Refractive Error Study Research Articles

Machine Learning Models for Predicting Cycloplegic Refractive Error and Myopia Status Based on Non-Cycloplegic Data in Chinese Students.

To develop and validate machine learning (ML) models for predicting cycloplegic refractive error and myopia status using noncycloplegic refractive error and biometric data. Cross-sectional study of children aged five to 18years who underwent biometry and autorefraction before and after cycloplegia. Myopia was defined as cycloplegic spherical equivalent refraction (SER) ≤-0.5 Diopter (D). Models were evaluated for predicting SER using R2 and mean absolute error (MAE) and myopia status using area under the receiver operating characteristic (ROC) curve (AUC). Best-performing models were further evaluated using sensitivity/specificity and comparison of observed versus predicted myopia prevalence rate overall and in each age group. Independent data sets were used for training (n = 1938) and validation (n = 1476). In the validation dataset, ML models predicted cycloplegic SER with high R2 (0.913-0.935) and low MAE (0.393-0.480 D). The AUC for predicting myopia was high (0.984-0.987). The best-performing model for SER (XGBoost) had high sensitivity and specificity (91.1% and 97.2%). Random forest (RF), the best-performing model for myopia, had high sensitivity and specificity (92.2% and 96.9%). Within each age group, difference between predicted and actual myopia prevalence was within 4%. Using noncycloplegic refractive error and ocular biometric data, ML models performed well for predicting cycloplegic SER and myopia status. When measuring cycloplegic SER is not feasible, ML may provide a useful tool for estimating cycloplegic SER and myopia prevalence rate in epidemiological studies. Using ML to predict cycloplegic refraction based on noncycloplegic data is a powerful tool for large, population-based studies of refractive error.

Characteristics of refractive development in children aged 4 months to 8 years in urban China: A retrospective screening analysis.

To conduct a large retrospective study of screening refractive error in young children. This retrospective study included children aged from 4 months to 8 years in Daxing District, Beijing, who underwent refractive examinations without cycloplegia. It included a cross-sectional assessment of refractive error screening for all children, and a longitudinal component for a subgroup with data available for two to five visits. A total of 14,987 children were included in the cross-sectional study. In the group <1 year of age, the percentage of children with a spherical equivalent (SE) >+2.00 D or with cylinder <-1.50 D was 15.25% and 33.24%, respectively. These were significantly higher than for the 1- to 4-year-old group (SE 8.1% higher, cylinder 13.2% higher) (χ2 = 53.57, p < 0.001; χ2 = 790.39, p < 0.001). Furthermore, 34.83% of children in the 0-year-old group had amblyopia risk factors (ARFs). In the 4-year-old group, boys had a significantly longer axial length (AL) than girls (differences in the right and left eyes were 0.53 and 0.56 mm, respectively; z = 5.48 p < 0.001, z = 5.80, p < 0.001). AL increased with age, while the AL difference between boys and girls remained stable at 4-8 years of age. The percentage of children aged 5-8 years with myopia in 2020-2021 was significantly higher than that in 2018-2019 (H = 12.44, p = 0.006). In the longitudinal study of 4406 children (up to 12-month follow-up), annual changes in SE were -0.27, -0.06, 0.19 and 0.13 D between 0 and 3 years, and -0.38, -0.58, -0.70 and -0.75 D between 5 and 8 years. Children's refractive error varied significantly from ages 4 months to 1 year, with a high proportion having ARFs. Children aged 5-8 years showed a trend towards myopia. The prevalence of myopia in the cross-sectional analysis in 2020-2021 was greater than in 2018-2019. Screening refraction changed minimally over a 12-month period for children aged 1-3 years, but became more myopic for children aged 5-8 years.

Refractive Errors of School Children from Economically Disadvantaged Areas in Northwest México.

