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Dose–Response Relationship of Outdoor Exposure and Myopia Indicators: A Systematic Review and Meta-Analysis of Various Research Methods

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  • Ciao-Lin Ho

    (School of Nursing, National Yang-Ming University, Taipei 11221, Taiwan)

  • Wei-Fong Wu

    (Department of Pediatrics, Taipei City Hospital Ren-Ai Branch/Department of Allergy and Immunology, West Garden Hospital, Taipei 10864, Taiwan)

  • Yiing Mei Liou

    (School of Nursing, National Yang-Ming University, Taipei 11221, Taiwan)

Abstract

Myopia in children has dramatically increased worldwide. A systematic review and meta-analysis were conducted to evaluate the effects of outdoor light exposure on myopia. According to research data from 13 studies of 15,081 children aged 4–14 at baseline, outdoor light exposure significantly reduced myopia incidence/prevalence (odds ratio [OR] = 0.85, 95% confidence interval [CI]: 0.80–0.91, p < 0.00001; I2 = 90%), spherical equivalent refractive error (SER) by 0.15 D/year (0.09–0.27, p < 0.0001), and axial elongation by 0.08 mm/year (−0.14 to −0.02, p = 0.02). The benefits of outdoor light exposure intervention, according to pooled overall results, included decreases in three myopia indicators: 50% in myopia incidence, 32.9% in SER, and 24.9% in axial elongation for individuals in Asia. Daily outdoor light exposure of more than 120 min was the most effective intervention, and weekly intervention time exhibited a dose–response relationship with all three indicators. Subgroup comparisons revealed that interventional studies report greater benefits from outdoor light exposure compared with cohort and cross-sectional studies, and individuals with myopia in intervention studies experienced slightly greater benefits than individuals without, in terms of SER and axial elongation. Therefore, this study suggests 120 min/day of outdoor light exposure at school.

Suggested Citation

  • Ciao-Lin Ho & Wei-Fong Wu & Yiing Mei Liou, 2019. "Dose–Response Relationship of Outdoor Exposure and Myopia Indicators: A Systematic Review and Meta-Analysis of Various Research Methods," IJERPH, MDPI, vol. 16(14), pages 1-17, July.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:14:p:2595-:d:250265
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    References listed on IDEAS

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    1. Elie Dolgin, 2015. "The myopia boom," Nature, Nature, vol. 519(7543), pages 276-278, March.
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    1. David Rojas-Rueda & Emily Morales-Zamora & Wael Abdullah Alsufyani & Christopher H. Herbst & Salem M. AlBalawi & Reem Alsukait & Mashael Alomran, 2021. "Environmental Risk Factors and Health: An Umbrella Review of Meta-Analyses," IJERPH, MDPI, vol. 18(2), pages 1-38, January.
    2. Einat Shneor & Ravid Doron & Jonathan Levine & Deena Rachel Zimmerman & Julia S. Benoit & Lisa A. Ostrin & Ariela Gordon-Shaag, 2021. "Objective Behavioral Measures in Children before, during, and after the COVID-19 Lockdown in Israel," IJERPH, MDPI, vol. 18(16), pages 1-15, August.

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