The Causal Effect of Education on Myopia: Evidence That More Exposure to Schooling, Rather Than Increased Age, Causes the Onset of Myopia

被引：8

作者：

Ding, Xiaohu ^{[1
]}

Morgan, Ian G. ^{[1
,2
]}

Hu, Yin ^{[1
]}

Tang, Xianghua ^{[1
]}

Zhang, Jiayu ^{[3
]}

Guo, Lan ^{[3
]}

Guo, Yangfeng ^{[4
]}

Deng, Nali ^{[4
]}

Du, Xueying ^{[4
]}

Zheng, Yingfeng ^{[1
]}

He, Mingguang ^{[1
,5
]}

Lu, Ciyong ^{[3
,7
]}

Yang, Xiao ^{[1
,6
]}

Liu, Yizhi ^{[1
,6
]}

机构：

[1] Sun Yat Sen Univ, Zhongshan Ophthalm Ctr, Guangdong Prov Clin Res Ctr Ocular Dis, State Key Lab Ophthalmol,Guangdong Prov Key Lab Op, Guangzhou, Peoples R China

[2] Australia Natl Univ, Coll Med Biol & Environm, Res Sch Biol, Canberra, Australia

[3] Sun Yat Sen Univ, Sch Publ Hlth, Dept Med Stat & Epidemiol, Guangzhou, Peoples R China

[4] Hlth Promot Ctr Primary, Secondary Sch Guangzhou Municipal, Guangzhou, Peoples R China

[5] Univ Melbourne, Ctr Eye Res Australia Ophthalmol, Dept Surg, Melbourne, Australia

[6] Sun Yat sen Univ, Zhongshan Ophthalm Ctr, Guangdong Prov Clin Res Ctr Ocular Dis, State Key Lab Ophthalmol,Guangdong Prov Key Lab Op, Guangzhou 510060, Peoples R China

[7] Sun Yat Sen Univ, Sch Publ Hlth, Dept Med Stat & Epidemiol, Guangzhou 510080, Peoples R China

来源：

INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE | 2023年 / 64卷 / 04期

基金：

中国国家自然科学基金;

关键词：

myopia; school; education; regression discontinuity; relative age effect; REFRACTIVE ERROR; VISUAL IMPAIRMENT; CHILDREN; PREVALENCE; PROGRESSION;

D O I：

10.1167/iovs.64.4.25

中图分类号：

R77 [眼科学];

学科分类号：

100212 ;

摘要：

PURPOSE. To distinguish the effects of age and grade on the development of myopia.METHODS. Grade 1 (n = 1465, mean age 6.71 & PLUSMN; 0.29 years; 53.5% male) and Grade 2 students (n = 1381, mean age 7.76 & PLUSMN; 0.30 years; 52.5% male) were examined in 2018, with a follow-up examination in 2019. Cycloplegic spherical equivalent (SE) in diopter (D) was measured. Regression discontinuity (RD) analysis was used to assess the causal effects on refraction at each visit.RESULTS. The sample in a grade was divided into three 4-month age blocks according to their birth month, the youngest, middle, and the oldest. At the 2018 visit, within each grade, there were no significant differences in SE among age blocks (all P > 0.05), despite an age range of 12 months. However, comparing the youngest block in Grade 2 to the oldest block in Grade 1, an average age difference of four months, a significant difference in SE was found (0.82 & PLUSMN; 0.69 D vs. 1.05 & PLUSMN; 0.55 D, t-test P < 0.01). Formal RD analysis found a significant casual effect of grade increase on myopic refraction shift (& beta; = -0.32 D; 95% CI, -0.73 to -0.01; P = 0.042). Consistent results were found using the 2019 data.CONCLUSIONS. Increased grade, rather than increasing age, is the major cause of myopic shifts in refraction. A causal link implies that interventions aimed at reducing the myopi-genic exposures experienced during a school year have the potential to markedly reduce the myopic shifts in refraction associated with a grade of schooling.

引用

页数：6