The influence of vitamin D deficiency and stress level on the development of myopia in children

Abstract

Introduction. Myopia remains a pressing issue in the field of pediatric ophthalmology, especially considering the forced transition to online learning in recent years, prompted by epidemic conditions and the state of war in Ukraine. Such rapid and extreme changes in children's lives objectively affect their mental health and may induce excessive anxiety. Vitamin D, as a potential factor influencing the development of myopia and contributing to stable mental health, is gradually being recognized for its multifaceted role in overall well-being. Aim. To determine the correlation between the degree of vitamin D deficiency in children with axial and refractive myopia dynamically and its relation to increased anxiety level. Materials and methods. Under our supervision were 42 children aged 8-10, divided into 2 groups based on axial or refractive myopia. Ophthalmic exams were conducted every 6 months, assessing serum vitamin D levels. Psychological assessments included anxiety tests (P. Temple, M. Dorkey, E. W. Amen), with psychologists offering anxiety control techniques and gym relaxation activities during the study. Results. At the start of observation, mean indicators for children in groups 1 (axial) and 2 (refractive myopia) were: eye length - 25.02±0.13 and 23.51±0.13 mm, corneal curvature - 42.63±0.24 and 45.21±0.20 D, vitamin D levels were 17.28 ± 5.05 and 16.65±4.03 ng/ml, respectively. The average anxiety index in both groups was 7.69± 1.54. Over the year, in group 1 an average vitamin D increase of 14.96±3.63 ng/ml, reaching normal levels within 6-9 months. Refraction remained unchanged in 23.8% of children, while 76.2% experienced myopia increase by 0.54±0.16 D. In group 2, a vitamin D increase of 15.41±2.93 ng/ml over the year, reaching normal levels within 9-12 months. In 66.7% of children, refraction remained unchanged, while in 33.3%, myopia increased by 0.38±0.13 D. The average vitamin D increase twice in both groups. Pearson coefficient in both groups revealed an inverse relationship between investigated signs (r1 = -0.682 and r2 = -0.623). Anxiety index decreased by 47% to an average level of 4.07±0.81, indicating potential improvement in children's well-being. Conclusion. According to the study results, a significant inverse correlation was found between myopia progression and normalized vitamin D levels in axial and refractive myopia. However, the association between vitamin D and anxiety levels requires further investigation. Patients in both groups were advised to maintain their regimen, undergo follow-up examinations every 3 months, and take 2000 IU of vitamin D3 regularly as recommended by the pediatrician.