Cognitive, behavioural, environmental and genetic associations of myopia in the Twins Early Development Study

近视，或称近视，发生在所看物体的图像没有准确聚焦到视网膜上（屈光不正），特别是近视，图像聚焦在视网膜前面。这导致观察者看到模糊的图像，需要眼镜或隐形眼镜的形式进行校正。近视是世界上最常见的眼病。如果不能对近视进行适当的矫正，就会使儿童出现视力障碍，从而影响其发展、教育和未来的前景。世界卫生组织（世卫组织）已确定1.53亿人因未矫正的屈光不正而视力受损。目前，识别和治疗近视是世卫组织消除可避免失明行动中的一项重点。患有近视的人，特别是那些在童年时期发展成近视的人，因为他们很可能在成年后变得高度近视，他们还面临着视力威胁问题的风险，比如视网膜“磨损”变性或视网膜脱离。近视的人数正在增加；在一些国家，高达80%的离开学校的孩子是近视的，我们相信这意味着由于这个普遍的问题，中老年人的失明问题将会越来越多。目前尚不清楚是什么导致了这种增长，尽管人们知道一个人的基因和环境都有影响；先前的研究已经确定了潜在的风险因素，如长时间的近距离工作、城市化和缺乏户外光线。这项研究的目的是研究基因和环境对一个人患近视风险的复杂影响，研究对象是一群英国双胞胎。这项独特的双胞胎早期发展研究（TEDS）由1万多对双胞胎组成，他们从出生到现在18岁左右。TEDS的科学家已经评估了先天（基因）和后天（环境）对认知、语言、行为和教育等方面的相对影响。之前的研究已经在不同学习障碍和能力的共同遗传影响方面取得了有趣的发现。我们计划将这些数据与18岁时的近视程度联系起来。复杂的统计技术将用于调查一个人的基因和环境对近视风险的相对影响和相互作用。我们还计划使用先进的遗传技术来识别潜在的遗传变异（DNA的变化），这些基因变异可能会导致这个年龄段的近视，使用的是4000对双胞胎先前提供的DNA。这项研究将由来自TEDS和遗传流行病学和双胞胎研究部门（TwinsUK）的合作者在伦敦国王学院进行。这项研究将由眼科研究人员（专门研究眼病的医生）与遗传学家和统计学家合作进行。我们希望这项研究能为近视发生的原因和发病率上升的原因提供新的信息。将获得英国这个年龄组近视水平的估计，并增加对导致该疾病的环境和遗传影响的了解，这些只能从双胞胎研究中获得。这可能有助于有针对性地改变生活方式或开发治疗方法，从而在未来减少近视的发展或进展。

Myopia, or short-sightedness, occurs when the image of a viewed object is not focused accurately onto the retina (refractive error), specifically in myopia the image is focussed in front of the retina. This results in the observer seeing a blurred image and requires correction in the form of glasses or contact lenses. Myopia is the most common eye condition worldwide. Failure of adequate correction of myopia leaves a child with a visual disability that can affect development, education and future prospects. The World Health Organization (WHO) has identified 153 million people who are visually impaired due to uncorrected refractive errors. The identification and treatment of myopia is now a WHO priority within their initiative to eliminate avoidable blindness.People with myopia, especially those developing myopia in childhood, as they are likely to become highly myopic by adulthood, are additionally at risk of sight threatening problems such as retinal "wear and tear" degeneration or retinal detachment. The number of people with myopia is increasing; in some countries up to 80% of children leaving school are myopic, and we believe this means that there is going to be an increasing problem of blindness in middle aged and older people due to this common problem. It is not known what is driving this increase although it is known that both a person's genes and environment are influential; previous studies have identified potential risk factors such as prolonged close work, urbanisation and lack of outdoor light. The aim of this study is to examine the complex influence of genes and environment on a person's risk of developing myopia in a large cohort of British twins. The unique Twins Early Development Study (TEDS) consists of over 10,000 twins who have been studied since birth to their current age of around18 years old. TEDS researchers have assessed the relative influence of nature (genes) and nurture (environment) on aspects of cognition, language, behaviour and education. Previous research has yielded interesting findings on shared genetic influences for diverse learning disabilities and abilities. We plan to correlate this data with the level of myopia at the age of 18. Sophisticated statistical techniques will be used to investigate the relative effects and interactions between a person's genes and their environment on the risk of developing myopia. We also plan to use advanced genetic techniques to identify potential genetic variations (changes in the DNA) that could cause myopia in this age group using DNA that 4,000 of the twins have previously provided.This research will be carried within Kings College London by collaborators from both TEDS and the Department of Genetic Epidemiology and Twin Research (TwinsUK). The research will be undertaken by researchers in ophthalmology (doctors specialising in eye diseases), in partnership with geneticists and statisticians.We hope this research will provide novel information on why myopia develops and why the incidence is increasing. A estimate of the level of myopia in this age group within the UK will be obtained and an increased undertstanding of the environmental and genetic influences causing the disease, which can only be obtained from twin studies. This may enable targeted lifestyle modifications or development of treatments that could reduce myopia development or progression in the future.