Identification of high-risk patterns of myopia in Chinese students based on four major behavioral risk factors: a latent class analysis

Dan-Lin Li; Zhi-Jian Yin; Yue-Zu Li; Ya-Jie Zheng; Yu Qin; Gang Liang; Chen-Wei Pan

doi:10.1186/s12889-023-15963-7

Identification of high-risk patterns of myopia in Chinese students based on four major behavioral risk factors: a latent class analysis

BMC Public Health. 2023 Jul 18;23(1):1378. doi: 10.1186/s12889-023-15963-7.

Authors

Dan-Lin Li¹, Zhi-Jian Yin², Yue-Zu Li^{3

4}, Ya-Jie Zheng^{3

4}, Yu Qin^{3

4}, Gang Liang^{5

6}, Chen-Wei Pan⁷

Affiliations

¹ School of Public Health, Suzhou Medical College of Soochow University, 199 Ren Ai Road, Suzhou, 215123, China.
² Department of Ophthalmology, the First Affiliated Hospital of Dali University, Dali, China.
³ Department of Ophthalmology, the Affiliated Hospital of Yunnan University, Kunming, China.
⁴ Department of Ophthalmology, the Second People's Hospital of Yunnan Province, Kunming, China.
⁵ Department of Ophthalmology, the Affiliated Hospital of Yunnan University, Kunming, China. lianggang@ynu.edu.cn.
⁶ Department of Ophthalmology, the Second People's Hospital of Yunnan Province, Kunming, China. lianggang@ynu.edu.cn.
⁷ School of Public Health, Suzhou Medical College of Soochow University, 199 Ren Ai Road, Suzhou, 215123, China. pcwonly@gmail.com.

Abstract

Background: Myopia is prevalent in children and adolescents. Understanding the effect of multiple behaviors and their latent patterns on ocular biometric parameters may help clinicians and public health practitioners understand the behavioral risk pattern of myopia from a person-centered perspective. The purpose of this study was to identify the patterns of four major behavioral risk factors associated with myopia, including time spent outdoors, digital screen time, sleep duration, and performance of Chinese eye exercises. The study also examined the relationships between these behavioral patterns and myopia as well as ocular biometric parameters in a sample of Chinese college students.

Methods: This study included 2014 students from the Dali University Students Eye Health Study. The average age of the subjects was 19.0 ± 0.9 years old, ranging from 15.7 to 25.1 years old. Each participant's refractive status was measured using an autorefractor without cycloplegia and ocular biometric parameters were measured using an IOL Master. Behavioral risk factors were collected using a pre-designed self-administered questionnaire. Latent class analysis (LCA) was performed to identify cluster patterns of various behaviors.

Results: The prevalence of myopia was 91.8% in this population. The 2-class model was selected for the LCA based on goodness-of-fit evaluation metrics. Among the overall study sample, 41.1% and 58.9% were assigned into the high-risk and low-risk class, respectively. The risk of myopia [odds ratio (OR) = 2.12, 95% confidence interval (CI) = 1.52-3.14], high myopia (OR = 1.43, 95% CI = 1.14-1.78) and axial length/corneal radius (AL/CR) ratio of more than 3.0 (OR = 1.82, 95% CI = 1.22-2.72) were significantly higher in the high-risk compared with low-risk class.

Conclusions: Chinese university students showed differential risks of myopia and could be subdivided into high- and low-risk clusters based on four behavioral variables.

Keywords: Behaviors; Latent class analysis; Myopia; Ocular biometric parameter.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Child
China / epidemiology
Humans
Latent Class Analysis
Myopia* / epidemiology
Refraction, Ocular
Students
Vision Tests
Young Adult