Visual impairment and spectacle coverage rate in Baoshan district, China: population-based study

BACKGROUND: To investigate the prevalence and risk factors of visual impairment associated with refractive error and the unmet need for spectacles in a special suburban senior population in Baoshan District of Shanghai, one of several rural areas undergoing a transition from rural to urban area, where data of visual impairment are limited. METHODS: The study was a population based survey of 4545 Chinese aged (age: >60 years or older ) at Baoshan, Shanghai, in 2009. One copy of questionnaire was completed for each subject. Examinations included a standardized refraction and measurement of presenting and best corrected visual acuity (BCVA) as well as tonometry, slit lamp biomicroscopy, and fundus photography. RESULTS: The prevalence of mild (6/12 to 6/18), moderate (6/18 to 6/60) and severe visual impairment was 12.59%, 8.38% and 0.44%, respectively, and 5.26%, 3.06% and 0.09% with refractive correction. Visual impairment was associated with age, gender, education and career, but not insurance . The prevalence of correctable visual impairment was 5.81% (using 6/18 cutoff) and 13.18% (using 6/12 cutoff). Senior people and women were significantly at a higher risk of correctable visual impairment, while the well-educated on the contrary. The prevalence of undercorrected refractive error (improves by 2 or more lines with refraction) was 24.84%, and the proportion with undercorrected refractive error for mild, moderate , severe and no visual impairment was 61.54%, 67.98%, 60.00% and 14.10%, respectively. The spectacle coverage rate was 44.12%. Greater unmet need for spectacles was observed among elderly people, females, non-peasant, and subjects with less education and astigmatism only. CONCLUSIONS: High prevalence of visual impairment, visual impairment alleviated by refractive correction, and low spectacle coverage existed among the senior population in Baoshan District of Shanghai. Education for the public of the importance of regular examination and appropriate and accessible refraction service might be helpful to solve the problem

Responses of the Ocular Anterior Segment and Refraction to 0.5% Tropicamide in Chinese School-Aged Children of Myopia, Emmetropia, and Hyperopia

Purpose. To investigate the changes of anterior segment after cycloplegia and estimate the association of such changes with the changes of refraction in Chinese school-aged children of myopia, emmetropia, and hyperopia. Methods. 309 children were recruited and eligible subjects were assigned to three groups: hyperopia, emmetropia, or myopia. Cycloplegia was achieved with five cycles of 0.5% tropicamide. The Pentacam system was used to measure the parameters of interest before and after cycloplegia. Results. In the myopic group, the lenses were thinner and the lens position was significantly more posterior than that of the emmetropic and hyperopic groups in the cycloplegic status. The correlations between refraction and lens thickness (age adjusted; r=0.26, P<0.01), and lens position (age adjusted; r=-0.31, P<0.01) were found. After cycloplegia, ACD and ACV significantly increased, while ACA significantly decreased. Changes in refraction, ACD, ACV, and ACA were significantly different among the three groups (P<0.05, all). Changes of refraction were correlated with changes of ACD (r=0.41, P<0.01). Conclusions. Myopia presented thinner lenses and smaller changes of anterior segment and refraction after cycloplegia when compared to emmetropia and hyperopia. Changes of anterior chamber depth were correlated with refraction changes. This may contribute to a better understanding of the relationship between anterior segment and myopia

Existing climate change will lead to pronounced shifts in the diversity of soil prokaryotes

© The Author(s), 2018. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in mSystems 3 (2018): e00167-18, doi:10.1128/mSystems.00167-18.Soil bacteria are key to ecosystem function and maintenance of soil fertility. Leveraging associations of current geographic distributions of bacteria with historic climate, we predict that soil bacterial diversity will increase across the majority (∼75%) of the Tibetan Plateau and northern North America if bacterial communities equilibrate with existing climatic conditions. This prediction is possible because the current distributions of soil bacteria have stronger correlations with climate from ∼50 years ago than with current climate. This lag is likely associated with the time it takes for soil properties to adjust to changes in climate. The predicted changes are location specific and differ across bacterial taxa, including some bacteria that are predicted to have reductions in their distributions. These findings illuminate the widespread potential of climate change to influence belowground diversity and the importance of considering bacterial communities when assessing climate impacts on terrestrial ecosystems.This work was supported by the Strategic Priority Research Program (XDB15010101, XDA05050404) of the Chinese Academy of Sciences, the National Program on Key Basic Research Project (2014CB954002, 2014CB954004), the National Natural Science Foundation of China (41701298, 41371254), the “135” Plan and Frontiers Projects of Institute of Soil Science (ISSASIP1641), and the National Science and Technology Foundation project (2015FY110100). J.A.G. was supported by the U.S. Dept. of Energy under contract DE-AC02-06CH11357. N.F. was supported by a grant from the National Science Foundation (DEB-0953331). K.S.P. and J.L. were supported by the National Science Foundation (DMS-1069303), the Gordon and Betty Moore Foundation (grant no. 3300), the Gladstone Institutes, and a gift from the San Simeon Fund

