Comparison of the Effectiveness of 7 Common Types of Myopia Screening Methods among Children
Liu Jiang1, Hong Wang1, Shuangqin Yan1, Guopeng Gao1, Mingfang Liu1, Cai Ren1, Peng Ding2, Xiaoyan Wu2, Fangbiao Tao2
1Department of Child Health Care, Maternal and Child Health Care Center of Ma'anshan, Ma'anshan 243011, China
2Anhui Provincial Key Laboratory of Population Health & Aristogenics, Hefei 230032, China
Abstract：Objective: To evaluate the accuracy of common types of myopia screening methods among children with the results of cycloplegic refraction as the gold standard for the diagnosis of myopia. Methods: In this case series study, a total of 543 children aged 6-8 years old who visited Maternal and Child Health Care Center of Ma'anshan from December 2021 to November 2022 were enrolled. Uncorrected distance visual acuity (UCDVA), axial length (AL), mean corneal radius (CR), pre-cycloplegia refraction (PR), and cycloplegic refraction were assessed and recorded. PR≤-0.50 D, UCDVA<5.0, andAL/CR>3 were defned as myopia-positive boundary value, respectively.And the results of cycloplegic refraction were defned as the gold standard for the diagnosis of myopia. In this study, there were 7 screening methods: UCDVA, PR,AL/CR, UCDVA+PR, UCDVA+AL/CR, PR+AL/CR, and UCDVA+PR+AL/CR. The evaluation indicators of the screening methods included sensitivity, specificity, Youden index, positive predictive value, negative predictive value, diagnostic coincidence rate, and area under ROC curve. The Chi-square test was used to compare the positive detection rate among different myopia screening methods. Results: When a single index was used for myopia screening, PR had the best effect, with the highest sensitivity (100.0%), specifcity (89.2%), Youden index (0.89), positive predictive value (64.7%), negative predictive value (100.0%), diagnostic coincidence rate (0.732), and area under ROC curve (0.95). When two indexes were combined for myopia screening, the effectiveness of UCDVA+PR and PR+AL/CR were similar (Youden index were 0.91 and 0.92, respectively), and both were greater than UCDVA+AL/CR (Youden index was 0.87). When UCDVA+PR+AL/CR was used for myopia screening, only specifcity (96.2%), positive predictive value (83.3%), and diagnostic coincidence rate (0.861) were slightly improved, compared with UCDVA+PR and PR+AL/CR, while other accuracy and reliability indexes were decreased. Conclusions: In the large-scale screening of myopia in children, if only a single index was used to screen myopia, PR can be considered. If two indexes could be combined to screen myopia, the PR combined with UCDVA or AL/CR can be considered. When all three indexes combined to screen myopia, the improvements of screening accuracy were limited.
江流, 王虹, 严双琴, 等. 7种儿童常用近视筛查方案的准确性比较[J]. 中华眼视光学与视觉科学杂志, 2023, 25(8): 601-606.
Liu Jiang1, Hong Wang1, Shuangqin Yan1, et al. Comparison of the Effectiveness of 7 Common Types of Myopia Screening Methods among Children. Chinese Journal of Optometry Ophthalmology and Visual science, 2023, 25(8): 601-606. DOI: 10.3760/cma.j.cn115909-20221202-00474
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