1
|
Liu S, Chen J, Wang J, Zhu Z, Zhang J, Zhang B, Yang J, Du L, Zhu J, Zou H, He X, Xu X. Cutoff values of axial length/corneal radius ratio for determining myopia vary with age among 3-18 years old children and adolescents. Graefes Arch Clin Exp Ophthalmol 2024; 262:651-661. [PMID: 37578514 DOI: 10.1007/s00417-023-06176-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 07/01/2023] [Accepted: 07/16/2023] [Indexed: 08/15/2023] Open
Abstract
PURPOSE To investigate the effectiveness and cutoffs of axial length/corneal radius (AL/CR) ratio for myopia detection in children by age. METHODS Totally, 21 kindergartens and schools were enrolled. Non-cycloplegic autorefraction (NCAR), axial length (AL), horizontal and vertical meridian of corneal radius (CR1, CR2), and cycloplegic autorefraction were measured. Receiver operating characteristic (ROC) curve was used to obtain the effectiveness and cutoff for myopia detection. RESULTS Finally, 7803 participants aged 3-18 years with mean AL/CR ratio of 2.99 ± 0.16 were included. Area under the ROC curve (AUC) of AL/CR ratio for myopia detection (0.958 for AL/CR1, 0.956 for AL/CR2, 0.961 for AL/CR) was significantly larger than that of AL (0.919, all P < 0.001), while AUCs of the three were similar with different cutoffs (> 2.98, > 3.05, and > 3.02). When divided by age, the ROC curves of AL/CR ratio in 3- to 5-year-olds showed no significance or low accuracy (AUCs ≤ 0.823) in both genders. In ≥ 6-year-olds, the accuracies were promising (AUCs ≥ 0.883, all P < 0.001), the cutoffs basically increased with age (from > 2.93 in 6-year-olds to > 3.07 in 18-year-olds among girls, and from > 2.96 in 6-year-olds to > 3.07 in 18-year-olds among boys). In addition, boys presented slightly larger cutoffs than girls in all ages except for 16 and 18 years old. For children aged 3-5 years, AL/CR ratio or AL combined with NCAR increased AUC to > 0.900. CONCLUSION AL/CR ratio provided the best prediction of myopia with age-dependent cutoff values for all but preschool children, and the cutoffs of boys were slightly larger than those of girls. For preschool children, AL/CR ratio or AL combined with NCAR is recommended to achieve satisfactory accuracy. AL/CR ratio calculated by two meridians showed similar predictive power but with different cutoffs.
Collapse
Affiliation(s)
- Shang Liu
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, No.380 Kangding Road, Shanghai, 200040, China
- Department of Ophthalmology, Shanghai General Hospital, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Jiao Tong University School of Medicine, No.100 Haining Road, Shanghai, 200080, China
| | - Jun Chen
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, No.380 Kangding Road, Shanghai, 200040, China
| | - Jingjing Wang
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, No.380 Kangding Road, Shanghai, 200040, China
| | - Zhuoting Zhu
- Centre for Eye Research Australia; Ophthalmology, University of Melbourne, Melbourne, Australia
| | - Junyao Zhang
- Centre for Eye Research Australia; Ophthalmology, University of Melbourne, Melbourne, Australia
| | - Bo Zhang
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, No.380 Kangding Road, Shanghai, 200040, China
| | - Jinliuxing Yang
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, No.380 Kangding Road, Shanghai, 200040, China
| | - Linlin Du
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, No.380 Kangding Road, Shanghai, 200040, China
| | - Jianfeng Zhu
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, No.380 Kangding Road, Shanghai, 200040, China
| | - Haidong Zou
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, No.380 Kangding Road, Shanghai, 200040, China
- Department of Ophthalmology, Shanghai General Hospital, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Jiao Tong University School of Medicine, No.100 Haining Road, Shanghai, 200080, China
| | - Xiangui He
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, No.380 Kangding Road, Shanghai, 200040, China.
- Department of Ophthalmology, Shanghai General Hospital, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Jiao Tong University School of Medicine, No.100 Haining Road, Shanghai, 200080, China.
| | - Xun Xu
- Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, No.380 Kangding Road, Shanghai, 200040, China.
