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Prevalence and Progression of Myopia in Children and Adolescents
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Prevalence and Progression of Myopia in Children and Adolescents

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Global Pediatric Health".

Deadline for manuscript submissions: closed (20 May 2022) | Viewed by 26274

Special Issue Editors

Dr. Jason C. S. Yam

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Guest Editor
Department of Ophthalmology and Visual Sciences, Chinese University of Hong Kong, Hong Kong, China
Interests: genetics, prevention, detection, and treatment of children eye diseases; mechanisms of myopia and retinoblastoma; pediatric ophthalmology
Dr. Xiu Juan Zhang

E-Mail Website
Guest Editor
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Kowloon, Hong Kong
Interests: epidemiology and gene mapping of myopia; amblyopia and pediatric ocular diseases; blindness prevention
Dr. Wai Kit Chu

E-Mail Website
Guest Editor
Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong 999077, China
Interests: visual sciences; retinoblastoma; ocular inflammation; pterygium; thyroid-associated orbitopathy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Myopia is one of the most common ocular disorders that affects children and adolescents, which may lead to irreversible visual impairment. With increasing prevalence in recent decades, myopia has reached epidemic proportions in many regions and has become a global public health threat. The progression of myopia typically happens faster at younger ages, and an uncorrected refractive error may impose significant burden on children and adolescents regarding education achievement and social capacity. The role of several genetic and environmental exposures in the development and progression of myopia has been suggested by previous studies, among which our Hong Kong Children Eye Study reported a dose-related effect of parental myopia on childhood myopia, while more time spent on outdoor activities was associated with reduced odds of myopia. Establishing these important etiological indicators facilitates the planning of healthcare strategies and benefit children and adolescents with targeted interventions. Evidence about effectiveness and side effects of myopia control interventions were also critical to achieve the ultimate goal of eliminating myopia-related preventable risk of blindness, making any new findings in relevance to be highly valuable.

This Special Issue aims to provide advanced understandings of the epidemiological significance of myopia, the genetic and environmental exposures in association with myopia progression, and the efficacy and clinical applications of preventive interventions in children and adolescents. Relevant articles including original research, reviews, editorials, and case studies are all welcome to be submitted to this Special Issue.

Dr. Jason C. Yam
Dr. Xiu Juan Zhang
Dr. Wai Kit Chu
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • myopia
  • prevalence
  • risk factors
  • myopia gene
  • interventions
  • prevention
  • children
  • adolescents

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Published Papers (5 papers)

