu QX, Qian DJ, Hu DN, Li J, Saw SM, Zhong H. Iris colour in relation to myopia among Chinese school-aged children. Ophthalmic Physiol Opt. 2018;38(1):48–55.CrossRefPubMed
18.
Pan CW, Wu RK, Liu H, Li J, Zhong H. Types of lamp for homework and myopia among Chinese school-aged children. Ophthalmic Epidemiol. 2017:1–7.
19.
Pan CW, Wu RK, Wang P, Li J, Zhong H. Reduced vision, refractive errors and health-related quality of life among adolescents in rural China. Clin Exp Optom. 2018;
20.
Luo HD, Gazzard G, Liang Y, Shankar A, Tan DT, Saw SM. Defining myopia using refractive error and uncorrected logMAR visual acuity >0.3 from 1334 Singapore school children ages 7–9 years. Br J Ophthalmol. 2006;90(3):362–6.CrossRefPubMedPubMedCentral
21.
Qian DJ, Zhong H, Li J, Niu Z, Yuan Y, Pan CW. Myopia among school students in rural China (Yunnan). Ophthalmic Physiol Opt. 2016;36(4):381–7.CrossRefPubMed
22.
Li SM, Liu LR, Li SY, Ji YZ, Fu J, Wang Y, Li H, Zhu BD, Yang Z, Li L, et al. Design, methodology and baseline data of a school-based cohort study in Central China: the Anyang childhood eye study. Ophthalmic Epidemiol. 2013;20(6):348–59.CrossRefPubMed
23.
Wu JF, Bi HS, Wang SM, Hu YY, Wu H, Sun W, Lu TL, Wang XR, Jonas JB. Refractive error, visual acuity and causes of vision loss in children in Shandong, China. The Shandong children eye study. PLoS One. 2013;8(12):e82763.CrossRefPubMedPubMedCentral
24.
Pan CW, Zheng YF, Wong TY, Lavanya R, Wu RY, Gazzard G, Saw SM. Variation in prevalence of myopia between generations of migrant indians living in Singapore. Am J Ophthalmol. 2012;154(2):376–81. e371CrossRefPubMed
25.
Wong TY, Klein R, Duncan BB, Nieto FJ, Klein BE, Couper DJ, Hubbard LD, Sharrett AR. Racial differences in the prevalence of hypertensive retinopathy. Hypertension. 2003;41(5):1086–91.CrossRefPubMed
26.
Sun J, Zhou J, Zhao P, Lian J, Zhu H, Zhou Y, Sun Y, Wang Y, Zhao L, Wei Y, et al. High prevalence of myopia and high myopia in 5060 Chinese university students in shanghai. Invest Ophthalmol Vis Sci. 2012;53(12):7504–9.CrossRefPubMed
27.
He M, Zeng J, Liu Y, Xu J, Pokharel GP, Ellwein LB. Refractive error and visual impairment in urban children in southern China. Invest Ophthalmol Vis Sci. 2004;45(3):793–9.CrossRefPubMed
28.
Au Eong KG, Tay TH, Lim MK. Education and myopia in 110,236 young Singaporean males. Singap Med J. 1993;34(6):489–92.
29.
Edwards MH, Lam CS. The epidemiology of myopia in Hong Kong. Ann Acad Med Singap. 2004;33(1):34–8.PubMed
30.
Lin LL, Shih YF, Hsiao CK, Chen CJ. Prevalence of myopia in Taiwanese schoolchildren: 1983 to 2000. Ann Acad Med Singap. 2004;33(1):27–33.PubMed
31.
Guo K, Yang d Y, Wang Y, Yang XR, Jing XX, Guo YY, Zhu D, You QS, Tao Y, Jonas JB. Prevalence of myopia in schoolchildren in Ejina: the Gobi Desert children eye study. Invest Ophthalmol Vis Sci. 2015;56(3):1769–74.CrossRefPubMed
32.
He M, Huang W, Zheng Y, Huang L, Ellwein LB. Refractive error and visual impairment in school children in rural southern China. Ophthalmology. 2007;114(2):374–82.CrossRefPubMed
33.
Saw SM. A synopsis of the prevalence rates and environmental risk factors for myopia. Clin Exp Optom. 2003;86(5):289–94.CrossRefPubMed
34.
Gao Z, Meng N, Muecke J, Chan WO, Piseth H, Kong A, Jnguyenphamhh T, Dehghan Y, Selva D, Casson R, et al. Refractive error in school children in an urban and rural setting in Cambodia. Ophthalmic Epidemiol. 2012;19(1):16–22.CrossRefPubMed
35.
Casson RJ, Kahawita S, Kong A, Muecke J, Sisaleumsak S, Visonnavong V. Exceptionally low prevalence of refractive error and visual impairment in schoolchildren from Lao People's Democratic Republic. Ophthalmology. 2012;119(10):2021–7.CrossRefPubMed
36.
Pokharel GP, Negrel AD, Munoz SR, Ellwein LB. Refractive error study in children: results from Mechi zone, Nepal. Am J Ophthalmol. 2000;129(4):436–44.CrossRefPubMed
37.
He M, Xiang F, Zeng Y, Mai J, Chen Q, Zhang J, Smith W, Rose K, Morgan IG. Effect of time spent outdoors at school on the development of myopia among children in China: a randomized clinical trial. JAMA. 2015;314(11):1142–8.CrossRefPubMed
Metadata
Title
Low prevalence of myopia among school children in rural China
Authors
Chen-Wei Pan
Rong-Kun Wu
Jun Li
Hua Zhong
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Ophthalmology / Issue 1/2018
Electronic ISSN: 1471-2415
DOI
https://doi.org/10.1186/s12886-018-0808-0

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