Analysis on life quality of children with high myopia

Objective·To explore the association between high myopia and life quality among children.Methods·Cross-sectional study method was adopted in this study. Highly myopic children aged 4‒10 from 16 districts in Shanghai were enrolled through Shanghai Child and Adolescent Large-scale Eye Study-High Myopia Registration Study. Baseline data for spherical equivalent after cycloplegia and questionnaire data in 2020 were collected. Emmetropic children aged 4‒10 from 16 kindergartens and elementary schools in Jing'an District and Pudong New Area were enrolled. The uncorrected visual acuity, corrected visual acuity and spherical equivalent without cycloplegia were measured through myopia screening in schools, and the questionnaire on quality of life was filled out. Quality of life was measured by the Strengths and Difficulties Questionnaire (SDQ) and EuroQol Five Dimensions Questionnaire Visual Analogue Scale (EQ-VAS). After describing and testing the differences in variable distributions between the highly myopic children group and the emmetropic children group, the differences in life quality between the two groups, and the association between spherical equivalent and life quality scores of the highly myopic children were examined by a linear regression model.Results·A total of 193 children with high myopia and 209 children with emmetropia were enrolled. There were statistically significant differences in age [(9.58±0.94) years vs (7.63±1.50) years, P<0.001] and gender distribution (46.6% males vs 62.7% males, P=0.001) between the highly myopic children and emmetropic children. After adjusting for age and gender, it was found that there was no statistically significant difference in SDQ score between the highly myopic children and emmetropic children (β=0.313, 95%CI -0.723‒1.349, P=0.553), but the EQ-VAS score in the highly myopic children was lower than that in the emmetropic children (β=-3.805, 95%CI -6.593‒ -1.017, P=0.008). There was no significant relationship between spherical equivalent and SDQ score (β=0.297, 95%CI -0.035‒0.628, P=0.079) and EQ-VAS score (β=0.579, 95%CI -0.330‒1.489, P=0.211) in the highly myopic children.Conclusion·In children with high myopia, self-evaluated overall health status reflected by EQ-VAS score is poorer compared with that in children with emmetropia. However, the EQ-VAS score is not associated with the degree of high myopia

Eyes grow towards mild hyperopia rather than emmetropia in Chinese preschool children

