Please use this identifier to cite or link to this item: http://scholarbank.nus.edu.sg/handle/10635/23756
Title: Risk Factors for Early - onset Myopia in Singapore Chinese Preschool Children
Authors: LOW CONG JIN, WILSON
Keywords: Myopia, refraction, axial length, near work, outdoor, family history
Issue Date: 11-Jan-2011
Source: LOW CONG JIN, WILSON (2011-01-11). Risk Factors for Early - onset Myopia in Singapore Chinese Preschool Children. ScholarBank@NUS Repository.
Abstract: Background: Both genes and environments are known to play important roles in the onset and development of myopia. Family history of myopia is a major risk factor for myopia and ocular biometry and represents a surrogate for genetic or shared environmental factors. However, current evidence also suggests that environmental factors such as near work and outdoor activity are implicated in the development of myopia and longer axial length (AL). Height and birth weight are potential risk factors for myopia and ocular biometry. Objectives: The primary aim is to investigate the risks factors for myopia and ocular biometry in Singapore Chinese preschool children aged 6 to 72 months. The secondary aims include assessment of the association of family history of myopia, near work, outdoor activity, stature, birth parameters, and parental smoking with myopia and ocular biometry. Methodology: A population-based cross-sectional study, with disproportionate random sampling by 6-month age groups, was conducted to determine the prevalence of and risk factors for myopia in a representative sample of 3009 Singaporean Chinese preschool children aged 6 to 72 months living in the South-Western and Western part of Singapore. Spherical equivalent refraction (SER) was measured using cycloplegic autorefraction or streak retinoscopy. AL was obtained monocularly using non-contact partial coherence interferometry (IOL Master). Height and weight were assessed by standard protocols. Information on family history of myopia, near work and outdoor activities, birth parameters and parental smoking were determined by comprehensive questionnaires. Results: Children with two myopic parents were more likely to be myopic (adjusted odds ratio (OR) = 1.91; 95% confidence interval (CI) = 1.38 - 2.63), and were found to have a 0.35 diopters (D) (95% CI = -0.47 - -0.22) more myopic SER and a 0.16 mm (95% CI = 0.08 - 0.24) longer AL than children without myopic parents. For each 1 cm increase in height, the SER was more myopic by 0.01 D and AL longer by 0.02 mm. Neither near work nor outdoor activity was associated with myopia. The proportion of children with myopia was significantly less than among those whose mothers ever smoked compared to those whose mothers never smoked (7.6% vs. 11.8%, p = 0.047). Birth weight was associated with longer AL (regression coefficient = 0.26; 95% CI = 0.18 - 0.33). Conclusion: Our study found an association of family history of myopia with prevalence of myopia, more myopic refraction and longer AL in Singaporean Chinese preschool children aged 6 to 72 months. Height was associated with more myopic SER and longer AL. Birth parameters were associated with longer AL. Maternal smoking appeared to reduce the risk of myopia in this very young group of children. Key lifestyle factors such as near work and outdoor activity were not significantly associated with myopia in this study which might be due to the lesser amount of nearwork or outdoor activity performed. This contradicts the association between myopia and near work or outdoor activity found in older children reported by previous studies in which the findings suggest that the cumulative effects of near work and outdoor activity may only influence the development of myopia in older children aged more than 6 years during the school years. In summary, genetic factors may play a more substantial role in the development of early-onset myopia as compared to environmental factors.
URI: http://scholarbank.nus.edu.sg/handle/10635/23756
Appears in Collections:Master's Theses (Open)

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