Grupo de Investigación en Optometría-Facultad de Optometría de la Universidad Antonio Nariño, Bogotá, Colombia.
Retinal Pathologies and New Therapies Group, Experimental Ophthalmology Laboratory, Department of Ophthalmology, Clinica Universidad de Navarra, Pamplona, Spain.
Sci Rep. 2024 Jan 11;14(1):1097. doi: 10.1038/s41598-024-51417-9.
Outdoor exposure is considered the primary modifiable risk factor in preventing the development of myopia. This effect is thought to be attributed to the light-induced synthesis and release of dopamine in the retina. However, until recent years, there was no objective quantifiable method available to measure the association between time spent outdoors and myopia. It is only recently that the conjunctival ultraviolet autofluorescence (CUVAF) area, serving as a biomarker for sun exposure, has begun to be utilized in numerous studies. To provide a comprehensive summary of the relevant evidence pertaining to the association between the CUVAF area and myopia across different geographic regions and age groups, a systematic review and meta-analysis were conducted. The search encompassed multiple databases, including MEDLINE, SCIENCE DIRECT, GOOGLE SCHOLAR, WEB OF SCIENCE, and SCOPUS, and utilized specific search terms such as "conjunctival ultraviolet autofluorescence", "CUVAF", "UVAF", "objective marker of ocular sun exposure", "myopia", "degenerative myopia", and "high myopia". The bibliographic research included papers published between the years 2006 and 2022. A total of 4051 records were initially identified, and after duplicates were removed, 49 articles underwent full-text review. Nine articles were included in the systematic review. These studies covered myopia and outdoor exposure across different regions (Australia, Europe and India) with a total population of 3615 individuals. They found that myopes generally had smaller CUVAF areas compared to non-myopes. The meta-analysis confirmed this, revealing statistically smaller CUVAF areas in myopic patients, with a mean difference of - 3.30 mm (95% CI - 5.53; - 1.06). Additionally, some studies showed a positive correlation between more outdoor exposure and larger CUVAF areas. In terms of outdoor exposure time, myopic patients reported less time outdoors than non-myopic individuals, with a mean difference of - 3.38 h/week (95% CI - 4.66; - 2.09). Overall, these findings highlight the connection between outdoor exposure, CUVAF area and myopia, with regional variations playing a significant role. The results of this meta-analysis validate CUVAF as a quantitative method to objectively measure outdoor exposure in relation with myopia development.
户外暴露被认为是预防近视发展的主要可改变风险因素。这种影响被认为归因于光诱导的视网膜中多巴胺的合成和释放。然而，直到最近几年，还没有可用于衡量户外活动时间与近视之间关联的客观可量化方法。直到最近，作为太阳暴露生物标志物的结膜紫外线自发荧光 (CUVAF) 区域才开始在许多研究中得到应用。为了全面总结不同地理区域和年龄组的 CUVAF 区域与近视之间关联的相关证据，进行了系统评价和荟萃分析。检索涵盖了多个数据库，包括 MEDLINE、SCIENCE DIRECT、GOOGLE SCHOLAR、WEB OF SCIENCE 和 SCOPUS，并使用了特定的搜索词，如“结膜紫外线自发荧光”、“CUVAF”、“UVAF”、“眼部阳光暴露的客观标志物”、“近视”、“退行性近视”和“高度近视”。文献研究包括 2006 年至 2022 年期间发表的论文。最初确定了 4051 条记录，去除重复项后，有 49 篇文章进行了全文审查。有 9 篇文章被纳入系统评价。这些研究涵盖了澳大利亚、欧洲和印度等不同地区的近视和户外活动，总共有 3615 人。他们发现，与非近视者相比，近视者的 CUVAF 区域通常较小。荟萃分析证实了这一点，表明近视患者的 CUVAF 区域较小，平均差异为-3.30mm（95%CI-5.53；-1.06）。此外，一些研究表明，更多的户外活动与更大的 CUVAF 区域之间存在正相关。就户外活动时间而言，近视患者报告的户外活动时间少于非近视者，平均差异为-3.38 小时/周（95%CI-4.66；-2.09）。总体而言，这些发现强调了户外暴露、CUVAF 区域和近视之间的联系，区域差异起着重要作用。荟萃分析的结果验证了 CUVAF 作为一种客观测量与近视发展相关的户外活动的定量方法。
