Abstract
BACKGROUND: Myopia is a growing global health issue. This study aims to determine the current status and determinants of primary and secondary school students with myopia in the Shekou District, and to propose reforms in myopia prevention. METHODS: Four thousand seven hundred and sixty-three students were involved in this retrospective study, and categorized by spherical equivalent into normal, low myopia, moderate myopia, and high myopia. Multinomial logistic regression and multiple linear regression analyses were conducted to examine factors on the severity of myopia and axial length [AL], respectively. RESULTS: The multinomial logistic regression model indicated, compared to the normal group, each additional year of age significantly increased the odds for low myopia (odds ratio [OR] = 1.285, 95% confidence interval [CI]: 1.122-1.472), moderate myopia (OR = 1.271, 95% CI: 1.074-1.502), and high myopia (OR = 1.411, 95% CI: 1.090-1.826). Compared to the Grade 1, the OR for low myopia showed a gradual increase across grades: Grade 3 (OR = 2.065, 95% CI: 1.394-3.058), Grade 4(OR = 2.184, 95% CI: 1.338-3.562), Grade 5(OR = 2.640, 95% CI: 1.438-4.850) and Grade 6 (OR = 2.239, 95% CI: 1.077-4.657); The OR for moderate myopia rose significantly from Grade 2 (OR = 2.239, 95% CI: 1.077-4.657), peaked at Grade 9 (OR = 90.445, 95% CI: 14.325-571.040), and remained elevated at Grade 12 (OR = 72.069, 95% CI: 3.818-1360.260); The OR for high myopia was significantly elevated in Grade 6 (OR = 11.490, 95% CI: 1.082-122.077) and Grade 9 (OR = 26.259, 95% CI: 1.429-482.616). The multiple linear regression model indicated that longer AL was significantly associated with older age (β = 0.109, 95% CI: 0.065-0.141), males(β = 0.533, 95% CI: 0.482-0.583), and higher grade level (the largest effect observed at Grade 9, β = 1.124, 95% CI: 0.792-1.455). CONCLUSION: Most myopic students in Shekou District exhibited low or moderate myopia. Alleviating educational stress and implementing AL monitoring are the essential measures for myopia prevention. A comprehensive myopia prevention necessitates a two-pronged strategy combining educational reforms and medical interventions.