Original articleEnvironmental Risk Factors Can Reduce Axial Length Elongation and Myopia Incidence in 6- to 9-Year-Old Children
Section snippets
Methods
This study was embedded in the Generation R Study, a population-based prospective cohort study of pregnant women and their children in Rotterdam, The Netherlands. The complete methodology has been described elsewhere.23, 24 Briefly, 9778 pregnant women were included in the study, and children were born between April 2002 and January 2006. The children were invited at 6 and 9 years of age for examination at the research center. Of the initial cohort, 6690 children (68.4%) participated in the
General Characteristics
A total of 4734 children, 50.7% girls, underwent ocular biometry measurements at both 6.0±0.5 years of age and 9.8±0.3 years of age (Fig 1). Despite a difference in eye size, the increase in AL was not different between boys and girls (P = 0.95) and averaged 0.21 mm/year (SD, 0.09 mm/year). Children with myopia at the last visit demonstrated significantly greater axial elongation compared with nonmyopic participants (0.34 mm/year vs. 0.19 mm/year; P < 0.001).
Cycloplegic measurements of
Discussion
In this study, we identified ocular as well as environmental risk factors for axial eye growth. By combining these risk factors, we calculated a prediction score for myopia onset between 6 and 9 years of age and found a predictive value of 0.78. Axial length elongation had the highest predictive value for onset of myopia with an AUC of 0.85. Environmental factors were associated significantly with both increase in AL and incident myopia and had the greatest effect in children with the highest
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Supplemental material available at www.aaojournal.org.
Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
The Generation R Study is supported by the Erasmus Medical Centre, Rotterdam, Erasmus University, Rotterdam, The Netherlands; the Netherlands Organisation of Scientific Research (NWO); Netherlands Organization for the Health Research and Development (ZonMw); the Ministry of Education, Culture and Science; the Ministry for Health, Welfare and Sports; the European Commission (DG XII); European Research Council (ERC) under the European Union’s Horizon 2020 Research and Innovation Programme (grant 648268); the Netherlands Organisation for Scientific Research (NWO, grant 91815655); Uitzicht (grant 2013-24; Algemene Nederlandse Vereniging ter Voorkoming van Blindheid, Novartis Fund, Oogfonds, ODAS; Landelijke Stichting voor Blinden en Slechtzienden; MaculaFonds). The researchers are independent from the funders. The sponsor or funding organization had no role in the design or conduct of this research.
HUMAN SUBJECTS: Human subjects were included in this study. The human ethics committees at Erasmus Medical Centre approved the study. All research adhered to the tenets of the Declaration of Helsinki. All participants provided informed consent.
No animal subjects were included in this study.
Author Contributions:
Conception and design: Tideman, Polling, Jaddoe, Klaver
Analysis and interpretation: Tideman, Klaver
Data collection: Tideman, Polling, Klaver
Obtained funding: Klaver
Overall responsibility: Tideman, Polling, Jaddoe, Vingerling, Klaver