Structure of green space may affect myopia progression in school-aged children
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Key takeaways:
- An increase in green space morphology may be associated with a decreased risk for myopia.
- The association persisted after adjusting for outdoor time, screen time, reading time and parental myopia.
An increase in green space morphology was correlated with slowing myopia progression in primary school-aged children, according to a study published in JAMA Ophthalmology.
“To mitigate the surge in prevalence of myopia, it is important to understand the role of environmental factors in delaying onset and slowing progression and to explore effective approaches suitable for large-scale myopia prevention, particularly among school-aged children,” Yahan Yang, MD, PhD, of Zhongshan Ophthalmic Centre, Guangzhou, China, and colleagues wrote.
In a cohort study of 138,735 children in grades 1 to 4 from 110 schools in Shenzhen, China, Yang and colleagues assessed 2-year changes in myopia progression in areas with various green space morphology. The schools represented a variety of socioeconomic rankings, with 19.1% in the highest socioeconomic ranking, 47.3% in the moderate socioeconomic ranking and 33.6% in the low socioeconomic ranking.
Because students spend most of their day in school, the researchers used high-resolution satellite images to assess school campuses and 500-m buffer zones for vegetation index and landscape metrics, including percentage of landscape, area-weighted mean greenness area, largest patch index, aggregation index, cohesion index, patch density, area-weighted mean of proximity index and area-weighted mean patch shape index.
The average increase in myopia prevalence was 21.2%, and of the 101,897 students who did not have myopia at baseline, 25.8% developed it during follow-up.
Larger greenness proportion, larger areas of green space, better connectivity between green patches, more aggregated green space, less fragmented green space and shorter distance between patches were associated with decreased risk for myopia development. A one-unit increase in myopia-related green space morphology index was associated with a 1.7% decrease in myopia prevalence at the school level and a 9.8% decrease on an individual level. This association persisted after adjusting for outdoor time, screen time, reading time and parental myopia.
“A well-arranged green space with larger areas, better connectivity, increased aggregation, lower fragmentation and shorter distance between patches was correlated with slower progression in school myopia prevalence,” Yang and colleagues wrote. “Prospective interventional studies are needed to assess the effects on childhood myopia of the intentional manipulation of green space layouts.”
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