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Published on: March 29, 2022
Generational difference of refractive error and risk factors in the Handan Offspring Myopia Study
Zhong Lin1, Tie Ying Gao2, Balamurali Vasudevan3
1The Affiliated Eye Hospital, School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, China Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Lab, Beijing, China.
Insights
Children
Area of Science:
- Ophthalmology
- Genetics
- Public Health
Background:
- Refractive error differences between parents and children are significant in understanding myopia progression.
- Rural Chinese populations present unique environmental and genetic factors influencing vision.
- The Handan Offspring Myopia Study (HOMS) provides valuable data on childhood eye conditions.
Purpose of the Study:
- To investigate the refractive error difference (RED) between parents and children in rural China.
- To identify risk factors associated with RED in a pediatric population.
- To estimate the generational myopic shift in young individuals.
Main Methods:
- Enrollment of 356 parent-child pairs and 585 children (6-17 years) from the HOMS.
- Cycloplegic autorefraction for children and non-cycloplegic for parents to measure spherical equivalent (SE).
- Vision-based questionnaire and prediction model for generational myopic shift estimation.
Main Results:
- RED increased with age, shifting from myopic in younger children to hyperopic in older children.
- Children's SE was predicted to reach parental SE around age 14.
- Older age and female gender were associated with higher RED in children.
Conclusions:
- Children's refractive error approaches parental levels by age 14 in this population.
- An estimated generational myopic shift of approximately 1 D is observed by age 18.
- Increasing myopia prevalence in younger generations may be linked to environmental changes.
Purpose:
To report the refractive error difference (RED) between parents and their children, and its risk factors, in a rural area of China.
Methods:
Children (6-17 years) and their parents (36.2 ± 4.1 years) from the Handan Offspring Myopia Study (HOMS) were enrolled. Cycloplegic autorefraction (cyclopentolate 1%, Topcon KR8800) of the children and noncycloplegic autorefraction of their parents were assessed. A detailed vision-based questionnaire was also completed. Refractive error difference was defined as the difference between the parental spherical equivalent (SE) and their children's SE. Generational myopic shift was defined as the estimated RED when a child would be 18 years old according to a prediction model.
Results:
Three hundred fifty-six pairs of parents and 585 children were enrolled. The RED (median, quartiles) increased from -1.33 (-1.99, -0.98) diopters (D) in children aged 6 to 7 years to 0.81 (-0.16, 2.28) D in children aged 16 to 17 years. The children's SE was predicted to approach the parental SE at 14 years of age. Moreover, the children's estimated myopic shift would be 1.03 D. Multiple linear regression revealed that older children (β = 0.23 D/y, P < 0.0001) and girls (β = 0.24, P = 0.01) tended to have a higher RED.
Conclusions:
In this rural Chinese population, the children's refraction was estimated to be similar to the parental refraction at 14 years of age. Moreover, the generational myopic shift was estimated to be approximately 1 D at 18 years of age. These data suggest that the generational difference reflects the increasing prevalence of myopia in the younger generation, which is likely due to changes in environmental exposure.
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