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Evidence that emmetropization buffers against both genetic and environmental risk factors for myopia
Pozarickij, A. Enthoven, C.A. Ghorbani Mojarrad, Neema Plotnikov, D. Tedja, M.S. Haarman, A.E.G. Tideman, J.W.L. Polling, J.R. Northstone, K. Williams, C.
Pozarickij, A.
Enthoven, C.A.
Ghorbani Mojarrad, Neema
Plotnikov, D.
Tedja, M.S.
Haarman, A.E.G.
Tideman, J.W.L.
Polling, J.R.
Northstone, K.
Williams, C.
Publication Date
2020-02
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Copyright 2020 The Authors. This work is licensed under a Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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openAccess
Accepted for publication
2019-12-23
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Abstract
PURPOSE. To test the hypothesis that emmetropization buffers against genetic and environmental
risk factors for myopia by investigating whether risk factor effect sizes vary
depending on children’s position in the refractive error distribution.
METHODS. Refractive error was assessed in participants from two birth cohorts: Avon
Longitudinal Study of Parents and Children (ALSPAC) (noncycloplegic autorefraction) and
Generation R (cycloplegic autorefraction). A genetic risk score for myopia was calculated
from genotypes at 146 loci. Time spent reading, time outdoors, and parental myopia were
ascertained from parent-completed questionnaires. Risk factors were coded as binary
variables (0 = low, 1 = high risk). Associations between refractive error and each risk
factor were estimated using either ordinary least squares (OLS) regression or quantile
regression.
RESULTS. Quantile regression: effects associated with all risk factors (genetic risk,
parental myopia, high time spent reading, low time outdoors) were larger for children
in the extremes of the refractive error distribution than for emmetropes and low
ametropes in the center of the distribution. For example, the effect associated with
having a myopic parent for children in quantile 0.05 vs. 0.50 was as follows: ALSPAC:
age 15, –1.19 D (95% CI –1.75 to –0.63) vs. –0.13 D (–0.19 to –0.06), P = 0.001; Generation
R: age 9, –1.31 D (–1.80 to –0.82) vs. –0.19 D (–0.26 to –0.11), P < 0.001. Effect sizes
for OLS regression were intermediate to those for quantiles 0.05 and 0.50.
CONCLUSIONS. Risk factors for myopia were associated with much larger effects in children
in the extremes of the refractive error distribution, providing indirect evidence that
emmetropization buffers against both genetic and environmental risk factors.
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Citation
Pozarickji A, Enthoven CA, Ghorbani Mojarrad N et al (2020) Evidence that emmetropization buffers against both genetic and environmental risk factors for myopia. Investigative Ophthalmology & Visual Science. 61(2): 41.
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Article