- Department of Ophthalmology, Shanghai General Hospital, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Jiao Tong University School of Medicine, No.100 Haining Road, Shanghai, 200080, China.
| |
Collapse
|
2
|
Zhang Z, Mu J, Wei J, Geng H, Liu C, Yi W, Sun Y, Duan J. Correlation between refractive errors and ocular biometric parameters in children and adolescents: a systematic review and meta-analysis. BMC Ophthalmol 2023; 23:472. [PMID: 37990308 PMCID: PMC10662558 DOI: 10.1186/s12886-023-03222-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 11/14/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Refractive errors are one of the most common ocular conditions among children and adolescents, with myopia showing an increasing prevalence and early onset in this population. Recent studies have identified a correlation between refractive errors and ocular biometric parameters. METHODS A systematic search was conducted in electronic databases including PubMed, EMBASE, Cochrane Library, Web of Science, and Medline from January 1, 2012, to May 1, 2023. Various ocular biometric parameters were summarized under different refractive states, including axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), corneal curvature (CC), Corneal curvature radius (CR),axial length-to-corneal radius ratio (AL/CR ratio), choroidal thickness (ChT), retinal thickness (RT), retinal nerve fiber layer thickness (RNFL), and retinal blood density (VD). The differences in these parameters among different refractive states were analyzed using Stata software with fixed or random-effects models, taking into account the assessed heterogeneity level. RESULTS This meta-analysis included a total of 69 studies involving 128,178 eyes, including 48,795 emmetropic eyes, 60,691 myopic eyes, 13,983 hyperopic eyes, 2,040 low myopic eyes, 1,201 moderate myopic eyes, and 1,468 high myopic eyes. The results of our study demonstrated that, compared to the control group (emmetropic group), the myopic group and low, moderate, and high myopic groups showed significant increases in AL, AL/CR ratio, and ACD, while the hyperopic group exhibited significant decreases. Compared to the control group, the myopic group had a significantly increase for CC, while CR, CCT, perifoveal RT, subfoveal ChT, foveal ChT, parafoveal ChT, perifoveal (except nasal) ChT, and pRNFL (except temporal) significantly decreased. Compared to the control group, the hyperopic group had a significantly increase for subfoveal ChT, foveal ChT, parafoveal ChT, perifoveal ChT, and nasal pRNFL. Compared to the control group, the low and moderate myopic groups had a significantly decreases for the CCT, parafoveal RT (except nasal), perifoveal RT (except nasal), and pRNFL (except superior and temporal). Compared to the control group, the high myopic group had a significantly increase for CR, while LT, perifoveal ChT (except nasal), parafoveal RT, perifoveal RT, and pRNFL (except temporal) had significant decreased. CONCLUSION The changes of ocular biometric parameters in children and adolescents are closely related to refractive errors. Ocular biometric parameters devices, as effective non-invasive techniques, provide objective biological markers for monitoring refractive errors such as myopia.
Collapse
Affiliation(s)
- Zengrui Zhang
- Chengdu University of TCM, Chengdu, Sichuan, China
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Jingyu Mu
- Chengdu University of TCM, Chengdu, Sichuan, China
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Jing Wei
- Chengdu University of TCM, Chengdu, Sichuan, China
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Haoming Geng
- Chengdu University of TCM, Chengdu, Sichuan, China
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Chunmeng Liu
- Chengdu University of TCM, Chengdu, Sichuan, China
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Wenhua Yi
- Chengdu University of TCM, Chengdu, Sichuan, China
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Yue Sun
- Chengdu University of TCM, Chengdu, Sichuan, China
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China
| | - Junguo Duan
- Chengdu University of TCM, Chengdu, Sichuan, China.
- Eye college of Chengdu University of TCM, Chengdu, Sichuan, China.
- Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China.
- Key Laboratory of Sichuan Province Ophthalmopathy Prevention & Cure and Visual Function Protection with TCM Laboratory, Chengdu, Sichuan, China.
| |
Collapse
|
3
|
Methods in Medicine CAM. Retracted: Development of Refractive Parameters in 3- to 6-Year-Old Children and Its Application in Myopia Prediction and Intervention Guidance. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2023; 2023:9801927. [PMID: 37946975 PMCID: PMC10631909 DOI: 10.1155/2023/9801927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 10/31/2023] [Indexed: 11/12/2023]
Abstract
[This retracts the article DOI: 10.1155/2021/3656831.].