Background: Refractive errors, including myopia, hyperopia, and astigmatism, are the leading causes of visual impairment in school-aged children and can significantly impact their academic performance and quality of life. This study aimed to assess the prevalence of refractive errors among school children from economically disadvantaged areas in Northwest México, using a consistent methodology to facilitate comparison with global data. Methods: We adopted the Refractive Error Study in Children (RESC) protocol by the World Health Organization to examine the prevalence of myopia, hyperopia, and astigmatism. The study comprised a systematic sampling of children aged 6 to 18 years from diverse schools in Northwest México. Trained optometrists conducted visual acuity testing and autorefraction, while ophthalmologists performed cycloplegic refraction to ensure accuracy. Results: The study found a myopia (SE ≤-1.50 D at least one eye) prevalence of 14.55% (95% CI: 13.27-15.91), with a higher incidence in females (6.92%) compared to males (6.00%) in at least one eye. Hyperopia (SE ≥ +1.00 D at least one eye) was less common, at 3.23% (95% CI: 2.61-3.95), with a slightly higher occurrence in males in at least one eye. Astigmatism (Cylinder ≥ 0.75 D at least one eye) was present in 18.63% (95% CI: 17.21-20.12) of the students in at least one eye, with no significant difference between genders. These findings are consistent with other studies in regions such as Puerto Rico and Iran, indicating widespread refractive error issues among schoolchildren. Conclusions: The high prevalence of refractive errors, particularly myopia and astigmatism, highlights the critical need for regular vision screenings in schools and the implementation of public health interventions to provide corrective eyewear. Our study confirms the importance of utilizing standardized methodologies like the RESC protocol to compare refractive error prevalence across different geographical and socio-economic contexts, thereby informing global public health strategies.

Predicting the onset of myopia in children by age, sex, and ethnicity: Results from the CLEERE Study.

Clinicians and researchers would benefit from being able to predict the onset of myopia for an individual child. This report provides a model for calculating the probability of myopia onset, year-by-year and cumulatively, based on results from the largest, most ethnically diverse study of myopia onset in the United States. This study aimed to model the probability of the onset of myopia in previously nonmyopic school-aged children. Children aged 6 years to less than 14 years of age at baseline participating in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) Study who were nonmyopic and less hyperopic than +3.00 D (spherical equivalent) were followed up for 1 to 7 years through eighth grade. Annual measurements included cycloplegic autorefraction, keratometry, ultrasound axial dimensions, and parental report of children's near work and time spent in outdoor and/or sports activities. The onset of myopia was defined as the first visit with at least -0.75 D of myopia in each principal meridian. The predictive model was built using discrete time survival analysis and evaluated with C statistics. The model of the probability of the onset of myopia included cycloplegic spherical equivalent refractive error, the horizontal/vertical component of astigmatism (J0), age, sex, and race/ethnicity. Onset of myopia was more likely with lower amounts of hyperopia and less positive/more negative values of J0. Younger Asian American females had the highest eventual probability of onset, whereas older White males had the lowest. Model performance increased with older baseline age, with C statistics ranging from 0.83 at 6 years of age to 0.92 at 13 years. The probability of the onset of myopia can be estimated for children in the major racial/ethnic groups within the United States on a year-by-year and cumulative basis up to age 14 years based on a simple set of refractive error and demographic variables.

Understanding Vision Impairment: A Comprehensive Study of Uncorrected Refractive Errors among Primary School Teachers and Pupils in Nongowa Chiefdom, Kenema District, Sierra Leone

Introduction: Uncorrected Refractive Error (URE) is a major concern globally, particularly in developing nations like Sierra Leone, where limited access to eye care services poses challenges. Aim: This study, conducted in Nongowa Chiefdom, Kenema District, Sierra Leone, aimed to investigate the prevalence of URE and associated knowledge, attitudes, and practices among primary school pupils and teachers. Methods: Descriptive cross-sectional designs, incorporating both qualitative and quantitative methods were used. A structured survey questionnaire and visual acuity screening tools were used to assess uncorrected refractive errors among 692 randomly selected participants, data analysis involved descriptive statistics and qualitative content analysis. Results: The study involved 374 pupils and 318 teachers from 145 public and 14 private schools, uncorrected refractive error prevalence was 66%, with hypermetropia most prevalent and blindness at 0.13%. Girls contributed 29% of cases compared to boys' 25%. Ages 5-17 were most affected. Public schools accounted for 91% of cases, with peri-urban areas contributing 24% and urban areas 76%. Economic status and education influenced prevalence. Teachers played a crucial role in promoting eye health education. Economic factors may have influenced observed differences in refractive errors. Conclusion: The study highlighted the multifaceted nature of URE, involving demographic, economic, and educational factors. Addressing these complexities through targeted interventions is crucial for mitigating the burden of visual impairment in the region.

A Two-Year Longitudinal Study of Refractive Error and Ocular Biometry among Young Adults in Brazil

A Two-Year Longitudinal Study of Refractive Error and Ocular Biometry among Young Adults in Brazil

Epidemiological study of refractive errors in children and adolescents of Han and Li ethnics in the Ledong and Wanning areas of Hainan Province.

