Gene-environment Interaction in Spherical Equivalent and Myopia: An Evidence-based Review

Association between gene-environment interaction and myopia/spherical equivalent has not been systematically reported. This paper reviewed nine studies concerning gene-environment interaction in myopia.We obtained relevant studies concerning gene-environment interaction in myopia by systematically searching the MEDLINE(PubMed), Cochrane, Web of Science, CNKI, Wanfang databases before 31 March 2020. Data were analyzed by STATA version 16.0 software, and figures were drawn by ArcGIS V.10.0 software.Nine studies were included in this review concerning gene-environment interaction. Gene and education interaction in adult cohorts suggested a more significant genetic effect in higher education levels than lower education levels, using both candidate genes and PRS approaches. Several interacted genetic variants, including ZMAT4(rs2137277), GJD2(rs524952), TJP2 (rs11145488) from adult study and ZMAT4(rs7829127) from child study are pinpointed out, but the replication attempts were limited. Besides, the genetic effect was associated with a significant shift at a higher educational level (Pooled β = -0.15,95%CI = -0.19-0.11) towards myopia than that at a lower education level (Pooled β = -0.10,95%CI = -0.11-0.09).This study summarizes the relationship between gene-environment interaction and myopia, and interaction effect of the gene or genetic risk score with the environment could be found in these studies. The effect of gene-environment (higher education) interaction substantially impacts myopia in adult studies. Evidence that environmental factors (Increased near-work time/decreased outdoor activities) increase the genetic risk is still limited, and specific SNPs contributing to gene-environment effect are not determined yet.