Wang Jiaying, Zhou Jing
Department of Ophthalmology, Children'S Hospital of Fudan University, National Children'S Medical Center, Shanghai, China.
Shanghai University of Medicine & Health Sciences, Shanghai, China.
BMC Ophthalmol. 2025 Apr 11;25(1):198. doi: 10.1186/s12886-025-04020-z.
This study aimed to investigate the association between the axial length (AL) to average corneal curvature (CR) ratio and hyperopia reserve in preschool children.
AL, CR, horizontal and vertical meridians of the corneal radius (CR1, CR2), and 1% atropine cycloplegic refraction were measured in preschool children aged 3 - 6 years. The corneal curvatures were then used to calculate the AL/CR1, AL/CR2, and AL/CR ratios.
A total of 338 children were included, comprising 178 boys (52.7%) and 160 girls (47.3%). The mean values for AL, CR, AL/CR1, AL/CR2, AL/CR, and spherical equivalent refractive error (SER) were 22.11 ± 0.88 mm, 7.77 ± 0.26 mm, 2.80 ± 0.09, 2.90 ± 0.09, 2.85 ± 0.09, and + 2.13 ± 1.46 D, respectively. AL, AL/CR1, AL/CR2, and AL/CR increased with age, showing significant differences among age groups (P < 0.001). Conversely, SER moved from higher hyperopia toward lesser hyperopia with age, also showing significant differences among age groups (P < 0.001). Linear regression equations were established, with Y representing hyperopia reserve and X representing AL/CR: Age 3: Y = 44.67 - 15.02X; Age 4: Y = 33.96 - 11.19X; Age 5: Y = 42.11 - 13.98X; Age 6: Y = 44.94 - 15.00X. These results suggest that the AL/CR ratio could be used to assess hyperopia reserve insufficiency. The optimal cut-off point for the receiver operating characteristic (ROC) curve was ≥ 2.91, with a sensitivity, specificity, and Youden index of 0.84, 0.88, and 0.73, respectively. The critical value of the ROC curve increased with age in children aged 3 - 6 years.
This cross-sectional study found that the hyperopia reserve in children of different ages can be estimated using the hyperopia reserve equation. Additionally, the AL/CR ratio can serve as an effective index for detecting hyperopia reserve insufficiency, with an optimal ROC curve cut-off point of ≥ 2.91 in preschool children aged 3 - 6 years, and the critical value increasing with age.
本研究旨在探讨学龄前儿童眼轴长度（AL）与平均角膜曲率（CR）之比与远视储备之间的关联。
对3至6岁的学龄前儿童测量其眼轴长度、角膜曲率、角膜半径的水平和垂直子午线（CR1、CR2）以及1%阿托品散瞳验光。然后用角膜曲率计算AL/CR1、AL/CR2和AL/CR比值。
共纳入338名儿童，其中男孩178名（52.7%），女孩160名（47.3%）。眼轴长度、角膜曲率、AL/CR1、AL/CR2、AL/CR以及等效球镜度（SER）的平均值分别为22.11±0.88mm、7.77±0.26mm、2.80±0.09、2.90±0.09、2.85±0.09和+2.13±1.46D。眼轴长度、AL/CR1、AL/CR2和AL/CR随年龄增长而增加，在各年龄组间差异有统计学意义（P<0.001）。相反，等效球镜度随年龄增长从较高远视向较低远视转变，在各年龄组间差异也有统计学意义（P<0.001）。建立了线性回归方程，Y代表远视储备，X代表AL/CR：3岁：Y = 44.67 - 15.02X；4岁：Y = 33.96 - 11.19X；5岁：Y = 42.11 - 13.98X；6岁：Y = 44.94 - 15.00X。这些结果表明，AL/CR比值可用于评估远视储备不足。受试者工作特征（ROC）曲线的最佳截断点为≥2.91，灵敏度、特异度和尤登指数分别为0.84、0.88和0.73。3至6岁儿童的ROC曲线临界值随年龄增长而增加。
本横断面研究发现，不同年龄儿童的远视储备可用远视储备方程进行估算。此外，AL/CR比值可作为检测远视储备不足的有效指标，3至6岁学龄前儿童的ROC曲线最佳截断点为≥2.91，且临界值随年龄增长而增加。
