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Sex judgment using color fundus parameters in elementary school students
Saki Noma1, Takehiro Yamashita2, Ryo Asaoka3,4,5,6
1Department of Ophthalmology, Seirei Hamamatsu General Hospital, 2-12-12 Sumiyoshi, Naka-ku, Hamamatsu, Shizuoka, Japan.
Sex can be determined from fundus photographs in elementary students, but with low accuracy. Ocular fundus sex differences may emerge after age 10, indicating early developmental changes.
Area of Science:
- Ophthalmology
- Medical Imaging
- Artificial Intelligence
Background:
- Artificial intelligence (AI) has shown potential in determining sex from fundus photographs in adults.
- Previous research established sex differentiation using color fundus photography (CFP) in adult eyes.
- The onset of sex-related differences in fundus parameters remains unclear.
Purpose of the Study:
- To investigate sex determination based on ocular fundus parameters in elementary school students.
- To identify specific fundus parameters that can differentiate sex in young children.
- To assess the feasibility of using AI and logistic regression for sex determination in this age group.
Main Methods:
- Prospective observational cross-sectional study of 119 elementary school students (8-9 years old).
- Calculation of tessellation fundus index, optic disc ovality ratio, papillomacular angle, retinal artery trajectory, and retinal vessel using CFP.
- Application of regularized binomial logistic regression and leave-one-out cross-validation for factor selection and performance evaluation.
Main Results:
- Ridge logistic regression identified smaller optic disc ovality ratio and higher nasal green and blue intensities in girls compared to boys.
- The area under the receiver-operating characteristic curve (AUC) for sex discrimination was 63.2%.
Conclusions:
- Sex determination using CFP is possible in elementary school students, but with limited accuracy.
- Subtle sex differences in ocular fundus parameters may begin to manifest after the age of 10 years.
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