{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T06:01:53Z","timestamp":1782540113353,"version":"3.54.5"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T00:00:00Z","timestamp":1761868800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ophthalmic Physiologic Optic"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This randomised clinical trial investigated whether a high spatial frequency enhancing classroom presenting outdoor scenes (outdoor scene classroom, OSC) can arrest myopia development in children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a two\u2010arm, parallel, non\u2010blinding, cluster randomised trial. The trial was single centre, school\u2010based and conducted in Lijiang Shiyan School, Lijiang, Yunnan. China. Grade 3 primary school students were recruited. The intervention was the OSC, designed to resemble the natural outdoor environment by adorning the walls with wallpaper featuring natural images with high spatial frequency content. The primary outcome was 1\u2010year myopia incidence. Secondary outcomes were 1\u2010year change of spherical equivalent refraction (SER) and 1\u2010year change in axial length (AL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The primary outcome, myopia incidence, was not significantly different between the OSC group and the traditional classroom (TC) group, (14.1% vs 16.9%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.42). The secondary outcomes showed a protective effect of OSC. The mean\u2009\u00b1\u2009SE of the 1\u2010year change in SER was \u22120.47\u2009\u00b1\u20090.04 and \u22120.67\u2009\u00b1\u20090.04\u2009D in the OSC and TC groups, respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The mean\u2009\u00b1\u2009SE 1\u2010year change in AL was 0.25\u2009\u00b1\u20090.01 and 0.31\u2009\u00b1\u20090.02\u2009mm in the OSC and TC groups, respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02). In multivariable analysis, the TC group had a 0.21\u2009D (95% CI \u22120.30, \u22120.11) more myopic shift than the OSC group, after controlling for age, gender and baseline refractive error.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>OSC was protective in slowing myopic shift. Large implementation of OSC provides an alternative strategy to increased time outdoors in myopia prevention and provides an approach that involves less disruption to school routines.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/opo.70038","type":"journal-article","created":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T10:13:43Z","timestamp":1761905623000},"page":"1989-1999","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Supplementation with high spatial frequency in visual environments for Chinese children to arrest myopia: A proof\u2010of\u2010concept exploratory study"],"prefix":"10.1007","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5234-9413","authenticated-orcid":false,"given":"Wei","family":"Pan","sequence":"first","affiliation":[{"name":"Aier Academy of Ophthalmology Central South University  Changsha 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