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Correlation between longitudinal serum vitamin D levels and myopia in children: a prospective birth cohort analysis

BMC Ophthalmology volume 25, Article number: 143 (2025) Cite this article

Abstract

Background

Myopia is an increasingly prevalent visual impairment associated with severe ocular complications. Risk factors for childhood myopia include genetics, East Asian ethnicity, age, parental myopia, and various environmental factors. The relationship between vitamin D levels, outdoor activity, and myopia remains inconclusive. This study aims to investigate the correlation between longitudinal serum vitamin D levels and myopia in Taiwanese children.

Methods

The study measured serum 25-hydroxyvitamin D (25(OH)D) concentrations in children from the Prediction of Allergies in Taiwanese Children (PATCH) study at multiple time points, including umbilical cord blood and ages 1, 3, and 5 years. Refractive error under cycloplegic conditions and axial length were assessed from January 2021 to April 2022. Myopia was defined as a mean spherical equivalent in both eyes ≤ -0.5 diopter. Independent sample t-tests, partial correlation analyses, and generalized estimating equation (GEE) analyses were conducted to examine the relationship between serum vitamin D concentrations and myopia.

Results

A total of 126 eyes from 63 children (mean age: 8.90 ± 2.24 years) were analyzed. The lowest serum vitamin D level (19.11 ± 9.10 ng/mL) was observed in umbilical cord blood, while the highest level (37.01 ± 12.61 ng/mL) occurred at 1 year of age. No significant differences in serum vitamin D concentrations were found between children with and without myopia during gestation, at birth, or at ages 1, 3, and 5 years (all P > 0.05). Additionally, GEE analysis revealed that serum vitamin D levels were not significantly associated with cycloplegic spherical equivalent or axial length after adjusting for age and sex.

Conclusions

This prospective birth cohort study found no association between serum vitamin D concentrations at birth, 1, 3, or 5 years of age and the development of myopia in Taiwanese children. These findings suggest that other factors, such as ethnicity, near work activities, or lighting conditions, may play more significant roles in myopia development, particularly among East Asian populations.

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Introduction

Myopia is a refractive error related to excessive axial elongation. As a primary cause of visual impairment, myopia has become an global public health problem due to its rapidly increasing prevalence and various ocular complications [1, 2]. Commonly associated complications include myopic macular degeneration, retinal detachment, open-angle glaucoma, and cataract [3]. Childhood myopia has multiple risk factors, such as ethnicity (particularly occurring in those of East Asian descent), age, genetics, parental myopia, and environmental factors [4,5,6]. Other potential etiologies include up-close activities, school achievement, and urbanization [5, 7, 8].

Vitamin D, an endogenous hormone synthesized through sunlight exposure, is a biomarker of time spent outdoors [9, 10]. The relationship between vitamin D and myopia remains undetermined, although some studies have demonstrated that low serum vitamin D concentration was related to myopia prevalence [11,12,13]. However, other studies have demonstrated that vitamin D was not an indicator of future myopia, and they argued that the association was an erroneous link possibly resulting from the confounding effect of outdoor activities [9, 14]. Most studies supporting the association between low vitamin D levels and myopia have been cross-sectional studies based on single measurements of vitamin D concentration, not longitudinal birth cohort studies [9, 11,12,13].

The present prospective birth cohort study longitudinally measured serum vitamin D concentrations from birth to childhood [15,16,17] to explore the correlation between longitudinal vitamin D concentrations and myopia in children.

Materials and methods

Study population

This study utilized participants from the Prediction of Allergies in Taiwanese Children (PATCH) study, a prospective, population-based birth cohort established at Keelung Chang Gung Memorial Hospital between October 2007 and September 2010. The PATCH study recruited healthy newborns with a gestational age greater than 34 weeks, after obtaining informed consent from pregnant mothers at 32 weeks of gestation. Detailed prenatal information was collected, and cord blood samples were obtained at birth. The study protocol, including inclusion and exclusion criteria, has been described in detail in previous publications. The PATCH study was approved by the Human Research Ethics Committee of Chang Gung Memorial Hospital (No. 100–0201B) [15,16,17].