To determine the prevalence of refractive error and ocular biometric data (corneal curvature, axial length, and central corneal thickness) in 6 to 15 years old children of Li and Han ethnicities of China. This study was a cross-sectional study. A cluster sampling method was used to select 2 nine-year consistent schools in the Ledong and Wanning areas of Hainan Province, with a total of 4,197 students, 3,969 valid data. Eyesight test, slit lamp, autorefraction after cycloplegia, and ocular biometric assessment were performed. The chi-square test and logistic regression analysis was taken as the comparative method. Myopia, hyperopia, and astigmatism are defined as: myopia: SE ≤-0.50 D; hyperopia: 0.50 D <SE. The absolute value of the cylinder diopter is ≥0.75 D, and the uncorrected visual acuity is lower than the lower limit of the normal age for astigmatism. The prevalence of myopia in the 6-9, 10-12, and 13-15 years old were 3.4%, 16.6%, and 36.4% for the Li, while 11.1%, 32.6 %, and 42.6% for the Han. The prevalence of myopia was significantly different between the three age groups (χ2=26.809, 48.045, 4.907, P<0.001, P<0.001, P<0.05). The prevalences of myopia in Li boys and girls were 12.3% and 24.2%, and in the Han boys and girls were 26.1% and 36.6%. The prevalence of myopia was different between boys and girls (χ2=60.645, 31.137, P<0.001, P<0.001). In the Wanning and Ledong areas, the prevalences of myopia for the Li were 30.5% and 16.8%, and for the Han were 30.8% and 31.1%. In regard to the prevalence of myopia, no statistical difference was seen in the two nationalities in the Wanning area (χ2=0.012, 0.914), but not in the Ledong area (χ2=27.305, P<0.001). The overall prevalence of myopia in children and adolescents in Han is higher than that in Li The prevalence of myopia in Han and Li was significantly different in different age groups from 6 to 15 years old. The prevalence of myopia in girls was higher than that in boys, in the Wanning area than that in the Ledong area.

A refractive error study in western region of Uttar Pradesh

Refractive error is the leading global problem throughout the world and India also affected moderately with this type of problem. In India most of peoples either they are male or female, whatever they are old, whatever the profession and habitat, various peoples can identified who are suffering with the refractive error diseases acutely, moderately and severely. So this study is focused on the identification of refractive error cases among the peoples of western Uttar Pradesh especially form the Meerut, Muzzafar Nagar and Bahpat. During this study the different type of refractive error cases are identified among the peoples using different inclusion criteria like Gender, Age, Occupation and living area. During this study the various patients were identified with the conform cases of Myopia, Hypermetropia and Astigmatism and Presbyopia.

Results of the School Children Ocular Biometry and Refractive Error Study in South India.

Axial length (AL) is an important contributor to refraction, and growth curves are gaining importance in the prediction of myopia. This study aimed to profile the distribution of ocular biometry parameters and to identify correlates of spherical equivalent refraction (SE) among school children in South India. The School Children Ocular Biometry and Refractive Error study was conducted as part of a school screening program in southern India. The enrolled children underwent tests that included vison check, refraction, binocular vision assessment, and biometry measurements. The study included 1382 children whose mean (standard deviation [SD]) age was 10.18 (2.88) years (range: 5-16 years). The sample was divided into 4 groups (grades 1-2, grades 3-5, grades 6-9, and grade 10) based on significant differences in right AL (p<0.001). The mean (SD) AL (range: 20.33-27.27 mm) among the four groups was 22.50 (0.64) mm, 22.88 (0.69) mm, 23.30 (0.82) mm, and 23.58 (0.87) mm, respectively. The mean SE (range: +1.86 to -6.56 D) was 0.08 (0.65 D) in class 1 and decreased with increasing grade to -0.39 (1.20 D) in grade 10. There was a significant difference in all biometry parameters between boys and girls (p<0.001). Age, AL, and mean corneal curvature were the main predictors of SE. This study provides a profile of ocular biometry parameters among school children in South India for comparison against profiles from other regions across the country. The study data will form a reference for future studies assessing myopia in this ethnicity.

Ocular health among industrial workers: a prevalence study of foreign body injury, refractive error, dry eye, pterygium and pingueculae.

