Chen Haichao, Pan Zhe, Liu Xinyu, Xie Hui, Zaman Fahim Ahmed, Wu Xiaodong, Fang Yuxin, Xue Can Can, Mao Yu, Wang Xiaofei, Xiong Zhuxin, Han Yingxiang, Jonas Jost B, Wong Tien Yin, Wang Ya Xing
From the Beijing Visual Science and Translational Eye Research Institute (BERI) (H.C., Z.P., J.B.J., T.Y.W., Y.X.W.), Eye Center of Beijing Tsinghua Changgung Hospital, Tsinghua Medicine, Tsinghua University, Beijing, China.
Institute of Medical Technology (X.L.), Peking University Health Science Center, Peking University, Beijing, China.
Am J Ophthalmol. 2025 Jul;275:88-98. doi: 10.1016/j.ajo.2025.03.024. Epub 2025 Mar 18.
To characterize posterior eye curvature and to assess its diagnostic performance in differentiating pathologic myopia (PM) from simple high myopia (SHM).
Population-based, cross-sectional study.
A total of 790 eyes from 790 participants (mean age: 60.6 ± 8.3 years; 59% female) were randomly selected from the Beijing Eye Study, including 406 nonmyopic eyes, 175 eyes with mild myopia, 102 eyes with moderate myopia, 76 eyes with simple SHM, and 31 eyes with PM.
Posterior eye curvature was calculated using the outer boundary of the retinal pigment epithelium layer, derived from automatically segmented spectral-domain optical coherence tomography images. Three curvature parameters were computed: curvature, curvature and curvature.
The values and spatial distribution of curvature parameters across different myopia groups, and their diagnostic performance in distinguishing PM from SHM.
Higher curvature parameters were significantly associated with older age, longer axial length (AL), more myopic refractive error (RE), lower best-corrected visual activity, and smaller subfoveal choroidal thickness (all P < .001). These parameters increased progressively with myopia severity (all P < .001). Unlike traditional metrics such as AL, which demonstrated a steady increase across the entire spectrum of myopia, curvature parameters showed a significantly sharper increase between SHM and PM, compared to other pairwise comparisons (nonmyopia vs mild myopia, mild vs moderate myopia, and moderate myopia vs SHM) (all P < .001). After adjusting for age, AL, and RE, the curvature parameters remained significantly associated with the occurrence of PM (all P ≤ .003). In distinguishing PM from SHM, curvature achieved the highest diagnostic performance, with an area under the receiver operating characteristic curve (AUROC) of 0.92 (95% CI, 0.87-0.98), followed by 0.86 (95% CI, 0.78-0.94) for curvature, 0.84 (95% CI, 0.76-0.93) for curvature, 0.75 (95% CI, 0.62-0.89) for AL, and 0.76 (95% CI, 0.66-0.86) for RE. The performance of curvature was significantly higher than AL (P = .020) and RE (P = .006).
Posterior eye curvature increased with myopia severity and outperformed traditional AL and RE, suggesting its potential as a desirable biomarker in differentiating PM from SHM. Further research, particularly longitudinal studies, is warranted to evaluate whether the curvature can predict myopia prognosis and the development of pathologic changes.
描述眼后段曲率特征，并评估其在鉴别病理性近视（PM）与单纯高度近视（SHM）中的诊断性能。
基于人群的横断面研究。
从北京眼病研究中随机选取790名参与者的790只眼（平均年龄：60.6±8.3岁；59%为女性），包括406只非近视眼、175只轻度近视眼、102只中度近视眼、76只单纯高度近视眼和31只病理性近视眼。
使用从自动分割的谱域光学相干断层扫描图像中获取的视网膜色素上皮层外边界计算眼后段曲率。计算了三个曲率参数：曲率、曲率和曲率。
不同近视组曲率参数的值和空间分布，以及它们在区分病理性近视与单纯高度近视中的诊断性能。
较高的曲率参数与年龄较大、眼轴长度（AL）较长、近视屈光不正（RE）较高、最佳矫正视力较低以及黄斑中心凹下脉络膜厚度较小显著相关（均P<.001）。这些参数随近视严重程度逐渐增加（均P<.001）。与传统指标如眼轴长度不同（眼轴长度在整个近视范围内呈稳步增加），与其他两两比较（非近视与轻度近视、轻度与中度近视、中度近视与单纯高度近视）相比，曲率参数在单纯高度近视和病理性近视之间的增加明显更陡（均P<.001）。在调整年龄、眼轴长度和屈光不正后，曲率参数仍与病理性近视的发生显著相关（均P≤.003）。在区分病理性近视与单纯高度近视时，曲率的诊断性能最高，受试者工作特征曲线下面积（AUROC）为0.92（95%CI，0.87 - 0.98）；其次，曲率为0.86（95%CI，0.78 - 0.94），曲率为0.84（95%CI，0.76 - 0.93），眼轴长度为0.75（95%CI，0.62 - 0.89），屈光不正为0.76（95%CI，0.66 - 0.86）。曲率的性能显著高于眼轴长度（P =.020）和屈光不正（P =.006）。
眼后段曲率随近视严重程度增加，且优于传统眼轴长度和屈光不正指标，提示其在鉴别病理性近视与单纯高度近视中作为理想生物标志物的潜力。有必要进行进一步研究（尤其是纵向研究），以评估曲率是否可预测近视预后及病理变化的发展。
