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1.
Medicine (Baltimore) ; 99(17): e19531, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32332602

RESUMO

To observe the effectiveness and complications of inverted internal limiting membrane insertion through 25-G minimally invasive vitrectomy assisted with autologous blood adhesion fixation and combined with gas tamponade type-II macular hole retinal detachment in pathologic myopia.This was a retrospective study. The best-corrected visual acuity, intraocular pressure, macular hole closure, retinal reattachment, and systemic and ocular adverse events were observed.Twenty-three eyes were operated. Best-corrected visual acuity before surgery and at 3 and 6 months were 2.25 ±â€Š0.47, 1.85 ±â€Š0.32, and 1.32 ±â€Š0.36 LogMAR (P < .001). On days 2 to 5, all the retinas reattached, and the macular holes closed. On days 5 to 9, 5 eyes showed increased intraocular pressure. At 2 and 4 months, 2 eyes showed retinal detachment recurrence. No serious systemic or ocular adverse events were observed.This surgical technique showed clinical benefits and no significant complications. Clinical trials are necessary to confirm efficacy and safety.


Assuntos
Miopia/epidemiologia , Descolamento Retiniano/epidemiologia , Descolamento Retiniano/cirurgia , Perfurações Retinianas/epidemiologia , Perfurações Retinianas/cirurgia , Vitrectomia/métodos , Fatores Etários , Idoso , Feminino , Humanos , Pressão Intraocular , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Minimamente Invasivos/métodos , Estudos Retrospectivos , Fatores Sexuais , Tomografia de Coerência Óptica , Acuidade Visual
2.
N Z Med J ; 133(1509): 9-16, 2020 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-32027634

RESUMO

AIM: The purpose of this paper is to assess whether screening for myopia in New Zealand is valid under scrutiny of the Wilson and Jungner criteria. There is a worldwide myopia epidemic which requires urgent attention to reduce vision impairment, blindness and costs to wider society. The risks associated with myopia are under-appreciated in New Zealand, and treatments need to be refocused from correcting refractive error to preventing axial length elongation. METHODS: The Wilson and Jungner criteria was used to assess the validity of screening for myopia in New Zealand through review of the latest evidence relevant to each point within the criteria. RESULTS: We found that the screening for myopia in New Zealand met 7 out of 10 of the Wilson and Jungner criteria. CONCLUSIONS: The concept of a screening programme for myopia in New Zealand performed relatively well, and should be considered further. Further randomised clinical trials, which clearly identify the appropriate treatment modalities and timing, would allow the establishment of robust New Zealand specific myopia management guidelines. We would then suggest a trial of a screening programme in New Zealand setting to assess real-world feasibility and cost-effectiveness to identify early myopia and provide treatment to slow progression. Adjustments could be made to the already available screening programme, consisting of suitable reduction of screening age, and introduction of autorefractors.


Assuntos
Programas de Rastreamento/normas , Miopia/diagnóstico , Criança , Pré-Escolar , Humanos , Miopia/epidemiologia , Nova Zelândia/epidemiologia , Prevalência , Reprodutibilidade dos Testes , Testes Visuais , Acuidade Visual
3.
BMC Ophthalmol ; 20(1): 2, 2020 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-31898504

