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Prediction of premyopia and myopia in Chinese preschool children: a longitudinal cohort
1Department of Ophthalmology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, China.
Insights
Axial length (AL) and AL/corneal radius of curvature (CR) can predict myopia in preschoolers. These easily measured parameters help identify children at high risk for early intervention.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Public Health
Background:
- Myopia is a growing global health concern, particularly in children.
- Early-onset myopia increases the risk of severe complications.
- Identifying at-risk children during preschool years is crucial for prevention.
Purpose of the Study:
- To determine if premyopia and myopia in preschoolers can be predicted using simple measurements.
- To identify key parameters for early detection of myopia risk.
Main Methods:
- Population-based cohort study with 830 preschool children.
- Collected data included height, weight, refraction, axial length (AL), corneal radius of curvature (CR), and parental myopia history.
- Used multivariate linear regression and Cox proportional hazard regression with a nomogram for prediction over a 2-year follow-up.
Main Results:
- Baseline axial length (AL), AL/corneal radius of curvature (CR) ratio, and having two myopic parents were significantly associated with future myopia.
- Higher AL and AL/CR ratio strongly predicted premyopia onset.
- The AL/CR ratio demonstrated the most significant impact on myopia development.
Conclusions:
- Axial length (AL) and the AL/CR ratio are valuable, easily obtainable indicators for identifying preschool children at high risk of developing myopia.
- These parameters facilitate early identification and intervention for myopia prevention.
Backgrounds:
Myopia has become a global public health problem. Children with early onset of myopia are at particular risk of complications associated with myopia. Younger children and children with greater initial myopic refractive errors are at a greater risk of myopia progression. Therefore, it is essential to identify subjects at high risk of developing myopia to facilitate myopia prevention in the early stage, especially during the preschool period. The purpose of this study was to determine whether premyopia and myopia in preschool children can be predicted by easily obtainable parameters.
Methods:
Data was collected in a population-based cohort. Comprehensive examinations included height, weight, refraction, axial length (AL), and corneal radius of curvature (CR), with a follow-up of 2 years. Parental myopia history was obtained from a questionnaire. Myopia was defined as spherical equivalent (SE) ≤ - 0.50 D. Premyopia was defined as - 0.50 D < SE ≤ + 0.75 D. Multivariate linear regression models were fitted to determine the associations between these parameters at baseline and future SE. To predict premyopia and myopia, Cox proportional hazard regression analysis coupled with a nomogram was used.
Results:
A total of 830 children (433 boys and 397 girls) were included (40.83 ± 3.43 months old at baseline). A significantly negative relationship was observed in the multivariate analysis between baseline AL, AL/CR, two myopic parents, and the future SE after adjusting for age and gender (coefficient = - 0.291, coefficient = - 5.791, coefficient = - 0.273, respectively, both p < 0.001). Higher baseline AL, AL/CR (hazard ratio (HR) = 4.916, HR = 2.979, respectively, comparing the top quartile with the bottom quartile, both p < 0.001) and two myopic parents (HR = 1.756, compared to no myopic parents, p = 0.001) were associated with a higher risk of future onset of premyopia. From the nomogram, AL/CR was found to have the most enormous effect on survival. Different baseline AL and AL/CR values (both Log Rank p < 0.001) had different survival curves.
Conclusions:
AL and AL/CR could be used as obtainable indicators for identifying subjects at high risk of developing premyopia and myopia in young preschool children.
