Center for Ophthalmic Epidemiology and Healthcare Research, Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
PLoS One. 2019 Jan 29;14(1):e0211196. doi: 10.1371/journal.pone.0211196. eCollection 2019.
Myopia is increasing worldwide and possibly linked to education. In this study, we analyse the association of myopia and education in the U.S. and investigate its age-dependency.
We conducted a secondary data analysis using the public use files from the cross-sectional study National Health and Nutrition Examination Survey of the period from 1999 to 2008. 19,756 participants aged 20 to 85 years were included with data on education and ophthalmic parameters (distance visual acuity, objective refraction and keratometry). Spherical equivalent, astigmatism, corneal power and corneal astigmatism were evaluated for an association with education using linear regression analysis with adjustment of potential confounders.
Analysis revealed an association between spherical equivalent and educational level in the univariate analysis (P < .001), and in the adjusted model (P < .001). Subjects who attend school to less than 9th grade had a mean spherical equivalent of 0.34 D, subjects with 9-11th grade -0.14 D, subjects that finished high school -0.33 D, subjects with partial college education -0.70 D, subjects that graduated from college or a higher formal education -1.22 D. Subjects that graduated from college or above were -1.47 D more myopic compared to subjects that completed less than 9th grade school in the adjusted analyses. Astigmatism and corneal curvature was not associated with education.
Myopia is associated with higher education in the U.S. Our analysis shows that corneal curvature does not contribute to this association, therefore axial elongation or lens power are likely to contribute to myopia.
近视在全球范围内呈上升趋势，且可能与教育有关。本研究分析了美国近视与教育的关系，并探讨了其与年龄的相关性。
我们使用了 1999 年至 2008 年横断面研究国家健康和营养调查的公共使用文件进行二次数据分析。共纳入了 19756 名 20 至 85 岁的参与者，他们的数据包括教育程度和眼科参数（远视力、客观折射和角膜曲率计）。使用线性回归分析评估了球镜等效值、散光、角膜力和角膜散光与教育的关系，并对潜在混杂因素进行了调整。
单因素分析显示，球镜等效值与教育程度之间存在相关性（P<0.001），调整后的模型也显示出这种相关性（P<0.001）。未完成 9 年级学业的受试者平均球镜等效值为 0.34 D，完成 9-11 年级学业的受试者为 0.14 D，完成高中学业的受试者为 0.33 D，接受部分大学教育的受试者为 0.70 D，大学毕业或接受更高正规教育的受试者为 1.22 D。在调整分析中，大学毕业或以上的受试者比完成 9 年级以下学业的受试者近视程度深 1.47 D。散光和角膜曲率与教育程度无关。
在美国，近视与较高的教育程度有关。我们的分析表明，角膜曲率并不能解释这种相关性，因此轴向伸长或晶状体屈光力可能是导致近视的原因。