Workplaces play a critical role in developing ocular diseases, owing to the risk of accidents. This study aimed to evaluate the ocular health of industrial workers by determining the prevalence of foreign body injury, refractive error, dry eye, and pterygium/pingueculae, as well as the factors influencing these diseases. This study involved on-site examinations of workers from an industrial area hosting marble processing factories and metal sectors. Data such as refractive error, foreign body injury-related corneal nephelium, pterygium/pingueculae presence, and Schirmer test-assisted dry eye evaluation were all collected. The average age of workers was 35.78±10.05 years, with a female-to-male ratio of 20:220. The majority of workers had completed primary school (56.3%), smoked >1 cigarette/day (57.6%), and did not use any assistive devices for bodily functions (88.3%). On average, working hours/week were 55.07±8.79, and working years were 5.99±7.00. Dry eyes were found in 31 (22%), and 35 (34%) marble and metal workers, respectively (p=0.042). 11 (7.9%) marble workers and 29 (28%) metal workers had foreign body ocular injury-related corneal nephelium (p=0.0001). Furthermore, pterygium/pingueculae were revealed in 17 marble workers (12.3%) and three metal workers (3%) (p=0.009). Ocular health is essential, and routine ocular health screening in industrial workers, as well as workplace safety measures, should be implemented to prevent potential occupational accidents.

Comparison of Accuracy of IOL Master and a Scan Acoustic Biometry in Silicon Oil Filled Eyes

Objective: Objective of our study was to determine accuracy of IOL Master and A scan acoustic biometry in silicon filled eyes in terms mean difference of axial length pre-operatively and mean post-operative refractive error Study design: Comparative cross sectional study Study settings and duration: Study was conducted at department of Ophthalmology (Eye Unit III) Mayo hospital Lahore (KEMU) from November 2019 to April 2020. Material and methods: WHO calculator was used for calculation of patient sample (N=34). Patients were randomly divide in two groups Group I underwent preoperative axial length (AXL) measurement by using IOL Master and by acoustic a-scan ultrasound in Siliconized mode. Results: Total 34 patients were included in study. There were 18(52.9%) male and 16(47.1%) female. Mean age of patients was 44.2±6.4 years. Patients undergone biometry with Master IOL showed better visual acuity (Log Mar) (0.25±0.7, 0.63±0.09, p=0.000), less post-operative refractive error (0.22±0.02, 0.72±0.17, p=0.000) as compared to those in which A scan acoustic biometry was done. A significant difference in post-operative axial length was reported (p=0.04) Conclusion: IOL master is more accurate and reliable method of IOL power calculation resulting in better visual outcomes and less post-operative refractive error as compared to A scan acoustic biometry in silicon filled eyes. Keywords: A scan Acoustic biometry, Axial length, IOL Master

The impact of uncorrected refractive error and visual impairment on the quality of life amongst school-going children in Sekhukhune district (Limpopo), South Africa

Background: Uncorrected refractive error (URE) and subsequent visual impairment (VI) is expected to have an impact on the quality of life (QoL) amongst schoolchildren.Aim: This study aimed to determine the impact of URE and VI on the QoL amongst school-going children aged 14–18 years.Settings: The study was performed at Sekhukhune district in the Limpopo province, South Africa.Methods: The tool used to assess the QoL was the National Eye Institute Quality of Life Questionnaire (NEI-VFQ-25). A modified refractive error study in children (RESC) protocol was employed to determine the value of URE and VI. The tests performed included Logarithm of the Minimum Angle of Resolution (LogMAR) visual acuity, cycloplegic autorefraction, binocular motor function tests, media and fundus examination.Results: A total of 154 learners, aged 14–18 years completed the NEI-VFQ-25, which was offered in an interview format. A total of 56 learners (36.3%, 95% confidence interval [CI]: 14.9–27.9]) had URE and VI. Children with URE and VI scored low on the NEI-VFQ-25 as compared with those without URE and VI.Conclusion: Uncorrected refractive error has an impact on the QoL of learners in the greater Sekhukhune district. This calls for policymakers and other relevant stakeholders in basic education to prioritise programmes that seek to address the visual health of scholars in rural schools.

The Limited Value of Prior Change in Predicting Future Progression of Juvenile-onset Myopia.

