Prevalence of fundus changes in healthy school-aged children and adolescents aged 5-19 years in Beijing.

OBJECTIVES

To investigate and analyse the epidemiological characteristics of fundus changes among school-aged children, and to explore its correlation with myopia.

METHODS

School-aged children from 20 schools in Beijing were screened under cooperation between Beijing Tongren Hospital and Beijing Daxing District Education Commission from September 2022 to March 2023. Uncorrected non-dilated visual acuity and refraction were examined. Fundus photographs of both eyes were evaluated by skilled clinicians. The differences in fundus changes among demographic characteristics were compared.

RESULTS

A total of 15,031 participants (30,062 eyes) from 20 schools were included, including 14 elementary schools and 6 secondary schools. The prevalence of fundus changes was 3.3%, 5.9%, and 6.2% for elementary schools, junior and senior high schools, respectively. The top five fundus changes comprised of myopia-related fundus changes (2.0%), physiologic enlarged cup (1.2%), suspected glaucoma (0.3%), myelinated nerve fibres (0.1%), and papillomacular bundle defect (PMBD) (0.1%). Males exhibited a 7.627 and 1.388 times higher risk of developing PMBD and physiological enlarged cup (p < 0.01, respectively). Eyes with myopia-related fundus changes and suspected glaucoma exhibited larger interpupillary distance, longer eye axis, worse visual acuity and lower spherical equivalent.

CONCLUSIONS

The prevalence of fundus changes varies with school ages, gender, and myopia status. The prevalence of myopia-related fundus changes, suspected glaucoma, and other retinopathy or optic neuropathy escalates with increasing age and the severity of myopia. The pathological myopia is scarce in children. Male gender is a risk factor for PMBD and is also modestly associated with physiological enlarged cup.