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Axial Length and Associated Factors in Children: The Shandong Children Eye Study
Tai Liang Lu1, Jian Feng Wu, Xiang Ye
1The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China.
Insights
Ocular axial length in Chinese children is linked to age, gender, and environment. Less time outdoors is a key factor associated with high axial myopia, a condition prevalent in adolescents.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Public Health
Background:
- Axial length (AL) is a critical determinant of refractive error and a key factor in myopia development.
- Understanding factors influencing AL in children is crucial for early detection and intervention of myopia.
Purpose of the Study:
- To investigate ocular axial length (AL) in a large cohort of Chinese children.
- To identify factors associated with AL and high axial myopia in this population.
Main Methods:
- The Shandong Children Eye Study enrolled 6,364 children aged 4-18 years.
- Multivariate analysis was employed to assess associations between AL and various demographic, environmental, and clinical factors.
Main Results:
- Longer AL was significantly associated with older age, male gender, urban residence, greater body height, maternal education, parental myopia, increased indoor reading/writing time, and longer corneal curvature radius.
- High axial myopia (AL ≥26.0 mm) was present in 3.4% of children and was associated with less time spent outdoors.
- The prevalence of high axial myopia exceeded 10% among 16-year-olds in Shandong.
Conclusions:
- Axial length in Chinese children is influenced by a combination of genetic and environmental factors.
- Reduced time spent outdoors is a significant modifiable risk factor associated with high axial myopia in children.
- Findings highlight the importance of lifestyle interventions, such as increasing outdoor activity, to mitigate myopia progression.
Purpose:
To investigate ocular axial length (AL) in Chinese children.
Methods:
The Shandong Children Eye Study included 6,364 children aged 4-18 years.
Results:
Longer AL (mean 23.45 ± 1.20 mm, range 18.80-28.59 mm) was associated (multivariate analysis; correlation coefficient r2: 0.61) with older age (p < 0.001, standardized correlation coefficient β = 0.35, unstandardized regression coefficient B = 0.13, 95% confidence interval [CI] 0.12, 0.15), male gender (p < 0.001, β = -0.24, B = -0.10, 95% CI -0.29, -0.19), urban region (p < 0.001, β = 0.10, B = 0.25, 95% CI 0.20, 0.31), body height (p < 0.001, β = 0.22, B = 0.02, 95% CI 0.01, 0.02), maternal education (p < 0.001, β = 0.07, B = 0.07, 95% CI 0.05, 0.10), paternal myopia (p < 0.001, β = 0.09, B = 0.26, 95% CI 0.20, 0.33), maternal myopia (p < 0.001, β = 0.08, B = 0.23, 95% CI 0.17, 0.30), more time spent indoors reading/writing (p < 0.001, β = 0.05, B = 0.03, 95% CI 0.02, 0.04), less time spent outdoors (p = 0.005, β = -0.03, B = -0.01, 95% CI -0.02, -0.003), longer corneal curvature radius (p < 0.001, β = 0.36, B = 1.63, 95% CI 1.53, 1.74) and higher intraocular pressure (p = 0.008, β = 0.03, B = 0.01, 95% CI 0.004, 0.02). High axial myopia (AL ≥26.0 mm) present in 202 children (3.4 ± 0.2%, 95% CI 2.92, 3.84) was associated with less time spent outdoors (p = 0.002, odds ratio 0.92, 95% CI 0.87, 0.97) in multivariate analysis.
Conclusions:
In children in the less developed Eastern Chinese province of Shandong, the prevalence of high axial myopia was >10% among 16-year-olds. A modifiable factor associated with higher prevalence of high axial myopia was less time spent outdoors.
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