Objective pulse wave amplitude as a potential systemic correlate in childhood myopia: a digital TCM-based study

Childhood myopia is increasingly recognized as a condition with systemic underpinnings, aligning with the holistic perspective of Traditional Chinese Medicine (TCM). This study aimed to explore associations between childhood myopia and objectively measured TCM pulse, tongue, and face diagnostic parameters using digital instruments.

In this cross-sectional, school-based study, 873 children aged 7-14 years from Shandong Province, China, underwent comprehensive examinations. Myopia was defined as a cycloplegic spherical equivalent (SE) ≤ -0.50 D. Objective parameters of pulse (using the DS01-DI pulse diagnosis instrument), tongue, and face (using the DS01-B system) were automatically acquired. Associations with myopia, SE, and axial length (AL) were evaluated using multivariable logistic regression and generalized linear models, adjusting for age, sex, BMI, parental myopia, time spent on near work and outdoor activities, and TCM body constitution.

Among 873 children, 464 (53.15%) had myopia. After covariate adjustment, the amplitude of the main pulse wave (h1) was independently and negatively associated with myopia in all children (Model 1: OR = 0.834, P < 0.001; Model 2: OR = 0.831, P < 0.001). This association remained significant in both age subgroups (7-10 and 11-14 years). Higher h1 correlated with greater SE and shorter AL in the older group. No significant associations were found between myopia and any quantified tongue or facial parameters. Myopic children also showed a significantly higher prevalence of biased TCM constitutions compared to those with a balanced constitution.

Reduced h1 amplitude is a systemic correlate of childhood myopia, whereas tongue and facial features showed no significant associations. These findings support the potential of pulse-based systemic assessment in integrated myopia research.