The Accuracy of Axial Ratio in Evaluating Myopia in Adolescents with Different Corneal Curvature
Objective:To investigate the accuracy and diagnostic threshold of the ratio of axial length(AL)to corneal curvature radius(CR)in diagnosing myopia among children and adolescents with varying corneal curvatures.Methods:This was a cross sectional study.A total of 3 424 children and adolescents aged 3 to 15 years who were treated in the Department of Ophthalmology,Haidian Maternal and Child Care Health Hospital from June 2022 to June 2024 were randomly selected in this study.The equivalent spherical degree(SE)was obtained by optometry after ciliary muscle paralysis,AL and mean CR were also recorded,and AL/CR values were calculated.With SE≤-0.50 D as the diagnostic criterion for myopia,the diagnostic threshold of AL/CR in different corneal curvature groups was calculated by receiver operating characteristic(ROC)curve.One-way ANOVA was used for comparison of AL and AL/CR groups,and rank-sum test was used for comparison between SE groups.Results:Participants in this study were divided into 3 groups according to age:3-7 years old,8-11 years old and 12-15 years old.According to CR,they were divided into high curvature group(CR＜7.51),medium curvature group(7.51 ≤ CR≤7.99),and low curvature group(CR＞7.99).AL and AL/CR in the whole high,medium and low curvature groups were significantly different,respectively(F=256.32,59.39,both P＜0.001).There were significant differences in AL/CR and SE in different age groups(all P＜0.05).The cut-off values of AL/CR in diagnosis of myopia in different age groups and different curvature groups were obtained by ROC curve:3.00,2.95,and 2.88,respectively,in high,medium,and low curvature groups in 3-7 years old group.The high,medium,and low curvature groups in 8 to 11 years old were 3.09,3.04,and 2.94,respectively.The high,medium,and low curvature groups in the 12-15 years old group were 3.16,3.06,and 3.07,respectively.The area under ROC curve was more than 90％.Conclusions:AL/CR can be used for the qualitative evaluation of myopia in children and adolescents with different corneal curvatures.The diagnostic threshold increases with the increase of age and decreases with the decrease of curvatures in the same age group.
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