Environment international · 2026
Street-view-measured greenspace components and childhood myopia: A population-based cross-sectional and prospective cohort study.
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Li Yingan, Zhang Yuzhou, Yim Charlene C, Su Lixian, Kam Ka Wai, Chan Poemen, Ip Patrick, Zhang Wei, Young Alvin, Pang Chi Pui, Tham Clement C, Chen Li Jia, Kwan Mei Po, Yam Jason C
Аннотация
BACKGROUND: Greater greenspace exposure may be associated with a lower risk of childhood myopia. However, most studies rely on satellite-derived greenness indices that cannot capture ground-level visual exposure or differentiate greenspace components. Whether specific greenspace components are differentially associated with myopia remains unclear.
OBJECTIVES: To examine associations between street-view-measured greenspace components and childhood myopia.
METHODS: This cross-sectional and prospective cohort study included children aged 6 to 8 years from a population-based study in Hong Kong (2015-2021). Incident myopia was assessed among children without myopia at baseline who completed 3-year follow-up. Applying deep learning segmentation to street-view imagery, we quantified four specific greenspace components (trees, grass, plants, and fields) within 500-m residential and school buffers. A time-weighted "home-school" metric was generated to represent cumulative daily exposure. Myopia was defined as cycloplegic spherical equivalent refraction ≤-80.50 diopters. Associations were estimated using multivariable logistic regression and Cox proportional hazards regression models with school-level cluster-robust standard errors, adjusting for sociodemographic and behavioral covariates.
RESULTS: Among 20,422 children, 5,623 (27.5%) had myopia at baseline. Cross-sectionally, higher cumulative exposures to home-school-trees (OR, 0.94; 95% CI, 0.90-0.97), home-school-grass (OR, 0.95; 95% CI, 0.90-0.99), and home-school-plants (OR, 0.93; 95% CI, 0.89-0.97) were associated with lower myopia prevalence, while home-school-fields increased myopia odds (OR, 1.06; 95% CI, 1.01-1.10). In prospective analyses of 2,667 children, only home-school-plants consistently associated with reduced incident myopia (HR, 0.89; 95% CI, 0.83-0.96), whereas home-fields increased incident myopia risk (HR, 1.05; 95% CI, 1.01-1.09). Protective effects of grass and plants were more pronounced among children with higher near-work time and those from lower-income families (both P for interaction < 0.05).
CONCLUSION: Specific street-view greenspace components were differentially associated with childhood myopia. These findings suggest the potential importance of considering specific greenspace components in urban planning strategies relevant to childhood myopia prevention.
OBJECTIVES: To examine associations between street-view-measured greenspace components and childhood myopia.
METHODS: This cross-sectional and prospective cohort study included children aged 6 to 8 years from a population-based study in Hong Kong (2015-2021). Incident myopia was assessed among children without myopia at baseline who completed 3-year follow-up. Applying deep learning segmentation to street-view imagery, we quantified four specific greenspace components (trees, grass, plants, and fields) within 500-m residential and school buffers. A time-weighted "home-school" metric was generated to represent cumulative daily exposure. Myopia was defined as cycloplegic spherical equivalent refraction ≤-80.50 diopters. Associations were estimated using multivariable logistic regression and Cox proportional hazards regression models with school-level cluster-robust standard errors, adjusting for sociodemographic and behavioral covariates.
RESULTS: Among 20,422 children, 5,623 (27.5%) had myopia at baseline. Cross-sectionally, higher cumulative exposures to home-school-trees (OR, 0.94; 95% CI, 0.90-0.97), home-school-grass (OR, 0.95; 95% CI, 0.90-0.99), and home-school-plants (OR, 0.93; 95% CI, 0.89-0.97) were associated with lower myopia prevalence, while home-school-fields increased myopia odds (OR, 1.06; 95% CI, 1.01-1.10). In prospective analyses of 2,667 children, only home-school-plants consistently associated with reduced incident myopia (HR, 0.89; 95% CI, 0.83-0.96), whereas home-fields increased incident myopia risk (HR, 1.05; 95% CI, 1.01-1.09). Protective effects of grass and plants were more pronounced among children with higher near-work time and those from lower-income families (both P for interaction < 0.05).
CONCLUSION: Specific street-view greenspace components were differentially associated with childhood myopia. These findings suggest the potential importance of considering specific greenspace components in urban planning strategies relevant to childhood myopia prevention.