Association of physical activity, sedentary behaviour, sleep duration and myopia in children and adolescents: a systematic review and dose-response meta-analysis
Description
This study aims to examine the dose-response relationships between physical activity (PA), sedentary behavior (SB), sleep duration (SD), and myopia incidence or prevalence, and to identify the daily exposure levels at which these factors significantly elevate the risk of myopia.
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1. Search methods for identifying studies The systematic search included the period from the inception of each database to November 19, 2024, and was conducted in four electronic databases: PubMed, EMBASE, The Cochrane Library, and Web of Science. The search terms included "myopia," "exercise," "sedentary behavior," and "sleep." 2.Eligibility criteria for considering studies for this review The inclusion criteria for the article were as follows: (1) Children and adolescents aged 5 to 19 years (2) PA, SB and SD as exposure factors and using a subjective or objective quantification of total daily or weekly time (3) Criteria defining myopia, with cycloplegia refraction or non-cycloplegia refraction measurements performed by ophthalmologists/optometrists, and myopia incidence or prevalence as an outcome indicator. (4) Prospective studies, cross-sectional studies, cohort studies (5) OR and 95% CI reported or sufficient data provided to calculate these values (6) Studies in English. Exclusions: (1) Participants younger than 5 or older than 19 years with eye disease or previously treated for myopia (2) Detailed information on daily/weekly physical activity, sedentary behavior, sleep duration, etc. was not provided. (3) Undefined criteria for myopia or self-reported myopia (4) Data types that could not be converted to OR and 95% CI (5) Abstracts, experimental studies, animal studies, systematic reviews or studies that were not written in English. 3. Study selection Two independent researchers (D.H.M. and J.L.Q.), independently screened titles and abstracts using EndNote (version: X20, Clarivate Analytics, Philadelphia, USA) against the inclusion and exclusion criteria. After comparing the screening results and clarifying any discrepancies, the full-text articles were obtained. Subsequently, the two reviewers independently reviewed the full-text articles and clarified any discrepancies through in-depth discussions. 4.Risk of Bias Assessment The methodological quality and risk of bias of the included studies were assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklists for Cross-Sectional and Cohort Studies26. The JBI tool for cross-sectional studies includes eight items that evaluate aspects such as study subjects, diseases, influencing factors, confounders, and data analysis, with each item rated as "yes," "no," "unclear," or "not applicable." The JBI tool for cohort studies includes 11 items, assessing the study design, control of confounding factors, and measurement of outcome indicators. Any disagreements between the two investigators were resolved through discussion with a senior investigator. 5.Data synthesis and analysis Categorical dose-response meta-analysis was performed using the META package for R (version 4.3.3). A continuous dose-response meta-analysis using the GLST package in Stata.