The Guangzhou Twin Eye Study (GTES) is a cohort of twins living in South China that has been longitudinally followed for more than 15 years. This study has extensively investigated the heritability of myopia and the influence of environmental factors, producing significant and far-reaching impacts. GTES has found a high heritability of axial length and peripheral refraction, the significant role of education in myopia progression, and established prediction model for myopia onset and progression. The study has also explore the impact of both genetic and environmental factors on myopia development. By reviewing the major findings on myopia from the GTES, we hope to better inform public health strategies and clinical practices aimed at mitigating the global myopia epidemic.

The Guangzhou Twin Eye Study (GTES) is a cohort of twins living in South China that has been longitudinally followed for more than 15 years. This study has extensively investigated the heritability of myopia and the influence of environmental factors, producing significant and far-reaching impacts. GTES has found a high heritability of axial length and peripheral refraction, the significant role of education in myopia progression, and established prediction model for myopia onset and progression. The study has also explore the impact of both genetic and environmental factors on myopia development. By reviewing the major findings on myopia from the GTES, we hope to better inform public health strategies and clinical practices aimed at mitigating the global myopia epidemic.

Objective: To investigate the lifestyle and myopia among primary school students in urban areas of Fujian with the context of myopia prevention and control measures, aiming to provide scientific evidence for identifying high-risk myopia population and formulating effective intervention strategies. 

Methods: A cross-sectional study was conducted from October to November 2023, enrolling 811 fourth-grade students from three primary schools in three cities across Fujian. Personal information and lifestyle-related pattern were collected using customized questionnaire. Participants underwent comprehensive ophthalmic assessments including distance visual acuity tests and refractive examinations. Logistic regression analysis was used to assess the impact of lifestyle on the onset of myopia.

Results: The prevalence of myopia among fourth-grade students in urban primary schools in Fujian was 46.4%. Only 25.8% students engaged in outdoor activities for more than 2 hours daily, while63.3% participated in outdoor activities during class breaks. Multivariate Logistic regression analysis revealed that outdoor activities during class breaks (OR= 0.646 [95% confidence interval(CI): 0.473-0.881], P = 0.006) and daily time spent outdoors (2-3 hours, OR=0.682 [95%CI：0.466-0.993], P=0.047; more than 3 hours, OR=0.403 [95%CI: 0.192-0.796], P = 0.01) were independent protective factors against myopia. Lifestyle significantly enhanced the predictive performance for myopia (P = 0.01). Additionally, parental myopia (one parent with myopia, OR=2.247 [95%CI: 1.612- 3.145], P < 0.001; both parents with myopia, OR=4.824 [95%CI: 3.262-7.204], P < 0.001) emerged as a key risk factor for myopia.

Conclusion: There is considerable scope for improving the lifestyle of primary school students in urban areas of Fujian. Lifestyle is strongly associated with myopia onset, highlighting the need for schools and families to actively encourage students to engage in more outdoor activities and take breaks outdoors to prevent and control myopia. Students with parents, especially both parents, having myopia should be considered as a key target group for myopia prevention efforts.

Objective: To investigate the lifestyle and myopia among primary school students in urban areas of Fujian with the context of myopia prevention and control measures, aiming to provide scientific evidence for identifying high-risk myopia population and formulating effective intervention strategies. 

Methods: A cross-sectional study was conducted from October to November 2023, enrolling 811 fourth-grade students from three primary schools in three cities across Fujian. Personal information and lifestyle-related pattern were collected using customized questionnaire. Participants underwent comprehensive ophthalmic assessments including distance visual acuity tests and refractive examinations. Logistic regression analysis was used to assess the impact of lifestyle on the onset of myopia.

Results: The prevalence of myopia among fourth-grade students in urban primary schools in Fujian was 46.4%. Only 25.8% students engaged in outdoor activities for more than 2 hours daily, while63.3% participated in outdoor activities during class breaks. Multivariate Logistic regression analysis revealed that outdoor activities during class breaks (OR= 0.646 [95% confidence interval(CI): 0.473-0.881], P = 0.006) and daily time spent outdoors (2-3 hours, OR=0.682 [95%CI：0.466-0.993], P=0.047; more than 3 hours, OR=0.403 [95%CI: 0.192-0.796], P = 0.01) were independent protective factors against myopia. Lifestyle significantly enhanced the predictive performance for myopia (P = 0.01). Additionally, parental myopia (one parent with myopia, OR=2.247 [95%CI: 1.612- 3.145], P < 0.001; both parents with myopia, OR=4.824 [95%CI: 3.262-7.204], P < 0.001) emerged as a key risk factor for myopia.

