Prevalence of Myopia in 19-Year-Old Men in Gyeongsangnam-do, Ulsan and Busan in 2002

Sang Joon Lee; Jung Min Kim; Byeng Chul Yu; Sang Hwa Urm; Ki Su Ahn; Yong Hwan Lee; Shin Dong Kim

doi:10.3341/jkos.2009.50.9.1392

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Lee, Kim, Yu, Urm, Ahn, Lee, and Kim: Prevalence of Myopia in 19-Year-Old Men in Gyeongsangnam-do, Ulsan and Busan in 2002

Original Article

J Korean Ophthalmol Soc 2009;50(9):1392-1403.

Published online: 7 September 2009

DOI: https://doi.org/10.3341/jkos.2009.50.9.1392

Prevalence of Myopia in 19-Year-Old Men in Gyeongsangnam-do, Ulsan and Busan in 2002

Sang Joon Lee, MD¹, Jung Min Kim, MD², Byeng Chul Yu, MD², Sang Hwa Urm, MD³, Ki Su Ahn, MD⁴, Yong Hwan Lee, MD², Shin Dong Kim, MD¹

¹Department of Ophthalmology, College of Medicine, Kosin University, Busan, Korea

²Department of Preventive medicine, College of Medicine, Kosin University, Busan, Korea

³Department of Preventive medicine, College of Medicine, Inje University, Busan, Korea

⁴Lee Eye Clnic, Busan, Korea

Address reprint requests to Byeng Chul Yu, MD Department of Preventive medicine, College of Medicine, Kosin University #34 Amnam-dong, Seo-gu, Busan 602-703, Korea Tel: 82-51-990-6425, Fax: 82-51-990-3081, E-mail: ybc777@kosinmed.or.kr

Received 7 August 2008 Accepted 30 June 2009

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To investigate the prevalence of myopia and its influencing factors in an epidemiologic study of conscripts living in Gyeongsangnam-do, Ulsan and Busan.

Methods

A cross-sectional study was conducted in 19-year-old conscripts in Gyeongsangnam-do, Ulsan and Busan. Health checkup data of the conscripts were collected and analyzed along with subjective visual acuity, noncycloplegic autorefraction test, biometric data, and social factors such as education level and residence area. Myopia and high myopia were defined as having a refractive error of more than −0.5D, −6.0D, respectively. To analyze the social and biometric effects, we classified social factors into three groups and biometric factors into five groups. The estimated myopic prevalence was calculated adding excluded conscripts who scored under 0.5 on the subjective visual acuity test and missed autorefraction data. Data analysis was performed with descriptive analysis and the chi square test for trends using the Statistical Package for the Social Sciences (SPSS) version 14.0K.

Results

From 66,917 eligible conscripts, 50,243 were analyzed. The prevalence of myopia and high myopia in 19-year-old men in Gyeongsangnam-do, Ulsan and Busan were 45.60% (95% CI: 45.17∼46.03) and 11.50% (95% CI: 11.23∼11.77). The estimated myopic prevalence using 66,917 eligible conscripts was 54.31% (95% CI: 53.88∼54.74).

Conclusions

The prevalence of myopia and high myopia and the estimated prevalence of myopia in 19– year-old men in Gyeongsangnam-do, Ulsan and Busan were 45.60%, 11.50% and 54.31%, respectively.

Keywords: Conscripts, High myopia, Myopia, Prevalence

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Table 1.

General characteristics of study subjects

Variable	Frequency (N)		Proportion (%)
Age
19 years old	50,243		100.00
Gender
male	50,243		100.00
Residence area
rural area (Eup & Myeon)	3,058		6.09
urban area (small city)	14,945		29.75
metropolis area (Busan & Ulsan)	32,231		64.16
Subtotal^∗	50,234		100.00
Education status
high school graduates & under	10,647		21.19
student of 2- and 3-year college	15,931		31.71
student of 4- and 6-year university	23,662		47.10
Subtotal^∗	50,240		100.00
Height (Mean± SD cm)		173.40±5.65
Weight (Mean± SD kg)		65.92±11.17
BMI (Mean± SD kg/m²)		21.90±11.17
BP (Mean± SD mmHg)
systolic BP		124.55±14.66
diastolic BP		71.39±9.19

^∗ Missing data were excluded from subtotal sum.

