Related Experiment Video
Updated: May 9, 2026
Binocular Dynamic Visual Acuity in Eyeglass-Corrected Myopic Patients
Published on: March 29, 2022
Choroidal thickness and peripapillary RNFL in relation to axial length and progression in myopic children
Zixun Wang1, Xiaoxue Hu2, Xiaoling Zhang3
1Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China.
Insights
Axial length (AL) elongation in children is linked to choroidal thickness and retinal nerve fiber layer (RNFL) measurements. These OCT-derived biomarkers show potential for predicting rapid myopia progression, aiding risk stratification.
Area of Science:
- Ophthalmology
- Biomedical Engineering
- Pediatric Medicine
Background:
- Axial length (AL) elongation is a primary indicator of myopia progression in children.
- Accurate prediction of AL growth is crucial for effective risk stratification in pediatric myopia.
- Current predictive models for myopia progression require further development and validation.
Purpose of the Study:
- To investigate the relationship between baseline ocular structural parameters and AL in myopic children.
- To assess the predictive capability of these parameters for rapid AL progression.
- To explore the utility of optical coherence tomography (OCT)-derived measurements in myopia management.
Main Methods:
- Retrospective analysis of 463 myopic children over one year.
- Baseline assessments included refraction, ocular biometry, and OCT-derived choroidal thickness (ChT) and retinal nerve fiber layer (RNFL) measurements.
- Lasso regression and logistic regression models were used to identify predictors of rapid AL progression (>0.2 mm/year).
Main Results:
- Baseline AL correlated significantly with ChT and RNFL parameters, particularly nasal-inferior RNFL thickness (RNFL[NI]).
- Age, baseline AL, ChT, and RNFL[NI] were identified as predictors for rapid AL progression.
- The predictive model achieved modest discrimination (AUC = 0.703) with acceptable calibration.
Conclusions:
- Posterior segment structural parameters, including ChT and RNFL, are associated with AL and may predict progression in pediatric myopia.
- OCT-derived biomarkers show promise for improving risk stratification strategies in myopic children.
- Further validation and refinement of predictive models incorporating OCT biomarkers are warranted.
Background:
Axial length (AL) elongation is a key structural hallmark of myopia progression in children. Identifying early ocular structural characteristics associated with AL growth may help improve risk stratification, although robust predictive models remain limited.
Purpose:
To explore cross-sectional associations between baseline ocular structural parameters and AL, and to preliminarily evaluate the predictive potential of these parameters for rapid AL progression in myopic children.
Methods:
A total of 463 myopic children were retrospectively followed for 1 year. Baseline assessments included cycloplegic refraction, ocular biometry, and optical coherence tomography (OCT)-derived measurements of choroidal thickness (ChT) and retinal nerve fiber layer (RNFL). Rapid AL progression was defined as an AL increase of >0.2 mm over 1 year. Cross-sectional correlations between baseline AL, ChT, and RNFL parameters were analyzed. Least absolute shrinkage and selection operator (Lasso) regression with 10-fold cross-validation was used for feature selection, followed by the development and validation of a logistic regression model. Model performance was assessed using the area under the receiver operating characteristic curve (AUC), calibration analysis, and decision curve analysis (DCA).
Results:
At baseline, AL showed significant cross-sectional associations with ChT and multiple RNFL parameters, with the strongest correlations observed for ChT and nasal-inferior RNFL thickness (RNFL[NI]). Lasso regression retained age, baseline AL, ChT, and RNFL[NI] as candidate predictors of rapid AL progression. In the validation set, the final model demonstrated modest discriminative performance (AUC = 0.703, 95% CI: 0.598-0.801) with acceptable calibration. Decision curve analysis indicated limited but consistent net clinical benefit across a range of threshold probabilities.
Conclusion:
This study provides exploratory evidence that posterior segment structural parameters are associated with AL and may be useful for predicting subsequent AL progression in myopic children. Although the model's predictive performance was modest, the findings support the hypothesis that OCT-derived biomarkers could contribute to future risk-stratification strategies, warranting further validation and refinement.