Purpose
To analyze the association between myopia and educational level in an adult European
cohort.
Design
Population-based cross-sectional study.
Participants
A cohort of the Gutenberg Health Study, including 4658 eligible enrollees between
35 and 74 years of age.
Methods
We applied a standardized protocol entailing a comprehensive questionnaire; thorough
ophthalmic, general, cardiovascular, and psychological examinations; and laboratory
tests, including genetic analyses. We documented achievement levels in school education
and post-school professional education. The spherical equivalent (SE) was determined
by noncycloplegic autorefractometry. We fitted mixed linear models including age,
gender, and 45 myopia-associated single nucleotide polymorphisms (SNP) as covariates.
Main Outcome Measures
Prevalence and magnitude of myopia in association with years spent in school and level
of post-school professional education.
Results
Individuals who graduated from school after 13 years were more myopic (median, −0.5
diopters [D]; first quartile [Q1]/third quartile [Q3], −2.1/0.3 D) than those who
graduated after 10 years (median, −0.2 D; Q1/Q3, −1.3/0.8 D), than those who graduated
after 9 years (median, 0.3 D; Q1/Q3, −0.6/1.4 D), and than those who never finished
secondary school (median, 0.2 D; Q1/Q3, −0.5/1.8 D;
P<0.001, respectively). The same holds true for persons with a university degree (median, −0.6
D; Q1/Q3, −2.3/0.3 D) versus those who finished secondary vocational school (median,
0 D; Q1/Q3, −1.1/0.8 D) or primary vocational school (median, 0 D; Q1/Q3, −0.9/1.1
D) versus persons without any post-school professional qualification (median, 0.6
D; Q1/Q3, −0.4/1.7 D;
P<0.001, respectively). Of persons who graduated from school after 13 years, 50.9%
were myopic (SE, ≤−0.5 D) versus 41.6%, 27.1%, and 26.9% after 10 years, in those
who graduated after 9 years, and in those who never graduated from secondary school,
respectively (
P<0.001). In university graduates, the proportion of myopic persons was higher (53%)
than that of those who graduated from secondary (34.8%) or primary (34.7%) vocational
schools and than in those without any professional training (23.9%;
P<0.001, respectively). In multivariate analyses: higher school and professional levels
of education were associated with a more myopic SE independent of gender. There was
a small effect of age and SNPs.
Conclusions
Higher levels of school and post-school professional education are associated with
a more myopic refraction. Participants with higher educational achievements more often
were myopic than individuals with less education.
Abbreviations and Acronyms:
CI ( confidence interval), D ( diopters), GHS ( Gutenberg Health Study), SE ( spherical equivalent), SNP ( single nucleotide polymorphism)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: June 16, 2014
Accepted:
April 18,
2014
Received in revised form:
March 17,
2014
Received:
May 18,
2013
Footnotes
Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
The Gutenberg Health Study is funded through the government of Rhineland-Palatinate, Germany (“Stiftung Rheinland-Pfalz für Innovation,” contract no.: AZ 961-386261/733); the research programs “Wissen schafft Zukunft” and “Schwerpunkt Vaskuläre Prävention” of the University Medical Center Mainz, Mainz, Germany, and its contract with Boehringer Ingelheim, Germany, and Philips Medical Systems, including an unrestricted grant for the Gutenberg Health Study. The sponsors (Boehringer Ingelheim, Ingelheim am Rhein, Germany, and Philips Medical Systems, Böblingen, Germany) and funding organizations played no role in the design or conduct of this research.
Identification
Copyright
© 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
