SEARCHMETA-ANALYSISophthalmology, pediatric ophthalmology

meta-analysis·ophthalmology, pediatric ophthalmology, epidemiology, systematic review, meta-analysis·PMC10511087

Global risk factor analysis of myopia onset in children: A systematic review and meta-analysis

PLOS ONE · 14 authors, 8 centres

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TL;DR

This systematic review and meta-analysis of 19 cohort studies found that female sex, parental myopia, and lower time spent outdoors were associated with a higher risk of myopia onset in children, while more outdoor time and less near work were protective factors.

Full summary

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The study conducted a systematic review and meta-analysis of 19 cohort studies involving 3,578 children to assess risk factors for the onset of myopia. The analysis identified that girls had a higher risk (RR: 1.28), children with myopic parents were at greater risk, and that longer outdoor activity time (RR: 0.97) and less near-work time (RR: 1.05) were significantly associated with decreased myopia incidence. Certain eye indicators, such as lower spherical equivalent, longer axial length, and poorer visual acuity, were also associated with myopia onset. The burden of myopia was found to be higher in underprivileged countries (RR: 5.28). Limitations included substantial heterogeneity between studies, differing definitions of factors like outdoor time, and an insufficient number of studies for some eye parameters. The evidence quality for the evaluated factors was rated as moderate to very low, indicating a need for further high-quality research.

STUDY TYPE

meta-analysis

SPECIALTY

ophthalmology

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100% · A

ORIGINAL PAPER

PMC10511087

Global risk factor analysis of myopia onset in children: A systematic review and meta-analysis

PLOS ONE

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ABSTRACT

Introduction This work aimed to comprehensively assess the risk factors affecting myopia in children to develop more effective prevention and treatment strategies. To this end, data from database were employed to assess the relationship between the incidence of myopia and its risk factors. Methods We searched eight databases online in June 2022. Cohort studies were included that measured the connection between risk factors and myopia. Eligibility was not restricted by language. The Newcastle–Ottawa Scale (NOS) was used to measure the risk of bias and conducted GRADE evaluation to determine the certainty of evidence. Potential risk factors with positive or negative results were seen. Inplasy Registration: https://inplasy.com/inplasy-2022-4-0109/ . Results Evidence that risk factors for myopia are mixed, comprising both positive (20) and null (17) findings. In 19 cohort studies on 3578 children, girls were more likely to develop myopia (RR: 1.28 [1.22–1.35]). Myopia can occur at any age, from early childhood to late adulthood. Children whose parents had myopia were more likely to develop myopia. Longer outdoor activities time (RR: 0.97 [0.95–0.98]) and less near-work time (RR: 1.05 [1.02–1.07]) appeared to be significantly decrease the incidence of myopia. Children with lower SE, longer AL, a lower magnitude of positive relative accommodation, worse presenting visual acuity, deeper anterior chamber, and thinner crystalline lens may be related to myopia onset. The burden of myopia in underprivileged countries is higher than in developed countries (RR: 5.28 [2.06–13.48]). The quality of evidence for the evaluated factors was moderate to low or very low. Conclusions Genetic factors, environmental factors (such as excessive use of electronic products, and poor study habits) and lifestyle factors (such as lack of outdoor activities, poor nutrition, etc.) are the main risk factors for myopia in children. Myopia prevention strategies should be designed based on environmental factors, gender, parental myopia and eye indicators in order to explore a lifestyle that is more conducive to the eye health of children.

CITATION EXPORT

Mingkun Yu, Yuanyuan Hu, Mei Han et al.. Global risk factor analysis of myopia onset in children: A systematic review and meta-analysis. PLOS ONE. (2023). https://doi.org/10.1371/journal.pone.0291470

AUTHORS

14 · 8 CENTRES

Mingkun Yu, Yuanyuan Hu, Mei Han, Jiawei Song, Ziyun Wu, Zihang Xu, Yi Liu, Zhen Shao, Guoyong Liu, Zhipeng Yang, Hongsheng Bi, Der-Chong Tsai, Der-Chong Tsai, Der-Chong Tsai

1 The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
2 Shandong Provincial Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases, Jinan, China
3 Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Therapy of Ocular Diseases in Universities of Shandong, Jinan, China
4 Eye Institute of Shandong University of Traditional Chinese Medicine, Jinan, China
5 Beijing University of Chinese Medicine, Beijing, China
6 Ophthalmology & Optometry Medical School, Shandong University of Traditional Chinese Medicine, Jinan, China
7 Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China
National Yang-Ming University Hospital, TAIWAN

EDITOR / REVIEWER

Der-Chong Tsai