ArticleJMIR public health and surveillance2023
Effects of Greenness on Myopia Risk and School-Level Myopia Prevalence Among High School-Aged Adolescents: Cross-sectional Study.
Article in JMIR public health and surveillance, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- Association between green space exposure and elderly health: a systematic review and meta-analysis.BMC public health · 2026Pooled it
- The relationship between green space and myopia in children and adolescents: a systematic review and meta-analysis.Frontiers in public health · 2026Pooled it
- Residential Greenspace and Domestic Gardens, Genetic Predisposition, and Incident Glaucoma: A Prospective Cohort Study.GeoHealth · 2026Article
- Gender disparities in the burden of vision impairment and regional environmental susceptibility among Chinese children and adolescents.The British journal of ophthalmology · 2026Article
- Using deep learning to explore the impacts of street-view green space on school myopia prevalence: a multicenter, cross-sectional study.Scientific reports · 2026Article
- Associated factors of myopia in a Portuguese sample of adolescents: Parental history and school-related lifestyle.PloS one · 2026Article
- Real-world evidence on childhood refractive errors in a developed coastal region of China: a multi-center analysis of 4.47 million school-based screening encounters in Southern Fujian.Frontiers in public health · 2026Article
- Association between dry eye disease and temperature is modified by residential greenness: case-crossover study in Beijing, China.BMC public health · 2025Article
- IMI-2025 Digest.Investigative ophthalmology & visual science · 2025Article
- Area-level factors influencing geographical distribution of myopia prevalence among school-aged children and adolescents in Northwest China.Journal of global health · 2025Article
- Prevalence, temporal trend, burden, and prediction of refractive disorders among children and adolescents.Chinese medical journal · 2025Article
- Shaping school for childhood myopia: the association between floor area ratio of school environment and myopia in China.The British journal of ophthalmology · 2024Article
- Impacts of environments on school myopia by spatial analysis techniques in Wuhan.Scientific reports · 2024Article
- Residential greenness, air pollution and visual impairment: a prospective cohort study.BMC public health · 2024Article
- A higher shadow ratio of the living environment on the remote sensing digital image is possibly protective for adolescent myopia.Scientific reports · 2024Article
- The influence of the environment and lifestyle on myopia.Journal of physiological anthropology · 2024Review
- Article
- The protective role of green spaces in mitigating myopia prevalence.Frontiers in public health · 2024Review
- Association of outdoor artificial light at night with myopia among Chinese adolescents: a representative cross-sectional study.Frontiers in medicine · 2024Article
- The Distribution and Influence Factors of Non-Invasive Tear Film Break-Up Time in Children.Clinical ophthalmology (Auckland, N.Z.) · 2024Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMyopia is a serious public health issue. High school-aged adolescents in Beijing have an alarming prevalence of myopia. Therefore, determining myopia protective factors is essential. Green space has a certain association with myopia protective factors that can protect against myopia.
objectiveThis study aims to examine the effects of green space around schools on individual myopia risk in high school-aged adolescents and the school-level myopia prevalence.
methodsGreen space was measured using the normalized difference vegetation index (NDVI). A total of 13,380 samples of 51 high schools were selected from a 2021 Beijing Municipal Health Commission survey. Adolescent myopia was defined as a spherical equivalent of ≤-1.00 diopters in the worse eye. Generalized linear mixed models with a binomial error structure were used to analyze the effects of the NDVI on personal myopia risk and adjust them by other factors, such as demographics, exposure time, and outdoor exercise. The effects of the NDVI on school-level myopia prevalence with adjusted demographics and the relative position factors of trees were analyzed through quasibinomial regression.
resultsThe overall prevalence of myopia was 80.61% (10,785/13,380, 95% CI 79.93%-81.27%). Although with a 0.1 increase in the 500 and 1000 m buffer NDVIs adjusted by demographic and other factors, the high school-aged personal myopia risk significantly dropped by 16% (odds ratio [OR] 0.84, 95% CI 0.73-0.97) and 12% (OR 0.88, 95% CI 0.79-0.99), respectively. However, only the adjusted 500 m buffer NDVI (by demographics and the position of trees) with a 0.1 increase significantly reduced the school-level myopia prevalence by 15% (OR 0.85, 95% CI 0.74-0.98). Subgroup analysis showed that the adjusted effects of the 500 m buffer NDVI are significant in schoolgirls (OR 0.82, 95% CI 0.72-0.93), juniors (OR 0.82, 95% CI 0.72-0.94), the Han nationality (OR 0.84, 95% CI 0.72-0.97), 1-year exposure (OR 0.84, 95% CI 0.71-0.99) and 3-year exposure (OR 0.78, 95% CI 0.65-0.94).
conclusionsThe greenness of a 500 m buffer around schools is associated with a lower personal myopia risk among adolescents and a lower prevalence of myopia in schools. With regard to prevention and control activities, green space within a 500 m buffer around schools is suggested as an independent protective factor for adolescent myopia.
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