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The Association between Nearwork-Induced Transient Myopia and Progression of Refractive Error: A 3-Year Cohort Report from Beijing Myopia Progression Study


Zhong Lin, Balamurali Vasudevan, Yuan Bo Liang, Hong Jia Zhou, Kenneth J. Ciuffreda


Beijing Science & Technology Novel Star Program




Journal of Optometry


  • The purpose of this study is to investigate the natural change of nearwork-induced transient myopia (NITM), and its association with the progression of refractive error.

  • Students of the Beijing Myopia Progression Study were examined at baseline and follow-up examinations, which included cycloplegic autorefraction. Initial NITM and its decay were assessed objectively immediately after binocularly-viewing and performing a sustained 5-minute near task (20 cm).

  • There were 223 students with both NITM and cycloplegic refractive data enrolled. There were 142 myopic (63.7%), 32 emmetropic (14.4%), and 49 hyperopic (22.0%) students according to their baseline cycloplegic refraction.

  • The annual refractive change was −0.45 (−0.73, −0.21) D. From the baseline to the one-year and two-year follow-up periods, the initial NITM (median) increased significantly in the myopic students (0.16, 0.21, and 0.20D, p = 0.01, respectively).

  • The overall proportion of NITM decay types shifted significantly from none being induced at baseline (non-induced: 17.0%, complete decay 57.4%, incomplete decay 25.6%) to incomplete decay at the 2-year follow-up (non-induced: 6.7%, complete decay 65.0%, incomplete decay 28.3%, p = 0.01).

  • For the hyperopic students, after adjusting for risk factors, for every 1 diopter increase in the initial NITM at baseline, there was approximately a −1.48 diopter more relative myopic refractive progression (p = 0.01).

  • No significant association was found between refractive change and the NITM parameters for either the myopic or emmetropic students after adjusting for the same confounders.

  • However, this relation was significant in the hyperopes (p = 0.01).

  • NITM was only found to be significantly associated with the progression of a myopic refractive shift among the hyperopes.