Prediction of myopia onset with refractive error measured using non-cycloplegic subjective refraction: the WEPrOM Study,BMJ Open Ophthalmology

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Prediction of myopia onset with refractive error measured using non-cycloplegic subjective refraction: the WEPrOM Study
BMJ Open Ophthalmology Pub Date : 2021-06-01 , DOI: 10.1136/bmjophth-2020-000628
Yee Ling Wong ₁ , Yimin Yuan _{2,

3} , Binbin Su _{2,

3} , Shezad Tufail ₁ , Yang Ding _{2,

3} , Yingying Ye ₂ , Damien Paille ₁ , Björn Drobe _{1,

3} , Hao Chen ₂ , Jinhua Bao _{2,

3}

Affiliation

Background/aims To evaluate the predictive performance of various predictors, including non-cycloplegic refractive error, for risk of myopia onset under pragmatic settings. Methods The Wenzhou Medical University Essilor Progression and Onset of Myopia Study is a prospective cohort study of schoolchildren aged 6–10 years from two elementary schools in Wenzhou, China. Non-cycloplegic refraction, ocular biometry and accommodation measurements were performed. Myopia was defined as spherical equivalent (SE) ≤−0.5 diopter (D). ORs using multivariable logistic regression were determined. Area under the curve (AUC) evaluation for predictors was performed. Results Schoolchildren who attended both baseline and 2-year follow-up were analysed (N=1022). Of 830 non-myopic children at baseline, the 2-year incidence of myopia was 27.6% (95% CI, 24.2% to 31.3%). Female gender (OR=2.2), more advanced study grades (OR=1.5), less hyperopic SE (OR=11.5 per D), longer axial length (AL; OR=2.3 per mm), worse presenting visual acuity (OR=2.3 per decimal), longer near work time (OR=1.1 per hour/day) and lower magnitude of positive relative accommodation (PRA; OR=1.4 per D) were associated with myopia onset. PRA (AUC=0.66), SE (AUC=0.64) and AL (AUC=0.62) had the highest AUC values. The combination of age, gender, parental myopia, SE, AL and PRA achieved an AUC of 0.74. Conclusion Approximately one in four schoolchildren had myopia onset over a 2-year period. The predictors of myopia onset include lower magnitude of PRA, less hyperopic SE, longer AL and female gender. Of these, non-cycloplegic SE and PRA were the top single predictors, which can facilitate risk profiling for myopia onset. Data are available upon request.

更新日期：2021-06-09

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