Axial Length and Associated Factors in Children: The Shandong Children Eye Study (original) (raw)

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Research Articles| January 20 2016

Tai Liang Lu;

aThe Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine,

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Jian Feng Wu;

bShandong University of Traditional Chinese Medicine and

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Xiang Ye;

cEye Institute of Shandong University of Traditional Chinese Medicine, Jinan, China;

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Yuan Yuan Hu;

aThe Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine,

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Hui Wu;

cEye Institute of Shandong University of Traditional Chinese Medicine, Jinan, China;

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Wei Sun;

aThe Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine,

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Da Dong Guo;

cEye Institute of Shandong University of Traditional Chinese Medicine, Jinan, China;

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Xing Rong Wang;

cEye Institute of Shandong University of Traditional Chinese Medicine, Jinan, China;

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Hong Sheng Bi;

cEye Institute of Shandong University of Traditional Chinese Medicine, Jinan, China;

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Jost B. Jonas

dDepartment of Ophthalmology, Medical Faculty Mannheim of the Ruprecht Karl University of Heidelberg, Seegartenklinik Heidelberg, Heidelberg, Germany

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Ophthalmologica (2016) 235 (2): 78–86.

Article history

Accepted:

October 20 2015

Published Online:

January 20 2016

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Abstract

Purpose: To investigate ocular axial length (AL) in Chinese children. Methods: The Shandong Children Eye Study included 6,364 children aged 4-18 years. Results: Longer AL (mean 23.45 ± 1.20 mm, range 18.80-28.59 mm) was associated (multivariate analysis; correlation coefficient r2: 0.61) with older age (p < 0.001, standardized correlation coefficient β = 0.35, unstandardized regression coefficient B = 0.13, 95% confidence interval [CI] 0.12, 0.15), male gender (p < 0.001, β = -0.24, B = -0.10, 95% CI -0.29, -0.19), urban region (p < 0.001, β = 0.10, B = 0.25, 95% CI 0.20, 0.31), body height (p < 0.001, β = 0.22, B = 0.02, 95% CI 0.01, 0.02), maternal education (p < 0.001, β = 0.07, B = 0.07, 95% CI 0.05, 0.10), paternal myopia (p < 0.001, β = 0.09, B = 0.26, 95% CI 0.20, 0.33), maternal myopia (p < 0.001, β = 0.08, B = 0.23, 95% CI 0.17, 0.30), more time spent indoors reading/writing (p < 0.001, β = 0.05, B = 0.03, 95% CI 0.02, 0.04), less time spent outdoors (p = 0.005, β = -0.03, B = -0.01, 95% CI -0.02, -0.003), longer corneal curvature radius (p < 0.001, β = 0.36, B = 1.63, 95% CI 1.53, 1.74) and higher intraocular pressure (p = 0.008, β = 0.03, B = 0.01, 95% CI 0.004, 0.02). High axial myopia (AL ≥26.0 mm) present in 202 children (3.4 ± 0.2%, 95% CI 2.92, 3.84) was associated with less time spent outdoors (p = 0.002, odds ratio 0.92, 95% CI 0.87, 0.97) in multivariate analysis. **_Conclusions:_** In children in the less developed Eastern Chinese province of Shandong, the prevalence of high axial myopia was >10% among 16-year-olds. A modifiable factor associated with higher prevalence of high axial myopia was less time spent outdoors.

References

Mutti DO, Mitchell GL, Jones LA, Friedman NE, Frane SL, et al: Axial growth and changes in lenticular and corneal power during emmetropization in infants. Invest Ophthalmol Vis Sci 2005;46:3074-3080.

Ip JM, Huynh SC, Kifley A, Rose KA, Morgan IG, et al: Variation of the contribution from axial length and other oculometric parameters to refraction by age and ethnicity. Invest Ophthalmol Vis Sci 2007;48:4846-4853.

Ip JM, Huynh SC, Robaei D, Kifley A, Rose KA, et al: Ethnic differences in refraction and ocular biometry in a population-based sample of 11-15-year-old Australian children. Eye (Lond) 2008;22:649-656.

