Development of a nomogram for predicting myopia risk among school-age children: a case-control study

Abstract

Objectives To analyze the factors influencing myopia and construct a nomogram to forecast the risk of myopia among school-age children, providing a reference for identifying high-risk groups to aid prevention and control. Methods This case-control study enrolled 3512 students from three primary schools in Shenzhen using random cluster sampling for a questionnaire survey, myopia screening and ocular biometric parameter measurement. Logistic regression was used to analyze the influencing factors of myopia, and a nomogram was constructed to forecast myopia risk. Bootstrap resampling was used to verify the practicability of the nomogram. Results Older age (odds ratio[OR] = 1.164; 95% confidence interval [CI]: 1.111–1.219), female sex (OR = 2.405; 95% CI: 2.003–2.887), maternal myopia (OR = 1.331; 95% CI: 1.114–1.589), incorrect posture during reading and writing (OR = 1.283; 95% CI: 1.078–1.528) and axial length (OR = 7.708; 95% CI: 6.044–8.288) are risk factors for myopia, whereas an increase in corneal radius (OR = 0.036; 95% CI: 0.025–0.052) is a protective factor against myopia. The area under the receiver operating characteristic (ROC) curve of the nomogram was 0.857, and the net benefit was high when the risk threshold of the decision curve analyses (DCA) ranged from 0.20 to 1.00. The measured values were consistent with the prediction. Conclusion The nomogram was accurate in predicting the risk of myopia among schoolchildren. This study provides a reference for screening high-risk students and for individualized myopia prevention and control.