Purpose: To document one-year changes in refraction and refractive components in preschool children. Methods: Children, 3–5 years old, in the Jiading District, Shanghai, were followed for one year. At each visit, axial length (AL), refraction under cycloplegia (1% cyclopentolate), spherical dioptres (DS), cylinder dioptres (DC), spherical equivalent refraction (SER) and corneal curvature radius (CR) were measured. Results: The study included 458 right eyes of 458 children. The mean changes in DS, DC and SER were 0.02 ± 0.35 D, −0.02 ± 0.33 D and 0.01 ± 0.37 D, while the mean changes in AL, CR and lens power (LP) were 0.27 ± 0.10 mm, 0.00 ± 0.04 mm and − 0.93 ± 0.49 D. The change in the SER was linearly correlated with the baseline SER (coefficient = −0.147, p < 0.001). When the baseline SER was at 1.05 D (95% CI = 0.21 to 2.16), the change in SER was 0 D. The baseline SER was also linearly associated with the change in LP (coefficient = 0.104, p = 0.013), but not with the change in AL (p = 0.957) or with the change in CR (p = 0.263). Conclusion: In eyes with a baseline SER less than +1.00 D, LP loss was higher compared to axial elongation, leading to hyperopic shifts in refraction, whereas for those with baseline SER over this range, loss of LP compared to axial elongation was reduced, leading to myopic shifts. This model indicated the homeostasis of human refraction and explained how refractive development leads to a preferred state of mild hyperopia.The study was funded by Chinese National NatureScience Foundation (No. 81670898), Chinese Nat-ural Science Foundation for Young Staff (No.81800881), The Shanghai Three Year Public HealthAction Program (No. GWIV-3.3), The ShanghaiHigh-level Oversea Training Team Program on EyePublic Health (No. GWTD2015S08), The ShanghaiOutstanding Academic Leader Program (No.16XD1402300), Shanghai Nature Science Founda-tion (NO. 15ZR1438400), Three-year Action Pro-gram of Shanghai Municipality for Strengtheningthe Construction of the Public Health System(NO.GWIV-13.2), Key Discipline of PublicHealth-Eye health in Shanghai (No.15GWZK0601), Municipal Human ResourcesDevelopment Program for Outstanding YoungTalents in Medical and Health Sciences in Shanghai(Grant No. 2017YQ019), Shanghai Sailing Program(No. 17YF1416100), Foundation of ShanghaiMunicipal Commission of Health and FamilyPlanning (No. 20184Y0217), National Key R&DProgramofChina(2016YFC0904800,2019YFC0840607), National Science and Technol-ogy Major Project of China (2017ZX09304010) andSongjiang Science Foundation (No. 19SJKJGG30)

IMI risk factors for myopia

Risk factor analysis provides an important basis for developing interventions for any condition. In the case of myopia, evidence for a large number of risk factors has been presented, but they have not been systematically tested for confounding. To be useful for designing preventive interventions, risk factor analysis ideally needs to be carried through to demonstration of a causal connection, with a defined mechanism. Statistical analysis is often complicated by covariation of variables, and demonstration of a causal relationship between a factor and myopia using Mendelian randomization or in a randomized clinical trial should be aimed for. When strict analysis of this kind is applied, associations between various measures of educational pressure and myopia are consistently observed. However, associations between more nearwork and more myopia are generally weak and inconsistent, but have been supported by meta-analysis. Associations between time outdoors and less myopia are stronger and more consistently observed, including by meta-analysis. Measurement of nearwork and time outdoors has traditionally been performed with questionnaires, but is increasingly being pursued with wearable objective devices. A causal link between increased years of education and more myopia has been confirmed by Mendelian randomization, whereas the protective effect of increased time outdoors from the development of myopia has been confirmed in randomized clinical trials. Other proposed risk factors need to be tested to see if they modulate these variables. The evidence linking increased screen time to myopia is weak and inconsistent, although limitations on screen time are increasingly under consideration as interventions to control the epidemic of myopia

IMI : global trends in myopia management attitudes and strategies in clinical practice : 2022 update

PURPOSE. Surveys in 2015 and 2019 identified a high level of eye care practitioner concern/activity about myopia, but the majority still prescribed single vision interventions to young myopes. This research aimed to provide updated information. METHODS. A self-administered, internet-based questionnaire was distributed in 13 languages, through professional bodies to eye care practitioners globally. The questions examined awareness of increasing myopia prevalence, perceived efficacy and adoption of available strategies, and reasons for not adopting specific strategies. RESULTS. Of the 3195 respondents, practitioners’ concern about the increasing frequency of pediatric myopia in their practices differed between continents (P < 0.001), being significantly higher in Asia (9.0 ± 1.5 of 10) than other continents (range 7.7–8.2; P ≤ 0.001). Overall, combination therapy was perceived by practitioners to be the most effective method of myopia control, followed by orthokeratology and pharmaceutical approaches. The least effective perceived methods were single vision distance undercorrection, spectacles and contact lenses, as well as bifocal spectacles. Practitioners rated their activity in myopia control between (6.6 ± 2.9 in South America to 7.9 ± 1.2/2.2 in Australasia and Asia). Single-vision spectacles are still the most prescribed option for progressing young myopia (32.2%), but this has decreased since 2019, and myopia control spectacles (15.2%), myopia control contact lenses (8.7%) and combination therapy (4.0%) are growing in popularity. CONCLUSIONS. More practitioners across the globe are practicing myopia control, but there are still significant differences between and within continents. Practitioners reported that embracing myopia control enhanced patient loyalty, increasing practice revenue and improving job satisfaction