Abstract:AIM:To investigate the differences in the effectiveness of different types of defocus spectacles—highly aspherical lenslets technology(HAL)and defocus incorporated multiple segments(DIMS)—compared with conventional single-vision spectacles(SVS)in the prevention and control of myopia in children, and to analyze related influencing factors based on a random forest model.
METHODS:A retrospective analysis was conducted on 190 myopic children(380 eyes)who attended the Ophthalmology Department of the Third People's Hospital of Chengdu between June 2022 and December 2023. According to the types of spectacle correction, patients were divided into three groups: SVS(84 cases, 168 eyes), HAL(58 cases, 116 eyes), and DIMS(48 cases, 96 eyes), all data from the right eye were selected for analysis, with a follow-up period of 12 mo. General information and changes in spherical equivalent(SE)and axial length(AL)were observed and compared among the three groups. A random forest model combined with Logistic regression analysis was used to identify factors influencing the effectiveness of treatment, and the predictive performance of these factors was evaluated using receiver operating characteristic(ROC)curves.
RESULTS:There was no statistical significance in the general characteristics among the three groups of patients before wearing lenses(P>0.05). Both the HAL and DIMS groups showed better control of SE progression and AL changes compared to the SVS group, and the HAL group demonstrated superior control effect compared to the DIMS group(all P<0.05). The random forest model indicated that the lowest mean out-of-bag estimation error rate, which was 0.1988, was achieved when the number of variables was 3, and the top 3 influencing factors were AL, spectacle-wearing age, and uncorrected visual acuity. Multivariate Logistic regression analysis revealed that AL was a protective factor for the effectiveness of defocus spectacles, while spectacle-wearing age and uncorrected visual acuity were risk factors. The area under the curve(AUC)values for predicting the effectiveness of defocus spectacles were 0.802, 0.747, and 0.720 for AL, spectacle-wearing age, and uncorrected visual acuity, respectively.
CONCLUSION:The HAL group demonstrated better effectiveness in myopia prevention and control compared to the DIMS and SVS groups. AL, spectacle-wearing age, and uncorrected visual acuity were identified as independent factors influencing the effectiveness of defocus spectacles.
