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  • Myopia Progression in Chinese Children During the Pandemic

    By Lynda Seminara
    Selected by Prem S. Subramanian, MD, PhD
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    Journal Highlights

    Graefe’s Archive for Clinical and Experimental Ophthalmology
    Published online July 21, 2021

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    The Ministry of Education of the People’s Republic of China estimated that more than 220 million Chinese children and adolescents have been educated online during the pandemic. Ma et al. aimed to determine whether this method of learning affects the time students spend on near work and outdoors, which could influence the incidence and progression of myopia. They found that the pandemic is has­tening myopia progression in East Asia, where myopia prevalence is historically very high.

    The study included 8-to 10-year-old children from Handan in the Hebei province of China. A control group of children treated before the pandemic was established for comparison pur­poses. Control participants had been admitted to Beijing Tongren Hospital before August 2018 and received follow-up care. All participants had logMAR best-corrected visual acuity of at least 0.0 or better. Reasons for exclusion were previous eye disease or injury, atropine use, orthokeratology, and any condition that could influence myopia.

    Baseline data were collected in July 2019. Participants attended follow-up appointments in January 2020 and August 2020, which included compre­hensive and standardized ocular exams. A detailed questionnaire was complet­ed during the second follow-up visit. Uncorrected visual acuity (UCVA), mydriatic spherical equivalent (SE), and axial length were compared for the two groups. Large correlation coeffi­cients were observed for cycloplegic SE between the two eyes (r = 0.73, p < .001); therefore, only right eyes underwent analysis.

    Altogether, there were 208 children in the pandemic cohort and 83 in the pre-pandemic control group. Myopia progression was significantly greater during the pandemic (–0.93 vs. –0.33 D; p < .001). However, there were no clinically meaningful differences in UCVA change or axial elongation between the study groups. According to logistic regression analysis, changes in SE were associated with baseline axial length (p = .028), online learning (p = .02), and digital screen time (p < .005). During the pandemic, children spent less time outdoors (1.04 vs. 1.75 hours per day beforehand).

    The original article can be found here.