Table 2.

Prevalence of myopia and high myopia

Classification	Number of subjects (N)	Prevalence^∗ (95% CI)
Non-myopia	27,330	54.39 (53.96∼54.82)
Myopia (≥-0.5D)	22,913	45.60 (45.17∼46.03)
High myopia (≥-6.0D)	5,776	11.50 (11.23∼11.77)

^∗ (%)

Table 3.

Comparison of myopic and high myopic prevalence by residence area

Type of residence area	Crude prevalence (%)		Adjusted prevalence (%)^Π
Type of residence area	Myopia^∗(95% CI)	High myopia^†(95% CI)	Myopia^‡(95% CI)	High myopia^§(95% CI)
Rural area	36.36	8.70	38.78	9.38
(Eup & Myeon)	(35.95∼36.77)	(8.45∼8.95)	(38.35∼39.21)	(9.13∼9,63)
Urban area	41.57	13.79	42.11	14.06
(small city)	(41.14∼42.00)	(13.50∼14.08)	(41.68∼42.54)	(13.75∼14.37)
Metropolis area	48.35	10.70	47.90	10.54
(Busan & Ulsan)	(47.92∼48.78)	(10.43∼10.97)	(47.47∼48.33)	(10.27∼10.81)

^∗ Chi square for trend (p<0.0001), Myopia≥-0.5D;

^† Chi square for trend (p<0.0001), High myopia≥-6.0D;

^‡ Chi square for trend (p<0.0001);

^§ Chi square for trend (p=0.0096);

^Π Adjusted by education status.

Table 4.

Comparison of myopic and high myopic prevalence by education status

Education status	Crude prevalence (%)		Adjusted prevalence (%)^Π
Education status	Myopia^∗(95% CI)	High myopia^†(95% CI)	Myopia^‡(95% CI)	High myopia^§(95% CI)
High school graduate & under	23.80	3.96	23.89	3.97
High school graduate & under	(23.43∼24.17)	(3.78∼4.14)	(23.52∼24.26)	(3.79∼4.15)
Student of 2- and 3-year college	36.76	7.85	36.98	7.82
Student of 2- and 3-year college	(36.33∼37.19)	(7.61∼8.09)	(36.55∼37.41)	(7.58∼8.06)
Student of 4- and 6-year university	61.37	17.34	61.22	17.40
Student of 4- and 6-year university	(60.94∼61.80)	(17.04∼17.67)	(60.79∼61.65))	(17.07∼17.73)

^∗ Chi square for trend (p<0.0001), Myopia≥-0.5D;

^† Chi square for trend (p<0.0001), High myopia≥-6.0D;

^‡ Chi square for trend (p<0.0001);

^§ Chi square for trend (p<0.0001);

^Π Adjusted by residence area.

Table 5.

Comparison of myopic and high myopic prevalence according to each residence area by education status

Type of residence area	Education status	Crude prevalence (%)
Type of residence area	Education status	Myopia	High myopia
Rural area^∗ (Eup & Myeon)	High school graduate & under	17.51	3.15
		(17.18∼17.84)	(2.99∼3.31)
	Student of 2- and 3-year college	27.83	6.42
		(27.44∼28.22)	(6.20∼6.64)
	Student of 4- and 6-year university	55.72	14.18
		(55.29∼56.15)	(13.87∼14.49)
Urban area^† (small city)	High school graduate & under	20.94	4.52
		(20.59∼21.29)	(4.34∼4.70)
	Student of 2- and 3-year college	32.85	9.21
		(32.44∼33.26)	(8.96∼9.46)
	Student of 4- and 6-year university	57.87	21.16
		(57.44∼58.30)	(20.81∼21.51))
Metropolis area^‡ (Busan & Ulsan)	High school graduate & under	28.54	4.18
		(28.15∼28.93)	(4.00∼4.36)
	Student of 2- and 3-year college	39.77	7.31
		(39.38∼40.16)	(7.09∼7.53)
	Student of 4- and 6-year university	63.30	15.76
		(62.87∼63.73)	(15.45∼16.07)

^∗ Chi square for trend, Myopia (≥-0.5D) (p<0.0001) & High myopia (≥-6.0D) (p<0.0001);

^† Chi square for trend, Myopia (p<0.0001) & High myopia (p<0.0001);

^‡ Chi square for trend, Myopia (p<0.0001) & High myopia (p<0.0001).