For this study, participants were selected from children who attended follow-up visits at Keelung Chang Gung Memorial Hospital between January 2021 and April 2022. During this period, 201 children were contacted via telephone and invited to participate in an ophthalmologic sub-study. The inclusion criteria for this analysis were children aged 5 to 14 years who had no prior ocular diseases and were able to complete comprehensive ocular examinations. However, the recruitment process coincided with the peak of the COVID-19 pandemic in Taiwan, which significantly limited participation due to widespread concerns about infection and potential isolation measures.

Of the 201 children contacted, many declined participation due to pandemic-related fears. Exclusions included three children with severe hyperopia, one child with a history of previous ocular surgeries, and one child diagnosed with amblyopia. Additionally, three families declined participation due to their children’s attention deficit hyperactivity disorder (ADHD), which made compliance with the prolonged ophthalmologic examinations challenging.

After accounting for these exclusions, 67 children agreed to participate in the ophthalmologic examination. Among them, four children were excluded due to incomplete ophthalmologic examinations, resulting in 63 eligible participants for the final analysis. Informed consent was obtained from the parents or legal guardians of all participants. The flowchart for study cohort assembly is presented in Fig. 1.

Fig. 1
figure 1

Algorithm of study population selection

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The study was approved by the Institutional Review Board of Chang Gung Memorial Hospital (IRB No.: 201901822A3) and was conducted in accordance with the Declaration of Helsinki.

Ocular examination data collection

All the participants underwent detailed ophthalmologic examinations that included axial length and refractive error under cycloplegic conditions (IOL Master 500, Carl Zeiss Meditec, Jena, Germany). Cycloplegia was induced using 0.5% Tropicamide, administered in three drops at five-minute intervals, followed by a 30-minute waiting period before refraction measurement. The ocular examinations were completed by certificated ophthalmologists. The spherical equivalent (SE) was defined as the sum of the sphere power and half of the cylinder power. Mean SE was the average of the SE in the participants’ 2 eyes. This study defined myopia as a mean SE of − 0.5 diopter (D) or worse.

Serum vitamin D concentration and questionnaire

Serum vitamin D concentrations were measured in maternal blood during pregnancy, in participants’ umbilical cord blood at birth, and at ages 1, 3, and 5 years. Serum vitamin D levels were analyzed using an automated electrochemiluminescence-based assay (Elecsys® Vitamin D Total assay; Roche Diagnostics, Mannheim, Germany) with nonfasting blood samples. The assay has been validated for precision and reliability in clinical and research settings. Additionally, parents completed a questionnaire during their children’s ocular examinations, which included information on the participants’ time spent outdoors and sun exposure duration. These details were incorporated into the analysis to account for potential confounding factors related to vitamin D status.

Statistical analysis

The collected data were analyzed using SPSS Version 26.0 (IBM, Armonk, NY, USA). Statistical significance was indicated at a two-tailed P value < 0.05. The differences between the patients with and without myopia were analyzed using independent samples t tests. Partial correlation analysis was also conducted to assess the relationship between serum vitamin D concentration and ocular parameters (i.e., cycloplegic SE and axial length), controlling for age and sex, at each time point (i.e., umbilical cord blood, 1 year, 3 years and 5 years). Moreover, generalized estimating equation (GEE) analysis was applied to investigate the associations between longitudinal serum vitamin D levels and ocular parameters, incorporating the data of multiple timepoints.

Results

The present study recruited a total of 134 eyes from 67 children. Eight eyes from 4 children were excluded due to incomplete ocular examinations. The final analysis included 38 patients with myopia and 25 patients without myopia (Fig. 1). The mean age of the 63 participants was 8.90 ± 2.24 years (range: 5–14).