RESUMO

BACKGROUND: Prevention of myopia has become a public health priority in China. This study is to investigate the prevalence of myopia and vision impairment, and their associated factors in school students in eastern China. METHOD: In this cross-sectional school-based study of 4801 students from 16 schools ranging from kindergarten to high school, students underwent refraction using non-cycloplegic autorefractor and visual acuity testing using logMAR chart with tumbling E. Myopia was defined as spherical equivalent (SPHE) ≤ - 0.5 diopter (D) and uncorrected visual acuity (UCVA) 20/25 or worse. High myopia was defined as SPHE ≤ - 6.0 D and UCVA 20/25 or worse. Vision impairment was defined as UCVA 20/40 or worse. Logistic regression models were used to determine factors associated with myopia and vision impairment. RESULTS: Among 4801 children (55% male) with mean age (standard deviation) 12.3 (3.8) years, 3030 (63.1, 95% CI: 61.7-64.5%) had myopia, 452 (9.4, 95% CI: 8.6-10.3%) had high myopia, and 2644 (55.1, 95% CI, 53.7-56.5%) had vision impairment. The prevalence rate of myopia increased with grade in a non-linear manner, 12% in kindergarten, 32% in grade 2, 69% in grade 5, and approximately 90% by grade 10 or above. The prevalence rate of high myopia was relatively low in grade 4 or below (< 1.5%), 4-7% in grade 5 to 7, 13-15% in grade 8-9, and > 20% in grade 10 to 12. The prevalence rate of vision impairment was 4% in kindergarten, 37% in elementary school, 77% in middle school and 87% in high school students. Higher grade (p < 0.0001), female (p < 0.0001) and higher school workload (p = 0.007) were independently associated with higher prevalence rates of myopia and vision impairment, while higher grade (p < 0.0001) and higher school workload (p < 0.0001) were independently associated with higher prevalence of high myopia. CONCLUSION: Prevalence of myopia and vision impairment was high among Chinese school students and increased with grade in a non-linear manner, reaching alarming high in high school students accompanied by high prevalence of high myopia. Increasing study burden on school students at younger age plays an important role on the higher prevalence rate of myopia and vision impairment.


Assuntos
Miopia/epidemiologia , Instituições Acadêmicas/estatística & dados numéricos , Transtornos da Visão/epidemiologia , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Prevalência , Refração Ocular , Erros de Refração/epidemiologia , Fatores de Risco , Acuidade Visual
4.
Optom Vis Sci ; 96(9): 647-654, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31479019

RESUMO

SIGNIFICANCE: This present study advances our knowledge on the role of lifestyle factors in myopia (short-sightedness), specifically dietary factors. It has been suggested in previous studies that lower zinc status is associated with myopia; however, this article shows no relationship between dietary zinc intake and myopia in U.S. adolescents. PURPOSE: It has been suggested that low zinc levels may contribute to the development of myopia. The aim of the present study is to examine, for the first time in a Western population, the association of total dietary and supplement zinc intake with myopia. METHODS: A total of 1095 children/adolescents aged 12 to 19 years who participated in the U.S. National Health and Nutrition Examination Survey from 2007 to 2008 were enrolled in this study. Multivariate logistic regression analysis was performed to examine the relationship between total zinc intake and myopia after adjustment for potential confounders. In addition, the association between total zinc intake and spherical equivalent refractive error was examined in the myopia group through multiple linear regression. RESULTS: Among study participants, 30% were found to be myopic (≤-1.00 D). Although median total daily zinc intake was lower among myopes (10.8 [10.2] mg/d) than among nonmyopes (11.1 [10.8] mg/d), the difference was not statistically significant (P = .11). In multiple logistic regression analyses, zinc and copper intakes were not significantly associated with myopia after adjustment for age, sex, body mass index, ethnicity, family income, recreational activity, copper intake, and daily energy intake (in kilocalories per day). In multiple linear regression, spherical equivalent refractive error was not associated with total zinc intake in the myopic group after adjustment for confounding factors (P = .13). CONCLUSIONS: In contrast to previous Asian studies, total zinc intake is not associated with the presence of myopia in U.S. adolescents/children.


Assuntos
Dieta , Miopia/epidemiologia , Compostos de Zinco/administração & dosagem , Adolescente , Índice de Massa Corporal , Criança , Feminino , Humanos , Masculino , Inquéritos Nutricionais , Estados Unidos/epidemiologia , Adulto Jovem
5.
Invest Ophthalmol Vis Sci ; 60(12): 4033-4040, 2019 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-31560768

