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Factors Influencing the Transition From Physiological Hyperopia to Myopia in Children: Protocol for a Prospective
Huaying Xu1, Jianing Pu2, Shimeng Bian1
1Department of Ophthalmology, Beijing Tongren Eye Center, Capital Medical University, Beijing Tongren Hospital, 2 West Ring South Road, Beijing Economic and Technological Development Zone, Beijing, 100730, China.
Insights
This study examines how children’s physiological hyperopia changes and its role in preventing myopia. Understanding these factors can improve myopia screening and prevention strategies for children.
Area of Science:
- Ophthalmology
- Public Health
- Pediatrics
Background:
- Early-onset myopia is a significant public health concern globally.
- High myopia leads to irreversible blindness, particularly in China.
- Physiological hyperopia is a protective factor against myopia development, but its regression dynamics are unclear.
Purpose of the Study:
- To investigate factors influencing physiological hyperopia fading in children.
- To identify key predictors for myopia onset.
- To elucidate the protective mechanisms of physiological hyperopia against myopia.
Main Methods:
- A 3-year prospective nested case-control study following 2109 children aged 6-9 years.
- Annual eye examinations and lifestyle questionnaires.
- Primary outcome: incident myopia; Secondary outcomes: myopia prevalence and ocular biometric changes.
Main Results:
- Recruitment ongoing, with final results anticipated by December 2026.
- This study builds upon a prior cohort of 2109 preschool children.
- Data collection includes annual eye exams and lifestyle questionnaires.
Conclusions:
- The study will analyze dynamic changes in physiological hyperopia and its regression patterns.
- Findings will inform myopia screening, clinical interventions, and public health policies.
- Understanding hyperopia regression is crucial for effective myopia prevention in children.
Background:
The early onset of myopia in children has become a critical public health issue that requires urgent attention. Notably, high myopia-related retinal diseases have emerged as the leading cause of irreversible blindness in adults in certain regions of China. Physiological hyperopia, as a protective factor and one of the strongest predictors of myopia development, plays a key role in delaying the progression of early-onset myopia and reducing the risk of high myopia in adulthood. However, the dynamic changes, critical turning points, and factors contributing to the rapid regression of physiological hyperopia during childhood remain unclear.
Objective:
This study aims to explore the key influencing factors for children's physiological hyperopia fading and myopia onset, as well as the protective mechanisms of physiological hyperopia against myopia.
Methods:
This was a prospective nested case-control study. Our research team previously established a prospective cohort of 2109 preschool children, aged 3 to 6 years, through cluster sampling in 22 kindergartens in Haidian District, Beijing, and completed a 3-year follow-up. Building on this cohort, this study adopts a prospective nested case-control design. We will continue to follow up this cohort with a 3-year longitudinal study, tracking children aged 6 to 9 years. During the 3-year follow-up period, participants will undergo annual eye examinations and complete questionnaires regarding their living habits and environment. The primary outcome is incident myopia, while secondary outcomes include the prevalence of myopia and the changes in various ocular biological parameters. The study received ethics approval on April 7, 2024, from the Ethics Committee of Beijing Tongren Eye Center, Beijing Tongren Hospital (TREC2024-KY034) and was registered on July 5, 2024.
Results:
Participant recruitment began on July 10, 2024, and is expected to be completed by December 31, 2026. As of February 2026, recruitment is ongoing, and the final results are expected by December 2026.
Conclusions:
This prospective nested casecontrol study investigates the dynamic changes and regression patterns of physiological hyperopia in school-aged children and evaluates the associations between ocular biometric parameters and the onset of myopia. The findings are expected to support standardized myopia screening, inform clinical interventions, and provide evidence-based guidance for government policies on myopia prevention and control in young children.
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