{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T19:44:52Z","timestamp":1790192692268,"version":"4.1.0"},"reference-count":47,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2019,10,25]],"date-time":"2019-10-25T00:00:00Z","timestamp":1571961600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Specified contribution from Keio University","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP16K11271"],"award-info":[{"award-number":["JP16K11271"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"name":"2015 Novartis Research Grant","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"name":"National Cancer Center Research and Development Fund","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The increasing prevalence of high myopia has been noted. We investigated the epidemiological characteristics and the related factors of high myopia in a Japanese adult population. Japan Public Health Center-Based Prospective Study for the Next Generation (JPHC-NEXT) Eye Study was performed in Chikusei-city, a rural area in mid-east Japan, between 2013 and 2015. A cross-sectional observational analysis was conducted to investigate prevalence and related factors of high myopia. A total of 6101 participants aged \u226540 years without a history of ocular surgeries was included. High myopia was defined as a spherical equivalent refraction of \u2264\u22126.00 diopters according to the American Academy of Ophthalmology. Potential high myopia-related factors included intraocular pressure (IOP), corneal structure, corneal endothelial cell density, age, height, body mass index, heart rate, blood pressure, biochemical profile, and current history of systemic and ocular disorders. The odds ratios of high myopia were estimated using the logistic regression models adjusted for the associated factors. The prevalence of high myopia was 3.8% in males and 5.9% in females with a significant difference. Age was inversely associated, IOP was positively associated, and none of other factors were associated with high myopia in both sexes. In conclusion, only age and IOP were associated with high myopia in this community-based sample.<\/jats:p>","DOI":"10.3390\/jcm8111788","type":"journal-article","created":{"date-parts":[[2019,10,25]],"date-time":"2019-10-25T11:05:18Z","timestamp":1572001518000},"page":"1788","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["High Myopia and Its Associated Factors in JPHC-NEXT Eye Study: A Cross-Sectional Observational Study"],"prefix":"10.3390","volume":"8","author":[{"given":"Kiwako","family":"Mori","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan"},{"name":"Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihide","family":"Kurihara","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan"},{"name":"Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miki","family":"Uchino","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidemasa","family":"Torii","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan"},{"name":"Laboratory of Photobiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Motoko","family":"Kawashima","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariko","family":"Sasaki","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoko","family":"Ozawa","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazumasa","family":"Yamagishi","sequence":"additional","affiliation":[{"name":"Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyasu","family":"Iso","sequence":"additional","affiliation":[{"name":"Public Health, Department of Social Medicine, Osaka University, Graduate School of Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9936-1476","authenticated-orcid":false,"given":"Norie","family":"Sawada","sequence":"additional","affiliation":[{"name":"Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4105-2774","authenticated-orcid":false,"given":"Shoichiro","family":"Tsugane","sequence":"additional","affiliation":[{"name":"Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenya","family":"Yuki","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8874-7111","authenticated-orcid":false,"given":"Kazuo","family":"Tsubota","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,10,25]]},"reference":[{"key":"ref_1","first-page":"1912","article-title":"High Myopia and the Vitreoretina; Complocations","volume":"Volume 3","author":"Ryan","year":"2013","journal-title":"Retina (Philadelphia, PA)"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.ajo.2013.08.010","article-title":"Epidemiology and disease burden of pathologic myopia and myopic choroidal neovascularization: An evidence-based systematic review","volume":"157","author":"Wong","year":"2014","journal-title":"Am. J. Ophthalmol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.ophtha.2003.05.011","article-title":"Prevalence and causes of visual impairment in an elderly Chinese population in Taiwan: The Shihpai Eye Study","volume":"111","author":"Hsu","year":"2004","journal-title":"Ophthalmology"},{"key":"ref_4","doi-asserted-by":"crossref","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":"ref_5","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1038\/eye.2013.254","article-title":"Genetic and environmental effects on myopia development and progression","volume":"28","author":"Goldschmidt","year":"2014","journal-title":"Eye"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"4756","DOI":"10.1167\/iovs.06-0270","article-title":"Heritability of refractive error and ocular biometrics: The Genes in Myopia (GEM) twin study","volume":"47","author":"Dirani","year":"2006","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1111\/opo.12246","article-title":"Risk factors for myopia in a discordant monozygotic twin study","volume":"35","author":"Ramessur","year":"2015","journal-title":"Ophthalmic Physiol. Opt. J. Br. Coll. Ophthalmic Opt. Optom."