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      Comment on: The effect of home education on myopia progression in children during the COVID-19 pandemic

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      1 , 2 , 3 ,
      Eye
      Nature Publishing Group UK
      Refractive errors, Autoimmune diseases

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          Abstract

          To the Editor: We read with interest the article titled “The effect of home education on myopia progression in children during the COVID-19 pandemic” by Aslan F and Sahinoglu-Keskek N, recently published in Eye [1]. The authors have extensively reviewed the effect of the COVID-19 pandemic restrictions on myopia progression in school-aged children. We would hereby like to suggest that the analysis should select the data from the monocular eye. Generally speaking, measurements obtained from the right and left eye of a subject are often correlated whereas many statistical tests assume observations in a sample are independent. Hence, data collected from both eyes cannot be combined without taking this correlation into account. If one eye is studied and both are eligible, then it should be chosen at random. Most of the previous studies are used for reference [2, 3], and in order to avoid the influence of binocular correlation on the results and the introduction of more systematic errors, we choose the right eye from each participant for data analysis. As for correlation analysis, if the basic information of the person, such as age and sex, is reused twice, it may have an impact on the results.

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          The effect of home education on myopia progression in children during the COVID-19 pandemic

          Objectives To evaluate the effect of the COVID-19 pandemic restrictions on myopia progression (MP) in school age children. Methods A total of 115 children aged 8–17 years with a diagnosis of myopia who had been followed-up for at least three years, were included in this study with a retrospective and single-centre design. The subjects’ age, the history of myopia in the family, the time spent in front of a screen, the digital devices used during home education (computer, tablet, smartphone, television), the time spent in open air (hours/day), the refractive error (RE) (spherical equivalent value) detected before the home education period and the changes in the myopia over the years, were recorded. Results The mean age was 12.06 (±2.29) years. Only the right eyes were included. The glasses use duration was 3.57 (±0.74) years. The annual MP amount 0.49 (±0.26), 0.41 (±0.36) and 0.54 (±0.43) dioptres (D) for the 2017, 2018 and 2019 years before home education, respectively, ( p  > 0.05), and 0.71 (±0.46) D in 2020, during home education. The increase in MP amount in 2020 compared to the 2019 and 2018 years was statistically significant ( p  < 0.003). MP was statistically significantly less in children who participated in open-air activities for 2 h a day and those who lived in detached houses ( p  = 0.004, p  = 0.006, respectively). Conclusion During home confinement, education programmes of school children should be designed while taking into account preventive measures for MP, in particular for allowing children to spend at least 2 h of outdoor time per day.
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            Is Open Access

            Correlation of subfoveal choroidal thickness with axial length, refractive error, and age in adult highly myopic eyes

            Background Subfoveal choroidal thickness (SFCT) in highly myopic eyes was found to be correlated with increasing age, refractive error (spherical equivalent), and axial length. Which factor is the most significant predictor of SFCT remains controversial. Methods A hospital-based cohort of highly myopic eyes (with spherical equivalent equal to or over 6.00 diopter) were retrospectively screened. Data from only right eye in those bilateral high myopia, and unilateral high myopia in any eye, were used for analysis. Correlations among the four biometric factors were analyzed. Linear correlation was performed to analyze the predictors of SFCT. Results A cohort of 312 eyes from 312 adults (98 men) was enrolled. Statistical analysis showed that axial length (R = − 0.592), spherical equivalent (R = − 0.471), and age (R = − 0.296) were significantly correlated with SFCT (P < 0.001). No significant correlation was found between age and axial length, or age and spherical equivalent. Partial correlation with controlled age confirmed that axial length (R = − 0.628) was a more significant predictor of SFCT than spherical equivalent (R = − 0.507). Conclusions SFCT was inversely correlated with increasing age, spherical equivalent and axial length, with axial length as the most significant predictor of SFCT, in adult highly myopic eyes.
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              Refractive error and biometrics of anterior segment of eyes of healthy young university students in Japan

              To determine the parameters of the anterior segment of eyes that are significantly associated with the refractive error in healthy young Japanese university students. This was a cross-sectional observational study of 229 healthy Japanese university students (men: women,147:82) whose age ranged between 20 to 29 years. Univariate and multivariate linear regression analyses were performed to identify the factors that were significantly correlated with the refractive error. The independent variables included age, sex, axial length, anterior chamber depth, corneal diameter, curvature of anterior surface of cornea, and central corneal thickness. The mean refractive error (spherical equivalent) was −4.1 ± 2.7 diopters (D) with a range of −12.5 to +0.5 D, and the mean axial length was 25.4 ± 1.3 mm with a range of 22.4 to 29.0 mm. Pearson univariate correlation analysis found that the refractive error was significantly and negatively correlated with the axial length (R = −0.82, P < 0.001), deeper anterior chamber (R = −0.30, P < 0.001), and larger corneal diameter (R = −0.21, P = 0.001). Multiple regression analysis showed that the refractive error was significantly associated with a longer axial length (P < 0.001), a deeper anterior chamber (P < 0.001), and a flatter corneal curvature (P < 0.001).The biometric values of the anterior segment of the eyes should make the eye more hyperopic which would reduce the myopia-inducing lengthening of the axial length.
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                Author and article information

                Contributors
                fanqian2002_yahoo@163.com
                Journal
                Eye (Lond)
                Eye (Lond)
                Eye
                Nature Publishing Group UK (London )
                0950-222X
                1476-5454
                29 March 2022
                : 1
                Affiliations
                [1 ]GRID grid.216938.7, ISNI 0000 0000 9878 7032, Tianjin Eye Hospital, Tianjin Key Lab of Ophthalmology and Visual Science, , Tianjin Eye Institute, Nankai University Affiliated Eye Hospital, ; Tianjin, China
                [2 ]GRID grid.216938.7, ISNI 0000 0000 9878 7032, Nankai Eye Institute, , Nankai University, ; Tianjin, China
                [3 ]GRID grid.265021.2, ISNI 0000 0000 9792 1228, Clinical College of Ophthalmology, , Tianjin Medical University, ; Tianjin, China
                Author information
                http://orcid.org/0000-0002-7617-9962
                Article
                2042
                10.1038/s41433-022-02042-1
                8961080
                35352012
                764e6bcf-84e2-4bcc-9ac2-a527b78694c8
                © The Author(s), under exclusive licence to The Royal College of Ophthalmologists 2022

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                : 9 March 2022
                : 17 March 2022
                : 17 March 2022
                Categories
                Correspondence

                Vision sciences
                refractive errors,autoimmune diseases
                Vision sciences
                refractive errors, autoimmune diseases

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