SEARCHCOHORTophthalmology, pediatric ophthalmology

cohort·ophthalmology, pediatric ophthalmology, epidemiology, public health, observational study·PMC10018376

Prevalence Patterns and Onset Prediction of High Myopia for Children and Adolescents in Southern China via Real-World Screening Data: Retrospective School-Based Study

Journal of Medical Internet Research · 14 authors, 3 centres

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TL;DR

The overall prevalence of high myopia ranged from 3.17% to 4.88%, increased with age, and a random forest algorithm using age, uncorrected distance visual acuity, and spherical equivalent achieved an AUC of 0.975 for predicting high myopia onset.

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This retrospective school-based cohort study analyzed real-world vision screening records from 1,285,609 children and adolescents (mean age 11.80, SD 3.07) across 13 cities with varying GDPs in Guangdong Province, southern China, between 2019 and 2021. High myopia was defined as SE ≤ -6 D using noncycloplegic refraction. The overall prevalence of high myopia was 4.48% in 2019, 4.88% in 2020, and 3.17% in 2021, with an increasing trend from ages 11 to 17 years. Coastal and southern cities with higher GDPs showed higher prevalence (2.60%-5.83%). Limitations include the use of noncycloplegic refraction rather than cycloplegic refraction as a gold standard, reliance on screening records, potential selection bias, and missing or incorrect data entry inherent to real-world screening data.

STUDY TYPE

cohort

SPECIALTY

ophthalmology

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AI pipeline

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ORIGINAL PAPER

PMC10018376

Prevalence Patterns and Onset Prediction of High Myopia for Children and Adolescents in Southern China via Real-World Screening Data: Retrospective School-Based Study

Journal of Medical Internet Research

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ABSTRACT

Background Patients with high myopia have an increased lifetime risk of complications. The prevalence patterns of high myopia in children and adolescents in southern China are unclear. Early identification of high-risk individuals is critical for reducing the occurrence and development of high myopia and avoiding the resulting complications. Objective This study aimed to determine the prevalence of high myopia in children and adolescents in southern China via real-world screening data and to predict its onset by studying the risk factors for high myopia based on machine learning. Methods This retrospective school-based study was conducted in 13 cities with different gross domestic products in southern China. Through data acquisition and filtering, we analyzed the prevalence of high myopia and its association with age, school stage, gross domestic product, and risk factors. A random forest algorithm was used to predict high myopia among schoolchildren and then assessed in an independent hold-out group. Results There were 1,285,609 participants (mean age 11.80, SD 3.07, range 6-20 years), of whom 658,516 (51.2%) were male. The overall prevalence of high myopia was 4.48% (2019), 4.88% (2020), and 3.17% (2021), with an increasing trend from the age of 11 to 17 years. The rates of high myopia increased from elementary schools to high schools but decreased at all school stages from 2019 to 2021. The coastal and southern cities had a higher proportion of high myopia, with an overall prevalence between 2.60% and 5.83%. Age, uncorrected distance visual acuity, and spherical equivalents were predictive factors for high myopia onset in schoolchildren. The random forest algorithm achieved a high accuracy of 0.948. The area under the receiver operator characteristic curve (AUC) was 0.975. Both indicated sufficient model efficacy. The performance of the model was validated in an external test with high accuracy (0.971) and a high AUC (0.957). Conclusions High myopia had a high incidence in Guangdong Province. Its onset in children and adolescents was well predicted with the random forest algorithm. Efficient use of real-world data can contribute to the prevention and early diagnosis of high myopia.

CITATION EXPORT

Jieying Guan, Yingting Zhu, Qiuyue Hu et al.. Prevalence Patterns and Onset Prediction of High Myopia for Children and Adolescents in Southern China via Real-World Screening Data: Retrospective School-Based Study. Journal of Medical Internet Research. (2023). https://doi.org/10.2196/39507

AUTHORS

14 · 3 CENTRES

Jieying Guan, Yingting Zhu, Qiuyue Hu, Shuyue Ma, Jingfeng Mu, Zhidong Li, Dong Fang, Xiaohua Zhuo, Haifei Guan, Qianhui Sun, Lin An, Shaochong Zhang, Peiwu Qin, Yehong Zhuo

1 State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science Guangdong Provincial Clinical Research Center for Ocular Diseases Guangzhou China
2 Institute of Biopharmaceutical and Health Engineering, Shenzhen International Graduate School, Tsinghua University Shenzhen China
3 Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute Shenzhen China

EDITOR / REVIEWER

Tiffany Leung, Gunther Eysenbach, Deevyankar Agarwal, Leming Zhou