RESUMO

Purpose: To determine the prevalence of fundus tessellation and associations with ocular and systemic parameters among junior students from Greater Beijing. Methods: The school-based study included 1443 individuals with a mean age of 12.4 ± 0.5 years (range: 9-16 years). All participants underwent a comprehensive ophthalmic examination and an interview. Fundus tessellation, defined as variation in the visibility of large choroidal vessels, was differentiated into three grades. Results: The prevalence and degree of fundus tessellation were 688/1430 (48.1%; 95% confidence intervals [CI]: 45.5%, 50.7%) and 0.54 ± 0.61 (median, 0.00; range, 0-3), respectively. In multivariable regression analysis, a higher degree of fundus tessellation was associated with reduced subfoveal choroidal thickness (P < 0.001; beta, -0.02; odds ratio [OR], 0.98; 95% CI: 0.98, 0.99) and longer axial length (P < 0.001; beta, 0.23; OR, 1.25; 95% CI: 1.10, 1.43). Subfoveal choroidal thickness decreased from 299 ± 61 µm (95% CI: 293, 304) in eyes without fundus tessellation to 246 ± 57 µm (95% CI: 241, 251), 197 ± 43 µm (95% CI: 187, 207), and 131 ± 30 µm (95% CI: 93, 168) in eyes with grade 1, 2, and 3 fundus tessellation, respectively. A higher degree of peripapillary fundus tessellation was associated with reduced subfoveal choroidal thickness (P < 0.001; beta, -0.02; OR, 0.98; 95% CI: 0.98, 0.99) and younger age at myopia onset (P = 0.008; beta, 0.41; OR, 1.51; 95% CI: 1.11, 2.04). Conclusions: The prevalence of fundus tessellation is relatively high in Chinese teenagers. As in adults, the degree of fundus tessellation is a surrogate for choroidal thickness in teenagers. Marked fundus tessellation indicates a leptochoroid and is associated with earlier myopia onset.


Assuntos
Doenças da Coroide/epidemiologia , Corioide/irrigação sanguínea , Fundo de Olho , Miopia/epidemiologia , Adolescente , Grupo com Ancestrais do Continente Asiático/etnologia , Pequim/epidemiologia , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , População Rural/estatística & dados numéricos , Inquéritos e Questionários , Tomografia de Coerência Óptica , População Urbana/estatística & dados numéricos , Acuidade Visual
6.
Biomed Res Int ; 2019: 5357241, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31485442

RESUMO

Objectives: To investigate the mechanism of rhegmatogenous retinal detachment (RRD) in young and elderly Korean patients based on the results of axial length distribution. Subjects/Methods: We retrospectively reviewed the medical records of 1599 patients with RRD who had bilateral axial length data examined at one center between 2003 and 2018. Axial lengths were measured using ultrasound or IOLMaster500. The frequency of RRD and axial length distribution according to age groups were investigated. Results: Patients with RRD displayed a bimodal distribution across ages with two age groups showing the highest peak at 55-59 years and a second peak at 25-29 years of age. The mean axial length was significantly longer in patients younger than 50 years old than that in patients ≥ 50 years old (26.18 ± 1.86 mm vs. 24.55 ± 1.67 mm, respectively, p < 0.001). The percentage of patients with high myopia (axial length ≥ 26 mm) in patients < 50 years old was higher than that in those ≥ 50 years old (51.9% vs. 15.0%, respectively, p < 0.001; odds ratio, 6.11; 95% confidence interval, 4.83 to 7.74). Conclusions: We found a difference in the prevalence of myopia between young and elderly patients with RRD, which corresponds to a bimodal distribution of RRD incidence in East Asian countries. Our data indicate that myopia or high myopia-induced early vitreous detachment appears to be a major mechanism of occurrence of RRD in young East Asian patients, while senile vitreous liquefaction and detachment is the main mechanism of RRD in elderly patients.


Assuntos
Miopia/epidemiologia , Descolamento Retiniano/epidemiologia , Adulto , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prevalência , República da Coreia/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Acuidade Visual/fisiologia
8.
Environ Pollut ; 254(Pt B): 113031, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31454569

RESUMO

Myopia is caused by complex genetic and environmental factors. However, information regarding the effect of long-term exposure to air pollutants on the risk of development of myopia is lacking. We collected data from two linked databases: the Taiwan National Health Insurance Research Database (NHIRD) and the Taiwan Air Quality-Monitoring Database (TAQMD). A total of 15,822 children (16.3%) were diagnosed with myopia within the cohort. The incidence rate of myopia increased with exposure to increasing concentrations of particulate matter (PM2.5) and nitrogen oxides (NOx), increasing from 15.8 to 24.5 and from 13.7 to 34.4, per 1000 person-years, respectively. The adjusted hazard ratio for myopia increased with elevated PM2.5 and NOx exposure concentrations in Q4 to 1.57 and 2.60, respectively, compared to those exposed to the corresponding concentrations in Q1. In the animal experiments, PM2.5 induced myopia in hamsters by enhancing inflammation and was inhibited by resveratrol treatment compared to the control group. The change in axial length in the PM2.5 group was 0.386 ± 0.069 mm versus 0.287 ± 0.086 mm in the control group and 0.257 ± 0.059 mm in the PM2.5 + resveratrol group. We provide both clinical and experimental correlations that exposure to ambient air pollutants is associated with the pathogenesis of myopia.


