{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T13:45:04Z","timestamp":1787579104693,"version":"build-2736575974"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T00:00:00Z","timestamp":1759104000000},"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. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To investigate the age-specific prevalence of hyperopic reserve deficiency and its predictive value for incident myopia among 6-12-year-old schoolchildren in Xi\u2019an, China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective cohort study enrolled 15,046 students from 30 primary schools. Diopter and visual acuity were assessed at baseline (2021) and follow-up (2023). Hyperopic reserve thresholds followed Chinese national guidelines (SE: &amp;lt;+1.00D for ages 6\u20138, &amp;lt;+0.50D for age 10). Multivariable logistic regression identified risk factors for myopia progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Myopia prevalence increased significantly with age (10.25% at 6\u202fyears to 49.77% at 12\u202fyears;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Females exhibited higher overall myopia rates (26.38% vs. 21.26%;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Hyperopic reserve deficiency peaked at age 8 (91.62%) and declined thereafter. Children with baseline reserve \u22120.5D to 0D demonstrated a 40.27% myopia conversion rate, compared to 3.33% in those with &amp;gt;\u202f+\u202f2.00D (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Key risk factors included parental myopia (OR\u202f=\u202f1.60, 95% CI:1.42\u20131.80,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001 for maternal, OR\u202f=\u202f1.35, 95% CI:1.20\u20131.54,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001 for paternal), prolonged study time (OR\u202f=\u202f1.49 95% CI: 1.33\u20131.68,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), prolonged screen time (OR\u202f=\u202f1.17, 95% CI:1.04\u20131.30,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.007), and high sugar intake (OR\u202f=\u202f1.46, 95% CI:1.30\u20131.64,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), while outdoor activity (OR\u202f=\u202f0.47, 95% CI:0.40\u20130.55,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), adequate sleep (OR\u202f=\u202f0.84, 95% CI:0.75\u20130.95,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.004) and good learning posture were protective(OR\u202f=\u202f0.63, 95% CI:0.56\u20130.71,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Hyperopic reserve \u22120.5D to 0D identifies high-risk subgroups for myopia development, particularly among females. Preventive interventions targeting reserve preservation should commence by age 6, integrating school-based strategies and personalized clinical protocols.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1660168","type":"journal-article","created":{"date-parts":[[2025,9,29]],"date-time":"2025-09-29T05:27:29Z","timestamp":1759123649000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Hyperopic reserve as a predictor of myopia incidence in schoolchildren aged 6\u201312\u202fyears: a 24-month prospective cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Wei","family":"Dong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunlin","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangbing","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengfei","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zihao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanying","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boyang","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaojiang","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1051\/medsci\/2020131","article-title":"Myopia 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