{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T16:54:52Z","timestamp":1791910492260,"version":"4.3.4"},"reference-count":67,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T00:00:00Z","timestamp":1749600000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Physical activity is recognized as an effective strategy for preventing myopia and cardiovascular diseases in children and adolescents; however, its impact on ocular biological parameters in this population remains poorly understood. This study systematically evaluates the effects of physical activity on ocular parameters in children and adolescents, aiming to provide a theoretical foundation for myopia and cardiovascular disease prevention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study was registered on PROSPERO (CRD4202454649). A comprehensive search of electronic databases\u2014Web of Science, Embase, Cochrane Library, and PubMed\u2014was conducted from their inception through April 2025. Two reviewers independently performed literature screening, data extraction, and risk-of-bias assessments using predefined inclusion\/exclusion criteria. Methodological quality was evaluated using the PEDro and NOS scales, and outcomes were analyzed via network meta-analysis in RevMan 5.3.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fourteen studies [8 randomized controlled trials (RCTs), 3 cross-sectional studies, 2 non-randomized controlled trials (NRCTs), and 1 cohort study] involving 12,548 participants aged 6\u201326\u202fyears were included. Meta-analysis revealed that physical activity significantly improved KVA (MD\u202f=\u202f0.23, 95% CI\u202f=\u202f0.18\u20130.29, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001), enhanced UDVA (MD\u202f=\u202f0.2, 95% CI\u202f=\u202f0.08\u20130.32, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001), delayed axial length (AL) progression (MD\u202f=\u202f0.2, 95% CI\u202f=\u202f0.08\u20130.32, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001), suppressed spherical equivalent refraction (SER) progression (MD\u202f=\u202f0.2, 95% CI\u202f=\u202f0.08\u20130.32, p\u202f&amp;lt;\u202f0.001), reduced central retinal venular equivalent (CRVE) (MD\u202f=\u202f\u22122.50, 95% CI\u202f=\u202f\u22124.86 to \u22120.13, <jats:italic>p<\/jats:italic>\u202f=\u202f0.04), and narrowed central retinal arteriolar equivalent (CRAE) (MD\u202f=\u202f\u22122.50, 95% CI\u202f=\u202f\u22124.86 to \u22120.13, p\u202f=\u202f0.04). Physical activity demonstrably enhances dynamic and uncorrected distance vision, attenuates SER progression, and positively influences retinal vascular parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Regular physical activity effectively slows myopia development and progression in children and adolescents while contributing to the prevention of cardiovascular diseases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Systematic review registration<\/jats:title><jats:p><jats:uri>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD42024546449<\/jats:uri>.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1615033","type":"journal-article","created":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T05:15:17Z","timestamp":1749618917000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Meta-analysis of the effects of physical activity on ocular biometrics in children and adolescents"],"prefix":"10.3389","volume":"13","author":[{"given":"Pengfei","family":"Nie","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tong","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,11]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e489","DOI":"10.1016\/S2214-109X(20)30488-5","article-title":"The lancet Global Health Commission on global eye health: vision beyond 2020","volume":"9","author":"Burton","year":"2021","journal-title":"Lancet Glob Health"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.1016\/j.ophtha.2016.01.006","article-title":"Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050","volume":"123","author":"Holden","year":"2016","journal-title":"Ophthalmology"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"677","DOI":"10.1016\/j.survophthal.2017.03.006","article-title":"Myopia among schoolchildren in East Asia and Singapore","volume":"62","author":"Ding","year":"2017","journal-title":"Surv Ophthalmol"},{"key":"ref4","first-page":"1489","article-title":"Increasing prevalence of myopia in Europe and the impact of education","volume":"122","author":"Galvis","year":"2016","journal-title":"Ophthalmology"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"3524","DOI":"10.1167\/iovs.06-1118","article-title":"Parental history of myopia, sports and outdoor activities, and future myopia","volume":"48","author":"Jones","year":"2007","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1111\/opo.12305","article-title":"Age of onset of myopia predicts risk of high myopia in later childhood in myopic Singapore children","volume":"36","author":"Chua","year":"2016","journal-title":"Ophthalmic Physiol Opt"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1038\/eye.2013.256","article-title":"Myopia, an underrated global challenge to vision: where the current data takes us on myopia control","volume":"28","author":"Holden","year":"2014","journal-title":"Eye"},{"key":"ref8","first-page":"1485","volume-title":"Correlation of static visual acuity and kinetic visual acuity in children and its implication to physical ActivityChin Rehabil Theory Pract","author":"Sun","year":"2018"},{"key":"ref9","first-page":"2140","article-title":"Eye elongation during accommodation in humans: differences between emmetropes and myopes","volume":"39","author":"Drexler","year":"1998","journal-title":"SPIE Milestone Series"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1016\/j.atherosclerosis.2018.09.003","article-title":"Effects of a cluster-randomized school-based prevention program on physical activity and microvascular function (JuvenTUM 3)","volume":"278","author":"Siegrist","year":"2018","journal-title":"Atherosclerosis"},{"key":"ref11","first-page":"1984","article-title":"Retinal vessel diameter and cardiovascular mortality: Pooled data analysis from two older populations","volume-title":"Eur. 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