ArticleFrontiers in medicine2026
Age-indexed cumulative risk of high myopia estimated from axial length and early axial elongation: a 7-year school-based longitudinal cohort study.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: To develop and validate age-indexed models estimating the cumulative risk of high myopia, defined as axial length (AL) ≥ 26.0 mm, using routinely collected ocular biometry, and to evaluate their potential for clinical risk stratification. Methods: This 7-year school-based longitudinal cohort included 7,052 Chinese children aged 6-16 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 (ΔAL) 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. Results: Overall, 577 participants (8.2%) developed high myopia. In the temporal holdout test set ( Conclusions: 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.
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