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Article

Dose–Response Relationship of Outdoor Exposure and Myopia Indicators: A Systematic Review and Meta-Analysis of Various Research Methods

1
School of Nursing, National Yang-Ming University, Taipei 11221, Taiwan
2
Department of Pediatrics, Taipei City Hospital Ren-Ai Branch/Department of Allergy and Immunology, West Garden Hospital, Taipei 10864, Taiwan
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(14), 2595; https://doi.org/10.3390/ijerph16142595
Received: 24 May 2019 / Revised: 15 July 2019 / Accepted: 18 July 2019 / Published: 21 July 2019
(This article belongs to the Special Issue Environmental Factors, Children’s Health and Safety)
Myopia in children has dramatically increased worldwide. A systematic review and meta-analysis were conducted to evaluate the effects of outdoor light exposure on myopia. According to research data from 13 studies of 15,081 children aged 4–14 at baseline, outdoor light exposure significantly reduced myopia incidence/prevalence (odds ratio [OR] = 0.85, 95% confidence interval [CI]: 0.80–0.91, p < 0.00001; I2 = 90%), spherical equivalent refractive error (SER) by 0.15 D/year (0.09–0.27, p < 0.0001), and axial elongation by 0.08 mm/year (−0.14 to −0.02, p = 0.02). The benefits of outdoor light exposure intervention, according to pooled overall results, included decreases in three myopia indicators: 50% in myopia incidence, 32.9% in SER, and 24.9% in axial elongation for individuals in Asia. Daily outdoor light exposure of more than 120 min was the most effective intervention, and weekly intervention time exhibited a dose–response relationship with all three indicators. Subgroup comparisons revealed that interventional studies report greater benefits from outdoor light exposure compared with cohort and cross-sectional studies, and individuals with myopia in intervention studies experienced slightly greater benefits than individuals without, in terms of SER and axial elongation. Therefore, this study suggests 120 min/day of outdoor light exposure at school. View Full-Text
Keywords: axial length; near-sightedness; preschool; school age; spherical equivalent refractive error (SER) axial length; near-sightedness; preschool; school age; spherical equivalent refractive error (SER)
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MDPI and ACS Style

Ho, C.-L.; Wu, W.-F.; Liou, Y.M. Dose–Response Relationship of Outdoor Exposure and Myopia Indicators: A Systematic Review and Meta-Analysis of Various Research Methods. Int. J. Environ. Res. Public Health 2019, 16, 2595. https://doi.org/10.3390/ijerph16142595

AMA Style

Ho C-L, Wu W-F, Liou YM. Dose–Response Relationship of Outdoor Exposure and Myopia Indicators: A Systematic Review and Meta-Analysis of Various Research Methods. International Journal of Environmental Research and Public Health. 2019; 16(14):2595. https://doi.org/10.3390/ijerph16142595

Chicago/Turabian Style

Ho, Ciao-Lin, Wei-Fong Wu, and Yiing M. Liou 2019. "Dose–Response Relationship of Outdoor Exposure and Myopia Indicators: A Systematic Review and Meta-Analysis of Various Research Methods" International Journal of Environmental Research and Public Health 16, no. 14: 2595. https://doi.org/10.3390/ijerph16142595

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