Skip to main content
Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology 3/2021

17.08.2020 | Retinal Disorders

Rural-urban differences in myopia prevalence among myopes presenting to Bhutanese retinal clinical services: a 3-year national study

verfasst von: Bhim Bahadur Rai, Regan S. Ashby, Amanda N. French, Ted Maddess

Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology | Ausgabe 3/2021

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To determine the prevalence and demographic characteristics of myopia among patients presenting to the national vitreo-retinal (VR) services in Bhutan.

Methods

The records of the VR clinic at the apex national referral centre, providing the only VR services in the country, were reviewed to identify all new myopia patients over three years. Thus, we surveyed all referrals nationally. The patients were categorised into urban and rural females and males. We assessed myopia prevalence in each group by occupational and educational categories. We examined univariate prevalence data and a multivariate logistic regression (MLR) identified independent factors.

Results

Of 2913 cases 1544 (53.0%) were males. Females presented earlier (mean ±SD): overall 45.7 ± 21.9 cf. 48.6 ± 21.6 years, p = 0.003, and among myopes 23.9 ± 13.5 cf. 27.6 ± 18.6 years, p = 0.032. Myopia constituted 92.1% of refractive error, an overall prevalence of 12.3%. Myopia was more common among females (p = 0.01) and urbanites (p = 0.02). Myopia prevalence was highest among urban females (20.9%), followed by urban males (11.9%), rural females (6.8%), and rural males (5.2%). Logistic regression revealed that the odds of having myopia were increased by being a student (4.96 ×) or professional (1.96 ×), and decreased by rural living (1.75 ×), all p ≤ 0.038.

