The Associations between Near Visual Activity and Incident Myopia in Children: A Nationwide 4-Year Follow-up Study

Po-Wen Ku, Andrew Steptoe, Yun Ju Lai, Hsiao Yun Hu, Dachen Chu, Yung Feng Yen, Yung Liao, Li Jung Chen

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective: This nationwide population-based study aimed to examine the prospective association between near visual activities and incident myopia in Taiwanese children 7 to 12 years old over a 4-year follow-up period. Design: Prospective cohort design. Participants: There were 1958 children aged 7 to 12 years from the Taiwan 2009 National Health Interview Survey who were linked to the 2009 through 2013 claims data from the National Health Insurance system. Methods: Multivariable Cox proportional hazard models were used to estimate the associations between 3 types of near visual activities in sedentary posture, namely reading (< 0.5, 0.5-0.9, ≥1.0 hours per day [h/d]), use of computer, Internet, and games (<0.5, 0.5-0.9, ≥1.0 h/d), and “cram school” attendance (<0.5, 0.5-1.9, ≥2.0 h/d), and incident myopia. Main Outcome Measures: Prevalent myopia was defined as those who had ≥2 ambulatory care claims (International Classification of Diseases code 367.1) in 2008-2009. Incident myopia was defined by those who had at least 2 ambulatory care claims (International Classification of Diseases code 367.1) during the 4-year follow-up period (2010-2013) after excluding prevalent cases. Results: Overall, 26.8% of children had myopia at baseline, and 27.7% of those without myopia at baseline developed incident myopia between 2010 and 2013. On average, they spent 0.68±0.86 h/d on computer/Internet use, 0.63±0.67 h/d on reading, and 2.78±3.53 h/d on cram school. The results showed that children attending cram schools ≥2 h/d (hazard ratio, 1.31; 95% confidence interval, 1.03-1.68) had a higher risk of incident myopia. The effects of these activities remained similar in sensitivity analyses. Conclusions: Cram school attendance for ≥2 h/d may increase the risk of children's incident myopia. This effect may be due to increased near visual activity or reduced time outdoors.

Original languageEnglish
Pages (from-to)214-220
Number of pages7
JournalOphthalmology
Volume126
Issue number2
DOIs
Publication statusPublished - 2019 Feb 1

Fingerprint

Myopia
International Classification of Diseases
Ambulatory Care
Internet
Reading
Video Games
National Health Programs
Health Surveys
Posture
Taiwan
Proportional Hazards Models
Outcome Assessment (Health Care)
Confidence Intervals
Interviews

All Science Journal Classification (ASJC) codes

  • Ophthalmology

Cite this

Ku, Po-Wen ; Steptoe, Andrew ; Lai, Yun Ju ; Hu, Hsiao Yun ; Chu, Dachen ; Yen, Yung Feng ; Liao, Yung ; Chen, Li Jung. / The Associations between Near Visual Activity and Incident Myopia in Children : A Nationwide 4-Year Follow-up Study. In: Ophthalmology. 2019 ; Vol. 126, No. 2. pp. 214-220.
@article{cf8e9ef468e2487f9badbc783b722a98,
title = "The Associations between Near Visual Activity and Incident Myopia in Children: A Nationwide 4-Year Follow-up Study",
abstract = "Objective: This nationwide population-based study aimed to examine the prospective association between near visual activities and incident myopia in Taiwanese children 7 to 12 years old over a 4-year follow-up period. Design: Prospective cohort design. Participants: There were 1958 children aged 7 to 12 years from the Taiwan 2009 National Health Interview Survey who were linked to the 2009 through 2013 claims data from the National Health Insurance system. Methods: Multivariable Cox proportional hazard models were used to estimate the associations between 3 types of near visual activities in sedentary posture, namely reading (< 0.5, 0.5-0.9, ≥1.0 hours per day [h/d]), use of computer, Internet, and games (<0.5, 0.5-0.9, ≥1.0 h/d), and “cram school” attendance (<0.5, 0.5-1.9, ≥2.0 h/d), and incident myopia. Main Outcome Measures: Prevalent myopia was defined as those who had ≥2 ambulatory care claims (International Classification of Diseases code 367.1) in 2008-2009. Incident myopia was defined by those who had at least 2 ambulatory care claims (International Classification of Diseases code 367.1) during the 4-year follow-up period (2010-2013) after excluding prevalent cases. Results: Overall, 26.8{\%} of children had myopia at baseline, and 27.7{\%} of those without myopia at baseline developed incident myopia between 2010 and 2013. On average, they spent 0.68±0.86 h/d on computer/Internet use, 0.63±0.67 h/d on reading, and 2.78±3.53 h/d on cram school. The results showed that children attending cram schools ≥2 h/d (hazard ratio, 1.31; 95{\%} confidence interval, 1.03-1.68) had a higher risk of incident myopia. The effects of these activities remained similar in sensitivity analyses. Conclusions: Cram school attendance for ≥2 h/d may increase the risk of children's incident myopia. This effect may be due to increased near visual activity or reduced time outdoors.",
author = "Po-Wen Ku and Andrew Steptoe and Lai, {Yun Ju} and Hu, {Hsiao Yun} and Dachen Chu and Yen, {Yung Feng} and Yung Liao and Chen, {Li Jung}",
year = "2019",
month = "2",
day = "1",
doi = "10.1016/j.ophtha.2018.05.010",
language = "English",
volume = "126",
pages = "214--220",
journal = "Ophthalmology",
issn = "0161-6420",
publisher = "Elsevier Inc.",
number = "2",

}

The Associations between Near Visual Activity and Incident Myopia in Children : A Nationwide 4-Year Follow-up Study. / Ku, Po-Wen; Steptoe, Andrew; Lai, Yun Ju; Hu, Hsiao Yun; Chu, Dachen; Yen, Yung Feng; Liao, Yung; Chen, Li Jung.

