Journal
INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE
Volume 55, Issue 12, Pages 8550-8558Publisher
ASSOC RESEARCH VISION OPHTHALMOLOGY INC
DOI: 10.1167/iovs.14-15839
Keywords
myopia; refractive error; epidemiology; vitamin D; light levels
Categories
Funding
- Medical Research Fellowship [G1002375]
- United Kingdom Medical Research Council (MRC) [MC_UU_12013/5, MC_UU_12013/9]
- MRC
- Wellcome Trust [092731]
- University of Bristol
- [G0701603]
- Medical Research Council [G0701603, MC_UU_12013/1, G1002375, MC_PC_15018, MC_UU_12013/9, MC_UU_12013/5] Funding Source: researchfish
- MRC [MC_UU_12013/5, G1002375, G0701603, MC_UU_12013/1, MC_UU_12013/9] Funding Source: UKRI
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PURPOSE. More time outdoors is associated with a lesser risk of myopia, but the underlying mechanism is unclear. We tested the hypothesis that 25-hydroxyvitamin D (vitamin D) mediates the protective effects of time outdoors against myopia. METHODS. We analyzed data for children participating in the Avon Longitudinal Study of Parents and Children (ALSPAC) population-based birth cohort: noncycloplegic autorefraction at age 7 to 15 years; maternal report of time outdoors at age 8 years and serum vitamin D2 and D3 at age 10 years. A survival analysis hazard ratio (HR) for incident myopia was calculated for children spending a high-versus low-time outdoors, before and after controlling for vitamin D level (N = 3677). RESULTS. Total vitamin D and D3, but not D2, levels were higher in children who spent more time outdoors (mean [95% confidence interval (CI)] vitamin D in nmol/L: Total, 60.0 [59.4-60.6] vs. 56.9 [55.0-58.8], P = 0.001; D3, 55.4 [54.9-56.0] vs. 53.0 [51.3-54.9], P = 0.014; D2, 5.7 [5.5-5.8] vs. 5.4 [5.1-5.8], P = 0.23). In models including both time outdoors and sunlight-exposure-related vitamin D, there was no independent association between vitamin D and incident myopia (Total, HR = 0.83 [0.66-1.04], P = 0.11; D3, HR = 0.89 [0.72-1.10], P = 0.30), while time outdoors retained the same strong negative association with incident myopia as in unadjusted models (HR = 0.69 [0.55-0.86], P = 0.001). CONCLUSIONS. Total vitamin D and D3 were biomarkers for time spent outdoors, however there was no evidence they were independently associated with future myopia.
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