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Updated: Jun 18, 2025

Inducement and Evaluation of a Murine Model of Experimental Myopia
Published on: January 22, 2019
Mendelian randomization analysis reveals a causal relationship between preterm birth and myopia risk
Bin Lin1,2,3,4,5,6, Long-Long Chen1,2,3,4,5,6, Dong-Kan Li1,2,3,4,5,6
1Xiamen Eye Center and Eye Institute of Xiamen University, Xiamen, China.
Background:
Preterm birth has been associated with an increased risk of myopia, but the causal relationship between these two factors remains unclear. Traditional epidemiological studies are limited by confounding factors and reverse causality. Mendelian randomization (MR) analysis, utilizing genetic variants as instrumental variables, provides a robust approach to investigate causal relationships. In this study, we aimed to explore the potential causal link between preterm birth and myopia risk using a two-sample MR analysis strategy.
Methods:
We conducted a Mendelian randomization study to investigate the causal relationship between preterm birth and myopia risk. Genetic variants (single nucleotide polymorphisms, SNPs) were used as instrumental variables, and summary data from genome-wide association studies (GWAS) were utilized. Four regression models, including MR-Egger regression, weighted median regression, inverse variance weighted regression, and Weighted mode regression, were employed to validate the causal relationship. Sensitivity analysis was performed using the leave-one-out method. At the same time, the funnel diagram and MR-Egger test were used to judge the stability of the research results.
Results:
The MR analysis revealed a significant causal effect of preterm birth on myopia risk. Both the inverse variance weighted regression and weighted median regression models showed a p-value less than 0.05, indicating a robust association. The risk of myopia increased by approximately 30% for everyone standard deviation increase in preterm birth. Sensitivity analysis, funnel plot and MR-Egger test all confirm the stability of the research results.
Conclusion:
Our findings provide evidence supporting a causal relationship between preterm birth and myopia risk. Preterm infants are at a higher risk of developing myopia, and this association is not likely to be influenced by confounding factors or reverse causality. The SNP loci rs6699397, rs10871582, and rs2570497 should be closely monitored as they may lead to abnormal concentrations of intraocular cytokines, particularly vascular endothelial growth factor, potentially elucidating one of the pathogenic mechanisms contributing to the higher incidence of myopia in preterm infants. However the complex interconnections involved extend beyond these factors alone.
Insights
Preterm birth significantly increases myopia risk, a causal link confirmed by Mendelian randomization. This finding helps understand myopia development in preterm infants, independent of confounding factors.
Area of Science:
- Ophthalmology
- Genetics
- Epidemiology
Background:
- Preterm birth is linked to higher myopia risk, but causality is debated due to confounding factors and reverse causality.
- Mendelian randomization (MR) offers a robust method to investigate causal relationships using genetic variants.
- This study employed a two-sample MR strategy to assess the causal link between preterm birth and myopia.
Purpose of the Study:
- To investigate the potential causal relationship between preterm birth and the risk of developing myopia.
- To utilize genetic variants as instrumental variables for a robust causal inference.
- To overcome limitations of traditional epidemiological studies in establishing causality.
Main Methods:
- A two-sample Mendelian randomization (MR) study design was implemented.
- Genetic variants (SNPs) from genome-wide association studies (GWAS) served as instrumental variables.
- Multiple regression models (MR-Egger, weighted median, inverse variance weighted, Weighted mode) and sensitivity analyses (leave-one-out, funnel plot, MR-Egger test) were used.
Main Results:
- MR analysis indicated a significant causal effect of preterm birth on myopia risk (p < 0.05).
- A one standard deviation increase in preterm birth was associated with approximately a 30% increase in myopia risk.
- Sensitivity analyses confirmed the robustness and stability of the findings.
Conclusions:
- Evidence supports a causal relationship between preterm birth and increased myopia risk.
- The observed association is unlikely due to confounding factors or reverse causality.
- Specific SNP loci (rs6699397, rs10871582, rs2570497) may be involved in pathogenic mechanisms, potentially via intraocular cytokine regulation.
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