In: Ophthalmology, Vol. 126, No. 2, 01.02.2019, p. 214-220.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The Associations between Near Visual Activity and Incident Myopia in Children

T2 - A Nationwide 4-Year Follow-up Study

AU - Ku, Po-Wen

AU - Steptoe, Andrew

AU - Lai, Yun Ju

AU - Hu, Hsiao Yun

AU - Chu, Dachen

AU - Yen, Yung Feng

AU - Liao, Yung

AU - Chen, Li Jung

PY - 2019/2/1

Y1 - 2019/2/1

N2 - Objective: This nationwide population-based study aimed to examine the prospective association between near visual activities and incident myopia in Taiwanese children 7 to 12 years old over a 4-year follow-up period. Design: Prospective cohort design. Participants: There were 1958 children aged 7 to 12 years from the Taiwan 2009 National Health Interview Survey who were linked to the 2009 through 2013 claims data from the National Health Insurance system. Methods: Multivariable Cox proportional hazard models were used to estimate the associations between 3 types of near visual activities in sedentary posture, namely reading (< 0.5, 0.5-0.9, ≥1.0 hours per day [h/d]), use of computer, Internet, and games (<0.5, 0.5-0.9, ≥1.0 h/d), and “cram school” attendance (<0.5, 0.5-1.9, ≥2.0 h/d), and incident myopia. Main Outcome Measures: Prevalent myopia was defined as those who had ≥2 ambulatory care claims (International Classification of Diseases code 367.1) in 2008-2009. Incident myopia was defined by those who had at least 2 ambulatory care claims (International Classification of Diseases code 367.1) during the 4-year follow-up period (2010-2013) after excluding prevalent cases. Results: Overall, 26.8% of children had myopia at baseline, and 27.7% of those without myopia at baseline developed incident myopia between 2010 and 2013. On average, they spent 0.68±0.86 h/d on computer/Internet use, 0.63±0.67 h/d on reading, and 2.78±3.53 h/d on cram school. The results showed that children attending cram schools ≥2 h/d (hazard ratio, 1.31; 95% confidence interval, 1.03-1.68) had a higher risk of incident myopia. The effects of these activities remained similar in sensitivity analyses. Conclusions: Cram school attendance for ≥2 h/d may increase the risk of children's incident myopia. This effect may be due to increased near visual activity or reduced time outdoors.

AB - Objective: This nationwide population-based study aimed to examine the prospective association between near visual activities and incident myopia in Taiwanese children 7 to 12 years old over a 4-year follow-up period. Design: Prospective cohort design. Participants: There were 1958 children aged 7 to 12 years from the Taiwan 2009 National Health Interview Survey who were linked to the 2009 through 2013 claims data from the National Health Insurance system. Methods: Multivariable Cox proportional hazard models were used to estimate the associations between 3 types of near visual activities in sedentary posture, namely reading (< 0.5, 0.5-0.9, ≥1.0 hours per day [h/d]), use of computer, Internet, and games (<0.5, 0.5-0.9, ≥1.0 h/d), and “cram school” attendance (<0.5, 0.5-1.9, ≥2.0 h/d), and incident myopia. Main Outcome Measures: Prevalent myopia was defined as those who had ≥2 ambulatory care claims (International Classification of Diseases code 367.1) in 2008-2009. Incident myopia was defined by those who had at least 2 ambulatory care claims (International Classification of Diseases code 367.1) during the 4-year follow-up period (2010-2013) after excluding prevalent cases. Results: Overall, 26.8% of children had myopia at baseline, and 27.7% of those without myopia at baseline developed incident myopia between 2010 and 2013. On average, they spent 0.68±0.86 h/d on computer/Internet use, 0.63±0.67 h/d on reading, and 2.78±3.53 h/d on cram school. The results showed that children attending cram schools ≥2 h/d (hazard ratio, 1.31; 95% confidence interval, 1.03-1.68) had a higher risk of incident myopia. The effects of these activities remained similar in sensitivity analyses. Conclusions: Cram school attendance for ≥2 h/d may increase the risk of children's incident myopia. This effect may be due to increased near visual activity or reduced time outdoors.

UR - http://www.scopus.com/inward/record.url?scp=85048732683&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85048732683&partnerID=8YFLogxK

U2 - 10.1016/j.ophtha.2018.05.010

DO - 10.1016/j.ophtha.2018.05.010

M3 - Article

C2 - 29934268

AN - SCOPUS:85048732683

VL - 126

SP - 214

EP - 220

JO - Ophthalmology

JF - Ophthalmology

SN - 0161-6420

IS - 2

ER -