Family history, near work, outdoor, height and myopia in 3 year old Asian children: The Growing Up in Singapore Towards healthy Outcomes (GUSTO) Study

Abstract

Purpose: To investigate the associations of parental myopia, early life exposure to near work and outdoor, as well as anthropometric measures with early-onset myopia in very young Asian children.

Methods: Methods: We conducted a birth cohort which recruited pregnant women and their offsprings at two major maternity units in Singapore. At 3 years of age, cycloplegic autorefraction and axial length (AL) were obtained from participating children (n=572). Myopia was defined as spherical equivalent (SE) of ≤ -0.50 diopters (D). Parents completed detailed questionnaires of near work, outdoor activities and parental myopia at the child’s two year visit. Taller children at birth, 12, 24 and 36 months, were found to have longer AL at 3 years.

Results: Results: In multivariable regression models adjusted for gender, race and maternal education, children with at least one myopic parent were more likely to have a more myopic SE (b= -0.29D; 95% CI: -0.49 to -0.09D; p<0.01), longer AL (b = 0.15mm; 95% CI: 0.03 to 0.27mm; p=0.02) and higher odds of myopia (OR= 3.31; 95% CI: 1.09 to 10.09; p=0.04). Neither near work nor outdoor activity were associated with SE, AL or myopia. Taller children were found to have longer AL at birth,12, 24 and 36 months, but there were no associations with SE or myopia.

Conclusions: Parental history of myopia was associated with early-onset myopia in young 3- year old Asian children. In contrast, neither near work nor outdoor activity were associated with early-onset myopia. Child’s height at regular intervals from birth to 3 years was related to AL, but not SE. These data suggest that early onset myopia is more likely due to genetic rather than environmental factors, while height at several age points predict AL at 3 years.