Tato stránka byla automaticky přeložena a přesnost překladu není zaručena. Podívejte se prosím na anglická verze pro zdrojový text.

AI-Stratified Myopia Control for Children in Remote Areas

AI-Based Risk-Stratified Intervention Strategy for Myopia Control in Children From Remote Areas: A Cluster Randomized Controlled Trial

This cluster-randomized controlled trial aims to evaluate the effectiveness and cost-effectiveness of an artificial intelligence-based, risk-stratified, tiered intervention model for childhood myopia prevention and control in resource-limited county areas of China, compared with the conventional screening-and-referral approach, with schools in project counties of Guizhou or Yunnan Province randomly assigned at a 1:1 ratio to either the intervention or control group over a 12-month follow-up period.

The study is motivated by the pressing reality that myopia among Chinese children is not only widespread but also occurring at younger ages than ever before, bringing with it a lifelong risk of sight-threatening complications, yet in remote county areas, routine vision screening programs are not yet widely available or well-established, due to a shortage of trained eye care professionals, the practical difficulties of performing cycloplegic refraction in school settings, and the lack of systematic follow-up, all of which make it hard to identify children with myopia or pre-myopia. Given that artificial intelligence may offer a practical way to assess risk without the need for pupil dilation, this study will enroll children in grades 1 through 3 from local primary schools. Over 12 months, an AI model will dynamically categorize children based on screening results and guide management adjustments(outdoor activity and defocus lenses) for the intervention group, while the control group receives routine care.

The findings are expected to provide evidence to inform and optimize AI-based myopia prevention and control strategies in remote areas.

Přehled studie

Postavení

Zatím nenabíráme

Podmínky

Intervence / Léčba

Typ studie

Intervenční

Zápis (Odhadovaný)

1600

Fáze

  • Nelze použít

Kontakty a umístění

Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.

Studijní kontakt

  • Jméno: Xiangui He, PhD
  • Telefonní číslo: +86 15000755422
  • E-mail: xianhezi@163.com

Studijní místa

    • Guizhou
      • Guiyang, Guizhou, Čína, 550000
        • The Affiliated Hospital of Guizhou Medical University
    • Shanghai Municipality
      • Shanghai, Shanghai Municipality, Čína, 200041
        • Shanghai Eye Disease Prevention & Treatment Center
    • Yunnan
      • Kunming, Yunnan, Čína, 650000
        • The First Affiliated Hospital of Kunming Medical University

Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

  • Dítě

Přijímá zdravé dobrovolníky

Ano

Popis

  1. School level:

    Inclusion Criteria:

    • The school is a regular public primary school located within a project county in Guizhou Province or Yunnan Province.
    • The school has the organizational capacity to conduct myopia screening and follow-up studies in children and adolescents, including the ability to coordinate screening organization, parent communication, informed consent collection, result feedback, and follow-up coordination.
    • The number of students in grades 1-3 in study school is sufficient to meet the requirements for conducting a cluster randomized study.

    Exclusion Criteria:

    • The school has implemented a similar systematic myopia intervention program within the past year that may affect the evaluation of study outcomes.
    • Student mobility is high, with a predicted high risk of transfer, missed visits, or loss to follow-up within 12 months.
    • There is a lack of accessible medical institutions near the school to support necessary cycloplegic examinations and related services.
  2. Participant level:

Inclusion Criteria:

  • Age of participants is 6-9 years (equivalent to grades 1-3 of primary school).
  • Participants can be able to complete baseline and follow-up examinations including visual acuity, non-cycloplegic autorefraction, and axial length measurements.
  • For participants who have previously received myopia control interventions such as low-dose atropine eye drops, defocus spectacle lenses, or red-light therapy, a washout period of at least 1 month is required prior to enrollment.

Exclusion Criteria:

  • Baseline spherical equivalent refraction (SER) ≤ -10.00 D.
  • Presence of ocular or systemic diseases (including infections) that may affect visual acuity or refraction, or use of systemic or topical medications that may alter ocular status or affect ocular health.
  • Presence of any ocular conditions that preclude suitability for the interventions in this study, including but not limited to amblyopia, manifest strabismus, or current use of orthokeratology lenses.
  • Presence of any other condition that, in the investigator's judgment, makes the participant unsuitable for enrollment.

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

Jak je studie koncipována?

