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Purpose: The aim was to screen children from Grades 1 to 6 in an urban elementary school in Central Taiwan for visual deficits and associated parameters and, as an extension, to examine the acceptance of cycloplegic therapy as well as the lag in optimal vision correction. Methods: Of 900 students in one school, 731 participated in the study, with parental consent. Data from 694 students, who had also completed a vision correction history were analysed. In addition to body height and weight, the screening included vision, non-cycloplegic autorefraction and distance retinoscopy, axial length and functional testing. Results: There was a decrease in students with vision of 1.0 or better from 55.8 per cent in Grade 1 to 20.0 per cent in Grade 6. The decreases between Grades 2 and 3 and Grades 5 and 6 were significant. These trends were in general agreement with those based on refractive error and axial length. The students had abnormal functional findings including: stereoscopic vision, 9.2 per cent; cover tests, 14.1 per cent; pupillary responses, 13.8 per cent; and less commonly in extraocular muscular functions (3.0 per cent) and colour vision (5.2 per cent). A full 40 per cent of students received cycloplegic therapy with 25 per cent dropping out for various reasons. These cases were generally associated with lower vision and higher myopia. A lag between subnormal vision and optical correction was also observed with 55.1 per cent apparently not optimally corrected. Other parameters, including body height, weight and body mass index were not correlated with vision or refractive error. Conclusions: Age-dependent increase in the prevalence of myopia appears to continue despite the common practice of topical cycloplegic therapy in Taiwan. Timely correction of the refractive error is also lacking. While maintaining a visual acuity of 1.0 or better for all students at all times is not possible, this lag might be shortened by more frequent screening and/or direct provision of optical aids. [ABSTRACT FROM AUTHOR]

The objective was to investigate different comorbidities developed in normal-tension glaucoma (NTG) and primary open-angle glaucoma (POAG) patients. This was a case-control study, with 1489 people in the NTG group and 5120 people in the POAG group. Patient data were obtained from the Longitudinal Health Insurance Database 2010 (LHID2010) of Taiwan for the 2008–2013 period. The chi-square test was used to compare categorical variables, such as gender, income and urbanisation level, between NTG and POAG patients, and the two-tailed t test was used to compare continuity between the two groups. We use a multivariate logic regression model to assess the risk of each participant. The results are expressed in terms of odds ratio (OR) and 95% confidence intervals (CI). Patients with NTG had significantly higher proportions of hypotension (adjusted OR, 1.984; 95% CI, 1.128–3.490), sleep disturbances (adjusted OR, 1.323; 95% CI, 1.146–1.528), peptic ulcers (adjusted OR, 1.383; 95% CI, 1.188–1.609) and allergic rhinitis (adjusted OR, 1.484; 95% CI, 1.290–1.707) than those with POAG. Conversely, arterial hypertension (adjusted OR, 0.767; 95% CI, 0.660–0.893), diabetes (adjusted OR, 0.850; 95% CI, 0.728–0.993) and atopic dermatitis (adjusted OR, 0.869; 95% CI, 0.763–0.990) had a lower risk in the NTG group than in the POAG group. We found that comorbidities such a hypotension, sleep disturbances and peptic ulcer and allergic rhinitis are more highly associated to NTG than POAG. [ABSTRACT FROM AUTHOR]

Patients with NTG or POAG with more than one outpatient or discharge diagnosis from the ophthalmology department were included in the study. These data were merged with the PM2.5 data from the Air Quality Monitoring Network for analysis. This was a case−control study, with 1006 participants in the NTG group and 2533 in the POAG group. To investigate fine particulate matter (PM2.5) exposure levels in patients with normal-tension glaucoma (NTG) and primary open-angle glaucoma (POAG), patient data were obtained from Taiwan’s Longitudinal Health Insurance Database 2000 for the 2008 to 2013 period. We used a multivariate logic regression model to assess the risk for each participant. The PM2.5 exposure levels were divided into four groups: <25th percentile (Q1), <617 μg/mm3; 25th to 50th percentile (Q2), 617 to 1297 μg/mm3; 50th to 75th percentile (Q3), 1297 to 2113 μg/mm3; and >75th percentile (Q4), >2113 μg/mm3. The results are expressed in terms of odds ratio (OR) and 95% CI. A multiple logistic regression was used to compare the results of the NTG group with those of the POAG group. Compared with the PM2.5 Q1 level, the OR of the PM2.5 Q2 level was 1.009 (95% CI 0.812−1.254), the PM2.5 Q3 level was 1.241 (95% CI 1.241−1.537, p < 0.05), and the PM2.5 Q4 level was 1.246 (95% CI 1.008−1.539, p < 0.05). Our research reveals that compared with POAG, the risk of developing NTG is more closely related with PM2.5 exposure, and PM2.5 has a concentration−dose effect. It is hoped that in the future, in the clinical judgment of NTG and POAG, the level of PM2.5 in the environment can be taken as a risk factor.

Primary open-angle glaucoma (POAG) is the most common type of glaucoma. However, little is known about POAG in adults and exposure to air pollution. The current study aims to investigate whether exposure to particulate matter with a mass median aerodynamic diameter of ≤2.5 μm (PM 2.5 ) is associated with POAG diagnosis. Patient data were obtained from the Longitudinal Health Insurance Database 2010 (LHID2010) of Taiwan for the 2008-2013 period. PM 2.5 concentration data, collected from the Ambient Air Quality Monitoring Network established by the Environmental Protection Administration of Taiwan, were categorized into four groups according to World Health Organization (WHO) exposure standards for PM 2.5 . We estimated the odds ratios (ORs) and 95% CIs for risk factors for POAG with logistic regression. The OR of per WHO standard level increase was 1.193 (95% CI 1.050-1.356). Compared with the normal level, the OR of WHO 2.0 level was 1.668 (95% CI 1.045-2.663, P < 0.05). After excluding confounding risk factors for POAG in this study, we determined that increased PM 2.5 exposure is related to POAG risk (ORs > 1, P < 0.05). In this study, PM 2.5 was an independent factor associated with open-angle glaucoma. Further research is required to better understand the mechanisms connecting PM 2.5 and open-angle glaucoma., Competing Interests: The authors declare no conflicts of interest.

Purpose: To investigate factors that may contribute to the myopization of urban elementary school students in Taiwan., Methods: Grades 1 to 6 students of the same racial background (n = 1894; mean age, 6.3-11.3 years) in three schools, located in Tamsui, Taichung, and Tainan, were refracted to obtain the best corrected visual acuity. The refractive power needed for best corrected visual acuity was used for subsequent statistical analysis. On behalf of their children, parents also completed a questionnaire on six categories of potential myopization variables. Correlation between these variables and the increase or decrease in the refractive error was assessed. The predictive value of each variable was also calculated based on linear regression analysis., Results: The overall mean refractive error in grades 1 to 6 was -0.37, -0.68, -1.33, -1.60, -1.90, and -2.51 D, respectively. The prevalence of myopia (-1.00 D or more minus) showed a significant difference between grades 2 and 3 and, again, between grades 5 and 6. In addition, 20 potential modulating factors were evaluated; 65.9% of the change in the refractive error could be explained by four: (1) lag in optimal correction, defined as a -1.00-D deficit between new refractive error and current optical correction; (2) outdoor spectacle wear; (3) spectacles for different working distances; and (4) hours spent on reading and writing on weekdays. In contrast, outdoor time and the intake frequency of 36 food items both held very low predictive values of 0.2% and 2.5%, respectively., Conclusions: Each variable associated with the refractive error has a different predictive value, either positive or negative. Ultimately, the interplay of these variables decides the outcome of the pattern and the degree of school myopia.