Table 1 presents the demographic characteristics and clinical data of the participants. The sample comprised 29 (46%) male patients and 34 (54%) female patients. Vitamin D concentrations were measured in the blood of the participants’ mothers during pregnancy, in the participants’ umbilical cord blood, and at years 1, 3, and 5. The serum vitamin D level was lowest in the umbilical cord blood. The highest serum vitamin D level occurred at 1 year (37.01 ± 12.61 ng/mL) and gradually decreased as the patients aged. This result accords with the pattern observed in the rest of the cohort population [18].

Table 1 Demographic characteristics and clinical data
Full size table

Table 2 presents the results of the GEE analysis examining the longitudinal relationships between serum vitamin D levels and two ocular parameters: SE and axial length. The analysis included sex (male vs. female) and age as covariates. For cycloplegic SE, age was significantly negatively associated (β = -0.511, P = 0.001), indicating that SE decreases with increasing age. Sex and serum vitamin D concentration were not significantly associated with SE. In contrast, axial length was positively associated with both sex and age; males had longer axial lengths than females (β = 0.490, P = 0.043), and axial length increased with age (β = 0.240, P = 0.002). Serum vitamin D concentration did not show a significant association with axial length.

Table 2 Generalized estimating equation analysis of the longitudinal serum vitamin D concentration and cycloplegic SE and axial length
Full size table

Table 3 presents the partial correlation analysis between cycloplegic SE, axial length, and serum vitamin D concentration by age (at each time point). After adjustments for age and sex, the results indicated no significant correlation between cycloplegic SE or axial length and serum vitamin D concentration.

Table 3 Partial correlation analysis between cycloplegic SE, axial length, and serum vitamin D concentration by age
Full size table

This study also investigated the effects of time spent outdoors and sun exposure time on myopia. The differences in time spent outdoors and sun exposure time between the myopia and nonmyopia groups did not achieve statistical significance (Table 4). The results did not reveal a significant difference in time spent outdoors or sun exposure time with respect to cycloplegic SE or axial length after adjusting for age and sex (Table 5).

Table 4 Comparison of time spent outdoors and sun exposure time in myopia and nonmyopia groups
Full size table
Table 5 Partial correlation analysis between cycloplegic SE, axial length, time spent outdoors, and sun exposure time
Full size table

Discussion

The relationship between vitamin D and myopia remains controversial. To address this, we utilized longitudinally measured vitamin D levels from the PATCH study, a prospective birth cohort, to explore the potential long-term effect of vitamin D on myopia. Our findings demonstrated no significant difference in serum vitamin D concentrations between children with and without myopia at birth or at ages 1, 3, and 5. Additionally, the GEE analysis showed that serum vitamin D levels were not significantly associated with cycloplegic SE or axial length.

This study is unique in collecting longitudinal data from a well-designed cohort, measuring vitamin D from maternal blood during pregnancy and from the participants’ blood across early childhood. Unlike many previous studies [9, 11, 12], which employed cross-sectional designs, this study benefits from multiple vitamin D measurements over time. For instance, Choi et al. reported a significant association between low vitamin D concentrations and myopia in Korean adolescents [11], and Tideman et al. found similar associations in a large cohort of young children [12]. However, these studies relied on single measurements of vitamin D and noncycloplegic refractive assessments, both of which may introduce biases.

Conversely, some recent studies align with our findings that vitamin D levels are not directly associated with myopia. Guggenheim et al., in a longitudinal study, suggested that vitamin D levels at age 10 reflect time spent outdoors rather than predicting future myopia [9]. Similarly, Cuellar-Partida et al., using Mendelian randomization analysis, examined single nucleotide polymorphisms in genes influencing vitamin D concentration, including DHCR7, CYP2R1, GC, and CYP24A1. After adjusting for the confounding effect of outdoor activity, they concluded that vitamin D played only a minimal role in myopia development [14, 19]. These findings suggest that vitamin D is better understood as a surrogate marker for time spent outdoors rather than as an independent risk factor for myopia.

