ReviewInvestigative ophthalmology & visual science2021
IMI Risk Factors for Myopia.
Review in Investigative ophthalmology & visual science, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 287 papers, 10 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
287 citing papers in PubMed, 10 syntheses or guidelines pooled it, 393 citations in OpenAlex.
- Exposure-response association between outdoor activity time and myopia risk in Chinese children and adolescents: a systematic review and meta-analysis.Journal of global health · 2026Pooled it
- Analysing myopia in Europe: A comprehensive meta-analysis.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026Pooled it
- Effects of table tennis on vision in children and adolescents: a multilevel dose-response meta-analysis.Frontiers in medicine · 2026Pooled it
- Exercise and visual training interventions for myopia in children and adolescents: a systematic review with a focus on near-far accommodation.Frontiers in public health · 2026Pooled it
- Economic evaluation, resource utilisation, and associated economic burden of myopia management: a systematic literature review.Journal of global health · 2025Pooled it
- SNTB1 gene polymorphisms and risk of high myopia: meta-analysis and single-center validation.Molecular vision · 2025Pooled it
- Bidirectional Relationship Between Myopia and Mental Disorders.Depression and anxiety · 2025Pooled it
- Myopia management algorithm. Annexe to the article titled Update and guidance on management of myopia. European Society of Ophthalmology in cooperation with International Myopia Institute.European journal of ophthalmology · 2024Guideline
- Factors associated with pathologic myopia onset and progression: A systematic review and meta-analysis.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2024Pooled it
- A meta-analysis of randomized controlled trials evaluating the effectiveness and safety of the repeated low-level red light therapy in slowing the progression of myopia in children and adolescents.Indian journal of ophthalmology · 2024Pooled it
- Effect of low-dose atropine on young premyopic and low-myopic children: atropine treatment of myopia (ATOM3) - a randomised control trial.The British journal of ophthalmology · 2026Trial
- Effect of Duration of Spectacle Lenses With Highly Aspherical Lenslets Wear on Choroidal Thickness in Low-Hyperopic Chinese Children.Translational vision science & technology · 2026Trial
- Clinical evaluation of MyoCare in Europe (CEME) for myopia management: One-year results.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2025Trial
- Prospective study of using 1064-nm Q-switched Nd: YAG combined with radiofrequency-imported vitamin C on pigmented infraorbital dark circles.Lasers in medical science · 2024Trial
- Effect of virtual reality-based visual training for myopia control in children: a randomized controlled trial.BMC ophthalmology · 2024Trial
- A Comparative Study of Atropine, Orthokeratology, and Combination Therapy for Axial Elongation in Children with Myopia.Journal of clinical medicine · 2026Article
- Trend of Myopia Incidence Among Adolescents (2018-2025) in Senior High School: An 8-Year Retrospective Study in Multi-Regions of China, With Projections to 2030.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2026Article
- Two-Year Efficacy of Cylindrical Annular Refractive Elements Spectacle Lenses for Myopia Control in European Children.Ophthalmology science · 2026Article
- Exploring Characteristics and Systemic Health Links in Myopic Australian Adults.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2026Article
- Longitudinal Changes in Relative Peripheral Refraction During Childhood Myopia Onset: A 3-year Prospective Observation.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2026Observational
227 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 12 institutions in 8 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Risk factor analysis provides an important basis for developing interventions for any condition. In the case of myopia, evidence for a large number of risk factors has been presented, but they have not been systematically tested for confounding. To be useful for designing preventive interventions, risk factor analysis ideally needs to be carried through to demonstration of a causal connection, with a defined mechanism. Statistical analysis is often complicated by covariation of variables, and demonstration of a causal relationship between a factor and myopia using Mendelian randomization or in a randomized clinical trial should be aimed for. When strict analysis of this kind is applied, associations between various measures of educational pressure and myopia are consistently observed. However, associations between more nearwork and more myopia are generally weak and inconsistent, but have been supported by meta-analysis. Associations between time outdoors and less myopia are stronger and more consistently observed, including by meta-analysis. Measurement of nearwork and time outdoors has traditionally been performed with questionnaires, but is increasingly being pursued with wearable objective devices. A causal link between increased years of education and more myopia has been confirmed by Mendelian randomization, whereas the protective effect of increased time outdoors from the development of myopia has been confirmed in randomized clinical trials. Other proposed risk factors need to be tested to see if they modulate these variables. The evidence linking increased screen time to myopia is weak and inconsistent, although limitations on screen time are increasingly under consideration as interventions to control the epidemic of myopia.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.