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Effect of Parental Myopia on Change in Refraction in Shanghai Preschoolers: A 1-Year Prospective Study
Yingyan Ma1,2, Senlin Lin1, Jianfeng Zhu1
1Department of Preventative Ophthalmology, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai, China.
Insights
Parental myopia, not environmental factors, influences preschool children's refractive development. Boys experienced more myopic shifts and axial length elongation than girls over one year.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Refractive Error Development
Background:
- Investigating risk factors for refractive changes in preschoolers is crucial for early intervention.
- Understanding the interplay between genetics and environment in early vision development.
Purpose of the Study:
- To identify risk factors associated with changes in refraction and axial length in preschool children.
- To explore the influence of parental myopia and environmental factors on refractive development.
Main Methods:
- Longitudinal study of 603 preschool children (3-5 years) over 1 year.
- Cycloplegic autorefraction and axial length measurements at baseline and follow-up.
- Questionnaires on parental myopia and environmental factors (near work, outdoor time).
Main Results:
- Parental myopia was linked to increased axial length elongation, but not refractive change.
- Boys exhibited a greater myopic shift and faster axial length elongation than girls.
- Near work and outdoor time were not significantly associated with refractive or axial length changes.
Conclusions:
- Environmental factors showed limited association with refractive changes in preschoolers.
- Parental myopia appears to be a continuous influence on refractive development from infancy through preschool.
- These findings suggest parental myopia may be a key biological basis for the development of school myopia.
Background:
To investigate the risk factors for change in refraction and refractive components in preschoolers.
Methods:
Preschool children aged 3-5 years old, from the junior and the middle grades of seven randomly selected kindergartens in Jia Ding District, Shanghai, were followed for 1 year. Cycloplegic autorefraction (1% cyclopentolate) and axial length (AL) were measured at baseline and at 1-year follow-up. Questionnaires about parental myopia and environmental risk factors, such as time of outdoors and near work, were collected.
Results:
A total of 603 right eyes of 603 children were included. Parental myopia was not associated with a change in refraction, but two myopic parents were associated with a longer change in AL (coefficient = 0.153, p = 0.006), after adjusted for baseline spherical refraction, age, gender, change in height, change in weight, and environment risk factors. In the multivariate analyses, boys showed a more myopic refraction shift than girls in 1 year (coefficient = -0.150, p = 0.008) and a quicker AL elongation (coefficient = 0.120, p = 0.008). Time of near work, such as watching television, using computer, reading and writing, and time of outdoor activities, was not associated with a change in refraction or AL.
Conclusions:
In preschool age, environmental risk factors were not strongly associated with the change in refraction or refractive components. Parental myopia influences the refractive development of children continuously from infancy to preschool age, which might be the biological basis of school myopia.
