机构:[1]State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.[2]Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill.[3]Guangzhou Urban Planning and Design Survey Research Institute, Guangzhou, China.[4]Centre for OPTical IMagery Analysis and Learning (OPTIMAL), Northwestern Polytechnical University, Xi'an, China.[5]Key Laboratory of Radiometric Calibration and Validation for Environmental Satellites (LRCVES/CMA), National Satellite Meteorological Center, China Meteorological Administration (NSMC/CMA), Beijing, China.[6]School of Aeronautics and Astronautics, Sun Yat-sen University, Shenzhen, China.深圳医学信息中心中国医学科学院阜外医院深圳医院[7]Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.[8]Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, China.[9]Department of Management, College of Business, City University of Hong Kong, Hong Kong, Special Administrative Region of China.[10]PolyU School of Optometry, Hong Kong Polytechnic University, Hong Kong, Special Administrative Region of China.[11]Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom.[12]Orbis International, New York, New York.[13]Research School of Biology, College of Medicine, Biology and Environment, Australian National University, Canberra, Australia.[14]Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Haikou, China.[15]Centre for Precision Medicine, Department of Genetics and Biomedical Informatics, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.
China has experienced both rapid urbanization and major increases in myopia prevalence. Previous studies suggest that green space exposure reduces the risk of myopia, but the association between myopia risk and specific geometry and distribution characteristics of green space has yet to be explored. These must be understood to craft effective interventions to reduce myopia.To evaluate the associations between myopia and specific green space morphology using novel quantitative data from high-resolution satellite imaging.This prospective cohort study included students grades 1 to 4 (aged 6 to 9 years) in Shenzhen, China. Baseline data were collected in 2016-2017, and students were followed up in 2018-2019. Data were analyzed from September 2020 to January 2022.Eight landscape metrics were calculated using land cover data from high-resolution Gaofen-2 satellite images to measure area, aggregation, and shape of green space.The 2-year cumulative change in myopia prevalence at each school and incidence of myopia at the student level after 2 years were calculated as main outcomes. The associations between landscape metrics and school myopia were assessed, controlling for geographical, demographic, and socioeconomic factors. Principal component analyses were performed to further assess the joint effect of landscape metrics at the school and individual level.A total of 138 735 students were assessed at baseline. Higher proportion, aggregation, and better connectivity of green space were correlated with slower increases in myopia prevalence. In the principal component regression, a 1-unit increase in the myopia-related green space morphology index (the first principal component) was negatively associated with a 1.7% (95% CI, -3.1 to 1.0) decrease in myopia prevalence change at the school level (P < .001). At the individual level, a 1-unit increase in myopia-related green space morphology index was associated with a 9.8% (95% CI, 4.1 to 15.1) reduction in the risk of incident myopia (P < .001), and the association remained after further adjustment for outdoor time, screen time, reading time, and parental myopia (adjusted odds ratio, 0.88; 95% CI, 0.80 to 0.97; P = .009).Structure of green space was associated with a decreased relative risk of myopia, which may provide guidance for construction and renovation of schools. Since risk estimates only indicate correlations rather than causation, further interventional studies are needed to assess the effect on school myopia of urban planning and environmental designs, especially size and aggregation metrics of green space, on school myopia.
基金:
This study was supported by
the China Postdoctoral Science Foundation
(grant 2023M734047), National Natural Science
Foundation of China (grants 82301265 and
82171035), Key-Area of Research and Development
of Guangdong Province (grant 2020B1111190001),
Science and Technology Planning Projects of
Guangdong Province (grant 2021B1111610006),
and Guangzhou Key Laboratory Project (grant
202002010006).
语种:
外文
PubmedID:
中科院(CAS)分区:
出版当年[2023]版:
大类|1 区医学
小类|1 区眼科学
最新[2023]版:
大类|1 区医学
小类|1 区眼科学
第一作者:
第一作者机构:[1]State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.
通讯作者:
通讯机构:[1]State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.[14]Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Haikou, China.[15]Centre for Precision Medicine, Department of Genetics and Biomedical Informatics, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.[*1]State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Centre, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, #7 Jinsui Rd, Guangzhou 510623, China
推荐引用方式(GB/T 7714):
Yang Yahan,Liao Huipeng,Zhao Lanqin,et al.Green Space Morphology and School Myopia in China[J].JAMA Ophthalmology.2024,doi:10.1001/jamaophthalmol.2023.6015.
APA:
Yang Yahan,Liao Huipeng,Zhao Lanqin,Wang Xun,Yang XiaoWei...&Lin Haotian.(2024).Green Space Morphology and School Myopia in China.JAMA Ophthalmology,,
MLA:
Yang Yahan,et al."Green Space Morphology and School Myopia in China".JAMA Ophthalmology .(2024)