Assuntos
Poluentes Atmosféricos/efeitos adversos , Exposição Ambiental/efeitos adversos , Miopia/etiologia , Óxidos de Nitrogênio/efeitos adversos , Material Particulado/efeitos adversos , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Animais , Criança , Estudos de Coortes , Bases de Dados Factuais , Feminino , Humanos , Masculino , Miopia/epidemiologia , Óxidos de Nitrogênio/análise , Material Particulado/análise , Modelos de Riscos Proporcionais , Taiwan/epidemiologia
9.
Zhonghua Yan Ke Za Zhi ; 55(8): 561-564, 2019 Aug 11.
Artigo em Chinês | MEDLINE | ID: mdl-31422633

RESUMO

The prevalence of myopia in China is extraordinarily high, and much attention has been paid to the epidemiological studies related to myopia. Epidemiological investigations can be used to understand the incidence and prevalence of myopia, its epidemiological characteristics and the related risk factors. At present, there are many articlespublished in China on epidemiological surveys of myopia. However, the criteria for cycloplegic regimes are not uniform, the age limit is not definite, and cycloplegics are even not used in some researches. Lack of or insufficient cycloplegia is associated with overestimation of the prevalence of myopia and underestimation of hyperopia and leads to inaccurate assessment of risk factors. In this article, we propose standardized methods for cycloplegia in the epidemiological investigations of myopia in China by reviewing different types of cycloplegic regimes commonly used and the effects on different age groups. This will help to obtain the accurate incidence and prevalence of myopia, promote the interconnection and increase comparabilityof research data, improve the accuracy of assessing related risk factors and provide scientific evidence for the prevention and control of myopia. (Chin J Ophthalmol, 2019, 55: 561-564).


Assuntos
Hiperopia , Midriáticos , Miopia , China/epidemiologia , Estudos Epidemiológicos , Humanos , Miopia/diagnóstico , Miopia/epidemiologia , Prevalência , Refração Ocular
10.
Invest Ophthalmol Vis Sci ; 60(8): 3142-3149, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31323684

RESUMO

Purpose: To determine genetic correlations between common myopia and primary open-angle glaucoma (POAG). Methods: We tested the association of myopia polygenic risk scores (PRSs) with POAG and POAG endophenotypes using two studies: the Australian & New Zealand Registry of Advanced Glaucoma (ANZRAG) study comprising 798 POAG cases with 1992 controls, and the Rotterdam Study (RS), a population-based study with 11,097 participants, in which intraocular pressure (IOP) and optic disc parameter measurements were catalogued. PRSs were derived from genome-wide association study meta-analyses conducted by the Consortium for Refractive Error and Myopia (CREAM) and 23andMe. In total, 12 PRSs were constructed and tested. Further, we explored the genetic correlation between myopia, POAG, and POAG endophenotypes by using the linkage disequilibrium score regression (LDSC) method. Results: We did not find significant evidence for an association between PRS of myopia with POAG (P = 0.81), IOP (P = 0.07), vertical cup-disc ratio (P = 0.42), or cup area (P = 0.25). We observed a nominal association with retinal nerve fiber layer (P = 7.7 × 10-3) and a significant association between PRS for myopia and disc area (P = 1.59 × 10-9). Using the LDSC method, we found a genetic correlation only between myopia and disc area (genetic correlation [RhoG] = -0.12, P = 1.8 × 10-3), supporting the findings of the PRS approach. Conclusions: Using two complementary approaches we found no evidence to support a genetic overlap between myopia and POAG; our results suggest that the comorbidity of these diseases is not influenced by common variants. The association between myopia and optic disc size is well known and validates this methodology.