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1001\/archopht.126.4.527","article-title":"Myopia, lifestyle, and schooling in students of Chinese ethnicity in Singapore and Sydney","volume":"126","author":"Rose","year":"2008","journal-title":"Arch. Ophthalmol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1016\/j.ophtha.2012.11.009","article-title":"Outdoor activity during class recess reduces myopia onset and progression in school children","volume":"120","author":"Wu","year":"2013","journal-title":"Ophthalmology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1001\/jama.2015.10803","article-title":"Effect of Time Spent Outdoors at School on the Development of Myopia Among Children in China: A Randomized Clinical Trial","volume":"314","author":"He","year":"2015","journal-title":"JAMA"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"6270","DOI":"10.1167\/iovs.10-5528","article-title":"Ethnic differences in the prevalence of myopia and ocular biometry in 10- and 11-year-old children: The Child Heart and Health Study in England (CHASE)","volume":"51","author":"Rudnicka","year":"2010","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1007\/s10654-016-0128-8","article-title":"Low serum vitamin D is associated with axial length and risk of myopia in young children","volume":"31","author":"Tideman","year":"2016","journal-title":"Eur. J. Epidemiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.mehy.2016.02.006","article-title":"Is myopia another clinical manifestation of insulin resistance?","volume":"90","author":"Galvis","year":"2016","journal-title":"Med. Hypotheses"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1016\/j.jcma.2016.02.011","article-title":"Prevalence and risk factors for myopia in second-grade primary school children in Taipei: A population-based study","volume":"79","author":"Hsu","year":"2016","journal-title":"J. Chin. Med. Assoc."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"14523","DOI":"10.1038\/s41598-017-09388-7","article-title":"Violet Light Transmission is Related to Myopia Progression in Adult High Myopia","volume":"7","author":"Torii","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.ebiom.2016.12.007","article-title":"Violet Light Exposure Can Be a Preventive Strategy Against Myopia Progression","volume":"15","author":"Torii","year":"2017","journal-title":"EBioMedicine"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1167\/iovs.14-15499","article-title":"Correlation between light levels and the development of deprivation myopia","volume":"56","author":"Karouta","year":"2014","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"5449","DOI":"10.1167\/iovs.10-6770","article-title":"Refractive error in Nigerian adults: Prevalence, type, and spectacle coverage","volume":"52","author":"Ezelum","year":"2011","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2119","DOI":"10.1016\/j.ophtha.2009.04.040","article-title":"Refractive errors in a rural Chinese adult population the Handan eye study","volume":"116","author":"Liang","year":"2009","journal-title":"Ophthalmology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3166","DOI":"10.1167\/iovs.10-6210","article-title":"Prevalence and risk factors for refractive errors in Indians: The Singapore Indian Eye Study (SINDI)","volume":"52","author":"Pan","year":"2011","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_21","first-page":"3174","article-title":"Prevalence rates of refractive errors in Sumatra, Indonesia","volume":"43","author":"Saw","year":"2002","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1845","DOI":"10.1167\/iovs.05-1153","article-title":"Myopic refractive error in adult Latinos: The Los Angeles Latino Eye Study","volume":"47","author":"Varma","year":"2006","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.1038\/eye.2008.184","article-title":"Changes of the ocular refraction among freshmen in National Taiwan University between 1988 and 2005","volume":"23","author":"Wang","year":"2009","journal-title":"Eye"},{"key":"ref_24","first-page":"2486","article-title":"Prevalence and risk factors for refractive errors in adult Chinese in Singapore","volume":"41","author":"Wong","year":"2000","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1676","DOI":"10.1016\/j.ophtha.2005.05.015","article-title":"Refractive error in urban and rural adult Chinese in Beijing","volume":"112","author":"Xu","year":"2005","journal-title":"Ophthalmology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1016\/S0140-6736(54)91187-3","article-title":"The relation of myopia to growth","volume":"266","author":"Gardiner","year":"1954","journal-title":"Lancet"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1111\/j.1755-3768.1950.tb05368.x","article-title":"Simple myopia in schoolboys in relation to body height and weight","volume":"28","author":"Johansen","year":"1950","journal-title":"Acta Ophthalmol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"326","DOI":"10.3109\/08820538.2015.1088554","article-title":"Body Stature as an Age-Dependent Risk Factor for Myopia in a South Korean Population","volume":"32","author":"Rim","year":"2017","journal-title":"Semin. Ophthalmol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1657","DOI":"10.1007\/s00417-010-1448-0","article-title":"Body