Myopia is a multifactorial condition influenced by both genetic and environmental factors. It is well-established that less time spent outdoors is a significant risk factor [5, 20, 21]. In a Taiwanese study, Wu et al. observed that even low sunlight exposure during outdoor activities could reduce myopia progression, suggesting that sunlight is not the sole protective factor [22]. Ethnicity may be a potential factor in the development of axial elongation, particularly in those of Asian descent [23, 24]. Further, various environmental risk factors also affect myopia progression, such as dim light conditions, higher education level, close reading distance, and urbanization [5, 7]. These complexities warrant further investigation into additional potential myopia etiologies in the PATCH cohort.

A notable finding in this study is the longitudinal trend in vitamin D levels, with the lowest levels at birth and the highest at age 1. This pattern is consistent with our previous findings [18], supporting the representativeness of the study sample and minimizing concerns of selection bias. Additionally, the participants in this study maintained adequate vitamin D levels (> 30 ng/mL) [25], unlike those in studies such as Choi et al., which reported deficient vitamin D concentrations in participants with varying refractive statuses [11]. This discrepancy may partly explain the differing conclusions between our study and others.

While our study provides valuable insights, it is important to acknowledge certain limitations. The COVID-19 pandemic impacted our sample size, which may have constrained the statistical power to detect subtle associations between vitamin D levels and myopia. Consequently, some genuine relationships might not have reached statistical significance within our cohort. Nonetheless, the comprehensive longitudinal data collected offer a robust foundation for understanding vitamin D trends over time.

Additionally, the absence of longitudinal SE follow-up data limits our ability to observe changes and developments in myopia throughout the study period. Future research aims to incorporate longitudinal SE assessments to provide a more dynamic understanding of myopia progression. Despite this limitation, the single SE assessment still offers meaningful baseline information and contributes to the overall findings of the study.

Environmental factors such as near work and time spent outdoors were evaluated using a single parental questionnaire rather than objective measurements. This approach may have limited our ability to capture nuanced differences between the myopia and non-myopia groups. However, the study compensates for this by incorporating detailed ocular examinations under cycloplegic conditions and comprehensive longitudinal serum vitamin D measurements, thereby enhancing the reliability and validity of our findings.

Despite these limitations, the study’s strengths, including its longitudinal design, multiple vitamin D measurements, and thorough ocular assessments, underscore its significant contribution to the understanding of the relationship between vitamin D and myopia. Future research involving larger-scale studies with long-term SE follow-ups and more precise measurements of outdoor activities is warranted to further elucidate the relationship between vitamin D and myopia.

Conclusions

This prospective birth cohort study found no significant differences in serum vitamin D concentrations between children with and without myopia from birth to 5 years of age. Our findings highlight the multifactorial nature of myopia, influenced by genetic, environmental, and behavioral factors. Future research should explore these potential etiologies in greater depth to better understand and prevent myopia, particularly in populations with a high prevalence, such as East Asian children.

Data availability

The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

References

  1. Yoon KC, Mun GH, Kim SD, Kim SH, Kim CY, Park KH, Park YJ, Baek SH, Song SJ, Shin JP, et al. Prevalence of eye diseases in South Korea: data from the Korea National health and nutrition examination survey 2008–2009. Korean J Ophthalmol. 2011;25(6):421–33.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Morgan IG, Ohno-Matsui K, Saw SM. Myopia. Lancet. 2012;379(9827):1739–48.

    Article  PubMed  Google Scholar 

  3. Haarman AEG, Enthoven CA, Tideman JWL, Tedja MS, Verhoeven VJM, Klaver CCW. The complications of myopia: a review and meta-analysis. Invest Ophthalmol Vis Sci. 2020;61(4):49.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Recko M, Stahl ED. Childhood myopia: epidemiology, risk factors, and prevention. Mo Med. 2015;112(2):116–21.

    PubMed  PubMed Central  Google Scholar 

  5. Grzybowski A, Kanclerz P, Tsubota K, Lanca C, Saw SM. A review on the epidemiology of myopia in school children worldwide. BMC Ophthalmol. 2020;20(1):27.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Morgan I, Rose K. How genetic is school myopia? Prog Retin Eye Res. 2005;24(1):1–38.

