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Nasotemporal Asymmetry in Ocular Biometry as a Biomarker for Myopia Progression in Chinese Children
Tianli Peng1, Li Zhang1,2, Wenjun Xu1
1Beijing Tongren Eye Centre, Beijing Tongren Hospital, Beijing Institute of Ophthalmology, Beijing Key Laboratory of Intelligent Diagnosis Technology and Equipment for Optic Nerve-Related Eye Diseases, National Engineering Research Centre for Ophthalmology, Capital Medical University, Beijing, China.
Insights
Nasotemporal retinal asymmetry, especially temporal steepening, predicts myopia onset in children. This geometric biomarker can identify myopia risk years in advance, allowing for early interventions.
Area of Science:
- Ophthalmology
- Biomedical Engineering
- Pediatric Optometry
Background:
- Myopia is a growing global health concern, particularly in children.
- Early detection of myopia risk is crucial for timely intervention and management.
- Current methods for predicting myopia progression have limitations.
Purpose of the Study:
- To investigate nasotemporal retinal asymmetry as a geometric biomarker for monitoring myopia risk in children.
- To assess the potential of retinal asymmetry in predicting future refractive progression.
- To evaluate the utility of this biomarker for early identification of children at risk of myopia.
Main Methods:
- A multicentre longitudinal study involving 2520 Chinese children over 2 years.
- Annual measurements included axial length, central spherical equivalent, and peripheral measurements.
- Retinal morphology quantified using vertex radius of curvature, asphericity, and areas under the retinal curve (AUHRCn/t).
Main Results:
- Decreasing nasal retinal area (AUHRCn) preceded myopia onset, followed by temporal steepening.
- Baseline nasotemporal retinal asymmetry (AUHRCt/n) independently predicted myopic progression.
- A model incorporating AUHRCt/n improved the prediction of myopia progression risk.
Conclusions:
- Progressive nasotemporal retinal asymmetry, particularly temporal steepening, precedes myopia onset.
- This geometric biomarker can identify myopia risk up to two years before refractive changes.
- Early identification of myopia risk enables timely preventive interventions in children.
Purpose:
This multicentre longitudinal study investigated nasotemporal retinal asymmetry as a geometric biomarker for monitoring myopia risk in children.
Method:
A total of 2520 Chinese children (Beijing cohort: N = 49, 5-14 years old; Anyang cohort: N = 2471, 6-9 years old) underwent annual measurements over 2 years, including axial length (AL), central spherical equivalent (CSE) and peripheral AL (30° nasal, temporal, superior, inferior) in the Beijing cohort and horizontal meridian peripheral refractions (±15°, ±30°) in the Anyang cohort. Retinal morphology was quantified through the vertex radius of curvature, asphericity and areas under the horizontal nasal and temporal retinal curve (AUHRCn and AUHRCt, respectively). Nasotemporal retinal asymmetry was defined as AUHRCt/n. Vertical asymmetry was defined as superior peripheral AL/inferior peripheral AL. Participants from the Anyang cohort were stratified into persistent myopia (myopic at baseline), newly developed myopia (myopia onset during follow-up) and persistent non-myopia (remained non-myopic over 2 years).
Result:
In the Beijing cohort, the temporal-to-nasal AL ratio was the only factor significantly associated with myopic progression (ΔAL: r = -0.36, p = 0.01; ΔCSE: r = 0.37, p = 0.01). Validating this, in the Anyang cohort, decreasing AUHRCn preceded myopia onset, followed by progressive temporal steepening. Linear regression identified baseline AUHRCt/n as an independent negative predictor of myopic progression (β = 2.90, p = 0.03). A model incorporating baseline AUHRCt/n improved the prediction of progression risk (integrated discrimination improvement (IDI) = 3.74%, p = 0.03).
Conclusion:
Progressive nasotemporal retinal asymmetry, particularly temporal steepening, precedes clinical myopia onset and was correlated with future refractive progression. This geometric biomarker shows potential for identifying myopic risk up to 2 years before manifest refraction changes, enabling earlier preventive interventions.
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