Development of a risk score for myopia: A cohort study conducted among school-aged children in China

Abstract

Purpose: To evaluate the myopia risk in school-aged children one year after lifting a pandemic-related lockdown and develop a tool to identify high-risk groups. Methods: In total, 38,079 children without myopia from 38 schools were included. The outcomes were myopia incidence and progression in 1 year after the COVID-19 lockdown was lifted, both obtained by the spherical equivalent refraction (SER). We separated the population into an exploratory (75%) and a validation sample (25%) to construct the risk score model. Results: In total, 9811 (29.57%) students became myopic, and the overall myopia progression was 0.22 ± 0.62 D. Even less myopia progression was noted in the pre-myopia group at baseline (All: P = 0.045, Boy: P = 0.005). The risk score model included seven predictors: gender, grade, SER at baseline, residence, parental myopia, eye discomfort symptoms, and online courses. The model had a score range of 0–46 and an optimal cutoff of 34. The area under the receiver operating curve of the model was 0.726 (0.719–0.732) for the exploratory sample and 0.731 (0.720–0.742) for the validation sample. Conclusions: The risk score can serve as a practical tool for classifying the risk of myopia in school-aged children.