    Article  PubMed  Google Scholar 

  7. Lee YY, Lo CT, Sheu SJ, Lin JL. What factors are associated with myopia in young adults? A survey study in Taiwan military conscripts. Invest Ophthalmol Vis Sci. 2013;54(2):1026–33.

    Article  PubMed  Google Scholar 

  8. Guo Y, Liu LJ, Xu L, Lv YY, Tang P, Feng Y, Meng M, Jonas JB. Outdoor activity and myopia among primary students in rural and urban regions of Beijing. Ophthalmology. 2013;120(2):277–83.

    Article  PubMed  Google Scholar 

  9. Guggenheim JA, Williams C, Northstone K, Howe LD, Tilling K, St Pourcain B, McMahon G, Lawlor DA. Does vitamin D mediate the protective effects of time outdoors on myopia? Findings from a prospective birth cohort. Invest Ophthalmol Vis Sci. 2014;55(12):8550–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Wacker M, Holick MF. Sunlight and vitamin D: a global perspective for health. Dermatoendocrinol. 2013;5(1):51–108.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Choi JA, Han K, Park YM, La TY. Low serum 25-hydroxyvitamin D is associated with myopia in Korean adolescents. Invest Ophthalmol Vis Sci. 2014;55(4):2041–7.

    Article  CAS  PubMed  Google Scholar 

  12. Tideman JW, Polling JR, Voortman T, Jaddoe VW, Uitterlinden AG, Hofman A, Vingerling JR, Franco OH, Klaver CC. Low serum vitamin D is associated with axial length and risk of myopia in young children. Eur J Epidemiol. 2016;31(5):491–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Yazar S, Hewitt AW, Black LJ, McKnight CM, Mountain JA, Sherwin JC, Oddy WH, Coroneo MT, Lucas RM, Mackey DA. Myopia is associated with lower vitamin D status in young adults. Invest Ophthalmol Vis Sci. 2014;55(7):4552–9.

    Article  PubMed  Google Scholar 

  14. Cuellar-Partida G, Williams KM, Yazar S, Guggenheim JA, Hewitt AW, Williams C, Wang JJ, Kho PF, Saw SM, Cheng CY, et al. Genetically low vitamin D concentrations and myopic refractive error: a Mendelian randomization study. Int J Epidemiol. 2017;46(6):1882–90.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Su KW, Chiu CY, Tsai MH, Liao SL, Chen LC, Hua MC, Yao TC, Huang JL, Yeh KW. Asymptomatic toddlers with house dust mite sensitization at risk of asthma and abnormal lung functions at age 7 years. World Allergy Organ J. 2019;12(9):100056.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Su KW, Tu YL, Chiu CY, Huang YL, Liao SL, Chen LC, Yao TC, Ou LS, Lee WI, Huang JL, et al. Cord blood soluble CD14 predicts wheeze and prolonged cough in young children: the PATCH study. Int Arch Allergy Immunol. 2016;169(3):189–97.

    Article  CAS  PubMed  Google Scholar 

  17. Su KW, Chiu CY, Tsai MH, Liao SL, Chen LC, Hua MC, Yao TC, Huang JL, Yeh KW. Cord blood soluble Fas ligand linked to allergic rhinitis and lung function in seven-year-old children. J Microbiol Immunol Infect. 2022;55(2):300–6.

    Article  CAS  PubMed  Google Scholar 

  18. Chiu CY, Su KW, Tsai MH, Hua MC, Liao SL, Lai SH, Chen LC, Yao TC, Yeh KW, Huang JL. Longitudinal vitamin D deficiency is inversely related to mite sensitization in early childhood. Pediatr Allergy Immunol. 2018;29(3):254–9.

