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- Association of sleep traits with myopia in children and adolescents: a meta-analysis and Mendelian randomization studyPublication . Dong, Xing-Xuan; Xie, Jia-Yu; Li, Dan-Lin; Dong, Yi; Zhang, Xiao-Feng; Lança, Carla; Grzybowski, Andrzej; Pan, Chen-WeiPurpose: The association between sleep and myopia in children and adolescents has been reported, yet it remains controversial and inconclusive. This study aimed to investigate the influence of different sleep traits on the risk of myopia using meta-analytical and Mendelian randomization (MR) techniques. Methods: The literature search was performed on August 31, 2023, based on PubMed, Embase, Web of Science, and Cochrane Library. A meta-analysis of observational studies reporting the relationship between sleep and myopia was conducted. MR analyses were carried out to assess the causal impact of genetic pre-disposition for sleep traits on myopia. Results: The results of the meta-analysis indicated a significant association between the risk of myopia and both short sleep duration [odds ratio (OR) = 1.23, 95% confidence interval (CI) = 1.08-1.42, P = 0.003] and long sleep duration (OR = 0.75, 95% CI = 0.66-0.86, P < 0.001). MR analyses revealed no significant causal associations of genetically determined sleep traits with myopia, including chronotype, sleep duration, short sleep duration, and long sleep duration (all P > 0.05). Conclusions: No evidence was found to support a causal relationship between sleep traits and myopia. While sleep may not independently predict the risk of myopia, the potential impact of sleep on the occurrence and development of myopia cannot be disregarded.
- Anti-myopia spectacles: the standard of care in the future?Publication . Lança, Carla; Pan, Chen-Wei; Grzybowski, AndrzejReports of myopia increases across the world show an expanding growing public health problem. Myopia prevalence is exceptionally high in some continents, especially in Asia and particularly east Asian countries, but was also reported to have increased in other continents, such as North America and Europe, although there is considerable variation between geographic areas and racial groups in the myopia burden. The presence of myopia, especially high myopia, increases the risk of development of pathologic myopia and visual impairment. The peak incidence of myopia occurs in childhood, but the associated blinding ocular complications develop later during adulthood. Children with an increased risk of visual impairment due to pathologic myopia often have a longer duration of the disease, longer axial length (AL), and thinner choroid. Thus, myopia control therapies should be implemented early to avoid the development of high myopia, as the early age of myopia onset plays a fundamental role in myopia progression, with about 50% of children with myopia onset at 7 or 8 years of age developing high myopia in adulthood, if left untreated. Increased prevalence of high myopia related to AL elongation is likely to result in higher rates of myopic macular degeneration (MMD). At present, we do not know if treating myopic progression will avoid the development of MMD. However, it seems logical to slow AL elongation to prevent severe disease and complications associated with pathologic myopia. Consequently, controlling myopia progression has become one of the highest priorities for eye care professionals all over the world.
- Will the new anti-myopia spectacles be the standard of care in future?Publication . Lança, Carla; Pan, Chen-Wei; Grzybowski, AndrzejReports of myopia increases across the world show an expanding growing public health problem. Myopia prevalence is exceptionally high in some continents, especially in Asia, particularly East Asian countries, but was also reported to have increased in other continents, such as North America and Europe, although there is considerable variation between geographic areas and racial groups in the myopia burden. The presence of myopia, especially high myopia increases the risk of development of pathological myopia and visual impairment. The peak incidence of myopia occurs in childhood, but the associated blinding ocular complications develop later during adulthood. Children with an increased risk of visual impairment due to pathologic myopia often have a longer duration of the disease, longer axial length (AL), and thinner choroid. Thus, myopia control therapies should be implemented early to avoid the development of high myopia as early-age of myopia onset plays a fundamental role in myopia progression with about 50% of children with myopia onset at 7 or 8 years of age developing high myopia in adulthood, if left untreated. Increased prevalence of high myopia related to AL elongation is likely to result in higher rates of myopic macular degeneration (MMD). At present, we do not know if treating myopic progression will avoid the development of MMD. However, it seems logical to slow AL elongation to prevent severe disease and complications associated with pathologic myopia. Consequently, controlling myopia progression has become one of the highest priorities for eye care professionals all over the world.
