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June 2021
Volume 62, Issue 8
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Open Access
ARVO Annual Meeting Abstract| June 2021
Gender predisposition to myopia shifts to girls in the young generation.
Clair Enthoven; Annechien E.G. Haarman; Joanna Swierkowska; Willem Tideman; Jan Roelof Polling; Virginie JM Verhoeven; Caroline C. W. Klaver
Author Affiliations & Notes
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Clair Enthoven
Ophthalmology & Epidemiology, Erasmus MC, Rotterdam, Zuid-Holland, Netherlands
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Annechien E.G. Haarman
Ophthalmology & Epidemiology, Erasmus MC, Rotterdam, Zuid-Holland, Netherlands
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Joanna Swierkowska
Ophthalmology & Epidemiology, Erasmus MC, Rotterdam, Zuid-Holland, Netherlands
Instytut Genetyki Czlowieka Polskiej Akademii Nauk, Poznan, Poland -
Willem Tideman
Ophthalmology & Epidemiology, Erasmus MC, Rotterdam, Zuid-Holland, Netherlands
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Jan Roelof Polling
Ophthalmology & Epidemiology, Erasmus MC, Rotterdam, Zuid-Holland, Netherlands
Orthoptics & Optometry, Hogeschool Utrecht, Utrecht, Utrecht, Netherlands -
Virginie JM Verhoeven
Ophthalmology & Epidemiology, Erasmus MC, Rotterdam, Zuid-Holland, Netherlands
Clinical Genetics, Erasmus MC, Rotterdam, Zuid-Holland, Netherlands -
Caroline C. W. Klaver
Ophthalmology & Epidemiology, Erasmus MC, Rotterdam, Zuid-Holland, Netherlands
Ophthalmology, Radboudumc, Nijmegen, Gelderland, Netherlands
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 2331. doi:
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Citation
Clair Enthoven, Annechien E.G. Haarman, Joanna Swierkowska, Willem Tideman, Jan Roelof Polling, Virginie JM Verhoeven, Caroline C. W. Klaver; Gender predisposition to myopia shifts to girls in the young generation.. Invest. Ophthalmol. Vis. Sci. 2021;62(8):2331.
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© ARVO (1962-2015); The Authors (2016-present)
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Abstract
Purpose : Previous studies have suggested that female gender is a risk factor for myopia. The underlying mechanism is not well understood, and gender-specific factors such as age of growth spurt have been proposed. The aim of this study was to explore gender differences in myopia development in two prospective population-based cohorts from different generations, and to find possible explanations.
Methods : Analyses were performed in the birth cohort study Generation R (n=7229) and in the elderly Rotterdam Study I-III (45+ yrs; n=8674). Cycloplegic refraction was measured in the children at 6, 9, and 13 years, automated refraction was measured in the adults, and axial length and height was measured in both. Myopia was defined as spherical equivalent ≤-0.5D in at least one eye. Lifestyle factors including near work and outdoor exposure were assessed in the children and level of education in the adults, both by questionnaire. The association between gender and myopia was tested using Cox proportional hazards and logistic regression models adjusted for age; change in height, lifestyle factors and education were investigated as possible mediators.
Results : Myopia prevalence increased from 2.5%, to 11.5% and 22.5% at age 6, 9, and 13 years in the children, respectively; the prevalence was 30.6% in the adults. Female gender was associated with myopia in the children (HR=1.14 95% CI=1.02-1.27), but was inversely associated in the adults (OR=0.88 95%CI=0.80-0.96). Mediators of the association in children were outdoor exposure, growth in height, sport participation, reading time, and number of books read per month; these mediators together attenuated the effect of gender with 34.9% and reduced risk to HR=1.09 (95%CI=0.97-1.23). Education was the most important mediator of the association in adults, attenuating the effect with 89.7% to OR=0.98 (95%CI=0.90-1.09).
Conclusions : In our study, myopia was more common in girls in the young generation, but more common in men in the older generation. This paradigm shift and our mediation analysis provide compelling evidence that lifestyle factors and education are strong drivers of myopia. In the generations to come, particularly girls should be guided to adhere to protective behaviour.
This is a 2021 ARVO Annual Meeting abstract.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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