Ha Ahnul, Lee Yun Jeong, Lee Marvin, Shim Sung Ryul, Kim Young Kook
Department of Ophthalmology, Jeju National University Hospital, Jeju-si, Korea.
Department of Ophthalmology, Jeju National University School of Medicine, Jeju-si, Korea.
JAMA Netw Open. 2025 Feb 3;8(2):e2460026. doi: 10.1001/jamanetworkopen.2024.60026.
The association of digital screen time with myopia has been documented, but the dose-response association and safe exposure threshold remain unclear.
To evaluate the dose-response association of time spent on digital screens with myopia risk.
PubMed, EMBASE, Cochrane Library databases, CINAHL, and ClinicalTrials.gov were searched for full-length articles from peer-reviewed journals without restrictions on study design, publication date, or language from inception to November 25, 2024.
Primary research articles investigating the association of exposure to digital screen devices (ie, smartphones, tablets, game consoles, computers, or television) with myopia-related outcomes (ie, prevalent or incident myopia and the rate of myopia progression) were identified by reviewers.
Two independent reviewers extracted data using a standardized procedure in accordance with the Meta-Analysis of Observational Studies in Epidemiology (MOOSE) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. A random-effects, dose-response meta-analysis (DRMA) was utilized to examine the pattern of the association of screen time with myopia.
Increased odds of myopia per hour of daily screen time.
In the linear DRMA of 45 studies with 335 524 participants (mean [SD] age, 9.3 [4.3] years), an additional hour of daily screen time was associated with higher odds of myopia (odds ratio [OR], 1.21; 95% CI, 1.13-1.30). The nonlinear DRMA of 34 studies with 314 910 participants also indicated higher odds of myopia with increasing screen time, ranging from 1 hour of daily exposure (OR, 1.05; 95% CI, 1.01-1.09) to 4 hours (OR, 1.97; 95% CI, 1.56-2.40). The dose-response curve showed myopia risk increasing significantly between 1 to 4 hours of daily screen time, and then rising more gradually after 4 hours.
In this systematic review and DRMA, a daily 1-hour increment in digital screen time was associated with 21% higher odds of myopia and the dose-response pattern exhibited a sigmoidal shape, indicating a potential safety threshold of less than 1 hour per day of exposure, with an increase in odds up to 4 hours. These findings can offer guidance to clinicians and researchers regarding myopia risk.
数字屏幕使用时间与近视之间的关联已有文献记载，但剂量反应关联和安全暴露阈值仍不明确。
评估数字屏幕使用时间与近视风险之间的剂量反应关联。
检索了PubMed、EMBASE、Cochrane图书馆数据库、CINAHL和ClinicalTrials.gov，以获取同行评审期刊上的全文文章，对研究设计、出版日期或语言均无限制，检索时间从数据库建立至2024年11月25日。
评审人员确定了主要研究文章，这些文章调查了接触数字屏幕设备（即智能手机、平板电脑、游戏机、电脑或电视）与近视相关结果（即近视患病率或发病率以及近视进展率）之间的关联。
两名独立评审人员按照流行病学观察性研究的Meta分析（MOOSE）和系统评价与Meta分析的首选报告项目（PRISMA）报告指南，使用标准化程序提取数据。采用随机效应剂量反应Meta分析（DRMA）来研究屏幕使用时间与近视之间的关联模式。
每日屏幕使用时间每增加一小时，近视几率增加。
在对45项研究、335524名参与者（平均[标准差]年龄为9.3[4.3]岁）进行的线性DRMA中，每日屏幕使用时间每增加一小时，近视几率更高（优势比[OR]为1.21；95%置信区间为1.13 - 1.30）。对34项研究、314910名参与者进行的非线性DRMA也表明，随着屏幕使用时间增加，近视几率更高，范围从每日暴露1小时（OR为1.05；95%置信区间为1.01 - 1.09）到4小时（OR为1.97；95%置信区间为1.56 - 2.40）。剂量反应曲线显示，在每日屏幕使用时间1至4小时之间，近视风险显著增加，4小时后上升更为平缓。
在这项系统评价和DRMA中，数字屏幕使用时间每日增加1小时与近视几率高21%相关，且剂量反应模式呈S形，表明潜在安全阈值为每日暴露少于1小时，4小时内几率增加。这些发现可为临床医生和研究人员提供有关近视风险的指导。
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