Early-warning predictive model of retinal detachment in high myopia: a comprehensive construction and validation study

OBJECTIVE: To develop an early warning prediction model integrating clinical indicators, ocular structural parameters, and quantitative fundus imaging features for myopic retinal detachment (MRD) to enhance the accuracy and clinical utility of MRD risk screening, thereby providing a quantitative basis for intervention in high-risk populations. METHODS: A retrospective analysis was performed on 352 patients with high myopic admitted the ophthalmology department between January 2020 and December 2023. The patients were randomly divided into a training set and a validation set at a 7:3 ratio. Twenty indicators were collected, including clinical and demographic data, ocular biometric parameters and fundus imaging and lesion assessment. Univariate analysis was used to screen MRD-related indicators, followed by least absolute shrinkage and selection operator (LASSO) regression for variable compression. Independent risk factors were identified through multivariate logistic regression. Random forest (RF), support vector machine (SVM), and logistic regression (LR) models were constructed using Python 3.9.0 and the sklearn library. Model performance was evaluated based on the receiver operating characteristic (ROC) curve and area under the curve (AUC), sensitivity, and specificity, with the optimal model selected and key predictive indicators analyzed. RESULTS: There was no statistically significant difference in the baseline data of patients between the training set and the validation set (P > 0.05). Through univariate analysis and logistic multivariate regression analysis, it was found that axial length (AL), central macular thickness, degree of vitreous liquefaction, area of retinal degeneration, and number of retinal breaks were independent risk factors for the occurrence of MRD (P < 0.05). The AUC of the RF model (0.890) was significantly higher than that of the LR model (0.813) and the SVM model (0.872), making it the optimal model. CONCLUSION: This study successfully constructed and verified an MRD early warning prediction model based on multi-dimensional indicators. The study identified AL, central macular thickness, degree of vitreous liquefaction, area of retinal degeneration, and number of retinal breaks as independent risk factors for MRD. This model provides clear guidance for clinicians to conduct risk stratification and formulate follow-up strategies, demonstrating high clinical applicability and promotion potential. CLINICAL TRIAL NUMBER: Not applicable.