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已发表论文
高度近视伴视网膜格子样变性患者病理性近视诊断列线图的开发与验证：一项横断面研究
Authors Zuo H, Huang H, Huang B, He J, Liu X, Zhou H, Huang L, Bi F, Huang M
Received 24 June 2025
Accepted for publication 24 October 2025
Published 1 November 2025 Volume 2025:18 Pages 3539—3548
DOI https://doi.org/10.2147/RMHP.S549300
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 5
Editor who approved publication: Dr Keon-Hyung Lee
Huiyi Zuo,1,* Hai Huang,2,* Baoyu Huang,1 Jian He,1 Xin Liu,1 Haohui Zhou,3 Lijia Huang,1 Fulan Bi,1 Minli Huang1,*
1Department of Ophthalmology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530000, People’s Republic of China; 2Department of Ophthalmology, Beiliu City People’s Hospital, Beiliu, Guangxi Zhuang Autonomous Region, 537400, People’s Republic of China; 3School of Medical Technology and Engineering, Fujian Medical University, Fuzhou, Fujian Province, 350000, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Minli Huang, Department of Ophthalmology, The First Affiliated Hospital of Guangxi Medical University, No. 6, Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, 530000, People’s Republic of China, Tel +86-771-5356507, Email 420306@sr.gxmu.edu.cn
Purpose: Early identification of pathological changes in high myopia (HM) with tessellated fundus (TF) remains challenging. To address this, a diagnostic nomogram was developed and validated to aid clinical screening of pathologic myopia (PM) in HM patients with TF.
Patients and Methods: A cross-sectional study was performed at The First Affiliated Hospital of Guangxi Medical University between May 10, 2023, and March 31, 2024. Patients with HM, defined as a spherical refractive error of ≤ − 6.0 D or an axial length of ≥ 26.5 mm, who presented with TF were enrolled. The collected clinical data were randomly divided into training and validation sets at a 7:3 ratio. A diagnostic nomogram was constructed from independent predictive factors. Its discrimination, calibration, and clinical utility were assessed using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA).
Results: Data from 418 eyes with TF were included in this study. Independent predictors for PM, in descending order of association, were axial length, optic disc tilt ratio, spherical equivalent, education level, and extent of peripapillary atrophy. The nomogram demonstrated robust performance in both sets. In the training set, the area under the ROC curve (AUC) was 0.851 (95% CI: 0.808– 0.895), with a sensitivity of 0.775 and a specificity of 0.736. In the validation set, the AUC was 0.827 (95% CI: 0.755– 0.900), with a sensitivity of 0.773 and a specificity of 0.700.
Conclusion: This simple predictive model, developed and validated using common interpretable clinical and fundus imaging features, serves as a valuable tool for screening PM in HM patients with TF.
Keywords: high myopia, pathologic myopia, nomogram, tessellated fundus, interpretable model
1Department of Ophthalmology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530000, People’s Republic of China; 2Department of Ophthalmology, Beiliu City People’s Hospital, Beiliu, Guangxi Zhuang Autonomous Region, 537400, People’s Republic of China; 3School of Medical Technology and Engineering, Fujian Medical University, Fuzhou, Fujian Province, 350000, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Minli Huang, Department of Ophthalmology, The First Affiliated Hospital of Guangxi Medical University, No. 6, Shuangyong Road, Nanning, Guangxi Zhuang Autonomous Region, 530000, People’s Republic of China, Tel +86-771-5356507, Email 420306@sr.gxmu.edu.cn
Purpose: Early identification of pathological changes in high myopia (HM) with tessellated fundus (TF) remains challenging. To address this, a diagnostic nomogram was developed and validated to aid clinical screening of pathologic myopia (PM) in HM patients with TF.
Patients and Methods: A cross-sectional study was performed at The First Affiliated Hospital of Guangxi Medical University between May 10, 2023, and March 31, 2024. Patients with HM, defined as a spherical refractive error of ≤ − 6.0 D or an axial length of ≥ 26.5 mm, who presented with TF were enrolled. The collected clinical data were randomly divided into training and validation sets at a 7:3 ratio. A diagnostic nomogram was constructed from independent predictive factors. Its discrimination, calibration, and clinical utility were assessed using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA).
Results: Data from 418 eyes with TF were included in this study. Independent predictors for PM, in descending order of association, were axial length, optic disc tilt ratio, spherical equivalent, education level, and extent of peripapillary atrophy. The nomogram demonstrated robust performance in both sets. In the training set, the area under the ROC curve (AUC) was 0.851 (95% CI: 0.808– 0.895), with a sensitivity of 0.775 and a specificity of 0.736. In the validation set, the AUC was 0.827 (95% CI: 0.755– 0.900), with a sensitivity of 0.773 and a specificity of 0.700.
Conclusion: This simple predictive model, developed and validated using common interpretable clinical and fundus imaging features, serves as a valuable tool for screening PM in HM patients with TF.
Keywords: high myopia, pathologic myopia, nomogram, tessellated fundus, interpretable model