Abstract
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.