Conclusions

This is the first study on myopia in Bhutan. As observed throughout East and Southeast Asia, the prevalence of myopia was higher in females and urbanites and positively associated with formal education. Given known risk factors, these prevalences may be driven by educational pressures and reduced time spent outdoors.
Literatur
1.
Zurück zum Zitat Pascolini D, Mariotti SP (2012) Global estimates of visual impairment: 2010. Br J Ophthalmol 96(5):614–618CrossRef Pascolini D, Mariotti SP (2012) Global estimates of visual impairment: 2010. Br J Ophthalmol 96(5):614–618CrossRef
2.
Zurück zum Zitat Althomali TA (2018) Relative proportion of different types of refractive errors in subjects seeking laser vision correction. Open Ophthalmol J 12:53–62CrossRef Althomali TA (2018) Relative proportion of different types of refractive errors in subjects seeking laser vision correction. Open Ophthalmol J 12:53–62CrossRef
3.
Zurück zum Zitat Holden BA, Fricke TR, Wilson DA, Jong M, Naidoo KS, Sankaridurg P, Wong TY, Naduvilath TJ, Resnikoff S (2016) Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology 123(5):1036–1042CrossRef Holden BA, Fricke TR, Wilson DA, Jong M, Naidoo KS, Sankaridurg P, Wong TY, Naduvilath TJ, Resnikoff S (2016) Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050. Ophthalmology 123(5):1036–1042CrossRef
4.
Zurück zum Zitat Tano Y (2002) Pathologic myopia: where are we now? Am J Ophthalmol 134(5):645–660CrossRef Tano Y (2002) Pathologic myopia: where are we now? Am J Ophthalmol 134(5):645–660CrossRef
5.
Zurück zum Zitat Fricke TR, Holden BA, Wilson DA, Schlenther G, Naidoo KS, Resnikoff S, Frick KD (2012) Global cost of correcting vision impairment from uncorrected refractive error. Bull World Health Organ 90(10):728–738CrossRef Fricke TR, Holden BA, Wilson DA, Schlenther G, Naidoo KS, Resnikoff S, Frick KD (2012) Global cost of correcting vision impairment from uncorrected refractive error. Bull World Health Organ 90(10):728–738CrossRef
6.
Zurück zum Zitat Coppé AM, Ripandelli G, Parisi V, Varano M, Stirpe M (2005) Prevalence of asymptomatic macular holes in highly myopic eyes. Ophthalmology 112(12):2103–2109CrossRef Coppé AM, Ripandelli G, Parisi V, Varano M, Stirpe M (2005) Prevalence of asymptomatic macular holes in highly myopic eyes. Ophthalmology 112(12):2103–2109CrossRef
7.
Zurück zum Zitat Foster PJ, Jiang Y (2014) Epidemiology of myopia. Eye (Lond) 28(2):202–208CrossRef Foster PJ, Jiang Y (2014) Epidemiology of myopia. Eye (Lond) 28(2):202–208CrossRef
8.
Zurück zum Zitat Smith TS, Frick KD, Holden BA, Fricke TR, Naidoo KS (2009) Potential lost productivity resulting from the global burden of uncorrected refractive error. Bull World Health Organ 87(6):431–437CrossRef Smith TS, Frick KD, Holden BA, Fricke TR, Naidoo KS (2009) Potential lost productivity resulting from the global burden of uncorrected refractive error. Bull World Health Organ 87(6):431–437CrossRef
9.
Zurück zum Zitat Morgan IG, French AN, Ashby RS, Guo X, Ding X, He M, Rose KA (2018) The epidemics of myopia: Aetiology and prevention. Prog Retin Eye Res 62:134–149CrossRef Morgan IG, French AN, Ashby RS, Guo X, Ding X, He M, Rose KA (2018) The epidemics of myopia: Aetiology and prevention. Prog Retin Eye Res 62:134–149CrossRef
10.
Zurück zum Zitat Tedja MS, AEG H, Meester-Smoor MA, Kaprio J, Mackey DA, Guggenheim JA, Hammond CJ, Verhoeven VJM, Klaver CCW, Consortium C (2019) IMI - Myopia genetics report. Invest Ophthalmol Vis Sci 60(3):M89–M105CrossRef Tedja MS, AEG H, Meester-Smoor MA, Kaprio J, Mackey DA, Guggenheim JA, Hammond CJ, Verhoeven VJM, Klaver CCW, Consortium C (2019) IMI - Myopia genetics report. Invest Ophthalmol Vis Sci 60(3):M89–M105CrossRef
11.