Identifying children at highest risk for rapid myopia progression and/or rapid axial elongation could help prioritize who should receive clinical treatment or be enrolled in randomized clinical trials. Our models suggest that these goals are difficult to accomplish. This study aimed to develop models predicting future refractive error and axial length using children's baseline data and history of myopia progression and axial elongation. Models predicting refractive error and axial length were created using randomly assigned training and test data sets from 916 myopic participants in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error Study. Subjects were 7 to 14 years of age at study entry with three consecutive annual visits that included cycloplegic A-scan ultrasound and autorefraction. The effect of adding prior change in axial length and refractive error was evaluated for each model. Age, ethnicity, and greater myopia were significant predictors of future refractive error and axial length, whereas prior progression or elongation, near work, time outdoors, and parental myopia were not. The 95% limits for the difference between actual and predicted change were ±0.22 D and ±0.14 mm without prior change data compared with ±0.26 D and ±0.16 mm with prior change data. Sensitivity and specificity for identifying fast progressors were between 60.8 and 63.2%, respectively, when the cut points were close to the sample average. Positive predictive value and sample yield were even lower when the cut points were more extreme. Young, more myopic Asian American children in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error Study were the most likely to progress rapidly. Clinical trials should expect average progression rates that reflect sample demographics and may have difficulty recruiting generalizable samples that progress faster than that average. Knowing progression or elongation history does not seem to help the clinical decision regarding initiating myopia control.

Using electronic medical record data to establish and monitor the distribution of refractive errors,

ObjectiveTo establish the baseline distribution of refractive errors and associated factors amongst a population that attended primary care optometry clinics. DesignRetrospective cross sectional cohort study of electronic medical records (EMR). MethodsElectronic medical record data was extracted from forty optometry clinics, representing a mix of urban and rural areas in Ireland. The analysis was confined to demographic and clinical data gathered over a sixty-month period between 2015 and 2019. Distribution rates were calculated using the absolute and relative frequencies of refractive error in the dataset, stratified for age and gender using the following definitions: high myopia ≤ -6.00 D, myopia ≤ -0.50 D, hyperopia ≥ +0.50 D, astigmatism ≤ -0.75 DC and anisometropia ≥ 1.00 D. Visual acuity data was used to explore vision impairment rates in the population. Further analysis was carried out on a gender and age-adjusted subset of the EMR data, to match the proportion of patients in each age grouping to the population distribution in the most recent (2016) Irish census. Results153,598 clinic records were eligible for analysis. Refractive errors ranged from -26.00 to +18.50 D. Myopia was present in 32.7%, of which high myopia represented 2.4%, hyperopia in 40.1%, astigmatism in 38.3% and anisometropia in 13.4% of participants. The clinic distribution of hyperopia, astigmatism and anisometropia peaked in older age groups, whilst the myopia burden was highest amongst people in their twenties. A higher proportion of females were myopic, whilst a higher proportion of males were hyperopic and astigmatic. Vision impairment (LogMAR > 0.3) was present in 2.4% of participants. In the gender and age- adjusted distribution model, myopia was the most common refractive state, affecting 38.8% of patients. ConclusionAlthough EMR data is not representative of the population as a whole, it is likely to provide a reasonable representation of the distribution of clinically significant (symptomatic) refractive errors. In the absence of any ongoing traditional epidemiological studies of refractive error in Ireland, this study establishes, for the first time, the distribution of refractive errors observed in clinical practice settings. This will serve as a baseline for future temporal trend analysis of the changing pattern of the distribution of refractive error in EMR data. This methodology could be deployed as a useful epidemiological resource in similar settings where primary eyecare coverage for the management of refractive error is well established.

An evaluation of the IOLMaster 700 and its agreement with the IOLMaster v3 in children.