Detaily designu

  • Primární účel: Prevence
  • Přidělení: Randomizované
  • Intervenční model: Paralelní přiřazení
  • Maskování: Singl

Zbraně a zásahy

Skupina účastníků / Arm
Intervence / Léčba
Experimentální: Intervention Group

The intervention group receives routine screening (uncorrected visual acuity + non-cycloplegic autorefraction + axial length), followed by AI-based risk stratification at baseline, 6 months, and 12 months. Tiered interventions are adjusted according to the most recent risk-stratification result into three tiers: hyperopia, pre-myopia, and myopia. Corresponding tiered interventions are provided: outdoor activity (2 h/day on weekends) for tier 1; plano defocus lenses (≥8 h/day) + outdoor activity for tier 2; and defocus lenses (≥12 h/day) + outdoor activity for tier 3.

Participants with unclear AI risk stratification or newly onset myopia will be advised to undergo cycloplegic refraction and then to receive study-assigned intervention. For those already using myopia interventions (e.g., atropine, defocus spectacles), guardians will be fully informed of the study plan; if they agree, a 1-month washout period is required before starting the study intervention.

Students in the intervention group receive routine vision screening followed by AI-based risk stratification, which classifies each student into one of three categories, hyperopia, pre-myopia, or myopia, to guide subsequent tiered interventions. For children with hyperopia, the intervention consists of prescribed outdoor activities, with a target of 2 hours per day on weekends and daily activity records. For those with pre-myopia, the intervention combines plano defocus lenses (A.M.L.™) worn for at least 8 hours per day with the same outdoor activity regimen. For those with myopia, the intervention includes defocus lenses (A.M.L.™) worn for at least 12 hours per day, also combined with outdoor activities and records. All tiered assignments are dynamically adjusted at each follow-up visit based on the most recent AI classification.
Aktivní komparátor: Control Group
The control group receives the traditional model of "routine screening + feedback and referral." Based on routine screening using uncorrected visual acuity combined with non-cycloplegic autorefraction and axial length, screening reports, feedback, and referrals are provided to parents according to the technical standards of the national health industry.
Based on routine screening combining uncorrected visual acuity with non-cycloplegic autorefraction and axial length, the control group provides parents with screening reports, feedback, and referrals according to the national health industry standard, which provides tiered recommendations ranging from routine monitoring and eye hygiene, to ophthalmologic consultation for those at risk of myopia, to regular 3- to 6-month re-examination for those with reduced uncorrected but normal corrected visual acuity, and to timely referral for those identified as screening-positive or with possible visual function abnormalities.

Co je měření studie?

Primární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Rapid refractive progression
Časové okno: Baseline to 12 months
The rapid refractive progression is defined as axial length elongation >0.2 mm over 12 months.
Baseline to 12 months

Sekundární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Screened myopia
Časové okno: Baseline to 12 months
Screened myopia is defined as uncorrected visual acuity < 5.0 and spherical equivalent refraction < -0.50 D as measured by non-cycloplegic autorefraction.
Baseline to 12 months
Axial length change
Časové okno: Baseline to 12 months
Axial length change is defined as the difference in axial length obtained at baseline and at the 12-month follow-up in children.
Baseline to 12 months

Další výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Cost-effectiveness
Časové okno: During the 12-month follow-up period
Cost-effectiveness in this study refers to the economic evaluation assessing the balance between the resources invested and the health outcomes achieved in the context of childhood myopia prevention and control in resource-limited settings.
During the 12-month follow-up period
Duration of outdoor activity
Časové okno: During the 12-month follow-up period
Outdoor activity duration will be assessed through parent-reported daily diaries at each follow-up visit.
During the 12-month follow-up period

Spolupracovníci a vyšetřovatelé

Zde najdete lidi a organizace zapojené do této studie.

Sponzor

Spolupracovníci

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Hlavní termíny studia

Začátek studia (Odhadovaný)

1. září 2026

Primární dokončení (Odhadovaný)

31. října 2027

Dokončení studie (Odhadovaný)

31. října 2027

Termíny zápisu do studia

První předloženo

13. září 2026

První předloženo, které splnilo kritéria kontroly kvality

13. září 2026

První zveřejněno (Aktuální)

17. září 2026

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Aktuální)

17. září 2026

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

13. září 2026

Naposledy ověřeno

1. září 2026

Více informací

Termíny související s touto studií

Další identifikační čísla studie

  • QX-2026-A-011

Informace o lécích a zařízeních, studijní dokumenty

Studuje lékový produkt regulovaný americkým FDA

Ne

Studuje produkt zařízení regulovaný americkým úřadem FDA

Ne

Tyto informace byly beze změn načteny přímo z webu clinicaltrials.gov. Máte-li jakékoli požadavky na změnu, odstranění nebo aktualizaci podrobností studie, kontaktujte prosím register@clinicaltrials.gov. Jakmile bude změna implementována na clinicaltrials.gov, bude automaticky aktualizována i na našem webu .