{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T14:20:19Z","timestamp":1790864419059,"version":"4.1.0"},"reference-count":35,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T00:00:00Z","timestamp":1756080000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2025,7,29]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study explored the relationship between school-level built environment factors (building density and height) and myopia prevalence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In all 16 districts of Shanghai, students from public schools and kindergartens underwent visual acuity testing and non-cycloplegic refraction between 2019 and 2023. Building density and height within 500-metre and 1,000-metre buffers around the schools were obtained using GIS (Geographic Information System)-based spatial and network analyses from the Tianditu database. Demographic and behavioural covariates, such as age, gender, outdoor activity time and near-work time, were collected through questionnaires. Logistic mixed-effect models were used to analyse the association between the building environment and myopia, adjusting for relevant demographic and behavioural factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Data from 8\u2009647\u2009375 participants were analysed, with 1\u2009116\u2009851 followed consistently. The myopia rate among students was significantly higher during 2020\u20132021 compared with 2019, 2022 and 2023 (p&lt;0.05). Myopia was more prevalent in students aged 6 to 12, with a higher average age for myopic individuals (8.13 vs 6.64 years). The average building density was higher at schools of myopic students (15.70%) versus non-myopic students (14.90%) (p&lt;0.001). Building density near schools was negatively correlated with spherical equivalent (p&lt;0.05), while no significant association was found with building height. The risk of myopia increased with higher building density (OR: 1.143\u20131.202, p&lt;0.05), particularly in boys over 12 years old. A stronger association was observed in inner suburban areas (p&lt;0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Prolonged exposure to high building density may accelerate myopia progression. Urban planning should consider vision health, with regulations on building density near schools to reduce myopia risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjo-2025-327439","type":"journal-article","created":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T01:55:14Z","timestamp":1756173314000},"page":"197-203","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Association between building density and screening myopia in children and adolescents: a 5-year longitudinal study from China"],"prefix":"10.1136","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2279-9514","authenticated-orcid":false,"given":"Jingjing","family":"Wang","sequence":"first","affiliation":[{"name":"Shanghai Eye Diseases Prevention &Treatment Center\/ Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai, China"},{"name":"National Clinical Research Center for Eye Diseases, Shanghai, 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