To evaluate the repeatability and reproducibility of the swept-source optical coherence tomographer Zeiss IOLMaster 700 and compare its outputs with those obtained using partial coherence interferometry (Zeiss IOLMaster v3) in a healthy, paediatric population. This is a cross-sectional, observational study. Examiner 1 took two sets of biometric measurements (axial length [AL],mean corneal radius of curvature [Kmean ], anterior chamber depth [ACD] and lens thickness [LT]) using the IOLMaster 700, and one set of measurements (AL, Kmean and ACD) using the IOLMaster v3. Examiner 2 took one full set of measurements using the IOLMaster 700. Mean differences and 95% limits of agreement (LOA) were calculated, and Bland and Altman plots used to explore repeatability and reproducibility of the IOLMaster 700 alongside establishing its agreement with the IOLMaster v3. Mean participant age was 7.52±0.58years. Repeatability analyses demonstrated small mean differences and narrow 95% LOA for AL (0.001, -0.013 to 0.015mm),Kmean (0.002, -0.020 to 0.024mm),ACD (-0.003, -0.031 to 0.024mm)and LT (0.001, -0.024 to 0.026mm), respectively. Similarly, small mean differences and narrow 95% LOA established excellent reproducibility (AL 0.001, -0.016 to 0.018mm; Kmean -0.001, -0.027 to 0.025mm; ACD -0.010, -0.041 to 0.021mm; LT 0.002, -0.016 to 0.020mm). The IOLMaster 700 and IOLMaster v3 demonstrated good agreement with small mean differences and narrow 95% LOA (AL 0.009, -0.034 to 0.052mm; Kmean 0.016, -0.013 to 0.044mm;ACD 0.134, 0.055 to 0.212mm). When used within a paediatric population, these data demonstratethe IOLMaster 700 to be highly repeatable and reproducible for measures of AL, Kmean , ACD and LT. There is excellent inter-instrument agreement between the IOLMaster 700 and IOLMaster v3 for measures of AL and Kmean . ACD measurementsshowweaker agreement. These data will be useful when considering reports from population-based studies of refractive error and clinical myopia research.

Refractive Error of Students (15- to 18-year-olds) in Northwest Mexico.

We assessed the prevalence of refractive error in a sample of children of Northern Mexico using the Refractive Error Study in Children protocol of the World Health Organization, which allows for the comparison with other global studies. Uncorrected refractive error is the main cause of visual impairment in children. The purpose of this study was to assess the refractive error and visual dysfunctions of students (15 to 18 years old) in the upper-middle school system of Sinaloa, Mexico. A total of 3468 students in Sinaloa's high school system participated in the study from 2017 to 2019. Optometrists and student clinicians from the Optometry Program of the Autonomous University of Sinaloa conducted the testing. Tests included visual acuities and static retinoscopy. We did not use a cycloplegic agent. The results showed a high prevalence of uncorrected refractive errors. Myopia, defined as a refractive error ≤-0.50 D, had a prevalence of 36.11% (95% confidence interval, 33.47 to 38.83%); hyperopia, defined as a refractive error ≥+2.00 D, had a prevalence of 1.49% (95% confidence interval, 0.09 to 2.33%); and astigmatism, defined as a refractive error with a cylinder ≥0.75 D, had a prevalence of 29.17% (95% confidence interval, 26.60 to 31.76%). We found a significant effect of sex on visual acuity. Our results are consistent with a high prevalence of myopia reported in adolescents worldwide and in Mexico's northern regions. The results suggest that students attending high school and entering universities should be required to have an optometric eye examination. Additional studies are needed to investigate the prevalence of refractive errors in children in Mexico.

New Polygenic Risk Score to Predict High Myopia in Singapore Chinese Children.

PurposeThe purpose of this study was to develop an Asian polygenic risk score (PRS) to predict high myopia (HM) in Chinese children in the Singapore Cohort of Risk factors for Myopia (SCORM) cohort.MethodsWe included children followed from 6 to 11 years old until teenage years (12–18 years old). Cycloplegic autorefraction, ultrasound biometry, Illumina HumanHap 550, or 550 Duo Beadarrays, demographics, and environmental factors data were obtained. The PRS was generated from the Consortium for Refractive Error and Myopia genomewide association study (n = 542,934) and the Strabismus, Amblyopia, and Refractive Error in Singapore children Study (n = 500). The Growing Up in Singapore Towards healthy Outcomes Cohort study (n = 339) was the replication cohort. The outcome was teenage HM (≤ −5.00 D) with predictive performance assessed using the area under the curve (AUC).ResultsMean baseline age ± SD was 7.85 ± 0.84 (n = 1004) and 571 attended the teenage visit; 23.3% had HM. In multivariate analysis, the PRS was associated with a myopic spherical equivalent with an incremental R2 of 0.041 (95% confidence interval [CI] = 0.010, 0.073; P < 0.001). AUC for HM (0.77 [95% CI = 0.71–0.83]) performed better (P = 0.02) with the PRS compared with a model without (0.72 [95% CI = 0.65, 0.78]). Children at the top 25% PRS risk had a 2.34-fold-greater risk of HM (95% CI = 1.53, 3.55; P < 0.001).ConclusionsThe new Asian PRS improved the predictive performance to detect children at risk of HM.Translational RelevanceClinicians may use the PRS with other predictive factors to identify high risk children and guide interventions to reduce the risk of HM later in life.

