Prediction of premyopia and myopia in Chinese preschool children: a longitudinal cohort

Abstract

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.

Cysteine Substitution and Calcium-Binding Mutations in FBN1 cbEGF-Like Domains Are Associated With Severe Ocular Involvement in Patients With Congenital Ectopia Lentis

“…However, we found that in patients with cbEGF-like mutations, the total corneal K1 increased with aging (r s = 0.294, p = 0.038). This differs from the overall findings for MFS patients with lens subluxation ( Chen et al, 2018a ) or healthy children ( He et al, 2021 ; Liu et al, 2021 ), indicating the specific role of cbEGF-like mutations, rather than general FBN1 mutations, in age-related corneal changes.…”

Association Between Body Stature with Ocular Biometrics and Refraction among Chinese Preschoolers

“…However, some studies found no association between height and refraction in preschoolers 17,24,25 ,which is consistent with our study. It can be easily understood that taller and heavier children have longer AL but atter cornea, thus resulting in a slight difference in refraction in this study.…”

The impact of pre-operative axial length on myopic shift 3 years after congenital and developmental cataract surgery and intraocular lens implantation

“…Axial length growth is associated with MS and myopia, ( 25 ) and a longer AL can be used to identify those at high risk of myopia in both pre-school and school-aged children ( 26 , 27 ). However, in our study, a longer pre-operative AL led to a slower MS in children with congenital/developmental cataracts with pseudophakic eyes.…”