Table 6.

Comparison of myopic and high myopic prevalence according to each education status by type of residence area

Education status	Type of residence area	Crude prevalence (%)
Education status	Type of residence area	Myopia	High myopia
High school graduate & under^∗	Rural area (Eup & Myeon)	17.51	3.15
		(17.18∼17.84)	(2.99∼3.31)
	Urban area (small city)	20.94	4.52
		(20.59∼21.29)	(4.34∼4.70)
	Metropolis area (Busan & Ulsan)	28.54	4.18
		(28.15∼28.93)	(4.00∼4.36)
Student of 2- and 3-year-course college^†	Rural area (Eup & Myeon)	27.83	6.42
		(27.44∼28.22)	(6.20∼6.64)
	Urban area (small city)	32.85	9.21
		(32.44∼33.26)	(8.96∼9.46)
	Metropolis area (Busan & Ulsan)	39.77	7.31
		(39.38∼40.16)	(7.09∼7.53)
Student of 4- and 6-year-course university^‡	Rural area (Eup & Myeon)	55.72	14.18
		(55.29∼56.15)	(13.87∼14.49)
	Urban area (small city)	57.87	21.16
		(57.44∼58.30)	(20.81∼21.51))
	Metropolis area (Busan & Ulsan)	63.30	15.76
		(62.87∼63.73)	(15.45∼16.07)

^∗ Chi square for trend, Myopia (≥-0.5D) (p<0.0001) & High myopia (≥-6.0D) (p=0.0002);

^† Chi square for trend, Myopia (p<0.0001) & High myopia (p=0.0179);

^‡ Chi square for trend, Myopia (p<0.0001) & High myopia (p=0.0030).

Table 7.

Comparison of myopic and high myopic prevalence by level of stature

Level of stature (quintile)	Crude prevalence (%)		Adjusted prevalence (%)
	Crude prevalence (%)		Adjusted by residence area		Adjusted by education status
	Myopia^∗(95% CI)	High myopia^†(95% CI)	Myopia^‡(95% CI)	High myopia^§(95% CI)	Myopia^Π(95% CI)	High myopia^#(95% CI)
1st quintile^∗∗	44.31	10.83	44.50	10.83	45.59	11.25
	(43.88∼44.74)	(10.58∼11.08)	(44.07∼44.93)	(10.56∼11.10)	(45.16∼46.02)	(10.98∼11.54)
2nd quintile^††	45.74	11.43	45.80	11.55	45.85	11.42
	(45.31∼46.17)	(11.16∼11.70)	(45.42∼46.23)	(11.28∼11.82)	(45.42∼46.28)	(11.13∼11.69)
3rd quintile^‡‡	45.88	11.56	45.75	11.55	45.43	11.45
	(45.45∼46.31)	(11.29∼11.83)	(45.32∼46.18)	(11.28∼11.82)	(45.00∼45.86)	(11.16∼11.72)
4th quintile^§§	46.05	11.75	46.10	11.77	45.72	11.60
	(45.62∼46.93)	(11.48∼12.02)	(45.67∼46.53)	(11.50∼12.04)	(45.29∼46.15)	(11.33∼11.89)
5th quintile^ΠΠ	46.74	12.16	46.80	12.17	46.00	11.86
	(46.31∼47.17)	(11.87∼12.45)	(46.37∼47.23)	(11.88∼12.46)	(45.57∼46.43)	(11.57∼12.15)

^∗ Chi square for trend (p=0.0010), Myopia≥0.5D;

^† Chi square for trend (p=0.0032), High myopia≥-6.0D;

^‡ Chi square for trend (p=0.0019);

^§ Chi square for trend (p=0.0041);

^Π Chi square for trend (p=0.6614);

^# Chi square for trend (p=0.1655);

^∗∗ 1∼20 percentile (169 cm≤);

^†† 21∼40 percentile (169 cm<&≤172 cm);

^‡‡ 41∼60 percentile (172 cm<&≤175 cm);

^§§ 61∼80 percentile (175 cm<&≤178 cm);

^ΠΠ 81∼100 percentile (178 cm<).

