Correlation between ocular biological parameters and cycloplegic refractive shift in pediatric myopia.

Area of Science:

• Ophthalmology
• Pediatric Optometry
• Myopia Management

Background:

• Pediatric myopia management requires accurate refractive assessment.
• Cycloplegic refraction is crucial for determining true refractive error in children.
• Understanding ocular biometric predictors of cycloplegic response aids clinical decisions.

Purpose of the Study:

• To investigate the relationship between ocular biometric parameters and cycloplegic refractive shift (ΔSE) in myopic children.
• To establish evidence-based guidelines for cycloplegic refraction in pediatric myopia management.

Main Methods:

• Retrospective analysis of 996 myopic patients (aged 5-17 years).
• Data included pre- and post-cycloplegic refraction (SE1, SE2), axial length (AL), corneal curvature (K), lens thickness (LT), and accommodation measures (PRA, NRA).
• Patients categorized by ΔSE and post-cycloplegic refractive error (pre-myopia, low, moderate myopia).

Main Results:

• Lens thickness (LT) positively correlated with ΔSE (P=0.003); negative relative accommodation (NRA) negatively correlated (P=0.049).
• Axial length/corneal radius (AL/CR) showed the strongest negative association with ΔSE (P<0.001).
• Optimal LT cutoff for cycloplegic refraction was 3.39 mm; AL/CR cutoff for moderate myopia was 3.15 (AUC=0.851).

Conclusions:

• LT and NRA are significant predictors of ΔSE in pediatric myopia.
• Cycloplegic refraction is recommended for LT > 3.39 mm, considering age-related LT variations.
• The AL/CR ratio can guide decisions for cycloplegic refraction when pre-cycloplegic refraction is questionable.