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. 2025 Apr 14;15(1):12778.
doi: 10.1038/s41598-025-97336-1.

Twelve month refractive and axial length changes in the Israeli refractive error, activity, and devices (iREAD) study

Einat Shneor  1 , Lisa A Ostrin  2 , Ariela Gordon-Shaag  3 , Jonathan Levine  3 , Loraine T Sinnott  4 , Lisa A Jones-Jordan  4 , Kevin Davidson  5 , Ravid Doron  3
Affiliations

Twelve month refractive and axial length changes in the Israeli refractive error, activity, and devices (iREAD) study

Einat Shneor et al. Sci Rep. .

Erratum in

Abstract

The Israel Refraction, Environment, and Devices (iREAD) is a longitudinal study assessing myopia risk factors in three groups of boys with distinct lifestyles. Ultra-Orthodox (N = 41), Religious (N = 53), and Secular (N = 41) boys (ages 8.6 ± 1.5 years) had eye exams at baseline and 12 months, including cycloplegic autorefraction and axial length. Ocular history, education, near work, and electronic device use were assessed. Time outdoors and physical activity were measured objectively. At 12 months, myopia prevalence increased from 32 to 40% (P = 0.02), with no group differences (P > 0.05). The Ultra-Orthodox group had a more myopic spherical equivalent refraction (SER) at baseline and 12 months than the Religious and Secular groups and more myopic shift at 12 months (P < 0.05 for all). The Ultra-Orthodox group spent less time using electronic devices, more time in school, read at an earlier age, and had higher parental myopia (P < 0.01 for all). Time outdoors and activity did not differ between groups (P > 0.05 for both). In univariate and multivariate analyses, group and parental myopia were associated with greater myopic shift of SER and axial elongation (P < 0.05). In conclusion, risk factors associated with greater myopia progression included being part of the Ultra-Orthodox educational system and number of myopic parents and not screen use.

Keywords: Myopia; Near work; Refractive error; Risk factors; Time outdoors; Wearable sensors.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Conflict of Interest: All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript. Ethical approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Jerusalem Multidisciplinary College Ethics Committee) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent: Informed consent was obtained from all individual participants included in the study.

Figures

Fig. 1
Fig. 1
Protocol and number of children enrolled in baseline and 12-month follow up. Each visit included a comprehensive eye exam, visual activity questionnaire, and Actiwatch wear.
Fig. 2
Fig. 2
A) Spherical equivalent refraction (N = 124) and B) axial length (N = 125) at baseline (filled bars) and 12 months (open bars) for the Ultra-Orthodox (fuchsia), Religious (teal), and Secular (orange) groups. *significance at P < 0.05; **significance at P < 0.001.
See this image and copyright information in PMC

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