Risk Factors of Myopic Shift among Primary School Children in Beijing, China: A Prospective Study.
OBJECTIVE
To evaluate factors associated with myopic shift among primary school children.


METHODS
In a one-year prospective school-based study, 5052 children from ten schools were enrolled using a multi-stage random cluster approach. The baseline examination included non-cycloplegic auto-refractometry and questionnaire interview. Measurements were repeated at the follow-up.


RESULTS
Among 5052 students at baseline investigated, 4292 students (85.0%) returned for the follow-up examination. The mean refractive error (-1.13±1.57 diopters) had changed -0.52±0.73 diopters from the baseline to the follow-up examination. 2170 (51.0%) had a rate of significant myopic shift (significant myopic shift is defined as the change of spherical equivalent of the refraction ≤ -0.50D between the follow-up and baseline measures). We confirmed that common associated factors (older age, parental myopia, lower refractive status at baseline, shorter reading distance and lower frequency of outdoor activities during class recesses) were associated with greater shift towards myopia. After controlling for age, sex, region of habitation, parental myopia and refractive status at baseline, greater shift towards myopia was independently associated with distance from near-work (OR=1.48 , 95% CI=1.26-1.74, P<0.001) and longer time outdoors for leisure (OR=0.87, 95% CI=0.78-0.97, P<0.013).


CONCLUSIONS
Greater shift towards myopia was independently associated with modifiable factors (distance from near-work and longer time outdoors for leisure) might suggest that encouraging children to go outside for outdoor activities during class recess and after school may be a promising and feasible intervention against myopia development.
1. School of Public Health, Capital Medical University, Beijing 100069, China ; 2. Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing 100069, China.
Li-Juan
LJ
Wu
1. School of Public Health, Capital Medical University, Beijing 100069, China ; 2. Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing 100069, China.
You-Xin
YX
Wang
3. Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Lab, Beijing100005, China.
Qi-Sheng
QS
You
4. Beijing Center for Disease Prevention and Control, Beijing 100013, China.
Jia-Li
JL
Duan
1. School of Public Health, Capital Medical University, Beijing 100069, China ; 2. Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing 100069, China.
Yan-Xia
YX
Luo
3. Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Lab, Beijing100005, China.
Li-Juan
LJ
Liu
1. School of Public Health, Capital Medical University, Beijing 100069, China ; 2. Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing 100069, China.
Xia
X
Li
1. School of Public Health, Capital Medical University, Beijing 100069, China ; 2. Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing 100069, China.
Qi
Q
Gao
1. School of Public Health, Capital Medical University, Beijing 100069, China ; 2. Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing 100069, China.
Hui-Ping
HP
Zhu
1. School of Public Health, Capital Medical University, Beijing 100069, China ; 2. Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing 100069, China.
Yan
Y
He
3. Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Lab, Beijing100005, China.
Liang
L
Xu
1. School of Public Health, Capital Medical University, Beijing 100069, China ; 2. Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing 100069, China.
Man-Shu
MS
Song
3. Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Lab, Beijing100005, China ; 5. Department of Ophthalmology, Medical Faculty Mannheim of the Ruprecht-Karls-University Heidelberg, 68167 Mannheim, Germany.
Jost B
JB
Jonas
1. School of Public Health, Capital Medical University, Beijing 100069, China ; 2. Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing 100069, China.
Xiu-Hua
XH
Guo
1. School of Public Health, Capital Medical University, Beijing 100069, China ; 2. Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing 100069, China ; 6. School of Medical Science, Edith Cowan University, Perth 6027, Australia.
Wei
W
Wang
D000068476:Beijing / Q000453:epidemiology; D002648:Child; D016000:Cluster Analysis; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D009216:Myopia / Q000175:diagnosis* / Q000453:epidemiology*; D011446:Prospective Studies; D012029:Refraction, Ocular; D012030:Refractive Errors; D012307:Risk Factors; D012574:Schools; D011795:Surveys and Questionnaires
Beijing China.; Myopia; Myopic shifts; Primary school children; Risk factors