Conclusion: There is considerable scope for improving the lifestyle of primary school students in urban areas of Fujian. Lifestyle is strongly associated with myopia onset, highlighting the need for schools and families to actively encourage students to engage in more outdoor activities and take breaks outdoors to prevent and control myopia. Students with parents, especially both parents, having myopia should be considered as a key target group for myopia prevention efforts.

Macular hemorrhage (MH) is one of the most severe complications of high myopia, posing a significant threat to vision. MH can occur with or without choroidal neovascularization (CNV), with the CNV-associated form being the most prevalent. CNV-related MH may develop secondary to conditions such as pathological myopia, and punctate inner choroidopathy. Conversely, MH without CNV is often linked to factors like lacquer cracks, trauma, ocular surgery. While the exact mechanisms of CNV in high myopia are still not fully understood, anti-VEGF injections have been shown to be effective in improving visual function in patients with CNV. This review summarizes the clinical characteristics of various causes of MH and their respective treatments, providing valuable insights to help clinicians make informed diagnostic and therapeutic decisions.

Macular hemorrhage (MH) is one of the most severe complications of high myopia, posing a significant threat to vision. MH can occur with or without choroidal neovascularization (CNV), with the CNV-associated form being the most prevalent. CNV-related MH may develop secondary to conditions such as pathological myopia, and punctate inner choroidopathy. Conversely, MH without CNV is often linked to factors like lacquer cracks, trauma, ocular surgery. While the exact mechanisms of CNV in high myopia are still not fully understood, anti-VEGF injections have been shown to be effective in improving visual function in patients with CNV. This review summarizes the clinical characteristics of various causes of MH and their respective treatments, providing valuable insights to help clinicians make informed diagnostic and therapeutic decisions.

Myopia, a common cause of visual impairment, together with the global decline in physical fitness and increasing prevalence of childhood obesity, has become a prominent global health problem. The beneficial effect of increasing the time of outdoor activities on the incidence of myopia and physical well-being in children has been widely recognized. However, in countries with highly competitive education systems, such as China, parents and school administrators may be reluctant to increase their children's time for extracurricular outdoor activities for fear of affecting their academic performance. Therefore, it is crucial to accurately assess the role of after-school outdoor activities in preventing and controlling myopia, as well as in promoting the physical and mental development of adolescents. Schools and families should be encouraged to collaboratively support children’s engagement in outdoor activities to foster their healthy growth. 

Given the dual benefits of outdoor activities—improving visual health and promoting overall physical and mental well-being—it is essential to encourage schools and families to work together to support children's engagement in such activities. By doing so, it is hoped that a balanced environment can be created, one that values both academic achievement and healthy development. Policymakers, educators, and parents must recognize the long-term advantages of integrating outdoor activities into children's daily lives, as this approach can help alleviate the burden of myopia, enhance physical fitness, and support emotional and cognitive development. Ultimately, fostering a culture that views outdoor activities as an essential component of education and health will be key to ensuring the well-rounded development of future generations.

Myopia, a common cause of visual impairment, together with the global decline in physical fitness and increasing prevalence of childhood obesity, has become a prominent global health problem. The beneficial effect of increasing the time of outdoor activities on the incidence of myopia and physical well-being in children has been widely recognized. However, in countries with highly competitive education systems, such as China, parents and school administrators may be reluctant to increase their children's time for extracurricular outdoor activities for fear of affecting their academic performance. Therefore, it is crucial to accurately assess the role of after-school outdoor activities in preventing and controlling myopia, as well as in promoting the physical and mental development of adolescents. Schools and families should be encouraged to collaboratively support children’s engagement in outdoor activities to foster their healthy growth.

Given the dual benefits of outdoor activities—improving visual health and promoting overall physical and mental well-being—it is essential to encourage schools and families to work together to support children's engagement in such activities. By doing so, it is hoped that a balanced environment can be created, one that values both academic achievement and healthy development. Policymakers, educators, and parents must recognize the long-term advantages of integrating outdoor activities into children's daily lives, as this approach can help alleviate the burden of myopia, enhance physical fitness, and support emotional and cognitive development. Ultimately, fostering a culture that views outdoor activities as an essential component of education and health will be key to ensuring the well-rounded development of future generations.