Environmental factors explain socioeconomic prevalence differences in myopia in 6-year-old children

PurposeHigh myopia (≤−6 D) usually has its onset before 10 years of age and can lead to blinding complications later in life. We examined whether differences in myopia prevalences in socioeconomic risk groups could be explained by differences in lifestyle factors.MethodsA total of 5711 six-year-old...

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Published in:British journal of ophthalmology Vol. 102; no. 2; pp. 243 - 247
Main Authors: Tideman, J Willem L, Polling, Jan Roelof, Hofman, Albert, Jaddoe, Vincent WV, Mackenbach, Johan P, Klaver, Caroline CW
Format: Journal Article
Language:English
Published: England BMJ Publishing Group LTD 01.02.2018
Subjects:
Age
Education
Epidemiology
Ethnicity
Family income
Low income groups
Marital status
Ophthalmology
Outdoor activities
Outdoors
Population
Public health
Questionnaires
Research centers
Risk factors
Socioeconomic factors
Netherlands
Europe
myopia
mediation
children
lifestyle
ISSN:0007-1161, 1468-2079, 1468-2079
Online Access:Get full text
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Summary:PurposeHigh myopia (≤−6 D) usually has its onset before 10 years of age and can lead to blinding complications later in life. We examined whether differences in myopia prevalences in socioeconomic risk groups could be explained by differences in lifestyle factors.MethodsA total of 5711 six-year-old children participating in the prospective population-based birth cohort study Generation R underwent a stepwise ophthalmic examination, which included visual acuity and objective cycloplegic refraction to identify children with myopia (≤−0.5D). Daily activities, ethnicity, factors representing family socioeconomic status and housing were ascertained by questionnaire. Risk assessments of myopia and mediation analyses were performed using logistic regression; attenuation of risks was calculated by bootstrapping.ResultsPrevalence of myopia was 2.4% (n=137). Myopic children spent more time indoors and less outdoors than non-myopic children (p<0.01), had lower vitamin D (p=0.01), had a higher body mass index and participated less in sports (p=0.03). Children of non-European descent (OR 2.60; 95% CI 1.84 to 3.68), low maternal education (OR 2.27; 95% CI 1.57 to 3.28) and low family income (OR 2.62; 95% CI 1.8 to 3.74) were more often myopic. Lifestyle factors explained the majority of the increased risk for ethnicity (82%; 95% CI 55 to 120), maternal education (69%; 95% CI 45 to 109) and family socioeconomic status (71%; 95% CI 46 to 104).ConclusionThis study found environmental factors to be strong risk factors for myopia already at the age of 6 years. The myopia prevalence differences in socioeconomic groups were greatly determined by differences in distribution of these environmental risk factors, highlighting the importance of lifestyle adjustments in young children developing myopia.
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ISSN:0007-1161
1468-2079
1468-2079
DOI:10.1136/bjophthalmol-2017-310292