- Association between ambient air pollution and dry eye symptoms among Chinese individuals during the COVID-19 pandemic: a national-based studyPublication . Kai, Jia-Yan; Wu, Yi-Bo; Dong, Xing-Xuan; Miao, Yi-Fan; Li, Dan-Lin; Hu, Dan-Ning; Lança, Carla; Grzybowski, Andrzej; Pan, Chen-WeiPurpose: To examine the association between ambient air pollution and dry eye symptoms (DES) during the COVID-19 pandemic and explore whether air pollution had increased the risk of DES to a greater extent than other risk factors. Methods: A nationwide cross-sectional survey was conducted from June 20, 2022 to August 31, 2022. The Ocular Surface Disease Index-6 (OSDI-6) questionnaire was used to assess the presence of DES. Logistic regression models were employed to analyze the associations between DES and air pollution variables, including air quality index (AQI), fine particulate matter (PM2.5), PM10, sulfur dioxide (SO2), carbon monoxide (CO), nitrogen dioxide (NO2), ozone (O3) and residing near industrial zones. We explored the interactions of air pollutants and other risk factors in the additive models by calculating the synergy index (SI). Standardized regression coefficients were calculated to compare the relative importance of risk factors for DES. Results: A total of 21,909 participants were included in the analysis. Residing near industrial zones was significantly correlated with a higher risk of DES (Odds ratio (OR): 1.57, 95 % confidence interval (CI): 1.38–1.79). No significant associations were found between DES and air pollutants except SO2 (OR: 1.05, 95 % CI: 1.02–1.09, per standard deviation increment in SO2 concentration). The restricted cubic spline analyses revealed a linear concentration-response relationship between SO2 and DES. The interaction analyses suggested synergetic interactions of SO2 with depression and problematic internet use. Among the risk factors, depression, anxiety, and problematic Internet use contributed more to the increased risk of DES. Conclusion: The association between ambient air pollutants and DES may have been mitigated during the pandemic due to increased time spent indoors. Despite this, our findings support the deleterious health impact of air pollutants. Future urban planning should plan industrial zones further away from residential areas.
- The impact of 25-hydroxyvitamin D and calcium on risk of age-related macular degeneration: a Mendelian randomization studyPublication . Dong, Xing-Xuan; Chen, Dong-Ling; Miao, Yi-Fan; Li, Dan-Lin; Kai, Jia-Yan; Hu, Dan-Ning; Zhang, Xiao-Feng; Lança, Carla; Andrzej, Grzybowski; Pan, Chen-WeiBackground: The relationships between 25-hydroxyvitamin D [25(OH)D] and calcium and age-related macular degeneration (AMD) are unclear. Objectives: This study aimed to investigate the causal role of 25(OH)D concentrations, calcium concentrations, and dietary supplements use of vitamin D and calcium on the risk of AMD and its subtypes. Methods: Independent genetic variants associated with 25(OH)D and calcium concentrations were used as instrumental variables in published genome-wide association studies (GWASs) of European ancestry. The bidirectional 2-sample Mendelian randomization (MR) analyses were performed using summary-level data from the UK Biobank and FinnGen datasets. Sensitivity analyses were conducted to ensure the robustness of the MR results. The meta-analyses were conducted using fixed and random-effect models to provide comprehensive and reliable estimates. Results: A standard deviation increase in calcium concentrations was linked to a 14%, 17%, and 13% reduction in the likelihood of developing AMD (95% confidence interval [CI]: 0.77, 0.97), wet AMD (95% CI: 0.73, 0.95), and dry AMD (95% CI: 0.75, 1.00), respectively. No significant causal relationships were detected between genetically predicted 25(OH)D concentrations and AMD and its subtypes (all P > 0.05). The combined analyses showed that higher calcium concentrations were associated with a reduced risk of overall AMD, with an odds ratio of 0.89 (95% CI: 0.81, 0.98). Conclusions: This study supports the causal relationship between calcium concentrations and the risk of AMD and its subtypes, which may have important implications for the prevention, monitoring, and treatment of AMD.