Pediatric normative Retinal nerve fiber layer thickness in south Indian population

To study the retinal nerve fiber layer (RNFL) thickness in pediatric age group and its correlation with age, gender, refractive error and axial length Prospective observational study of 200 eyes of 100 children aged between 5-18 years presenting to the ophthalmic department. All children underwent detailed ophthalmic evaluation and SD OCT examination for RNFL thickness, Standard RNFL assessment protocol was used. Mean RNFL thickness in micrometers along the whole circle circumference, four quadrants, 12’o clock hours were obtained. RNFL measurements included average/full circle thickness — RNFL-FC (360ºmeasure), temporal quadrant thickness, RNFL-T, superior quadrant thickness, RNFL-S, nasal quadrant thickness, RNFL-N, inferior quadrant thickness, RNFL-I. Mean age was 13.3 ± 2.4 years. The refractive error in spherical equivalent was -0.28 ± 0.91 dioptre (SE). The mean axial length was 23.1 ± 0.7mm. The mean global RNFL thickness (RNFL-FC) was 97.0 ± 8.8mm (range 79.4 -114.6). RNFL thickness was maximum in the inferior quadrant (RNFL-I) 126 ± 13.7mm followed in order by superior (RNFL-S) 126 ± 16.3mm, nasal (RNFL-N) 70.5 ± 12.3mm and temporal (RNFL-T) 63.4 ± 9.2mm, in both the sexes. For every increase in one diopter of spherical equivalent of refractive error the mean RNFL increased by 3.77 microns and there was a reduction in mean RNFL thickness by 4.86 micron for every 1mm increase in axial length. RNFL varied minimally with gender. Positive correlation was seen with refractive error while inverse or negative correlation was seen with axial length and age. RNFL measurements could serve as reference for further studies on pediatric glaucoma or other optic nerve head pathologies.

Myopia progression from wearing first glasses to adult age: the DREAM Study

PurposeData on myopia progression during its entire course are scarce. The aim of this study is to investigate myopia progression in Europeans as a function of age and degree of...

Epidemiological Findings of Refractive Errors and Amblyopia among the Schoolchildren in Hatta Region of the United Arab Emirates

Introduction: Uncorrected refractive errors and amblyopia pose a major problem affecting schoolchildren. We had previously observed that many schoolchildren in the Hatta region presented to the ophthalmology clinic with uncorrected refractive errors and amblyopia, which led us to undertake this research. As per the WHO, the term “visual impairment” can be “low vision” or “blindness.” Based on the presenting vision, “low vision” is defined for children who have vision of <6/18 to 3/60 or having visual field loss to <20° in the better-seeing eye. Children defined to have “blindness” have presenting vision of <3/60 or corresponding visual field of <10°. Purpose: To estimate the magnitude of uncorrected refractive errors and amblyopia among the schoolchildren aged 6–19 years and to assess the efficacy of school-based refractive error screening programs in the Hatta region of the United Arab Emirates. Methods: An epidemiological, cross-sectional, descriptive study was conducted on the entire student population studying in the government schools of the region. Those who failed the Snellen visual acuity chart test and those who were wearing spectacles were evaluated comprehensively by the researcher in the Department of Ophthalmology of the Hatta Hospital. Data were entered in the Refractive Error Study in School Children (RESC) eye examination form recommended by the WHO, and were later transferred to Excel sheets and analyzed by SPSS. Results: 1,591 students were screened and evaluated from the end of 2016 to mid-2017. About 21.37% (n = 340) had impaired vision with 20.9% (n = 333) refractive errors, of which 58% were uncorrected. Among the refractive error group, 19% (64 subjects) had amblyopia (4% of total students). The incidence of low vision was 9.5% and blindness was 0.38%. Low vision was found to be 9.5% and blindness 0.38%, taking in to account presenting visual acuity rather than best-corrected visual acuity for defining low vision and blindness. Conclusion: A significant number of students were detected to have uncorrected refractive errors among the vision impaired group (59%, n = 197) despite a school-based vision screening program in place. Seventy-eight percent of the amblyopia cases (n = 50) were found to be in the 11–19 years age group. Noncompliance with optical corrections was the reason for the high number of cases. A rigorous vision screening program and refractive services, complimented with awareness among parents and teachers, are recommended.