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Rural-urban differences in myopia prevalence among myopes presenting to Bhutanese retinal clinical services: a 3-year national study

  • Retinal Disorders
  • Published:
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Abstract

Purpose

To determine the prevalence and demographic characteristics of myopia among patients presenting to the national vitreo-retinal (VR) services in Bhutan.

Methods

The records of the VR clinic at the apex national referral centre, providing the only VR services in the country, were reviewed to identify all new myopia patients over three years. Thus, we surveyed all referrals nationally. The patients were categorised into urban and rural females and males. We assessed myopia prevalence in each group by occupational and educational categories. We examined univariate prevalence data and a multivariate logistic regression (MLR) identified independent factors.

Results

Of 2913 cases 1544 (53.0%) were males. Females presented earlier (mean ±SD): overall 45.7 ± 21.9 cf. 48.6 ± 21.6 years, p = 0.003, and among myopes 23.9 ± 13.5 cf. 27.6 ± 18.6 years, p = 0.032. Myopia constituted 92.1% of refractive error, an overall prevalence of 12.3%. Myopia was more common among females (p = 0.01) and urbanites (p = 0.02). Myopia prevalence was highest among urban females (20.9%), followed by urban males (11.9%), rural females (6.8%), and rural males (5.2%). Logistic regression revealed that the odds of having myopia were increased by being a student (4.96 ×) or professional (1.96 ×), and decreased by rural living (1.75 ×), all p ≤ 0.038.

Conclusions

This is the first study on myopia in Bhutan. As observed throughout East and Southeast Asia, the prevalence of myopia was higher in females and urbanites and positively associated with formal education. Given known risk factors, these prevalences may be driven by educational pressures and reduced time spent outdoors.

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Availability of data and material

The data and material are available from the corresponding author

Funding

The study was financially supported by the John Curtin School of Medical Research at the Australian National University.

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Authors and Affiliations

  1. John Curtin School of Medical Research, Australian National University, Canberra, ACT, 2601, Australia

    Bhim Bahadur Rai & Ted Maddess

  2. Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan

    Bhim Bahadur Rai

  3. Faculty of Science & Technology, University of Canberra, Kirinari Street, Bruce, ACT, 2617, Australia

    Regan S. Ashby

  4. Faculty of Science & Technology, University of Technology, Sydney, NSW, Australia

    Amanda N. French

Authors
  1. Bhim Bahadur Rai
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  2. Regan S. Ashby
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  3. Amanda N. French
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  4. Ted Maddess
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Corresponding author

Correspondence to Bhim Bahadur Rai.

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Ethical approval, informed consent, and consent for publication

The study was approved by the Research Ethics Board of Health (REBH), Ministry of Health, Royal Government of Bhutan, and was conducted as per the REBH guidelines and tenets of the Declaration of Helsinki. The consent was waived by REBH as the retrospective study collected only the de-identified data.

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Rai, B.B., Ashby, R.S., French, A.N. et al. Rural-urban differences in myopia prevalence among myopes presenting to Bhutanese retinal clinical services: a 3-year national study. Graefes Arch Clin Exp Ophthalmol 259, 613–621 (2021). https://doi.org/10.1007/s00417-020-04891-6

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  • DOI: https://doi.org/10.1007/s00417-020-04891-6

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