Zurück zum Zitat Dirani M, Shekar SN, Baird PN (2008) The role of educational attainment in refraction: the Genes in Myopia (GEM) twin study. Invest Ophthalmol Vis Sci 49(2):534–538CrossRef Dirani M, Shekar SN, Baird PN (2008) The role of educational attainment in refraction: the Genes in Myopia (GEM) twin study. Invest Ophthalmol Vis Sci 49(2):534–538CrossRef
12.
Zurück zum Zitat Verhoeven VJ, Buitendijk GH, Rivadeneira F, Uitterlinden AG, Vingerling JR, Hofman A, Klaver CC (2013) Education influences the role of genetics in myopia. Eur J Epidemiol 28(12):973–980CrossRef Verhoeven VJ, Buitendijk GH, Rivadeneira F, Uitterlinden AG, Vingerling JR, Hofman A, Klaver CC (2013) Education influences the role of genetics in myopia. Eur J Epidemiol 28(12):973–980CrossRef
13.
Zurück zum Zitat Czepita DA, Zejmo M (2011) Environmental factors and myopia. Ann Acad Med Stetin 57(3):88–92 discussion 92PubMed Czepita DA, Zejmo M (2011) Environmental factors and myopia. Ann Acad Med Stetin 57(3):88–92 discussion 92PubMed
14.
Zurück zum Zitat French AN, Ashby RS, Morgan IG, Rose KA (2013) Time outdoors and the prevention of myopia. Exp Eye Res 114:58–68CrossRef French AN, Ashby RS, Morgan IG, Rose KA (2013) Time outdoors and the prevention of myopia. Exp Eye Res 114:58–68CrossRef
15.
Zurück zum Zitat Rose KA, Morgan IG, Ip J, Kifley A, Huynh S, Smith W, Mitchell P (2008) Outdoor activity reduces the prevalence of myopia in children. Ophthalmology 115(8):1279–1285CrossRef Rose KA, Morgan IG, Ip J, Kifley A, Huynh S, Smith W, Mitchell P (2008) Outdoor activity reduces the prevalence of myopia in children. Ophthalmology 115(8):1279–1285CrossRef
16.
Zurück zum Zitat Feldkaemper M, Schaeffel F (2013) An updated view on the role of dopamine in myopia. Exp Eye Res 114:106–119CrossRef Feldkaemper M, Schaeffel F (2013) An updated view on the role of dopamine in myopia. Exp Eye Res 114:106–119CrossRef
17.
Zurück zum Zitat Ashby R (2016) Animal studies and the mechanism of myopia-protection by light? Optom Vis Sci 93(9):1052–1054CrossRef Ashby R (2016) Animal studies and the mechanism of myopia-protection by light? Optom Vis Sci 93(9):1052–1054CrossRef
18.
Zurück zum Zitat Pan CW, Ramamurthy D, Saw SM (2012) Worldwide prevalence and risk factors for myopia. Ophthalmic Physiol Opt 32(1):3–16CrossRef Pan CW, Ramamurthy D, Saw SM (2012) Worldwide prevalence and risk factors for myopia. Ophthalmic Physiol Opt 32(1):3–16CrossRef
19.
Zurück zum Zitat Rai BB, Morley MG, Bernstein PS, Maddess T (2020) Pattern of vitreo-retinal diseases at the national referral hospital in Bhutan: a retrospective, hospital-based study. BMC Ophthalmol 20(1):51CrossRef Rai BB, Morley MG, Bernstein PS, Maddess T (2020) Pattern of vitreo-retinal diseases at the national referral hospital in Bhutan: a retrospective, hospital-based study. BMC Ophthalmol 20(1):51CrossRef
22.
Zurück zum Zitat Rai BB, Shresthra MK, Thapa R, Essex RW, Paudyal G, Maddess T (2019) Pattern and presentation of vitreo-retinal diseases: an analysis of retrospective data at a tertiary eye care center in Nepal. Asia-Pacific J Ophthalmol 8(6):481–488CrossRef Rai BB, Shresthra MK, Thapa R, Essex RW, Paudyal G, Maddess T (2019) Pattern and presentation of vitreo-retinal diseases: an analysis of retrospective data at a tertiary eye care center in Nepal. Asia-Pacific J Ophthalmol 8(6):481–488CrossRef
24.
Zurück zum Zitat He M, Zheng Y, Xiang F (2009) Prevalence of myopia in urban and rural children in mainland China. Optom Vis Sci 86(1):40–44CrossRef He M, Zheng Y, Xiang F (2009) Prevalence of myopia in urban and rural children in mainland China. Optom Vis Sci 86(1):40–44CrossRef
25.