Assuntos
Predisposição Genética para Doença , Estudo de Associação Genômica Ampla/métodos , Glaucoma de Ângulo Aberto/genética , Pressão Intraocular/fisiologia , Miopia/genética , Refração Ocular/fisiologia , Sistema de Registros , Idoso , Austrália/epidemiologia , Feminino , Seguimentos , Glaucoma de Ângulo Aberto/epidemiologia , Glaucoma de Ângulo Aberto/fisiopatologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Miopia/epidemiologia , Miopia/fisiopatologia , Nova Zelândia/epidemiologia , Disco Óptico/patologia , Estudos Prospectivos , Fatores de Risco
11.
Invest Ophthalmol Vis Sci ; 60(8): 2781-2786, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31260519

RESUMO

Purpose: To examine trends in the prevalence of myopia and myopic maculopathy in a general Japanese population. Methods: Residents of a Japanese community aged 40 years and older participated in surveys conducted in 2005, 2012, and 2017. Each participant underwent comprehensive eye examinations that included measurements of refractive error, axial lengths, and color fundus photography. Myopic maculopathy was defined according to the criteria of the Meta-analysis of Pathologic Myopia Study Group classification system. Trends in the prevalence of myopia and myopic maculopathy were tested by using a logistic regression analysis fitted by generalized estimating equations to account for individuals submitting to repeated examination. Results: The age-adjusted frequencies of myopia increased significantly from 2005 to 2017 (myopia, 37.7%-45.8%; high myopia 5.8%-9.5%; all P for trend <0.001). The age-adjusted frequency of an axial length level of 26.5 mm or more increased significantly from 2005 to 2017 (3.6%-6.0%; P for trend <0.001). The age-adjusted prevalence of myopic maculopathy also increased significantly with time (1.6% in 2005, 3.0% in 2012 and 3.6% in 2017; P for trend <0.001). Upward trends were observed in the prevalence of diffuse chorioretinal atrophy and patchy chorioretinal atrophy (all P for trend <0.05). Conclusions: Our findings suggest that the prevalence of myopia and myopic maculopathy, especially diffuse chorioretinal atrophy and patchy chorioretinal atrophy, increased significantly over the past 12 years in a general Japanese population.


Assuntos
Miopia/epidemiologia , Doenças Retinianas/epidemiologia , Idoso , Grupo com Ancestrais do Continente Asiático/etnologia , Comprimento Axial do Olho/patologia , Técnicas de Diagnóstico Oftalmológico , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Miopia/diagnóstico , Prevalência , Doenças Retinianas/diagnóstico , Estudos Retrospectivos , Fatores de Risco , Acuidade Visual
12.
Invest Ophthalmol Vis Sci ; 60(8): 3091-3099, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31323091

RESUMO

Purpose: We studied biometry changes before and after myopia onset in a cohort of Singaporean children. Methods: All data were taken from the Singapore Cohort Study of the Risk Factors for Myopia (SCORM). Participants underwent refraction and biometry measurements with a follow-up of 3 to 6 years. The longitudinal ocular biometry (spherical equivalent refraction, axial length, and lens power) changes were compared between children who suffered myopia during the study (N = 303), emmetropic children (N = 490), and children myopic at baseline (N = 509). Results: At myopia onset, the myopic shift increased to 0.50 diopters (D)/y or more in new myopes compared to the minor changes in emmetropes of the same age. New myopes had higher axial growth rates than emmetropes, even years before myopia onset (0.37 and 0.14 mm/y, respectively; ANOVA with Bonferroni post hoc test, P < 0.001). After onset, the change in both parameters slowed down gradually, but significantly (P < 0.05). In new myopes, lens power loss (-0.71 D/y) was significantly higher up to 1 year before myopia onset compared to emmetropes (-0.46 D/y), after which lens power loss slows down rapidly. At age 7 years, (future) new myopes had lens power values close to those of emmetropes (25.12 and 25.23 D, respectively), while later these values approached those of children who were myopic at baseline (23.06 and 22.79 D, respectively, compared to 23.71 D for emmetropes; P < 0.001). Conclusions: New myopes have higher axial growth rates and lens power loss before myopia onset than persistent emmetropes.