height and ocular dimensions in the adult population in rural Central India. The Central India Eye and Medical Study","volume":"248","author":"Nangia","year":"2010","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"ref_30","first-page":"AC01","article-title":"Variation of Axial Ocular Dimensions with Age, Sex, Height, BMI-and Their Relation to Refractive Status","volume":"9","author":"Roy","year":"2015","journal-title":"J. Clin. Diagn. Res. JCDR"},{"key":"ref_31","first-page":"1408","article-title":"Height and its relationship to refraction and biometry parameters in Singapore Chinese children","volume":"43","author":"Saw","year":"2002","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"638","DOI":"10.1097\/00006324-199610000-00002","article-title":"Do variations in normal nutrition play a role in the development of myopia?","volume":"73","author":"Edwards","year":"1996","journal-title":"Optom. Vis. Sci. Off. Publ. Am. Acad. Optom."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1111\/j.1755-3768.1990.tb01922.x","article-title":"Refraction in diabetics during metabolic dysregulation, acute or chronic. With special reference to the diabetic myopia concept","volume":"68","author":"Fledelius","year":"1990","journal-title":"Acta Ophthalmol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"29","DOI":"10.2337\/diab.25.1.29","article-title":"Relationship of serum glucose concentration to changes in refraction","volume":"25","author":"Gwinup","year":"1976","journal-title":"Diabetes"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1016\/j.ophtha.2009.10.003","article-title":"Dietary factors, myopia, and axial dimensions in children","volume":"117","author":"Lim","year":"2010","journal-title":"Ophthalmology"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1136\/bjo.2003.033175","article-title":"Childhood myopia and parental smoking","volume":"88","author":"Saw","year":"2004","journal-title":"Br. J. Ophthalmol."},{"key":"ref_37","first-page":"80","article-title":"Risk factor analysis of 167 patients with high myopia","volume":"3","author":"Mo","year":"2010","journal-title":"Int. J. Ophthalmol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1760","DOI":"10.1016\/j.ophtha.2012.02.034","article-title":"Prevalence and risk factors for myopic retinopathy in a Japanese population: The Hisayama Study","volume":"119","author":"Asakuma","year":"2012","journal-title":"Ophthalmology"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1001\/archopht.123.7.977","article-title":"Relationship of age, sex, and ethnicity with myopia progression and axial elongation in the correction of myopia evaluation trial","volume":"123","author":"Hyman","year":"2005","journal-title":"Arch. Ophthalmol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1016\/j.ajo.2011.03.005","article-title":"Intraocular pressure, central corneal thickness, and glaucoma in chinese adults: The liwan eye study","volume":"152","author":"Wang","year":"2011","journal-title":"Am. J. Ophthalmol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"4097","DOI":"10.1167\/iovs.08-2822","article-title":"The relationship of intraocular pressure with age, systolic blood pressure, and central corneal thickness in an asian population","volume":"50","author":"Wong","year":"2009","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1812","DOI":"10.1001\/archopht.1985.01050120046017","article-title":"The correlation between intraocular pressure and refractive status","volume":"103","author":"David","year":"1985","journal-title":"Arch. Ophthalmol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"e019416","DOI":"10.1136\/bmjopen-2017-019416","article-title":"Longitudinal changes in intraocular pressure and association with systemic factors and refractive error: Lingtou Eye Cohort Study","volume":"8","author":"Han","year":"2018","journal-title":"BMJ Open"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1136\/bjo.88.1.5","article-title":"Intraocular pressure associations with refractive error and axial length in children","volume":"88","author":"Lee","year":"2004","journal-title":"Br. J. Ophthalmol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e1976","DOI":"10.1097\/MD.0000000000001976","article-title":"Prevalence of Myopia in France: A Cross-Sectional Analysis","volume":"94","author":"Matamoros","year":"2015","journal-title":"Med. Baltim."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1066","DOI":"10.1016\/S0161-6420(99)90251-8","article-title":"Refractive errors in an older population: The Blue Mountains Eye Study","volume":"106","author":"Attebo","year":"1999","journal-title":"Ophthalmology"},{"key":"ref_47","first-page":"750","article-title":"High myopia as a risk factor in primary open angle glaucoma","volume":"5","author":"Chen","year":"2012","journal-title":"Int. J. Ophthalmol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/8\/11\/1788\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:29:29Z","timestamp":1760189369000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/8\/11\/1788"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,25]]},"references-count":47,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2019,11]]}},"alternative-id":["jcm8111788"],"URL":"https:\/\/doi.org\/10.3390\/jcm8111788","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.2.1754\/v1","asserted-by":"object"}]},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,25]]}}}