Collapse
|
4
|
Zhang Y, Su M, Liang L, Shi B, Gong D, Wu Y, Zhang J, Wang M. The Guiding Significance of Ocular Biometry in Evaluating the Refractive Status of Preschool Children. Ophthalmic Res 2023; 66:1213-1221. [PMID: 37666230 PMCID: PMC10614507 DOI: 10.1159/000533782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 08/22/2023] [Indexed: 09/06/2023]
Abstract
INTRODUCTIONS This study aimed to analyze the correlation between refractive status and ocular biological parameters in preschool-age children (3-6 years old), establish a regression curve, guide the clinical judgment of children's refractive status, and improve the accuracy of refractive screening for this age group. METHODS A total of 508 children, aged 3-6 years, were admitted to the hospital, exhibiting symptoms of ametropia and a need for dilation optometry. Among these, 326 children were included in the statistics group, having been examined between August 2021 and October 2022, and 182 children were included in the validation group, having been examined between November 2022 and March 2023. Using IOL Master700, ocular biometry parameters were measured for all participants, including axial length (AL), keratometry readings (K1 and K2), anterior chamber depth (ACD), lens thickness (LT), and central corneal thickness (CCT). One percent atropine sulfate eye gel was administered, and then the spherical equivalent (SE) was calculated by Bennett's formula. The correlation between SE and other ocular biometrics was analyzed, followed by the establishment of an SE prediction equation. The SE prediction equation was used to calculate the spherical equivalent (SE#) using ocular biometry data from the validation group, and the consistency between SE and SE# was evaluated. RESULTS SE showed a negative correlation with AL/CR (r = -0.936), AL (r = -0.811), ACD (r = -0.500), age (r = -0.396), and Km (r = -0.213) (p < 0.001), and positive correlation with LT (r = 0.301), LP (r = 0.176) (p < 0.001). A multiple linear regression equation was established for SE using the stepwise selection method, SE = 49.232 - 23.583 × AL/CR + 1.703 × ACD + 0.589 × Km - 0.609 × LP + 1.103 × LT (R2 = 0.997). Based on the regression equation, the predicted SE# highly correlated with SE after cycloplegia in the validation group (r = 0.998, p < 0.001). CONCLUSION The main ocular biological factors of ocular diopter in children aged 3-6 years are AL/CR, ACD, Km, LP, and LT, which are jointly influenced by multiple factors. Ocular biometry is a reliable predictor of real refraction among children aged 3-6.
Collapse
Affiliation(s)
- Ya Zhang
- Department of Optometry, Shijiazhuang Aier Eye Hospital, Shijiazhuang, China,
| | - Ming Su
- Department of Optometry, Shijiazhuang Aier Eye Hospital, Shijiazhuang, China
| | - Lingling Liang
- Department of Optometry, Shijiazhuang Aier Eye Hospital, Shijiazhuang, China
| | - Bingjie Shi
- Department of Optometry, Shijiazhuang Aier Eye Hospital, Shijiazhuang, China
| | - Dongmei Gong
- Department of Optometry, Shijiazhuang Aier Eye Hospital, Shijiazhuang, China
| | - Yidan Wu
- Department of Optometry, Shijiazhuang Aier Eye Hospital, Shijiazhuang, China
| | - Junying Zhang
- Department of Optometry, Shijiazhuang Aier Eye Hospital, Shijiazhuang, China
| | - Ming Wang
- Department of Optometry, Beijing Aier Intech Hospital, Beijing, China
| |
Collapse
|
5
|
Zhao MH, Song Y, Liu JL, Li J, Wang Y, Hua YJ, Wu Q. Investigation of ocular biometry in 4- to 9-year-old Chinese children. BMC Ophthalmol 2023; 23:225. [PMID: 37208745 DOI: 10.1186/s12886-023-02975-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 05/12/2023] [Indexed: 05/21/2023] Open
Abstract
PURPOSE To investigate the distribution and changes in ocular biometry in 4-to to 9-year-old Chinese children and to compare the differences between age and genders in these parameters. METHODS This was a school-based cross-sectional study. A total of 1,528 Chinese children, aged 4-9 years, from one primary school and 12 kindergartens, were included in the study. Axial length, corneal curvature, anterior chamber depth, and corneal diameter were measured for each child. RESULTS AL and anterior chamber depth gradually increased with age in both genders. No significant changes in corneal curvature or corneal diameter were detected at different ages in either genders group. The mean ALs of males and females were 22.94 ± 0.80 mm and 22.38 ± 0.79 mm, respectively. The mean corneal curvatures of males and females were 43.05 ± 1.37 D and 43.75 ± 1.48 D, respectively. The mean anterior chamber depth of males and females were 3.47 ± 0.24 mm and 3.38 ± 0.25 mm, respectively. The mean corneal diameter of males and females were 12.08 ± 0.43 mm and 11.94 ± 0.44 mm, respectively. Females had consistently shorter ALs, shorter anterior chamber depth, smaller corneal diameter, and steeper corneal curvatures than males at any age. CONCLUSIONS Boys had larger dimensions than girls for all ocular parameters except corneal curvature (flatter). Boys and girls showed similar trends for all parameters. Axial length and anterior chamber depth increased from 4 to 9 years of age, whereas corneal diameter and curvature did not change with age in either genders.