Assuntos
Comprimento Axial do Olho/crescimento & desenvolvimento , Cristalino/fisiopatologia , Miopia/diagnóstico , Refração Ocular/fisiologia , Biometria , Criança , Progressão da Doença , Feminino , Seguimentos , Humanos , Incidência , Masculino , Miopia/epidemiologia , Miopia/fisiopatologia , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Singapura/epidemiologia , Fatores de Tempo
13.
Artigo em Inglês | MEDLINE | ID: mdl-31330865

RESUMO

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.


Assuntos
Miopia/prevenção & controle , Luz Solar , Adolescente , Ásia/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Incidência , Masculino , Miopia/epidemiologia , Miopia/etiologia , Razão de Chances , Prevalência , Fatores de Proteção , Fatores de Tempo
14.
Pan Afr Med J ; 32: 162, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31303931

RESUMO

Introduction: Addition in patients of less than 40 years is not uncommon in our practice. We investigated the need for addition after objective refraction and thus determine the average age of onset of the presbyopia. Methods: We conducted a cross-sectional descriptive study of patients aged 35-45 years at the Central Hospital of Yaoundé over a period of three months. All patients underwent cycloplegic refraction. Distance visual acuity was corrected after instillation of cycloplegic eye drops while near addition was assessed two days later when the cycloplegia was no longer effective. Possible additional distance correction was done 2 days after cycloplegia. Statistical analysis was done using IBM SPSS 20.0 software. Results: We examined 55 patients, 110 eyes. The average age of patients was 41.87±2.5 years, the sex-ratio was 0.28. There was a female predominance. Hypermetropic astigmatism was the most common ametropia (58.2% of cases) followed by hyperopia (24.6%).No patient was myopic. the average age of presbyopia onset in this age group was 43.2±1.7 years. After objective correction of distance visual acuity, no patient needed for addition before the age of 40. Moreover, 4 out of 10 patients with hypermetropic ametropia did not need addition before the age of 40. Addition was significantly associated with age. Conclusion: The average age of presbyopia onset is 43.2±1.7 years. Before the age of 45, addition must be preceded by objective refraction.


Assuntos
Hiperopia/epidemiologia , Miopia/epidemiologia , Presbiopia/epidemiologia , Erros de Refração/epidemiologia , Adulto , Grupo com Ancestrais do Continente Africano , Idade de Início , Camarões/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Midriáticos/administração & dosagem , Acuidade Visual
15.
Med Hypotheses ; 128: 78-82, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31203915

RESUMO

In recent years, a trend has been noted for increasing numbers of myopia cases found globally, which could potentially be indicative of a bigger problem. However, the cause of this trend remains unknown and in addition, we have yet to be able to establish a reliable method for preventing the onset of myopia. Furthermore, previous myopia studies have not paid adequate attention to hyperopia. That is to say, it has been suggested that the development of refraction in infancy and the onset of myopia are distinct from emmetropization. However, myopia studies also need to focus on the development of refraction in infancy, which involves hyperopia. Based on this viewpoint, our new hypothesis is that the trend towards myopia is associated with changes during the infancy period. The supporting evidence for these changes can be found in four areas, epidemiology of hyperopia, relationship with body height, incidence of esotropia, and birth month research. If this hypothesis is true, we need to investigate why there has been a decrease in hyperopia patients rather than why there has been an increase in myopia patients.


Assuntos
Miopia/etiologia , Miopia/fisiopatologia , Adolescente , Estatura , Criança , Pré-Escolar , Esotropia , Humanos , Hiperopia/fisiopatologia , Incidência , Lactente , Recém-Nascido , Miopia/epidemiologia , Erros de Refração , Estações do Ano
16.
Twin Res Hum Genet ; 22(3): 177-182, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31213209

RESUMO

This case study examined the hypothesis that longer outdoor time results in normal vision and refractive status, using unique genetically informative kinships. The participants were the members of 29-year-old doubly exchanged monozygotic male twin pairs from Bogotá, Colombia, in South America. Comprehensive ophthalmological examinations, including uncorrected and corrected visual acuity, refraction and keratometry, and visual life history interviews were undertaken; all examinations were conducted by two ophthalmologists blind to the hypothesis, relatedness, and rearing status of the four participants. Normal uncorrected vision and refractive status were present in the two rural-raised, unrelated brothers, relative to their urban-raised counterparts. Uncorrected visual acuities were 20/160 and 20/200 for the city-raised twins and 20/20 and 20/30 for the country-raised twins. Premature birth, low birth weight, computer use, and reading time could not explain these differences. It was concluded that time spent outdoors appears to be a significant factor in the development of myopia, reinforcing extant findings via a novel experimental approach.


