Mu Jingfeng, Zeng Dan, Fan Jingjie, Liu Meizhou, Zhong Haoxi, Shuai Xinyi, Zhang Shaochong
Shenzhen Eye Hospital, Jinan University, Shenzhen Eye Institute, Shenzhen, China.
Affiliated Shenzhen Maternity & Child Healthcare Hospital, Southern Medical University, Shenzhen, China.
Front Pediatr. 2022 Sep 6;10:859944. doi: 10.3389/fped.2022.859944. eCollection 2022.
The aim of this study was to assess the association between axial length/corneal radius ratio (AL/CR ratio), AL, and refractive status and evaluate the accuracy of AL and AL/CR ratio for myopia assessment among Chinese children.
A diagnostic trial was conducted in Shenzhen Eye Hospital from June 2020 to December 2020. Cycloplegic refraction and demographic characteristic survey were carried out, and AL and CR were measured. The Pearson correlation analysis between AL, AL/CR ratio, and spherical equivalent (SE) was carried out. The sensitivity, specificity, Youden index, positive predictive value, and negative predictive value of the AL/CR ratio and AL for myopia assessment were analyzed using cycloplegic refraction as the gold standard by drawing receiver operating characteristic (ROC) curves.
A total of 300 children aged 8-18 years participated in this study. The Pearson correlation coefficient between AL and SE was -0.667 ( < 0.05) and -0.754 ( < 0.05) between AL/CR ratio and SE. There were significant differences in SE, AL, and AL/CR ratio among different age groups ( < 0.05). SE decreased by 1.185 diopter (D) for every 1 mm increase in AL and decreased by 0.667 D for every 0.1 increase in the AL/CR ratio. Taking cycloplegic refraction SE ≤ -0.50 D as the gold standard for the diagnosis of myopia, the area under the ROC curve of AL for myopia assessment was 0.836 (95% confidence interval [CI]: 0.767-0.906), with specificity, sensitivity, and Youden index of 0.833, 0.767, and 0.600, respectively. The area under the ROC curve of AL/CR ratio for myopia assessment was 0.937 (95% CI: 0.878-0.996), with specificity, sensitivity, Youden index, positive predictive value, and negative predictive value of 0.703, 0.913, 0.622, 0.956, and 0.771, respectively. The area under the ROC curve of the combination of AL/CR ratio and parental myopia for myopia assessment was 0.976 (95% CI: 0.957-0.996).
The correlation between SE and AL/CR ratio was stronger than that between SE and AL in children. The AL/CR ratio may be an alternative indicator for myopia assessment in children, and the combination of demographic factors and AL/CR ratio can improve the accuracy of myopia assessment.
本研究旨在评估眼轴长度/角膜半径比值（AL/CR比值）、眼轴长度（AL）与屈光状态之间的关联，并评估AL及AL/CR比值在中国儿童近视评估中的准确性。
于2020年6月至2020年12月在深圳眼科医院进行了一项诊断试验。进行了睫状肌麻痹验光和人口统计学特征调查，并测量了AL和CR。对AL、AL/CR比值与等效球镜度（SE）进行了Pearson相关性分析。以睫状肌麻痹验光为金标准，通过绘制受试者工作特征（ROC）曲线，分析AL/CR比值和AL在近视评估中的敏感度、特异度、约登指数、阳性预测值和阴性预测值。
共有300名8-18岁儿童参与本研究。AL与SE之间的Pearson相关系数为-0.667（P<0.05），AL/CR比值与SE之间的Pearson相关系数为-0.754（P<0.05）。不同年龄组之间的SE、AL和AL/CR比值存在显著差异（P<0.05）。AL每增加1mm，SE下降1.185屈光度（D）；AL/CR比值每增加0.1，SE下降0.667D。以睫状肌麻痹验光SE≤-0.50D作为近视诊断的金标准，AL在近视评估中的ROC曲线下面积为0.836（95%置信区间[CI]：0.767-0.906），特异度、敏感度和约登指数分别为0.833、0.767和0.600。AL/CR比值在近视评估中的ROC曲线下面积为0.937（95%CI：0.878-0.996），特异度、敏感度、约登指数、阳性预测值和阴性预测值分别为0.703、0.913、0.622、0.956和0.771。AL/CR比值与父母近视情况联合用于近视评估的ROC曲线下面积为0.976（95%CI：0.957-0.996）。
儿童中，SE与AL/CR比值之间的相关性强于SE与AL之间的相关性。AL/CR比值可能是儿童近视评估的替代指标，人口统计学因素与AL/CR比值联合使用可提高近视评估的准确性。
