Browsing by Author "Ang, Marcus"
Now showing 1 - 3 of 3
Results Per Page
Sort Options
- Cost of myopia correction: a systematic reviewPublication . Foo, Li Lian; Lança, Carla; Wong, Chee Wai; Ting, Daniel; Lamoureux, Ecosse; Saw, Seang-Mei; Ang, MarcusMyopia is one of the leading causes of visual impairment globally. Despite increasing prevalence and incidence, the associated cost of treatment remains unclear. Health care spending is a major concern in many countries and understanding the cost of myopia correction is the first step eluding to the overall cost of myopia treatment. As the cost of treatment will reduce the burden of the cost of illness, this will aid in future cost-benefit analysis and the allocation of healthcare resources, including considerations in integrating eye care (refractive correction with spectacles) into universal health coverage (UHC). We performed a systematic review to determine the economic costs of myopia correction. However, there were few studies for direct comparison. Costs related to myopia correction were mainly direct with few indirect costs. Annual prevalence-based direct costs for myopia ranged from $14-26 (USA), $56 (Iran), and $199 (Singapore) per capita, respectively (population: 274.63 million, 75.15 million, and 3.79 million, respectively). Annually, the direct costs of contact lens were $198.30-$378.10 while spectacles and refractive surgeries were $342.50 and $19.10, respectively. This review provides an insight into the cost of myopia correction. Myopia costs are high from nationwide perspectives because of the high prevalence of myopia, with contact lenses being the more expensive option. Without further interventions, the burden of illness of myopia will increase substantially with the projected increase in prevalence worldwide. Future studies will be necessary to generate more homogenous cost data and provide a complete picture of the global economic cost of myopia.
- Deep learning system to predict the 5-year risk of high myopia using fundus imaging in childrenPublication . Foo, Li Lian; Lim, Gilbert Yong San; Lança, Carla; Wong, Chee Wai; Hoang, Quan V.; Zhang, Xiu Juan; Yam, Jason C.; Schmetterer, Leopold; Chia, Audrey; Wong, Tien Yin; Ting, Daniel S. W.; Saw, Seang-Mei; Ang, MarcusOur study aims to identify children at risk of developing high myopia for timely assessment and intervention, preventing myopia progression and complications in adulthood through the development of a deep learning system (DLS). Using a school-based cohort in Singapore comprising 998 children (aged 6-12 years old), we train and perform primary validation of the DLS using 7456 baseline fundus images of 1878 eyes; with external validation using an independent test dataset of 821 baseline fundus images of 189 eyes together with clinical data (age, gender, race, parental myopia, and baseline spherical equivalent (SE)). We derive three distinct algorithms - image, clinical, and mix (image + clinical) models to predict high myopia development (SE ≤ -6.00 diopter) during teenage years (5 years later, age 11-17). Model performance is evaluated using the area under the receiver operating curve (AUC). Our image models (Primary dataset AUC 0.93-0.95; Test dataset 0.91-0.93), clinical models (Primary dataset AUC 0.90-0.97; Test dataset 0.93-0.94) and mixed (image + clinical) models (Primary dataset AUC 0.97; Test dataset 0.97-0.98) achieve clinically acceptable performance. The addition of 1 year SE progression variable has minimal impact on the DLS performance (clinical model AUC 0.98 versus 0.97 in the primary dataset, 0.97 versus 0.94 in the test dataset; mixed model AUC 0.99 versus 0.97 in the primary dataset, 0.95 versus 0.98 in test dataset). Thus, our DLS allows prediction of the development of high myopia by teenage years amongst school-going children. This has potential utility as a clinical decision support tool to identify "at-risk" children for early intervention.
- New polygenic risk score to predict high myopia in Singapore Chinese childrenPublication . Lança, Carla; Kassam, Irfahan; Patasova, Karina; Foo, Li-Lian; Li, Jonathan; Ang, Marcus; Hoang, Quan V.; Teo, Yik-Ying; Hysi, Pirro G.; Saw, Seang-MeiPurpose: The purpose of this study was to develop an Asian polygenic risk score (PRS) to predict high myopia (HM) in Chinese children in the Singapore Cohort of Risk factors for Myopia (SCORM) cohort. Methods: We included children followed from 6 to 11 years old until teenage years (12–18 years old). Cycloplegic autorefraction, ultrasound biometry, Illumina HumanHap 550, or 550 Duo Beadarrays, demographics, and environmental factors data were obtained. The PRS was generated from the Consortium for Refractive Error and Myopia genomewide association study (n = 542,934) and the Strabismus, Amblyopia, and Refractive Error in Singapore children Study (n = 500). The Growing Up in Singapore Towards healthy Outcomes Cohort study (n = 339) was the replication cohort. The outcome was teenage HM (≤ −5.00 D) with predictive performance assessed using the area under the curve (AUC). Results: Mean baseline age ± SD was 7.85 ± 0.84 (n = 1004) and 571 attended the teenage visit; 23.3% had HM. In multivariate analysis, the PRS was associated with a myopic spherical equivalent with an incremental R2 of 0.041 (95% confidence interval [CI] = 0.010, 0.073; P < 0.001). AUC for HM (0.77 [95% CI = 0.71–0.83]) performed better (P = 0.02) with the PRS compared with a model without (0.72 [95% CI = 0.65, 0.78]). Children at the top 25% PRS risk had a 2.34-fold-greater risk of HM (95% CI = 1.53, 3.55; P < 0.001). Conclusions: The new Asian PRS improved the predictive performance to detect children at risk of HM.