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Research

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10 pages, 2934 KiB  
Article
High Prevalence of Astigmatism in Children after School Suspension during the COVID-19 Pandemic Is Associated with Axial Elongation
by Suei-Cheng Wong, Chea-Su Kee and Tsz-Wing Leung
Children 2022, 9(6), 919; https://doi.org/10.3390/children9060919 - 19 Jun 2022
Cited by 11 | Viewed by 4081
Abstract
During the COVID-19 pandemic, the Hong Kong Government enforced a “school from home” policy between February and September 2020. This cross-sectional epidemiological study was conducted to investigate the prevalence of astigmatism and visual habits after the home confinement period. Vision screenings were conducted [...] Read more.
During the COVID-19 pandemic, the Hong Kong Government enforced a “school from home” policy between February and September 2020. This cross-sectional epidemiological study was conducted to investigate the prevalence of astigmatism and visual habits after the home confinement period. Vision screenings were conducted at three local government-funded primary schools in Hong Kong from October 2020 to December 2020. A total of 418 ethnically Chinese primary school children completed the eye examination and returned questionnaires concerning demographic information and visual habits. It was found that 46.5% (95% CI, 41.7–61.4%) of the children aged 8 to 11 years had astigmatism ≥ 0.75 D, which was predominately With-The-Rule astigmatism. The prevalence of astigmatism reported in these children is generally higher than that of studies conducted before COVID. Compared to their non-astigmatic peers, astigmatic children had a longer axial length (p < 0.001) and engaged in fewer outdoor activities (p = 0.04). Multiple linear regression analyses also revealed significant relationships between axial length and both cylindrical error and J0 astigmatism. Due to the high astigmatism prevalence, there is a pressing need for further studies on the long-term impact of the pandemic on children’s vision. Full article
(This article belongs to the Special Issue Prevalence and Progression of Myopia in Children and Adolescents)
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18 pages, 1451 KiB  
Article
The Impact of Cost-Containment Schemes on Outpatient Services for Schoolchildren with Refractive Errors in Taiwan—A Population-Based Study
by Koyin Chang, Wen-Li Lee and Yung-Hsiang Ying
Children 2022, 9(6), 880; https://doi.org/10.3390/children9060880 - 13 Jun 2022
Cited by 1 | Viewed by 1984
Abstract
Objectives: Extant research on cost-sharing finds no impact on health care utilization when the amount is insubstantial. This research investigates the effects on nonacute outpatient services for schoolchildren with refractive errors in Taiwan and discusses the potential harm caused by cost sharing and [...] Read more.
Objectives: Extant research on cost-sharing finds no impact on health care utilization when the amount is insubstantial. This research investigates the effects on nonacute outpatient services for schoolchildren with refractive errors in Taiwan and discusses the potential harm caused by cost sharing and relevant cost containment policies. Methods: Longitudinal claims data from the National Health Insurance database are employed. District demographic information is also used for aggregate-level analyses. Interventional modeling is conducted on pooled individual-level data with a Poisson model and negative binomial models. Generalized least square modeling is performed on aggregate district-level data to elucidate the impacts of cost sharing and the reimbursement rate with controls for patient and institutional characteristics, district socioeconomic factors, and competitiveness among institutions. Results: The findings of this study show that cost sharing does not significantly affect children’s utilization of outpatient services in the patient-level analyses. However, it significantly decreases the service volume based on the results of district aggregate analyses. There are potentially marginal patients in society, and they are more likely to be girls in poorer families, whose chances of seeking medical care significantly decrease when cost sharing increases. Conclusions: The gap in health inequity can be widened when stringent cost-containment policies are implemented. The offset effect caused by delayed care may also result in higher health care expenditures later. Cost sharing for children should be separately and prudently designed to better protect them from deprivations caused by changes in health policies. Full article
(This article belongs to the Special Issue Prevalence and Progression of Myopia in Children and Adolescents)
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11 pages, 703 KiB  
Article
The Evolution and the Impact of Refractive Errors on Academic Performance: A Pilot Study of Portuguese School-Aged Children
by Clara Martinez-Perez, Cristina Alvarez-Peregrina, Rita Brito, Miguel Ángel Sánchez-Tena and Grupo de Investigação Optovisão ISEC Lisboa
Children 2022, 9(6), 840; https://doi.org/10.3390/children9060840 - 6 Jun 2022
Cited by 1 | Viewed by 4401
Abstract
The relationship between vision and academic performance has been discussed for a long time, with special emphasis on visual factors associated with learning problems. The objective of this pilot study is to obtain an initial idea about the evolution and the impact of [...] Read more.
The relationship between vision and academic performance has been discussed for a long time, with special emphasis on visual factors associated with learning problems. The objective of this pilot study is to obtain an initial idea about the evolution and the impact of refractive errors on school-aged children. A visual examination was performed on 252 children between the ages of 6 and 11 years, which consisted of objective refraction, subjective refraction, and accommodative and binocular tests. No significant differences were observed regarding the refractive state when taking academic performance into account (p > 0.05). However, it was determined that academic performance was better among children with a negative spherical equivalent. Studies with a larger sample size must be conducted to verify the results that were attained in this present pilot study, and these must likewise look at possible ways in which strategies can be implemented in schools to reduce myopia progression. Full article
(This article belongs to the Special Issue Prevalence and Progression of Myopia in Children and Adolescents)
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9 pages, 230 KiB  
Article
Associations of Children’s Close Reading Distance and Time Spent Indoors with Myopia, Based on Parental Questionnaire
by Olavi Pärssinen, Essi Lassila and Markku Kauppinen
Children 2022, 9(5), 632; https://doi.org/10.3390/children9050632 - 28 Apr 2022
Cited by 9 | Viewed by 3220
Abstract
Purpose: To study the association of parents’ reports about their children’s near work and outdoor habits with myopia in their children. Methods: Data from a questionnaire study conducted in 1983 among Finnish schoolchildren were reanalyzed. Vision screening had been performed for all the [...] Read more.
Purpose: To study the association of parents’ reports about their children’s near work and outdoor habits with myopia in their children. Methods: Data from a questionnaire study conducted in 1983 among Finnish schoolchildren were reanalyzed. Vision screening had been performed for all the schoolchildren (n = 4961) in the 1st, 5th, and 8th grades (7-, 11-, and 15-year-olds) in an area of Central Finland. The questionnaire, including information about myopia, was returned by 4305 (86.7%) participants. Items concerned parents’ estimates of their child’s habitual reading distance, time spent indoors as compared with age peers, daily near work, outdoors time, and parents’ myopia. The associations of myopia with these factors were studied. Results: Myopia prevalence in those with a habitual close reading distance vs. others was 14.3% vs. 2.1%, 28.7% vs. 13.1% and 45.8% vs. 24.7% for the 7-, 11- and 15-year-olds (p < 0.001 in all age-groups). Myopia prevalence in children reported by their parents as spending more time indoors than age peers was 10.9% vs. 2.8% (p < 0.001), 25.0% vs. 14.7% (p = 0.004) and 41.9% vs. 25.7% (p < 0.001) in the three age groups. Myopia prevalence among those reported as spending both more time indoors and reading at a close distance vs. others was 44.2% vs. 11.9% (Fisher’s exact t-test, p < 0.001). In the multiple logistic regression models, parental myopia almost doubled the risk of myopia in the 11- and 15-year-olds. ORs (95% CI) for myopia adjusted for parental myopia and sex were for close reading distance 7.381 (4.054–13.440), 2.382 (1.666–3.406), 2.237 (1.498–3.057), (p < 0.001), and for more time spent indoors, 3.692 (1.714–7.954), p = 0.001, 1.861 (1.157–2.992), p = 0.010), 1.700 (1.105–2.615), p = 0.016, in the three age groups. Conclusion: Children, especially 7-year-olds, reported by their parents as having a close reading distance and spending a lot of time indoors were associated with a higher risk for myopia. Full article
(This article belongs to the Special Issue Prevalence and Progression of Myopia in Children and Adolescents)