Assuntos
Doenças em Gêmeos/epidemiologia , Miopia/epidemiologia , Refração Ocular/fisiologia , Gêmeos Monozigóticos , Acuidade Visual , Adulto , Educação Infantil , Meio Ambiente , Feminino , Humanos , Incidência , Recém-Nascido , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia
17.
Curr Med Sci ; 39(3): 455-462, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31209819

RESUMO

Myopia is the leading cause of visual impairments worldwide. Some studies revealed that visual experience in early life affected the final myopia, indicating that environmental factors play an impellent role in the development of myopia. However, risk factors of myopia are still not identified among adolescents in China. A total of 4104 cases of myopia symptom and 3306 emmetropia controls were selected from students in primary and middle schools in Wuhan in 2008. We identified the risk factors associated with myopia symptom by multivariate logistic regression in this cross-sectional study and constructed a risk score system for myopia symptom. The value of the area under the receiver operating characteristic curve (ROC) was 0.735. Furthermore, we followed up 93 students aged 7-9 years for one year and calculated the total points using the score system. We found no significant difference between the final myopia symptom and the results predicted by the total points by pair chi-square test (P>0.05). The score system had a modest ability to estimate the risk factors of myopia symptom. Using this score system, we could identify the students who are at risk of myopia symptom in the future according to their behaviors and environmental factors, and take measures to slow the progress of myopia symptom.


Assuntos
Miopia/diagnóstico , Miopia/epidemiologia , Adolescente , Área Sob a Curva , Criança , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Análise Multivariada , Miopia/fisiopatologia , Prognóstico , Curva ROC , Projetos de Pesquisa , Fatores de Risco , Instituições Acadêmicas , Estudantes , Adulto Jovem
18.
Ophthalmic Physiol Opt ; 39(4): 282-293, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31099434

RESUMO

PURPOSE: To assess associations between different types of electronic devices, myopic refraction and ocular biometric parameters in children aged 6-14 years in urban areas of Tianjin, China. METHODS: A school-based, cross-sectional study was performed on 566 children (302 boys and 264 girls). The children underwent a comprehensive eye examination, including cycloplegic autorefraction and ocular biometry. The children's parents completed a detailed questionnaire that included each child's demographics, the use of electronic devices and other related risk factors. RESULTS: Myopia was not associated with time spent using various electronic devices. However, the mean spherical equivalent refraction (SER) decreased by 0.28 D (p = 0.042) and 0.33 D (p = 0.018) for each 1-h increase in the time spent using smart phones and computers, respectively. In the multiple linear regression analyses of factors associated with the SER, the standardised coefficient B for time spent reading and writing was approximately four to five times larger than the standardised coefficient for time spent using smart phones or computers. Time spent using tablets and watching television was not significantly associated with the SER. A longer axial length (AL) was associated with more time spent using smart phones (B = 0.23, p = 0.006) and computers (B = 0.26, p = 0.002) but not using tablets (p = 0.45) and watching television (p = 0.45). No significant association was found between other ocular biometric parameters and time spent using various electronic devices. CONCLUSIONS: On average, a more myopic SER and longer AL were both associated with more time spent using smart phones and computers, but not with time spent using tablets and watching television. The magnitude of the association between SER and time spent reading and writing was a substantially larger than that for smart phone or computer use. Different types of electronic devices had differing levels of association with myopic refraction.


