| Summary: | Lin Leng,1 Jiafan Zhang,1 Sen Xie,2 Wenzhi Ding,1 Rongyuan Ji,1 Yuyin Tian,1 Keli Long,1 Hongliang Yu,3 Zhen Guo1 1Department of Ophthalmology, Qingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, Shandong Province, People’s Republic of China; 2Department of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, 510000, Guangdong Province, People’s Republic of China; 3Department of Ophthalmology, Shenyang Eye Docloud Internet Hospital, Shenyang, 110000, Liaoning Province, People’s Republic of ChinaCorrespondence: Zhen GuoQingdao Eye Hospital of Shandong First Medical University, State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, 266071, Shandong Province, People’s Republic of ChinaTel +86 532-87610198Email guoz@sdfmu.edu.cnBackground: To assess the current myopia prevalence rate and evaluate the effect of sunshine duration on myopia among primary school students in the north and south of China.Methods: This prospective cross-sectional study pooled data from 9171 primary school students (grades from 1 to 6) from four cities in the north and south of China. National Geomatics Center of China (NGCC) and China Meteorological Administration provided data about altitude, latitude, longitude, average annual temperature, and average annual sunshine duration. Non-cycloplegic refraction was recorded, and prevalence rates in primary school students and factors associated with myopia were analyzed. Univariate and multivariate logistic regression models were used to determine the independent association of risk factors of myopia.Results: The overall myopia prevalence was 28.0%, from 7.5% to 50.6% for first and sixth grades, respectively. Low, moderate and high myopia significantly increased with school grades from 7.30% to 35.0%, 0.3% to 13.60% and 0.00% to 1.9%, respectively. Multiple regression analysis revealed that longer average cumulative daylight hours were connected to lower myopia prevalence in primary school students (OR, 0.721; 95% CI, [0.593– 0.877]; P=0.001), whereas girls and higher grade was independently associated with higher myopia prevalence (girls: β=0.189; OR, 1.208; 95% CI, [1.052– 1.387]; P=0.007; higher grade: β=0.502; OR, 1.652; 95% CI, [1.580– 1.726]; P< 0.001).Conclusion: This study demonstrated that myopia was highly prevalent in southern Chinese cities over northern ones, linked to shorter light exposure, higher education level, and female gender. Such findings reinforced the beneficial impact of daylight exposure with a protective role against myopia development.Keywords: myopia, epidemiology, sunshine duration, China
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