Review

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19 pages, 371 KiB  
Review
Myopia Genetics and Heredity
by Yu-Meng Wang, Shi-Yao Lu, Xiu-Juan Zhang, Li-Jia Chen, Chi-Pui Pang and Jason C. Yam
Children 2022, 9(3), 382; https://doi.org/10.3390/children9030382 - 9 Mar 2022
Cited by 40 | Viewed by 11366
Abstract
Myopia is the most common eye condition leading to visual impairment and is greatly influenced by genetics. Over the last two decades, more than 400 associated gene loci have been mapped for myopia and refractive errors via family linkage analyses, candidate gene studies, [...] Read more.
Myopia is the most common eye condition leading to visual impairment and is greatly influenced by genetics. Over the last two decades, more than 400 associated gene loci have been mapped for myopia and refractive errors via family linkage analyses, candidate gene studies, genome-wide association studies (GWAS), and next-generation sequencing (NGS). Lifestyle factors, such as excessive near work and short outdoor time, are the primary external factors affecting myopia onset and progression. Notably, besides becoming a global health issue, myopia is more prevalent and severe among East Asians than among Caucasians, especially individuals of Chinese, Japanese, and Korean ancestry. Myopia, especially high myopia, can be serious in consequences. The etiology of high myopia is complex. Prediction for progression of myopia to high myopia can help with prevention and early interventions. Prediction models are thus warranted for risk stratification. There have been vigorous investigations on molecular genetics and lifestyle factors to establish polygenic risk estimations for myopia. However, genes causing myopia have to be identified in order to shed light on pathogenesis and pathway mechanisms. This report aims to examine current evidence regarding (1) the genetic architecture of myopia; (2) currently associated myopia loci identified from the OMIM database, genetic association studies, and NGS studies; (3) gene-environment interactions; and (4) the prediction of myopia via polygenic risk scores (PRSs). The report also discusses various perspectives on myopia genetics and heredity. Full article
(This article belongs to the Special Issue Prevalence and Progression of Myopia in Children and Adolescents)
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