Frontiers in Medicine (Dec 2024)

Conjunctival ultraviolet autofluorescence as a biomarker of outdoor time in myopic children

  • Miriam de la Puente,
  • Miriam de la Puente,
  • Valentina Bilbao-Malavé,
  • Valentina Bilbao-Malavé,
  • Jorge González-Zamora,
  • Jorge González-Zamora,
  • Aura Ortega Claici,
  • Aura Ortega Claici,
  • Jaione Bezunartea,
  • Jaione Bezunartea,
  • Jaione Bezunartea,
  • Leire Gomez-Arteta,
  • Elena Alonso,
  • Elena Alonso,
  • Elena Alonso,
  • Elena Alonso,
  • María Hernández,
  • María Hernández,
  • María Hernández,
  • María Hernández,
  • Patricia Fernández-Robredo,
  • Patricia Fernández-Robredo,
  • Patricia Fernández-Robredo,
  • Patricia Fernández-Robredo,
  • Manuel Sáenz de Viteri,
  • Manuel Sáenz de Viteri,
  • Manuel Sáenz de Viteri,
  • Manuel Sáenz de Viteri,
  • Nerea Martín Calvo,
  • Nerea Martín Calvo,
  • Nerea Martín Calvo,
  • Alfredo García-Layana,
  • Alfredo García-Layana,
  • Alfredo García-Layana,
  • Alfredo García-Layana,
  • Jesús Barrio-Barrio,
  • Jesús Barrio-Barrio,
  • Jesús Barrio-Barrio,
  • Jesús Barrio-Barrio,
  • Sergio Recalde,
  • Sergio Recalde,
  • Sergio Recalde,
  • Sergio Recalde

DOI
https://doi.org/10.3389/fmed.2024.1492180
Journal volume & issue
Vol. 11

Abstract

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IntroductionThe prevalence of myopia has increased significantly in recent years including an earlier onset of myopia development on the pediatric population. The main objective of the study is to compare CUVAF (Conjunctival Ultraviolet Autofluorescence) in children with and without myopia to validate its usefulness as an outdoor protective biomarker.MethodsA case–control observational study was conducted in a child cohort from subjects that attended to the Ophthalmology Department of Clínica Universidad de Navarra for an ophthalmological examination. The general exclusion criteria were (among others): amblyopia, congenital myopia, general ophthalmic disease, and any conjunctival alteration that might difficult the measurement of the CUVAF area. All participants underwent an automatic objective refraction under cycloplegic effect, biometry to measure axial length (AL) and central corneal radius (CCR), and completed a questionnaire about their lifestyle habits. A total of 4 images of the bulbar conjunctiva were taken with blue light in order to quantify the CUVAF area.ResultsA total of 263 subjects (6 to 17 years old) were analyzed with no significant differences in demographic data between case group and control group. There were 50 non-myopic subjects (19%) and 213 myopic subjects (81%). In relation to the outdoor activities (OA), myopic subjects spent significantly fewer hours per week outdoors than the control-group (p = 0.03). About the CUVAF area, the differences between groups were statistically significant, showing that the myopic group has a significantly smaller CUVAF area than the control-group (0.33 ± 0.72 mm2 vs. 0.78 ± 1.22 mm2; p = 0.0023), likewise, the frequency of CUVAF area absence between both groups showed an odds ratio (OR) of 2.52 (CI95% 1.33–4.74). A Pearson correlation test was done, obtaining a strong significant inverse correlation between myopia degree-CUVAF area (r = 0.1877; IC95% 0.068–0.302), and also ratio (AL/CCR)-CUVAF area (p = 0.002 and p = 0.04) respectively.ConclusionCUVAF is a useful biomarker for OA and it has an inverse relationship with myopia degree also in pediatric age, especially after the age of 12, so it could be useful to differentiate the risk of developing myopia. Having a CUVAF area greater than that corresponding to age, protect to myopia 2.5 times, being almost 5 times the protection in case of high myopia.

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