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JAMA Netw. Open, Feb 03 2025, 8 (2) e2460026 | https://doi.org/10.1001/jamanetworkopen.2024.60026
Digital Screen Time and Myopia: A Systematic Review and Dose-Response Meta-Analysis
Ahnul Ha, MD1,2; Yun Jeong Lee, MD3; Marvin Lee, MD4; Sung Ryul Shim, PhD5; Young Kook Kim, PhD6,7,8
1Department of Ophthalmology, Jeju National University Hospital, Jeju-si, Korea
2Department of Ophthalmology, Jeju National University School of Medicine, Jeju-si, Korea
3Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Korea
4Allbarun Eye Clinic, Suwon-si, Korea
5Department of Biomedical Informatics, College of Medicine, Konyang University, Daejeon, Korea
6Ranelagh Center for Biosocial Informatics, Seoul National University College of Medicine, Seoul, Korea
7Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea
8Trinity Biomedical Sciences Institute, School of Biochemistry and Immunology, Trinity College Dublin, The University of Dublin, Dublin, Ireland
Corresponding Author: Young Kook Kim, PhD
1Department of Ophthalmology, Jeju National University Hospital, Jeju-si, Korea
2Department of Ophthalmology, Jeju National University School of Medicine, Jeju-si, Korea
3Department of Ophthalmology, Chungnam National University Hospital, Daejeon, Korea
4Allbarun Eye Clinic, Suwon-si, Korea
5Department of Biomedical Informatics, College of Medicine, Konyang University, Daejeon, Korea
6Ranelagh Center for Biosocial Informatics, Seoul National University College of Medicine, Seoul, Korea
7Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea
8Trinity Biomedical Sciences Institute, School of Biochemistry and Immunology, Trinity College Dublin, The University of Dublin, Dublin, Ireland
Corresponding Author: Young Kook Kim, PhD
Abstract
Importance: The association of digital screen time with myopia has been documented, but the dose-response association and safe exposure threshold remain unclear.
Objective: To evaluate the dose-response association of time spent on digital screens with myopia risk.
Data sources: 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.
Study selection: 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.
Data extraction and synthesis: 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.
Main outcome and measures: Increased odds of myopia per hour of daily screen time.
Results: 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.
Conclusions and relevance: 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.
Objective: To evaluate the dose-response association of time spent on digital screens with myopia risk.
Data sources: 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.
Study selection: 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.
Data extraction and synthesis: 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.
Main outcome and measures: Increased odds of myopia per hour of daily screen time.
Results: 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.
Conclusions and relevance: 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.
논문정보
- Research article
- 2025년 02월 (BRIC 등록일 2025-02-25)
- 국내(교신)+국외 연구진
- 의약학 > 응용의학
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