- Association between pets and dry eye symptoms: a Chinese national-based studyPublication . Kai, Jia-Yan; Wu, Yi-Bo; Chen, Hui-Min; Hu, Dan-Ning; Lança, Carla; Grzybowski, Andrzej; Zhang, Lijun; Zhang, Xiao-Feng; Pan, Chen-WeiBackground: Pet-derived allergens are another source of indoor air pollution that could affect human health. However, the association between pet ownership and the risk of dry eye symptoms (DES) remains to be elucidated. Methods: We conducted a nationwide cross-sectional survey among Chinese residents aged over 12 years from June 20, 2022, to August 31, 2022. The Ocular Surface Disease Index-6 (OSDI-6) questionnaire was utilized to evaluate the presence of DES. Multivariable logistic regression models were used to analyze the associations between pet ownership and DES. Subgroup analyses were conducted based on sex, age, residence and affective disorders, and sensitivity analysis by excluding participants with major ocular diseases. The interactions between pet ownership and other risk factors on DES were explored in the additive scale by calculating the synergy index (SI). Results: A total of 21,916 subjects replied to the questionnaire. The prevalence of DES was 43.6 % (95 % confidence interval (CI), 43.0 %-44.3 %). Pet ownership was significantly associated with increased risk of DES (Odds ratio (OR): 1.13, 95%CI: 1.05-1.21), especially among the elderly (OR: 1.28, 95%CI: 1.09-1.51) and urban residents (OR: 1.13, 95%CI: 1.04-1.24). The individual effect of allergic rhinitis on DES was 2.59 (95%CI: 1.27-5.53), while the joint effect of pets and allergic rhinitis was 5.26 (95%CI: 1.20-36.74), suggesting a synergistic interaction with a SI of 2.48 (95%CI: 0.25-24.39). Furthermore, the interaction analysis also indicated a synergistic interaction between pet ownership and low health literacy with a SI of 1.12 (95%CI: 0.66-1.87). Conclusion: Pet ownership was identified as a risk factor for DES. The synergistic interaction of pet ownership and allergic rhinitis suggests shared mechanisms between DES and allergic conditions.
- Lower indoor spatial frequency increases the risk of myopia in childrenPublication . Li, Dan-Lin; Dong, Xing-Xuan; Yang, Jin-Liu-Xing; Lança, Carla; Grzybowski, Andrzej; Pan, Chen-WeiBackground/aims: Animal models have shown that the absence of high-frequency visual information can precipitate the onset of myopia, but this relationship remains unclear in humans. This study aims to explore the association between the spatial frequency content of the visual environment and myopia in children. Methods: Images from the rooms of children and their frequently visited outdoor areas were taken by their parents and collected by the researcher through questionnaires. The spatial frequency was quantified using Matlab. Cycloplegic refraction was used to measure the spherical equivalent (SE), and IOL Master was used to measure axial length (AL) and corneal radius (CR). AL/CR ratio was calculated. Results: The study included 566 children with an average age of (8.04±1.47) years, of which 270 were girls (47.7%), and the average SE was (0.70±1.21) D. Image analysis revealed that indoor spatial frequency slope was lower than that of the outdoor environment (-1.43±0.18 vs -1.11±0.23, p<0.001). There were 79 myopic individuals (14.0%). Images from indoor content of myopic children had a lower spatial frequency slope than non-myopic children (-1.47±0.16 vs 1.43±0.18, p=0.03) while there was no significant difference in outdoor spatial frequency slope. Regression analysis indicated that the indoor spatial frequency slope was positively associated with SE value (β=0.60, p=0.02) and inversely related to myopia (OR=0.24, p<0.05). Conclusion: The spatial frequency of the outdoor environment is significantly higher than that of the indoor environment. Indoor spatial frequency is related to children's refractive status, with lower indoor spatial frequency being associated with a higher degree of myopia.
- Spatial frequency of environments and myopia: a systematic review on associated evidence and underlying mechanismsPublication . Li, Dan-Li; Lança, Carla; Zhang, Xiu-Juan; Grzybowski, Andrzej; He, Xian-Gui; Pan, Chen-WeiPurpose: Previous animal studies have found a relationship between spatial frequency and myopia. New research in humans suggests that reduced high spatial content of the visual environment may be a contributing factor to myopia development. This study aims to review the literature and elucidate the potential biological mechanisms linking spatial frequency and myopia. Methods: A systematic search was conducted across PubMed and Web of Science databases. The studies published from their inception to August 2024 have explored the connection between spatial frequency and myopia. Only full-text articles in English were included. PRISMA was used for data validity. Results: A total of 13 articles were included in this review, comprising seven animal model studies, four population-based studies, one pictorial analysis, and one study on research design. Epidemiological evidence is comparatively limited and has only begun to emerge in recent years. Mid- to high spatial frequencies were found to play an important role in the emmetropization process of the eye. Low spatial frequencies can increase the risk of myopia incidence. Furthermore, the potential mechanisms of how spatial frequency affects myopia are summarized as visual information processing characteristics, eye accommodation function, eye movements, contrast sensitivity, and relevant molecules involved in the pathway. Conclusion: The evidence suggests that indoor spatial frequency may be related to the development of myopia. Further studies are warranted to understand if the incorporation of changes in indoor environments is helpful in the prevention and control of myopia.