{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T16:36:21Z","timestamp":1793118981836,"version":"4.5.0"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,12,14]],"date-time":"2023-12-14T00:00:00Z","timestamp":1702512000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003399","name":"Science and Technology Commission of Shanghai Municipality","doi-asserted-by":"publisher","award":["21Y11910100"],"award-info":[{"award-number":["21Y11910100"]}],"id":[{"id":"10.13039\/501100003399","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008750","name":"Shanghai Hospital Development Center","doi-asserted-by":"publisher","award":["SHDC12020127"],"award-info":[{"award-number":["SHDC12020127"]}],"id":[{"id":"10.13039\/501100008750","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Pre-myopia, a non-myopic refractive state, is a key concern for myopia prevention because of its association with a significantly higher risk of myopia in children under 3\u2009years of age. Amid the myopia pandemic, its onset at younger ages is increasing, yet research on screening methods for myopia and pre-myopia in preschool children remains limited. This study aimed to establish effective noncycloplegic screening methods for myopia and pre-myopia in preschool children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This cross-sectional study included 16 kindergartens in Shanghai, China. Uncorrected distance visual acuity (UDVA) was recorded using a logMAR visual acuity chart. Pre- and post-cycloplegic refractions were obtained using an auto-refractor (TopconKR-800). Noncycloplegic axial length (AL) and corneal curvature radius (CR) were measured using the IOL Master-700. Logistic regression models were developed to establish accurate noncycloplegic screening methods for myopia and pre-myopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 1,308 children with a mean age of 4.3\u2009\u00b1\u20090.9\u2009years were included; among them 640 (48.9%) were girls. The myopia prevalence rate was 2.8% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200936), and the prevalence of pre-myopia was 21.9% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009286). Pre-myopia screening (cycloplegic spherical equivalent [SE]\u2009\u2264\u2009\u22120.5\u2009&amp;lt;\u2009SE \u22640.75 diopters [D]) using UDVA exhibited an area under the receiver operating curve (AUC) of 0.52, noncycloplegic SE had an AUC of 0.70 and AL had an AUC of 0.63. The accuracy of combining the SE and AL\/CR ratio was among the best with the least number of checks used, and the AUC was 0.74 for pre-myopia screening and 0.94 for myopia screening (cycloplegic SE\u2009\u2264\u2009\u22120.5 D). The addition of UDVA did not further improve the accuracy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Using UDVA alone did not achieve good accuracy in pre-myopia or myopia screening of young children. Under non-cycloplegic conditions, the combination of AL\/CR and SE demonstrated favorable results for pre-myopia and myopia screening of preschool children.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2023.1291387","type":"journal-article","created":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T02:39:21Z","timestamp":1702607961000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":20,"title":["Establishment of noncycloplegic methods for screening myopia and pre-myopia in preschool children"],"prefix":"10.3389","volume":"10","author":[{"given":"Yao","family":"Yin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liping","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Senlin","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minmin","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingyan","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianfeng","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,12,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1167\/iovs.62.5.2","article-title":"IMI impact of myopia","volume":"62","author":"Sankaridurg","year":"2021","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"882","DOI":"10.1136\/bjophthalmol-2015-307724","article-title":"Global variations and time trends in the prevalence of childhood myopia, a systematic review and quantitative meta-analysis: implications for aetiology and early prevention","volume":"100","author":"Rudnicka","year":"2016","journal-title":"Br J Ophthalmol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"20","DOI":"10.3760\/cma.j.cn112150-20221008-00964","article-title":"Trend of the detection rate of myopia among Chinese Han children and adolescents aged 7-18 years from 2010 to 2019","volume":"57","author":"Zhong","year":"2023","journal-title":"Zhonghua Yu Fang Yi Xue Za Zhi"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1111\/opo.12238","article-title":"Current and predicted demographics of high myopia and an update of its associated pathological changes","volume":"35","author":"Verkicharla","year":"2015","journal-title":"Ophthalmic Physiol Opt"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"CD004916","DOI":"10.1002\/14651858.CD004916.pub4","article-title":"Interventions to slow progression of myopia in children","volume":"2021","author":"Walline","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1080\/09273972.2016.1276940","article-title":"Interventions to reduce myopia progression in children","volume":"25","author":"Tay","year":"2017","journal-title":"Strabismus"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2018\/5205946","article-title":"Refraction and ocular biometry of preschool children in Shanghai","volume":"2018","author":"Zhang","year":"2018","journal-title":"China J Ophthalmol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"6188","DOI":"10.1167\/iovs.16-20243","article-title":"Age-specific prevalence of visual impairment and refractive error in children aged 3-10 years in Shanghai","volume":"57","author":"Ma","year":"2016","journal-title":"China Invest Ophthalmol Vis Sci"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1111\/j.1442-9071.2010.02470.x","article-title":"Change in vision disorders among Hong Kong preschoolers in 10 years","volume":"39","author":"Fan","year":"2011","journal-title":"Clin Exp Ophthalmol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"8101","DOI":"10.1167\/iovs.15-16577","article-title":"Growing up in Singapore towards healthy outcomes Study Group. 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