Zurück zum Zitat Pan C-W, Wu R-K, Li J, Zhong H (2018) Low prevalence of myopia among school children in rural China. BMC Ophthalmol 18(1):140–140CrossRef Pan C-W, Wu R-K, Li J, Zhong H (2018) Low prevalence of myopia among school children in rural China. BMC Ophthalmol 18(1):140–140CrossRef
27.
Zurück zum Zitat Morgan IG, Iribarren R, Fotouhi A, Grzybowski A (2015) Cycloplegic refraction is the gold standard for epidemiological studies. Acta Ophthalmol 93(6):581–585CrossRef Morgan IG, Iribarren R, Fotouhi A, Grzybowski A (2015) Cycloplegic refraction is the gold standard for epidemiological studies. Acta Ophthalmol 93(6):581–585CrossRef
28.
Zurück zum Zitat Hashemi H, Khabazkhoob M, Asharlous A, Soroush S, Yekta A, Dadbin N, Fotouhi A (2016) Cycloplegic autorefraction versus subjective refraction: the Tehran Eye Study. Br J Ophthalmol 100(8):1122–1127CrossRef Hashemi H, Khabazkhoob M, Asharlous A, Soroush S, Yekta A, Dadbin N, Fotouhi A (2016) Cycloplegic autorefraction versus subjective refraction: the Tehran Eye Study. Br J Ophthalmol 100(8):1122–1127CrossRef
29.
Zurück zum Zitat Wu P-C, Huang H-M, Yu H-J, Fang P-C, Chen C-T (2016) Epidemiology of myopia. Asia-Pacific J Ophthalmol 5(6):386–393CrossRef Wu P-C, Huang H-M, Yu H-J, Fang P-C, Chen C-T (2016) Epidemiology of myopia. Asia-Pacific J Ophthalmol 5(6):386–393CrossRef
30.
Zurück zum Zitat Saw SMKJ, Schein OD, Chew SJ, Chan TK (1996) Epidemiology of Myopia. Epidemiol Rev 18(2):175–187CrossRef Saw SMKJ, Schein OD, Chew SJ, Chan TK (1996) Epidemiology of Myopia. Epidemiol Rev 18(2):175–187CrossRef
31.
Zurück zum Zitat Adhikari S, Nepal BP, Shrestha JK, Khandekar R (2013) Magnitude and determinants of refractive error among school children of two districts of Kathmandu, Nepal. Oman J Ophthalmol 6(3):175–178CrossRef Adhikari S, Nepal BP, Shrestha JK, Khandekar R (2013) Magnitude and determinants of refractive error among school children of two districts of Kathmandu, Nepal. Oman J Ophthalmol 6(3):175–178CrossRef
32.
Zurück zum Zitat Jung SK, Lee JH, Kakizaki H, Jee D (2012) Prevalence of myopia and its association with body stature and educational level in 19-year-old male conscripts in seoul, South Korea. Invest Ophthalmol Vis Sci 53(9):5579–5583CrossRef Jung SK, Lee JH, Kakizaki H, Jee D (2012) Prevalence of myopia and its association with body stature and educational level in 19-year-old male conscripts in seoul, South Korea. Invest Ophthalmol Vis Sci 53(9):5579–5583CrossRef
33.
Zurück zum Zitat Garner LF, Owens H, Kinnear RF, Frith MJ (1999) Prevalence of myopia in Sherpa and Tibetan children in Nepal. Optom Vis Sci 76(5):282–285CrossRef Garner LF, Owens H, Kinnear RF, Frith MJ (1999) Prevalence of myopia in Sherpa and Tibetan children in Nepal. Optom Vis Sci 76(5):282–285CrossRef
34.
Zurück zum Zitat JICA (2017) Survey of Country Gender Profile (Kingdom of Bhutan). Japan International Cooperation Agency. Accessed 8/4/2020 2020 JICA (2017) Survey of Country Gender Profile (Kingdom of Bhutan). Japan International Cooperation Agency. Accessed 8/4/2020 2020
36.
Zurück zum Zitat Morgan IG, Ohno-Matsui K, Saw SM (2012) Myopia. Lancet 379(9827):1739–1748CrossRef Morgan IG, Ohno-Matsui K, Saw SM (2012) Myopia. Lancet 379(9827):1739–1748CrossRef
38.
Zurück zum Zitat Wilkinson CP (2014) Interventions for asymptomatic retinal breaks and lattice degeneration for preventing retinal detachment. Cochrane Database Syst Rev 9:CD003170 Wilkinson CP (2014) Interventions for asymptomatic retinal breaks and lattice degeneration for preventing retinal detachment. Cochrane Database Syst Rev 9:CD003170
39.
Zurück zum Zitat Byer NE (1989) Long-term natural history of lattice degeneration of the retina. Ophthalmology 96(9):1396–1401 discussion 1401-1392CrossRef Byer NE (1989) Long-term natural history of lattice degeneration of the retina. Ophthalmology 96(9):1396–1401 discussion 1401-1392CrossRef
