Time spent outdoors partly accounts for the effect of education on myopia

Clark, Rosie, Kneepkens, Sander C. M., Plotnikov, Denis, Shah, Rupal L., Huang, Yu, Tideman, J. Willem L., Klaver, Caroline C. W., Atan, Denize, Williams, Cathy and Guggenheim, Jeremy A. ORCID: https://orcid.org/0000-0001-5164-340X 2023. Time spent outdoors partly accounts for the effect of education on myopia. Investigative Ophthalmology & Visual Science 64 (14) , 38. 10.1167/iovs.64.14.38

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Abstract

Purpose: The purpose of this study was to investigate if education contributes to the risk of myopia because educational activities typically occur indoors or because of other factors, such as prolonged near viewing. Methods: This was a two-sample Mendelian randomization study. Participants were from the UK Biobank, Avon Longitudinal Study of Parents and Children, and Generation R. Genetic variants associated with years spent in education or time spent outdoors were used as instrumental variables. The main outcome measures were: (1) spherical equivalent refractive error attained by adulthood, and (2) risk of an early age-of-onset of spectacle wear (EAOSW), defined as an age-of-onset of 15 years or below. Results: Time spent outdoors was found to have a small genetic component (heritability 9.8%) that tracked from childhood to adulthood. A polygenic score for time outdoors was associated with children's time outdoors; a polygenic score for years spent in education was inversely associated with children's time outdoors. Accounting for the relationship between time spent outdoors and myopia in a multivariable Mendelian randomization analysis reduced the size of the causal effect of more years in education on myopia to −0.17 diopters (D) per additional year of formal education (95% confidence interval [CI] = −0.32 to −0.01) compared with the estimate from a univariable Mendelian randomization analysis of −0.27 D per year (95% CI = −0.41 to −0.13). Comparable results were obtained for the outcome EAOSW. Conclusions: Accounting for the effects of time outdoors reduced the estimated causal effect of education on myopia by 40%. These results suggest about half of the relationship between education and myopia may be mediated by children not being outdoors during schooling.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Optometry and Vision Sciences
Publisher:	Association for Research in Vision and Ophthalmology
ISSN:	1552-5783
Funders:	Cardiff University, Welsh Government and Fight for Sight
Date of First Compliant Deposit:	29 November 2023
Date of Acceptance:	31 October 2023
Last Modified:	30 Nov 2023 09:30
URI:	https://orca.cardiff.ac.uk/id/eprint/164445

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