The relationship between outdoor activities time and children myopia prevention: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

WANG Ying ¹ , LUO Qu ² ,  ZHANG Ming ²

1. School of Medical Technology and Nursing, Shenzhen Polytechnic, Shenzhen, 518055, P.R.China;
2. Department of Ophthalmology, West China Hospital of Sichuan University, Chengdu, 610041, P.R.China;

Corresponding author：

ZHANG Ming, Email: zhangmingscu@126.com

Keywords：

Outdoor activity; Myopia; Children; Meta-analysis

DOI：

10.7507/1672-2531.201801043

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the effectiveness of outdoor activities in preventing myopia progression, and to provide scientific evidence for myopia prevention and management.Methods PubMed, MEDLINE, EMbase, CNKI and WanFang Data databases were searched from establishment to October 2017. Two researchers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software.Results A total of 10 studies involving 24 667 participants were included. The results of meta-analysis showed that the incidence of myopia in outdoor activities group was lower than that in control group (OR=0.67, 95%CI 0.55 to 0.81, P<0.000 1).Conclusion The current evidence shows that outdoor activities have protective effects on emmetropia children myopia onset. Due to the limited quality and quantity of included studies, more high quality studies are needed to verify the above conclusions.

Citation： WANG Ying, LUO Qu, ZHANG Ming. The relationship between outdoor activities time and children myopia prevention: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2019, 19(3): 287-292. doi: 10.7507/1672-2531.201801043 Copy

1.	Rose KA, Morgan IG, Ip J, et al. Outdoor activity reduces the prevalence of myopia in children. Ophthalmology, 2008, 115(8): 1279-1285.
2.	Jonas JB, Xu L, Wei WB, et al. Myopia in China: a population-based cross-sectional, histological, and experimental study. Lancet, 2016, 388: S20.
3.	郭寅, 刘丽娟, 徐亮, 等. 北京市城乡 681 名小学生户外活动时间及与近视的关系. 中华医学杂志, 2014, 94(3): 191-194.
4.	Öner V, Bulut A, Oruç Y, et al. Influence of indoor and outdoor activities on progression of myopia during puberty. Int Ophthalmol, 2016, 36(1): 121-125.
5.	Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9): 603-605.
6.	曾宪涛, 刘慧, 陈曦, 等. Meta 分析系列之四: 观察性研究的质量评价工具. 中国循证心血管医学杂志, 2012, 4(4): 297-299.
7.	Wu PC, Tsai CL, Wu HL, et al. Outdoor activity during class recess reduces myopia onset and progression in school children. Ophthalmology, 2013, 120(5): 1080-1085.
8.	He M, Xiang F, Zeng Y, et al. Effect of time spent outdoors at school on the development of myopia among children in china: a randomized clinical trial. JAMA, 2015, 314(11): 1142-1148.
9.	Jin JX, Hua WJ, Jiang X, et al. Effect of outdoor activity on myopia onset and progression in school-aged children in northeast china: the sujiatun eye care study. BMC Ophthalmol, 2015, 15(1): 73.
10.	French AN, Morgan IG, Mitchell P, et al. Risk factors for incident myopia in Australian schoolchildren: the Sydney adolescent vascular and eye study. Ophthalmology, 2013, 120(10): 2100-2108.
11.	Hsu CC, Huang N, Lin PY, et al. Prevalence and risk factors for myopia in second-grade primary school children in Taipei: A population-based study. J Chin Med Assoc, 2016, 79(11): 625-632.
12.	Guggenheim JA, Northstone K, Mcmahon G, et al. Time outdoors and physical activity as predictors of incident myopia in childhood: a prospective cohort study. Invest Ophth Vis Sci, 2012, 53(6): 2856-2865.
13.	Wu LJ, Wang YX, You QS, et al. Risk factors of myopic shift among primary school children in Beijing, China: a prospective study. Int J Med Sci, 2015, 12(8): 633-638.
14.	Chua SY, Ikram MK, Tan CS, et al. Relative contribution of risk factors for early-onset myopia in young Asian children. Invest Ophth Vis Sci, 2015, 56(13): 8101-8107.
15.	Guo Y, Liu L J, Xu L, et al. Outdoor activity and myopia among primary students in rural and urban regions of Beijing. Ophthalmology, 2013, 120(2): 277-283.
16.	Low W, Dirani M, Gazzard G, et al. Family history, near work, outdoor activity, and myopia in Singapore Chinese preschool children. Br J Ophthalmol, 2010, 94(8): 1012-1016.
17.	王丹, 翟俊霞, 牟振云, 等. Meta 分析中的异质性及其处理方法. 中国循证医学杂志, 2009, 9(10): 1115-1118.
18.	Dirani M, Tong L, Gazzard G, et al. Outdoor activity and myopia in Singapore teenage children. Br J Ophthalmol, 2009, 93(8): 997-1000.
19.	Jones-Jordan LA, Sinnott LT, Cotter SA, et al. Time outdoors, visual activity, and myopia progression in juvenile-onset myopes. Invest Ophth Vis Sci, 2012, 53(11): 7169-7175.
20.	Xiong S, Sankaridurg P, Naduvilath T, et al. Time spent in outdoor activities in relation to myopia prevention and control: a meta-analysis and systematic review. Acta Ophthalmologica, 2017, 95(6): 551-566.
21.	French AN, Ashby RS, Morgan IG, et al. Time outdoors and the prevention of myopia. Exp Eye Res, 2013, 114(9): 58-68.
22.	周旭毓, 方积乾. Meta 分析的常见偏倚. 循证医学, 2002, 2(4): 216-220.
23.	曾宪涛, 李胜, 马钻, 等. Meta 分析系列之八: Meta 分析的报告规范. 中国循证心血管医学杂志, 2012, 4(6): 500-503.
24.	康德英, 洪旗, 刘关键, 等. Meta 分析中发表性偏倚的识别与处理. 中国循证医学杂志, 2003, 3(1): 45-49.