40.
Zurück zum Zitat Folk JC, Arrindell EL, Klugman MR (1989) The fellow eye of patients with phakic lattice retinal detachment. Ophthalmology 96(1):72–79CrossRef Folk JC, Arrindell EL, Klugman MR (1989) The fellow eye of patients with phakic lattice retinal detachment. Ophthalmology 96(1):72–79CrossRef
41.
Zurück zum Zitat Wilkinson CP, Rice TA (1997) Retinal Detachment, vol Year Book. Mosby, St Louis Wilkinson CP, Rice TA (1997) Retinal Detachment, vol Year Book. Mosby, St Louis
42.
Zurück zum Zitat Avila MP, Weiter JJ, Jalkh AE, Trempe CL, Pruett RC, Schepens CL (1984) Natural history of choroidal neovascularization in degenerative myopia. Ophthalmology 91(12):1573–1581CrossRef Avila MP, Weiter JJ, Jalkh AE, Trempe CL, Pruett RC, Schepens CL (1984) Natural history of choroidal neovascularization in degenerative myopia. Ophthalmology 91(12):1573–1581CrossRef
43.
Zurück zum Zitat El Matri L, Chebil A, Kort F (2015) Current and emerging treatment options for myopic choroidal neovascularization. Clin Ophthalmol 9:733–744CrossRef El Matri L, Chebil A, Kort F (2015) Current and emerging treatment options for myopic choroidal neovascularization. Clin Ophthalmol 9:733–744CrossRef
44.
Zurück zum Zitat Leveziel N, Yu Y, Reynolds R, Tai A, Meng W, Caillaux V, Calvas P, Rosner B, Malecaze F, Souied EH, Seddon JM (2012) Genetic factors for choroidal neovascularization associated with high myopia. Invest Ophthalmol Vis Sci 53(8):5004–5009CrossRef Leveziel N, Yu Y, Reynolds R, Tai A, Meng W, Caillaux V, Calvas P, Rosner B, Malecaze F, Souied EH, Seddon JM (2012) Genetic factors for choroidal neovascularization associated with high myopia. Invest Ophthalmol Vis Sci 53(8):5004–5009CrossRef
45.
Zurück zum Zitat Ikuno Y, Jo Y, Hamasaki T, Tano Y (2010) Ocular risk factors for choroidal neovascularization in pathologic myopia. Invest Ophthalmol Vis Sci 51(7):3721–3725CrossRef Ikuno Y, Jo Y, Hamasaki T, Tano Y (2010) Ocular risk factors for choroidal neovascularization in pathologic myopia. Invest Ophthalmol Vis Sci 51(7):3721–3725CrossRef
46.
Zurück zum Zitat Wong TY, Ohno-Matsui K, Leveziel N, Holz FG, Lai TY, Yu HG, Lanzetta P, Chen Y, Tufail A (2015) Myopic choroidal neovascularisation: current concepts and update on clinical management. Br J Ophthalmol 99(3):289–296CrossRef Wong TY, Ohno-Matsui K, Leveziel N, Holz FG, Lai TY, Yu HG, Lanzetta P, Chen Y, Tufail A (2015) Myopic choroidal neovascularisation: current concepts and update on clinical management. Br J Ophthalmol 99(3):289–296CrossRef
47.
Zurück zum Zitat Lee JY, Kim JY, Lee SY, Jeong JH, Lee EK (2020) Foveal microvascular structures in eyes with silicone oil tamponade for rhegmatogenous retinal detachment: a swept-source optical coherence tomography angiography study. Sci Rep 10(1):2555CrossRef Lee JY, Kim JY, Lee SY, Jeong JH, Lee EK (2020) Foveal microvascular structures in eyes with silicone oil tamponade for rhegmatogenous retinal detachment: a swept-source optical coherence tomography angiography study. Sci Rep 10(1):2555CrossRef
Metadaten
Titel
Rural-urban differences in myopia prevalence among myopes presenting to Bhutanese retinal clinical services: a 3-year national study
verfasst von
Bhim Bahadur Rai
Regan S. Ashby
Amanda N. French
Ted Maddess
Publikationsdatum
17.08.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
Graefe's Archive for Clinical and Experimental Ophthalmology / Ausgabe 3/2021
Print ISSN: 0721-832X
Elektronische ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-020-04891-6

Weitere Artikel der Ausgabe 3/2021

Graefe's Archive for Clinical and Experimental Ophthalmology 3/2021 Zur Ausgabe

Neu im Fachgebiet Augenheilkunde

Update Augenheilkunde

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.