Table 8.

Comparison of myopic and high myopic prevalence by level of weight

Level of weight (quintile)	Crude prevalence (%)		Adjusted prevalence (%)
	Crude prevalence (%)		Adjusted by residence area		Adjusted by education status
	Myopia∗(95% CI)	High myopia^†‡(95% CI)	Myopia^‡(95% CI)	High myopia^§(95% CI)	Myopia^Π(95% CI)	High myopia^#(95% CI)
1st quintile^∗∗	45.00	11.00	45.15	10.90	47.97	12.09
	(44.57∼45.43)	(10.75∼11.25)	(44.72∼45.58)	(10.63∼11.17)	(47.54∼48.40)	(11.80∼12.38)
2nd quintile^††	45.00	11.50	45.20	11.48	45.79	11.76
	(44.57∼45.43)	(11.25∼11.75)	(44.77∼45.63)	(11.20∼11.76)	(45.36∼46.2)	(11.48∼12.04)
3rd quintile^‡‡	46.52	12.14	46.54	12.15	45.51	11.74
	(46.09∼46.95)	(11.85∼12.43)	(46.11∼46.97)	(11.86∼12.44)	(45.08∼45.94)	(11.47∼12.17)
4th quintile^§§	46.24	11.68	46.28	11.70	44.47	11.04
	(45.81∼46.67)	(11.43∼11.93)	(45.85∼46.71)	(11.42∼11.98)	(44.04∼44.90)	(10.77∼11.31)
5th quintile^ΠΠ	45.45	11.24	45.30	11.27	44.59	10.91
	(45.02∼45.88)	(10.99∼11.49)	(44.87∼45.73)	(10.98∼11.56)	(44.16∼45.02)	(10.64∼11.18)

^∗ Chi square for trend (p=0.1743), Myopia≥-0.5D;

^† Chi square for trend (p=0.5132), High myopia≥-6.0D;

^‡ Chi square for trend (p=0.3810);

^§ Chi square for trend (p=0.3062);

^Π Chi square for trend (p<0.0001);

^# Chi square for trend (p=0.0023);

^∗∗ 1∼20 percentile (57 kg≤);

^†† 21∼40 percentile5 (57 kg<&≤62 kg);

^‡‡ 41∼60 percentile (62 kg<&≤67 kg);

^§§ 61∼80 percentile (67 kg<&≤74 kg);

^ΠΠ 81∼100 percentile (74 kg<).

Table 9.

Comparison of subjective visual acuity and refractive error according to the degree of myopia

Reference	Myopic degree
Reference	-0.25D	-0.50D	-0.75D	-1.00D	-1.50D	-2.00D	-2.50D	-3.00D
Duke-Elder³⁶⁾					6/18		6/60
Jung et al³⁷⁾	20/20	20/38	20/50	20/63	20/85	20/105	20/124	20/142
Yang et al³⁸⁾		0.75	0.70	0.50
Baek et al³⁹⁾	0.76	0.66	0.58	0.50	0.38	0.31	0.22	0.17

Table 10.

Estimated prevalence of myopia using added subjects with myopic probability

	Limits of subjective visual acuity for estimated prevalence
	0.5	0.6	0.7	0.8
Number of added subjects with	9,575	12,049	14,545	16,636
myopic probability
Estimated prevalence	54.31	56.13	57.82	59.10
(95% CI)	(53.88∼54.74)	(55.70∼56.56)	(57.39∼58.25)	(58.67∼59.53)

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