Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Aug;103(8):1078-1084.
doi: 10.1136/bjophthalmol-2018-312439. Epub 2018 Nov 6.

Early life factors for myopia in the British Twins Early Development Study

Katie M Williams  1   2 , Eva Kraphol  3 , Ekaterina Yonova-Doing  2 , Pirro G Hysi  1   2 , Robert Plomin  3 , Christopher J Hammond  4   2
Affiliations

Early life factors for myopia in the British Twins Early Development Study

Katie M Williams et al. Br J Ophthalmol. 2019 Aug.

Abstract

Purpose: Myopia is an increasingly prevalent condition globally. A greater understanding of contemporaneous, early life factors associated with myopia risk is urgently required, particularly in younger onset myopia as this correlates with higher severity and increased complications in adult life.

Methods: Analysis of a subset of the longitudinal, UK-based Twins Early Development Study (n=1991) recruited at birth between 1994 and 1996. Subjective refraction was obtained from the twin's optometrists; mean age 16.3 years (SD 1.7). Myopia was defined as mean spherical equivalent ≤-0.75 dioptres. A life course epidemiology approach was used to appropriately weight candidate myopia risk factors during critical periods of eye growth. Adjusted ORs for myopia were estimated using multivariable logistic regression models at each life stage, together with variance explained (r2) and area under the receiver operator characteristic curve (AUROC) statistic of predictive models.

Results: Factors significantly associated with myopia included level of maternal education (OR 1.33, 95% CI 1.11 to 1.59), fertility treatment (OR 0.63, 95% CI 0.43 to 0.92), summer birth (OR 1.93, 95% CI 1.28 to 2.90) and hours spent playing computer games (OR 1.03, 95% CI 1.01 to 1.06). The total variance explained by this model was 4.4 % (p<0.001) and the AUROC was 0.68 (95% CI 0.64 to 0.72). Consistent associations were observed with socioeconomic status, educational attainment, reading enjoyment and cognitive variables, particularly verbal cognition, at multiple points over the life course.

Conclusions: This study identifies known and novel associations with myopia during childhood development; associated factors identified in early life reflect sociological and lifestyle trends such as rates of maternal education, fertility treatment, early schooling and computer games.

Keywords: child health (paediatrics); epidemiology; genetics; optics and refraction.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Predictors for myopia from the life course analysis (adjusted odds ratio for myopia with 95% confidence interval). Significant factors = *; significant factors after Bonferroni correction = **
Figure 2
Figure 2
Receiver operating characteristic curves for prediction of myopia
Figure 3
Figure 3
Association between myopia, overall cognition, verbal cognition and non-verbal cognition over the life course (adjusted odds ratio for myopia with 95% confidence interval)
See this image and copyright information in PMC

References

    1. Flitcroft DI. The complex interactions of retinal, optical and environmental factors in myopia aetiology. Progress in retinal and eye research. 2012;31(6):622–60. doi: 10.1016/j.preteyeres.2012.06.004. - DOI - PubMed
    1. Dolgin E. The myopia boom. Nature. 2015;519(7543):276–8. doi: 10.1038/519276a. - DOI - PubMed
    1. Larsen JS. The sagittal growth of the eye. IV. Ultrasonic measurement of the axial length of the eye from birth to puberty. Acta Ophthalmol (Copenh) 1971;49(6):873–86. - PubMed
    1. Harper AR, Summers JA. The dynamic sclera: extracellular matrix remodeling in normal ocular growth and myopia development. Exp Eye Res. 2015;133:100–11. doi: 10.1016/j.exer.2014.07.015. - DOI - PMC - PubMed
    1. Stone RA, Lin T, Desai D, et al. Photoperiod, early post-natal eye growth, and visual deprivation. Vision Res. 1995;35(9):1195–202. - PubMed

Publication types