Ojaimi E, Rose KA, Morgan IG, Smith W, Martin FJ, et al: Distribution of ocular biometric parameters and refraction in a population-based study of Australian children. Invest Ophthalmol Vis Sci 2005;46:2748-2754.

Huang Y, Huang C, Li L, Smith W, Martin FJ, et al: Corneal biomechanics, refractive error, and axial length in Chinese primary school children. Invest Ophthalmol Vis Sci 2011;52:4923-4928.

You QS, Peng XY, Xu L, Chen CX, Wang YX, et al: Myopic maculopathy imaged by optical coherence tomography. The Beijing Eye Study. Ophthalmology 2014;121:220-224.

Zhao J, Pan X, Sui R, Munoz SR, Sperduto RD, et al: Refractive Error Study in Children: results from Shunyi District, China. Am J Ophthalmol 2000;129:427-435.

Morgan IG, Ohno-Matsui K, Saw SM: Myopia. Lancet 2012;379:1739-1748.

Xu L, Wang Y, Li Y, Li J, Wang Y, et al: Causes of blindness and visual impairment in urban and rural areas in Beijing: the Beijing Eye Study. Ophthalmology 2006;113:1134-1141.

Jiang WJ, Wu JF, Hu YY, Wu H, Sun W, et al: Intraocular pressure and associated factors in children: the Shandong Children Eye Study. Invest Ophthalmol Vis Sci 2014;55:4128-4134.

McKean-Cowdin R, Cotter SA, Tarczy-Hornoch K, Wen G, Kim J, et al: Prevalence of amblyopia or strabismus in Asian and Non-Hispanic white preschool children: Multi-Ethnic Pediatric Eye Disease Study. Ophthalmology 2013;120:2117-2124.

Zadnik K, Manny RE, Yu JA, Mitchell GL, Cotter SA, et al: Ocular component data in schoolchildren as a function of age and gender. Optom Vis Sci 2003;80:226-236.

Lin LL, Shih YF, Hsiao CK, Chen CJ, Lee LA, et al: Epidemiologic study of the prevalence and severity of myopia among schoolchildren in Taiwan in 2000. J Formos Med Assoc 2001;100:684-691.

Twelker JD, Mitchell GL, Messer DH, Bhakta R, Jones LA, et al: Children's ocular components and age, gender, and ethnicity. Optom Vis Sci 2009;86:918-935.

Wong TY, Foster PJ, Johnson GJ, Klein BE, Seah SK: The relationship between ocular dimensions and refraction with adult stature: the Tanjong Pagar Survey. Invest Ophthalmol Vis Sci 2001;42:1237-1242.

Eysteinsson T, Jonasson F, Arnarsson A, Sasaki H, Sasaki K: Relationships between ocular dimensions and adult stature among participants in the Reykjavik Eye Study. Acta Ophthalmol Scand 2005;83:734-738.

Warrier S, Wu HM, Newland HS, Muecke J, Selva D, et al: Ocular biometry and determinants of refractive error in rural Myanmar: the Meiktila Eye Study. Br J Ophthalmol 2008;92:1591-1594.

Yin G, Wang YX, Zheng ZY, Yang H, Xu L, et al: Ocular axial length and its associations in Chinese. The Beijing Eye Study. PLoS One 2012;7:e43172.

Nangia V, Jonas JB, Sinha A, Matin A, Kulkarni M, et al: Ocular axial length and its associations in an adult population of central rural India: the Central India Eye and Medical Study. Ophthalmology 2010;117:1360-1366.

Saw SM, Chua WH, Hong CY, Wu HM, Chia KS, et al: Height and its relationship to refraction and biometry parameters in Singapore Chinese children. Invest Ophthalmol Vis Sci 2002;43:1408-1413.

Ojaimi E, Morgan IG, Robaei D, Rose KA, Smith W, et al: Effect of stature and other anthropometric parameters on eye size and refraction in a population-based study of Australian children. Invest Ophthalmol Vis Sci 2005;46:4424-4429.

Zadnik K, Satariano WA, Mutti DO, Sholtz RI, Adams AJ: The effect of parental history of myopia on children's eye size. JAMA 1994;271:1323-1327.

Lam DS, Fan DS, Lam RF, Rao SK, Chong KS, et al: The effect of parental history of myopia on children's eye size and growth: results of a longitudinal study. Invest Ophthalmol Vis Sci 2008;49:873-876.

