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The accuracy of using vergence formula to screen myopia in children: a cross-sectional study
Zhen Yi1, Chang Hong2, Huang Haikuo3
1National Engineering Research Center for Ophthalmology, Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Engineering Research Center of the Ministry of Education for Ophthalmic Diagnosis and Treatment Equipment and Materials, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Insights
The vergence formula accurately screens myopia in children and adolescents. This method offers high accuracy without requiring cycloplegic refraction, simplifying the myopia screening process.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Refractive Error Research
Background:
- Myopia screening in children and adolescents is crucial for early intervention.
- Traditional methods like cycloplegic refraction can be time-consuming and require specialized equipment.
Purpose of the Study:
- To assess the diagnostic accuracy of the vergence formula for screening myopia in pediatric populations.
- To compare the vergence formula's effectiveness against established refractive measurements.
Main Methods:
- A cross-sectional study involving 336 children (aged 6-12) with refractive errors.
- Collected biometric data (axial length, corneal thickness, etc.) and calculated spherical equivalent (SE) using the vergence formula.
- Compared calculated SE with subjective SE obtained via cycloplegic refraction.
Main Results:
- The vergence formula showed a high positive correlation with subjective SE (r=0.827, p<0.01).
- The area under the ROC curve for the vergence formula was 0.962, significantly higher than AL/CR (0.876).
- Calculated SE achieved 85.7% accuracy with 100% specificity in diagnosing myopia.
Conclusions:
- The vergence formula provides a highly accurate and efficient method for myopia screening in children and adolescents.
- This approach can potentially replace or supplement traditional cycloplegic refraction, improving accessibility and reducing clinical burden.
Objective:
To evaluate the accuracy of using the vergence formula to screen myopia in children and adolescents.
Methods:
This was a cross-sectional study conducted between December 2022 and May 2023 at the ophthalmology clinic of Beijing Tongren Hospital. A total of 336 children aged 6 to 12 years with refractive errors were selected according to the inclusion criteria. Biometric measurements, including axial length, corneal thickness, anterior chamber depth, corneal curvature, and lens thickness, were obtained using a biometer. The Calculated spherical equivalent (SE) was then calculated using the vergence formula. Cycloplegic refraction was performed after paralysis of the ciliary muscle, and the subjective SE was recorded. A diagnosis of myopia was made if the subjective SE was ≤ -0.50 diopters.
Results:
The AL/CR, subjective SE, and calculated SE were not normally distributed (p < 0.05). The AL/CR value was 3.08 (2.81, 3.27), the SE was -1.60 D (-6.00 D, 3.75 D), and the calculated SE was -1.42 D (-6.64 D, 5.73 D). There was no significant difference between the calculated SE and the SE (Z = -2.899, p = 0.004). The AL/CR value was negatively correlated with SE (r = -0.687, p < 0.01), and the calculated SE was positively correlated with SE (r = 0.827, p < 0.01). The area under the ROC curve for predicting myopia using AL/CR and calculated SE was 0.876 and 0.962, respectively, and the difference between the two was significant (p < 0.001). The sensitivity of AL/CR was 84.2%, the specificity was 70.6%, the accuracy was 82.1%, and the Youden index was 0.548. The sensitivity of calculated SE was 83.1%, the specificity was 100%, the accuracy was 85.7%, and the Youden index was 0.831.
Conclusion:
The vergence formula can be used to evaluate myopia in children and adolescents with relatively high accuracy without cycloplegic refraction.
