Abstract
PURPOSE: To evaluate the efficacy of Spot vision screening combined with axial length measurement for early identification of myopia risk in Chinese Young children. METHODS: This cross-sectional study included 210 children aged 3-8 years, classified into a Myopia Risk Group [cycloplegic spherical equivalent, cycloplegic spherical equivalent (SE) ≤ +0.75 D] and a Sufficient Hyperopia Reserve Group (SE > +0.75 D). All participants underwent comprehensive examinations including axial length, anterior chamber depth (ACD), Spot vision screening, auto-refraction, and cycloplegic refraction. RESULTS: The Myopia Risk Group was significantly older and had a higher prevalence of parental myopia history. They also exhibited significantly longer axial length, deeper ACD, higher intraocular pressure, and higher best-corrected visual acuity. Refractive measurements from both the Spot screener and auto-refractor showed significantly lower spherical power, cylindrical power, and spherical equivalent values in the Myopia Risk Group (all P < 0.05). Multivariable analysis identified axial length as an independent risk factor (OR = 4.73, P = 0.002). Spot SE showed a strong correlation with cycloplegic SE (r = 0.85, P < 0.001) and demonstrated excellent predictive value for myopia risk (AUC = 0.931). The combination of axial length and Spot SE achieved an AUC of 0.956 for identifying children at risk of myopia. CONCLUSION: The combination of Spot vision screening and axial length measurement effectively identifies young children at risk for myopia, supporting its use in early screening programs.