Assuntos
Computadores/estatística & dados numéricos , Miopia/epidemiologia , Adolescente , Biometria , Criança , China/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Miopia/etiologia , Prevalência , População Urbana
19.
Ophthalmic Epidemiol ; 26(4): 286-294, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31094286

RESUMO

Purpose: To evaluate common strategies for screening myopia. Methods: A total of 2,248 children aged 6 to 12 years from five randomly selected primary schools were included for the screening. Enrolled study participants underwent distant uncorrected visual acuity (UCVA, Standard Logarithmic Visual Acuity E Chart) and non-cycloplegic auto-refraction (NCAR, Topcon KR-8800). Among them, 1,639 children (72.9%) accepted cycloplegic auto-refraction. Taking rejection of cycloplegia into account, receiver operating characteristic curves were drawn to compare the accuracies of the four strategies (I, Cycloplegic auto-refraction; II, NCAR; III, UCVA; IV, Combination of UCVA and NCAR). Decision curve analysis (DCA) was used to compare net benefits. Tenfold cross-validation was used for statistical analyses. Results: For myopia (spherical equivalent refraction, SE ≤ -0.5D) screening, the mean sensitivities were 73.79% (SD: 5.40%), 85.57% (6.84%), 59.71% (13.49%), and 85.06% (6.68%) for Strategy I to IV; with mean specificities of 100% (0%), 87.43% (4.27%), 89.74% (10.25%), and 88.65% (5.07%), respectively. For screening early myopia (SE ≤ -0.5D and ≥-1.0D), the mean sensitivities were 73.44% (7.69%), 82.39% (5.32%), 54.27% (14.58%), and 81.76% (9.60%) for Strategy I to IV; with mean specificities of 100% (0%), 79.13% (4.86%), 85.48% (9.86%), and 81.17% (4.16%). Based on DCA, the net benefits of Strategy IV were the highest, with the probability thresholds ranging from 12% to 50%, after adjusting the TestHarms. For early myopia, the net benefits of Strategy IV were the highest with the probability threshold ranging from 5% to 34%. Conclusion: Combination of UCVA and NCAR produced the highest net benefits for myopia screening.


Assuntos
Técnicas de Apoio para a Decisão , Guias como Assunto , Miopia/diagnóstico , Refração Ocular/fisiologia , Estudantes/estatística & dados numéricos , Seleção Visual/normas , Acuidade Visual , Criança , China/epidemiologia , Progressão da Doença , Feminino , Humanos , Incidência , Masculino , Miopia/epidemiologia , Miopia/fisiopatologia , Prevalência , Curva ROC
20.
Ophthalmic Epidemiol ; 26(4): 244-250, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30957606

RESUMO

Purpose: To report baseline information for a medical university cohort with the aim of exploring related factors for adult myopic progression. Methods: This study included Chinese freshmen students from a medical school in Guangzhou, China. All participants underwent detailed eye examinations, including cycloplegic refraction, ocular biometry and swept source optical coherence tomography. Choroidal thickness (CT) measurements were performed at nine locations in the macular area. Eye care habits and physical activities were measured by questionnaire. Results: The mean age of the study population (N = 307) was 18.8 ± 2.3 years, and 46.3% were male. The prevalence of myopia and high myopia was 92.8% and 21.1%, respectively. In emmetropia (spherical equivalent, SE -0.49D to +0.5D), mild to moderate myopia (SE -0.50D to -5.99D) and high myopia groups (SE <-6.00D), the average subfoveal CT was 300.3 ± 62.1 µm, 219.3 ± 65.4 µm and 194.0 ± 59.7 µm, respectively. In all eyes, the temporal CT was the thickest among all of the locations in the macular area, and the CT was thinnest nasally. Gender, axial length (AL), anterior chamber depth (ACD) and intraocular pressure (IOP) were the strongest related factors for subfoveal CT in mild to moderate myopia, while AL was the only significant determinant for subfoveal CT in highly myopic eyes. Conclusions: The prevalence of myopia was high in Chinese medical students. Macular CT was generally thinner in highly myopic eyes. Our study provided baseline information for the medical school cohort, including CT, AL, ACD, IOP and eye care habits.


Assuntos
Corioide/patologia , Miopia/epidemiologia , Refração Ocular/fisiologia , Faculdades de Medicina/estatística & dados numéricos , Estudantes de Medicina/estatística & dados numéricos , Tomografia de Coerência Óptica/métodos , Adolescente , Biometria/métodos , China/epidemiologia , Feminino , Humanos , Masculino , Miopia/diagnóstico , Miopia/fisiopatologia , Prevalência , Estudos Retrospectivos , Adulto Jovem
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