Collapse
Affiliation(s)
- Ming-Hui Zhao
- Department of Ophthalmology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, China.
| | - Yi Song
- Department of Ophthalmology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, China
| | - Jia-Li Liu
- Department of Ophthalmology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, China
| | - Juan Li
- Department of Ophthalmology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, China
| | - Ying Wang
- Department of Ophthalmology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200071, China
| | - Yan-Jun Hua
- Department of Ophthalmology, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - Qiang Wu
- Department of Ophthalmology, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| |
Collapse
|
6
|
Matsumura S, Dannoue K, Kawakami M, Uemura K, Kameyama A, Takei A, Hori Y. Prevalence of Myopia and Its Associated Factors Among Japanese Preschool Children. Front Public Health 2022; 10:901480. [PMID: 35812505 PMCID: PMC9257008 DOI: 10.3389/fpubh.2022.901480] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/19/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To investigate the prevalence of myopia and factors associated with spherical equivalent (SE), axial length (AL), and axial length to corneal radius of curvature (AL/CR) ratio among Japanese preschool children. Study Design Prospective observational study. Methods This cross-sectional study evaluated subjects aged 4–6 years from a preschool. Non-cycloplegic autorefraction was measured using the Spot Vision Screener, while AL and corneal radius (CR) were measured using the Myopia Master. Parental myopia and environmental factors were investigated using the myopia-related factor questionnaire. The worse eye with higher myopic SE was chosen for analysis, and multiple linear regression models was performed using AL, SE, and AL/CR ratio as dependent variables. Results A total of 457 out of 514 participants (239 males, 52.3%) aged 4–6 years (mean 4.77 ± 0.65 years) were included. The mean SE was 0.13 ± 0.63 D, AL was 22.35 ± 0.67 mm, CR was 7.76 ± 0.25 mm, and AL/CR ratio was 2.88 ± 0.72. The overall prevalence of myopia and high myopia were 2.9 and 0.2%, respectively. Multiple regression analysis showed that myopic SE was significantly associated with male sex (β = −0.14, p = 0.02) and parental myopia (β = −0.15, p = 0.04). Meanwhile, longer AL was significantly associated with older age (β = 0.13, p = 0.02), male sex (β = 0.44, p < 0.001), parental myopia (β = 0.24, p = 0.01), and screen time (including smartphones, tablets, and computers) (>1 h, β = 0.14, p = 0.04). A higher AL/CR was significantly associated with older age (β = 0.02, p < 0.001), male sex (β = 0.03, p < 0.001), ratio and parental myopia (β = 0.03, p = 0.02). Conclusion The prevalence of myopia and high myopia were 2.9 and 0.2%, respectively, among Japanese preschool children in 2021. Longer AL was associated with older age, male sex, parental myopia, and screen time in children aged 4–6 years. Children with a high risk of myopia can be identified early based on parental myopia information for early prevention.
Collapse
Affiliation(s)
- Saiko Matsumura
- Department of Ophthalmology, Toho University School of Medicine, Tokyo, Japan
- *Correspondence: Saiko Matsumura
| | | | - Momoko Kawakami
- Department of Ophthalmology, Toho University School of Medicine, Tokyo, Japan
| | | | | | | | - Yuichi Hori
- Department of Ophthalmology, Toho University School of Medicine, Tokyo, Japan
| |
Collapse
|