School-based epidemiology study of myopia in Tianjin, China

• Type of Material: Article
• Authors: Jiaxing Wang, Emory University; Ying Li, Emory University; Zhenyang Zhao, Univ Texas Med Branch; Nan Wei, Tianjin Medical University; Xiaoli Qi, Tianjin Medical University; Gang Ding, Tianjin Medical University; Xue Li, Tianjin Medical University; Jing Li, Tianjin Medical University; Linlin Song, Tianjin Medical University; Ying Zhang, Emory University; Richard Hyun Yi, University of Georgia; Yuxian Ning, Tianjin Medical University; Xiaoyu Zeng, Tianjin Medical University; Ning Hua, Tianjin Medical University; Xuehan Qian, Tianjin Medical University
• Language: English
• Date: 2020-05-29
• Publisher: SPRINGER
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2020
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1007/s10792-020-01400-w
• Title of Journal or Parent Work: INTERNATIONAL OPHTHALMOLOGY
• Volume: 40
• Issue: 9
• Start Page: 2213
• End Page: 2222
• Grant/Funding Information: This work was supported by Grant 17ZXHLSY00020 from Tianjin municipal Science and Technology Commission and Grant YDYYRCXM-B2018-02LC from Tianjin Medical University Eye Hospital High-level Innovative Talent Program for Distinguished Scholar
• Keywords: Photoscreen; Life Sciences & Biomedicine; Children; Visual acuity; SIGNIFICANT REFRACTIVE ERRORS; AMBLYOPIA RISK-FACTORS; Epidemiology; Refractive error; TESTABILITY; CHILDREN; Ophthalmology; VISION; VISUAL-ACUITY; ASSOCIATIONS; Science & Technology; ANISOMETROPIA; PHOTOSCREENERS; Myopia; PREVALENCE
• Research Categories: Health Sciences, Health Care Management; Health Sciences, Epidemiology

Abstract

Purpose: To study the epidemiology of myopia in school-aged children in Tianjin and the relationship between visual acuity-based screening and refraction-based screening. Method: This school-based prospective cohort study was performed on children from 42 elementary schools and 17 middle schools in Tianjin, China. Totally 14,551 children, ages ranging from 5 to 16 years, were included in this study. Uncorrected visual acuity (UCVA) was determined by logarithmic tumbling E chart. Non-cycloplegic photorefraction was examined by the Spot (v2.1.4) photoscreener. The relationship between the UCVA and refractive error was investigated for different age groups. Results: The overall prevalence of myopia at this school based screen is 78.2%, ranged from 10% at age of 5 to 95% at age of 16. The most dramatic increase in prevalence is from age of 6 (14.8%) to age of 7 (38.5%). The overall prevalence of high myopia is 2.5%. UCVA is found corresponding to spherical equivalent refraction (SER) in a manner of normal distribution and is significantly affected by age. When using UCVA to estimate the prevalence of myopia, the overall sensitivity and specificity are 0.824 and 0.820, respectively. Age-dependent optimal cutoff points and 95% confident intervals of such estimation are reported. Conclusions: Myopia is heavily affecting school-aged children in Tianjin, China. The refraction screening is preferable for myopia screening, whereas the UCVA screening results need to be interpreted in an age-dependent manner for myopia estimation.