1. Rose KA, Morgan IG, Ip J, et al. Outdoor activity reduces the prevalence of myopia in children. Ophthalmology, 2008, 115(8): 1279-1285.
2. Jonas JB, Xu L, Wei WB, et al. Myopia in China: a population-based cross-sectional, histological, and experimental study. Lancet, 2016, 388: S20.
3. 郭寅, 刘丽娟, 徐亮, 等. 北京市城乡 681 名小学生户外活动时间及与近视的关系. 中华医学杂志, 2014, 94(3): 191-194.
4. Öner V, Bulut A, Oruç Y, et al. Influence of indoor and outdoor activities on progression of myopia during puberty. Int Ophthalmol, 2016, 36(1): 121-125.
5. Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9): 603-605.
6. 曾宪涛, 刘慧, 陈曦, 等. Meta 分析系列之四: 观察性研究的质量评价工具. 中国循证心血管医学杂志, 2012, 4(4): 297-299.
7. Wu PC, Tsai CL, Wu HL, et al. Outdoor activity during class recess reduces myopia onset and progression in school children. Ophthalmology, 2013, 120(5): 1080-1085.
8. He M, Xiang F, Zeng Y, et al. Effect of time spent outdoors at school on the development of myopia among children in china: a randomized clinical trial. JAMA, 2015, 314(11): 1142-1148.
9. Jin JX, Hua WJ, Jiang X, et al. Effect of outdoor activity on myopia onset and progression in school-aged children in northeast china: the sujiatun eye care study. BMC Ophthalmol, 2015, 15(1): 73.
10. French AN, Morgan IG, Mitchell P, et al. Risk factors for incident myopia in Australian schoolchildren: the Sydney adolescent vascular and eye study. Ophthalmology, 2013, 120(10): 2100-2108.
11. Hsu CC, Huang N, Lin PY, et al. Prevalence and risk factors for myopia in second-grade primary school children in Taipei: A population-based study. J Chin Med Assoc, 2016, 79(11): 625-632.
12. Guggenheim JA, Northstone K, Mcmahon G, et al. Time outdoors and physical activity as predictors of incident myopia in childhood: a prospective cohort study. Invest Ophth Vis Sci, 2012, 53(6): 2856-2865.
13. Wu LJ, Wang YX, You QS, et al. Risk factors of myopic shift among primary school children in Beijing, China: a prospective study. Int J Med Sci, 2015, 12(8): 633-638.
14. Chua SY, Ikram MK, Tan CS, et al. Relative contribution of risk factors for early-onset myopia in young Asian children. Invest Ophth Vis Sci, 2015, 56(13): 8101-8107.
15. Guo Y, Liu L J, Xu L, et al. Outdoor activity and myopia among primary students in rural and urban regions of Beijing. Ophthalmology, 2013, 120(2): 277-283.
16. Low W, Dirani M, Gazzard G, et al. Family history, near work, outdoor activity, and myopia in Singapore Chinese preschool children. Br J Ophthalmol, 2010, 94(8): 1012-1016.
17. 王丹, 翟俊霞, 牟振云, 等. Meta 分析中的异质性及其处理方法. 中国循证医学杂志, 2009, 9(10): 1115-1118.
18. Dirani M, Tong L, Gazzard G, et al. Outdoor activity and myopia in Singapore teenage children. Br J Ophthalmol, 2009, 93(8): 997-1000.
19. Jones-Jordan LA, Sinnott LT, Cotter SA, et al. Time outdoors, visual activity, and myopia progression in juvenile-onset myopes. Invest Ophth Vis Sci, 2012, 53(11): 7169-7175.
20. Xiong S, Sankaridurg P, Naduvilath T, et al. Time spent in outdoor activities in relation to myopia prevention and control: a meta-analysis and systematic review. Acta Ophthalmologica, 2017, 95(6): 551-566.
21. French AN, Ashby RS, Morgan IG, et al. Time outdoors and the prevention of myopia. Exp Eye Res, 2013, 114(9): 58-68.
22. 周旭毓, 方积乾. Meta 分析的常见偏倚. 循证医学, 2002, 2(4): 216-220.
23. 曾宪涛, 李胜, 马钻, 等. Meta 分析系列之八: Meta 分析的报告规范. 中国循证心血管医学杂志, 2012, 4(6): 500-503.
24. 康德英, 洪旗, 刘关键, 等. Meta 分析中发表性偏倚的识别与处理. 中国循证医学杂志, 2003, 3(1): 45-49.

Chinese Journal of Evidence-Based Medicine

The relationship between outdoor activities time and children myopia prevention: a meta-analysis

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