Xiang F, He M, Morgan IG: The impact of severity of parental myopia on myopia in Chinese children. Optom Vis Sci 2012;89:884-891.

Verhoeven VJ, Hysi PG, Wojciechowski R, Fan Q, Guggenheim JA, et al: Genome-wide meta-analyses of multiancestry cohorts identify multiple new susceptibility loci for refractive error and myopia. Nat Genet 2013;45:314-318.

Northstone K, Guggenheim JA, Howe LD, Tilling K, Paternoster L, et al: Body stature growth trajectories during childhood and the development of myopia. Ophthalmology 2013;120:1064-1073.e1.

You QS, Wu LJ, Duan JL, Luo YX, Liu LJ, et al: Prevalence of myopia in school children in greater Beijing: the Beijing Childhood Eye Study. Acta Ophthalmol 2014;92:e398-e406.

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;45:793-799.

Saw SM, Carkeet A, Chia KS, Stone RA, Tan DT: Component dependent risk factors for ocular parameters in Singapore Chinese children. Ophthalmology 2002;109:2065-2071.

Lee KE, Klein BE, Klein R, Quandt Z, Wong TY: Association of age, stature, and education with ocular dimensions in an older white population. Arch Ophthalmol 2009;127:88-93.

Yang DY, Guo K, Wang Y, Guo YY, Yang XR, et al: Intraocular pressure and associations in children. The Gobi Desert Children Eye Study. PLoS One 2014;9:e109355.

Jonas JB, Nangia V, Matin A, Sinha A, Kulkarni M, et al: Intraocular pressure and associated factors. The Central India Eye and Medical Study. J Glaucoma 2011;20:405-409.

Kawase K, Tomidokoro A, Araie M, Iwase A, Yamamoto T, et al: Ocular and systemic factors related to intraocular pressure in Japanese adults: the Tajimi Study. Br J Ophthalmol 2008;92:1175-1179.

Wong TY, Klein BE, Klein R, Knudtson M, Lee KE: Refractive errors, intraocular pressure, and glaucoma in a white population. Ophthalmology 2003;110:211-217.

Memarzadeh F, Ying-Lai M, Azen SP, Varma R; Los Angeles Latino Eye Study Group: Associations with intraocular pressure in Latinos: the Los Angeles Latino Eye Study. Am J Ophthalmol 2008;146:69-76.

Pruett RC: Progressive myopia and intraocular pressure: what is the linkage? A literature review. Acta Ophthalmol Suppl 1988;185:117-127.

Edwards MH, Brown B: IOP in myopic children: the relationship between increases in IOP and the development of myopia. Ophthalmic Physiol Opt 1996;16:243-246.

Goss DA, Caffey TW: Clinical findings before the onset of myopia in youth: 5. Intraocular pressure. Optom Vis Sci 1999;76:286-291.

Jonas JB: Optic disk size correlated with refractive error. Am J Ophthalmol 2005;139:346-348.

Xu L, Wang YX, Wang S, Jonas JB: Definition of high myopia by parapapillary atrophy. The Beijing Eye Study. Acta Ophthalmol 2010;88:e350-e351.

Xu L, Wang Y, Wang S, Wang Y, Jonas JB: High myopia and glaucoma susceptibility. The Beijing Eye Study. Ophthalmology 2007;114:216-220.

Liu HH, Xu L, Wang YX, Wang S, You QS, et al: Prevalence and progression of myopic retinopathy in Chinese adults: the Beijing Eye Study. Ophthalmology 2010;117:1763-1768.

Jonas JB, Jonas SB, Jonas RA, Holbach L, Dai Y, et al: Parapapillary atrophy: histological gamma zone and delta zone. PLoS One 2012;7:e47237.

Jonas JB, Ohno-Matsui K, Spaide RF, Holbach L, Panda-Jonas S: Macular Bruch's membrane defects and axial length: association with gamma zone and delta zone in peripapillary region. Invest Ophthalmol Vis Sci 2013;54:1295-1302.

Jonas JB, Holbach L, Panda-Jonas S: Scleral cross section area and volume and axial length. PLoS One 2014;9:e93551.

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