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Published on: April 3, 2016
Corneal radius-specific axial length/corneal radius ratio cut-offs for improved myopia detection in children: a
Daixi Chen1,2, Linlin Du1, Jun Chen1
1Clinical Research Center, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai Vision Health Center, Shanghai Children Myopia Institute, Eye Public Health Research Center, School of Medicine, Tongji University, Shanghai, China.
Purpose:
To investigate how corneal radius (CR) affects the optimal axial length-to-corneal radius (AL/CR) ratio cut-off for myopia detection and to construct a multivariable model for estimating myopia probability in children and adolescents.
Methods:
A total of 6782 children and adolescents aged 3-18 years from Shanghai, China, were included. Myopia was defined as a cycloplegic spherical equivalent (SE) less than or equal to -0.50 dioptres. Participants were stratified into six CR groups (0.25 mm intervals). Receiver operating characteristic curve analysis was used to determine optimal AL/CR cut-off values for each CR group. Linear regression was performed to model the relationship between CR and optimal cut-offs. A multivariable logistic regression model incorporating CR, AL/CR ratio, age and sex was fitted, and model-based estimates were summarised using contour plots and lookup tables.
Results:
Mean age was 9.36±3.59 years, and myopia prevalence was 33.8%. Optimal AL/CR cut-offs decreased with increasing CR, from 3.10 (7.08≤CR≤7.33 mm) to 2.93 (8.33
Conclusions:
The optimal AL/CR ratio cut-off for myopia detection varies systematically with CR. These findings indicate that CR contributes to variation in AL/CR-based myopia classification. The fitted equation, probability contour plots and lookup tables provide CR-informed reference estimates for interpreting AL/CR in children and adolescents.