{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T04:53:54Z","timestamp":1791176034213,"version":"4.1.0"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"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>To develop and validate age-indexed models estimating the cumulative risk of high myopia, defined as axial length (AL)\u2009\u2265\u200926.0\u2005mm, using routinely collected ocular biometry, and to evaluate their potential for clinical risk stratification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This 7-year school-based longitudinal cohort included 7,052 Chinese children aged 6\u201316 years at baseline who participated in a school-based screening program in Tianjin, China, from 2018 to 2024. Discrete-time survival models with age as the timescale estimated cumulative risk from ages 9 to 18 years. Two models were tested: baseline AL plus sex and baseline AL plus first-year axial elongation (\u0394AL) plus sex. Performance was assessed in a participant-level temporal holdout test set using iAUC, iBrier, calibration, and decision-curve analysis, and by school-level internal-external cross-validation using iAUC and iBrier.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 577 participants (8.2%) developed high myopia. In the temporal holdout test set (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095,245), the AL\u2009+\u2009\u0394AL model outperformed the AL-only model, with higher discrimination [iAUC, 0.919 [95% CI, 0.902\u20130.933] vs. 0.851 [95% CI, 0.833\u20130.869]] and lower prediction error [iBrier, 0.074 [95% CI, 0.068\u20130.081] vs. 0.087 [95% CI, 0.080\u20130.095]]. Calibration was close to ideal, decision-curve analysis showed clinical net benefit, and school-level validation confirmed stable performance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Routine AL measurement, particularly when combined with early axial elongation, enables accurate age-specific risk estimation of AL-defined high myopia and provides a transparent basis for timely and proportionate myopia-control decisions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1939322","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T04:33:13Z","timestamp":1791174793000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Age-indexed cumulative risk of high myopia estimated from axial length and early axial elongation: a 7-year school-based longitudinal cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Jing","family":"Yang","sequence":"first","affiliation":[{"name":"Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Li","sequence":"additional","affiliation":[{"name":"Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bei","family":"Du","sequence":"additional","affiliation":[{"name":"Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Desheng","family":"Song","sequence":"additional","affiliation":[{"name":"Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Jin","sequence":"additional","affiliation":[{"name":"Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruihua","family":"Wei","sequence":"additional","affiliation":[{"name":"Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1136\/bjo-2024-325427","article-title":"Global prevalence, trend and projection of myopia in children and adolescents from 1990 to 2050: a comprehensive systematic review and meta-analysis","volume":"109","author":"Liang","year":"2025","journal-title":"Br J Ophthalmol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.1016\/j.ophtha.2016.01.006","article-title":"Global prevalence of myopia 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