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Factors influencing refractive status distribution and amblyopia in preschool children with low vision
Jun Wu1, Jili Wen1, Yong Yang1
1Department of Ophthalmology, Jinhua Municipal Central Hospital Jinhua 321000, Zhejiang, China.
Insights
Hyperopic refractive error is common in preschool children with low vision and is a key risk factor for amblyopia (AMB). A new prediction model effectively identifies children at high risk for AMB, aiding early screening.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Public Health
Background:
- Low vision in preschoolers presents unique refractive challenges.
- Amblyopia (AMB) is a significant cause of visual impairment in early childhood.
- Understanding refractive status distribution is crucial for early intervention.
Purpose of the Study:
- Characterize refractive status in preschool children with low vision.
- Identify independent risk factors for amblyopia (AMB).
- Develop and validate a risk prediction model for AMB screening.
Main Methods:
- 180 preschoolers (3-6 years) with low vision were examined.
- Refractive status and visual characteristics were recorded.
- Univariate and multivariate analyses identified risk factors; ROC curves validated the model.
Main Results:
- Hyperopia was the dominant refractive error; its prevalence decreased with age.
- Amblyopia (AMB) incidence was 40%, highest in the 4-5-year age group.
- Parental myopia, close-range eye use, and refractive status were independent AMB risk factors.
Conclusions:
- Hyperopic refractive error is a primary abnormality and core risk factor for AMB in this population.
- The developed risk prediction model demonstrates clinical utility for identifying high-risk children.
- This tool supports efficient early clinical screening and intervention for amblyopia.
Objective:
To reveal the distribution characteristics of refractive status of preschool children with low vision, analyze the independent risk factors of amblyopia (AMB), and build a risk prediction model, so as to provide a basis for early screening and precise intervention.
Methods:
We enrolled 180 preschoolers (3-6 years old) with low vision from January 2023 to December 2024. All of the participants underwent standardized examinations, with their refractive status and visual characteristics recorded. Subsequently, a univariate analysis was conducted to identify differences in demographic characteristics, perinatal factors, environmental behaviors, and refractive state between AMB and non-AMB children, followed by regression coefficient-based AMB risk assessment model construction, with model performance validated by receiver operating characteristic (ROC) curves.
Results:
Hyperopia was dominant in children with low vision. With an increase in age, the proportion of hyperopic refractive error gradually decreased. AMB occurred at an overall incidence of 40.00% (72/180) among our cohort, with the prevalence being dominant in the 4-5-year age group. According to multivariate analysis, parental myopia, time spent on close-range eye use, and refractive status were independent risk factors for AMB. Through internal validation, it was found that the prediction model had clinical application value in AMB screening.
Conclusion:
The main refractive abnormality in preschool children with low vision is hyperopic refractive error, which is also the core risk factor for AMB. The risk prediction model we constructed can effectively identify high-risk groups, providing an efficient tool for early clinical screening.
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