    Article  PubMed  Google Scholar 

  19. Greenland S. An introduction to instrumental variables for epidemiologists. Int J Epidemiol. 2000;29(4):722–9.

    Article  CAS  PubMed  Google Scholar 

  20. Sherwin JC, Reacher MH, Keogh RH, Khawaja AP, Mackey DA, Foster PJ. The association between time spent outdoors and myopia in children and adolescents: a systematic review and meta-analysis. Ophthalmology. 2012;119(10):2141–51.

    Article  PubMed  Google Scholar 

  21. French AN, Morgan IG, Mitchell P, Rose KA. Risk factors for incident myopia in Australian schoolchildren: the Sydney adolescent vascular and eye study. Ophthalmology. 2013;120(10):2100–8.

    Article  PubMed  Google Scholar 

  22. Wu PC, Chen CT, Lin KK, Sun CC, Kuo CN, Huang HM, Poon YC, Yang ML, Chen CY, Huang JC, et al. Myopia prevention and outdoor light intensity in a school-based cluster randomized trial. Ophthalmology. 2018;125(8):1239–50.

    Article  PubMed  Google Scholar 

  23. Myopia stabilization and. Associated factors among participants in the correction of myopia evaluation trial (COMET). Invest Ophthalmol Vis Sci. 2013;54(13):7871–84.

    Article  Google Scholar 

  24. Hyman L, Gwiazda J, Hussein M, Norton TT, Wang Y, Marsh-Tootle W, Everett D. Relationship of age, sex, and ethnicity with myopia progression and axial elongation in the correction of myopia evaluation trial. Arch Ophthalmol. 2005;123(7):977–87.

    Article  PubMed  Google Scholar 

  25. Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357(3):266–81.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

We thank Hsing-Fen Lin, Yu-Lin Chou, and the Center for Data Science and Biostatistics at Keelung Chang Gung Memorial Hospital for their invaluable assistance with statistics consultation.

Funding

This study was supported by Dr. Chi-Chin Sun of the Chang Gung Medical Research Foundation (CMRPG2K0341, CMRPG2K0342, CMRPG2K0331-2, and CMRPG3K1361-2). The funder had no role in the study design, data collection, analysis, decision to publish, or preparation of the manuscript.

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Authors and Affiliations

  1. Department of Ophthalmology, Chang Gung Memorial Hospital, 222 Mai Chin Road, An Leh District, Keelung, Taiwan

    Ju-Hsien Li, Ho-Min Chen, Yu-Kai Kuo, Cheng-Hsiu Wu, Pei-Wei Huang & Chi-Chin Sun

  2. Division of Allergy, Asthma and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan

    Kuan-Wen Su

  3. School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Kuan-Wen Su & Chi-Chin Sun

  4. Department of Ophthalmology, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan

    Nan-Ni Chen

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  1. Ju-Hsien Li
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Contributions

Conception and design of the study (CCS, KWS, JHL); analysis, and interpretation of the data (JHL, HMC, PWH); writing of the article (JHL, HMC, KWS); critical revision (CCS, KWS, NNC); final approval (JHL, KWS, CCS); data collection, (JHL, HMC); provision of materials, patients, or resources (YKK, CHW); obtaining funding (CCS); literature search (YKK, CHW, NNC); administrative, technical, or logistic support (YKK, CHW, NNC, PWH).

Corresponding author

Correspondence to Chi-Chin Sun.

Ethics declarations

Ethics approval and consent to participate

This study was approved by the Institutional Review Board of Chang Gung Memorial Hospital (IRB No.: 201901822A3) and conducted in accordance with the principles outlined in the Declaration of Helsinki. As all participants were under the age of 16, informed consent was obtained from their parents or legal guardians.

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Not applicable.

Competing interests

The authors declare no competing interests.

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Li, JH., Chen, HM., Su, KW. et al. Correlation between longitudinal serum vitamin D levels and myopia in children: a prospective birth cohort analysis. BMC Ophthalmol 25, 143 (2025). https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s12886-025-03960-w

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BMC Ophthalmology

ISSN: 1471-2415

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