To develop a predictive model based on school-based vision screening programs for evaluating hyperopic reserve status in children aged 5–10 years.
This cross-sectional study included 8,035 students aged 5–10 years from senior kindergarten and primary school in Guangdong Province, China. Participants underwent ocular biometric measurements, autorefraction, and questionnaire assessment before cycloplegia, after which autorefraction was repeated. An ensemble learning model was constructed to predict low hyperopic reserve (LHR), a refractive status below age-appropriate norms but not yet myopic, using NCR ocular parameters and questionnaire data. Model performance was evaluated and compared through nested 5-fold cross-validation. Sensitivity and robustness analyses were conducted to verify the comprehensive model performance. SHapley Additive exPlanations (SHAP) was utilized to interpret feature contributions and model logic.
On the test set, the ensemble learning model achieved an area under the curve (AUC) of 0.807, an accuracy of 0.737, and a precision of 0.747, outperforming all the single machine learning models. Compared to the direct NCR-based assessment and the +0.50 D / +0.75 D fixed-offset benchmarks (accuracy = 0.614–0.669, precision = 0.593–0.683), the ensemble learning model improved accuracy by 0.068–0.123 and precision by 0.064–0.154. SHAP analysis identified axial length to corneal radius ratio (SHAP value = 0.652), spherical equivalent (SHAP value = 0.514), and school type (SHAP value = 0.312) as the most three important predictors.
The proposed ensemble learning model offers a noncycloplegic, convenient approach for school-based vision programs to predict LHR in children aged 5–10 years. This model and its risk-assessment tool may support existing school-based vision programs in preserving children's hyperopic reserve.
Jingwei Jiang, Yu Lu, Meng Li et al.· Frontiers in Public Health· 0 citations
Purpose To evaluate tilted crystalline lens morphology in children across different orientations and their correlations with age and spherical equivalent (SE). Methods This cross-sectional study encompassed 966 eyes of 493 children (5–15 years; SE, −6.00 to +3.00 diopters [D]). The binocular crystalline lens biometrics in 16 orientations were measured using swept-source anterior segment optical coherence tomography. Parameters included the anterior radius of the lens (LAR), posterior radius of the lens (LPR), thickness, and diameter, as well as lens tilt and decentration. Group comparisons were performed among non-, low-, and moderate-myopic eyes. Results Lens tilt and decentration demonstrated semi-periodic variations (R2 = 0.984 and R2 = 0.789, respectively). Lenses predominantly tilted temporal–inferiorly, with corresponding temporal decentration. The non-myopia group had significantly higher LAR and LPR (more curved) than the low- and moderate-myopia groups (all P < 0.001). As myopia increased, lens tilt consistently decreased across all refractive subgroups (all P < 0.001), whereas other parameters either reached a turning point at approximately −4.00 D or showed no linearity. Age-stratified polynomial analysis revealed that the positive correlation between lens tilt and SE remained strong within the range of −4.18 D to +3.00 D. Conclusions Although the lens maintains a greater tilt toward the temporal and inferior regions, it exhibits less tilt and becomes more orthotopic in eyes with higher myopia across different age groups in children. Translational Relevance This study established crystalline lens tilt as a robust, less age-dependent biomarker that could enhance the prediction of myopia progression and facilitate individualized risk assessment in pediatric refractive development.
Ruozhen Ruan, Jian Cao, Xuepei Li et al.· Translational Vision Science...· 0 citations
