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Updated: Jun 16, 2025
Inducement and Evaluation of a Murine Model of Experimental Myopia
Published on: January 22, 2019
Establishment of Myopia Occurrence Prediction Model in Children without Myopia Using Cycloplegic Refraction and Prior
Shengsong Xu1, Zhenbang Ruan1, Yanbin Wang1
1State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China.
Insights
This study developed a myopia prediction model using baseline refraction and axial length changes in children. The model accurately predicts myopia onset and helps define pre-myopia criteria for early intervention.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Biostatistics
Background:
- Myopia onset prediction is crucial for identifying pre-myopia.
- Early identification allows for timely intervention to prevent high myopia.
Purpose of the Study:
- To develop and validate a myopia occurrence prediction model.
- To investigate potential pre-myopia criteria using established models.
Main Methods:
- A 5-year prospective study involving 4,437 children aged 6-9 years.
- Collected data included cycloplegic spherical equivalent refraction (SER) and axial length (AL) measurements.
- Developed a prediction model incorporating baseline SER, 1-year AL change, sex, and parental myopia history.
Main Results:
- Baseline SER and prior AL change demonstrated strong predictive value for myopia onset.
- The final model showed excellent calibration and discrimination (AUCs 0.877-0.941) for 1- to 4-year predictions.
- Established SER thresholds for defining pre-myopia risk, integrated into an online risk calculator.
Conclusions:
- A validated myopia prediction model was developed using cycloplegic refraction and axial length changes.
- Potential SER thresholds for pre-myopia definition were established.
- Further validation in diverse populations is recommended.
Purpose:
Predicting myopia onset is critical for the identification of premyopia. This study aimed to develop and validate a myopia occurrence prediction model and further investigated potential premyopia criteria.
Design:
Five-year prospective study.
Participants:
Four thousand four hundred thirty-seven children 6 to 9 years of age from 12 schools.
Methods:
Five valid follow-up visits were completed from 2018 through 2023. At each visit, uncorrected visual acuity was evaluated using the Early Treatment Diabetic Retinopathy Study chart with tumbling E optotypes (Precision Vision). Cycloplegic autorefraction was performed with a desktop autorefractor (KR8800; Topcon Corp). Cycloplegia was induced with 3 drops of 1% cyclopentolate, instilled 5 minutes apart. Refraction measurements were obtained after complete cycloplegia, which was confirmed by the absence of light reflex and a dilated pupil of at least 6 mm in diameter. Axial length (AL) was measured using noncontact partial-coherence laser interferometry (IOL Master 500; Zeiss).
Main Outcome Measures:
Cycloplegic spherical equivalent refraction (SER) and AL.
Results:
Baseline SER and prior AL change showed strong predictive value. Minimal improvement was found using prior 2-year changes, and hence the final model incorporated prior 1-year AL change, baseline SER, sex, and parents with myopia. The nomogram exhibited excellent calibration, clinical net benefit, and discrimination, with areas under the receiver operating characteristic curve of 0.879 to 0.941 (1- to 4-year prediction) in the primary cohort and 0.877 to 0.928 (1- to 4-year prediction) in the validation cohort. Calibration plots and decision curve analysis showed good consistency (all Brier scores < 0.25) and clinical value. Based on the model, SER thresholds under various conditions were established to map the risk of myopia occurrence in the future. The model was integrated into an open-source online risk calculator.
Conclusions:
This prospective study combined cycloplegic refraction with prior AL change to develop and validate a myopia prediction model, establishing potential SER thresholds for premyopia definition. Larger-scale studies across diverse populations are warranted to validate these findings.
Financial Disclosure(S):
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
