The accuracy of the axial length and axial length/corneal radius ratio for myopia assessment among Chinese children

Mu, Jingfeng; Zeng, Dan; Fan, Jingjie; Liu, Meizhou; Zhong, Haoxi; Shuai, Xinyi; Zhang, Shaochong

doi:10.3389/fped.2022.859944

Cited by 12 publications

(16 citation statements)

References 34 publications

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“…Exploring the relationship between the ocular biometric parameters and the refractive status can simplify the process of myopia monitoring and better predict myopia progression. Axial length (AL) is an important indicator for monitoring the progress of myopia, but the quantitative relationship between AL and dioptre change is not clear [19,20]. Based on the value of ocular parameters and sociological information of 1011 adolescents, Tang et al [8] used six ML models to analyze the multimode data, and then used the five-fold cross-validation method to train and test the model to predict the SER changes in myopic population at different ages when the AL increased by 1.0 mm.…”

Section: Discussionmentioning

confidence: 99%

Prediction of Spherical Equivalent Refraction and Annual Myopia Progression Rate in Chinese Schoolchildren Based on Random Forest Model

Guo

Luo

Lin

et al. 2023

Preprint

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Purpose To establish a machine learning (ML) model for predicting future spherical equivalent refraction (SER) and its annual progression rate in Chinese schoolchildren. Methods A total of 23,832 participants were analyzed, including 12,514 females and 11,318 males. The follow-up visits were conducted between February 2008 and June 2021. The SER value at a specific future time point was predicted based on the results of at least two cycloplegic refraction measurements. The prediction model was established using a random forest (RF) model. A five-fold cross-validation was used to select the parameters and train an optimal RF model for prediction. Axial position, SER values, and age were selected as predictors. The performance of the algorithm was evaluated using the coefficient of determination (R2), mean squared error (MSE), and mean absolute error (MAE). Results The RF algorithm had a great advantage in the detection of high myopia, with an R2 value of 0.944 in the training datasets. The established model achieved clinically acceptable predictions of SER values at a specific future time point. For the performance of the algorithm, the R2 achieved 0.994 in the training datasets, and 0.963 in the validation datasets, respectively. For the testing datasets, the MAE, MSE, and R2 achieved 0.489, 0.502, and 0.964 for the entire population, respectively. Conclusions Our ML model performs well in the prediction of SER and myopia progression in Chinese schoolchildren. Random forest algorithm has potential advantages in the detection of high myopia and thus provides evidence for precise individual intervention and control of myopia.

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Section: Discussionmentioning

confidence: 99%

Prediction of Spherical Equivalent Refraction and Annual Myopia Progression Rate in Chinese Schoolchildren Based on Random Forest Model

Guo

Luo

Lin

et al. 2023

Preprint

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“…The effects of age have been investigated in eye models 9,14,45 but these start in young adulthood (around 20 years). There is a paucity of models for the developing eye that need to consider the changes in the biometry of the eye and the AL/CRC ratio as the eye grows 41,46,47 . Furthermore, the growing eye is exposed to different mismatches (of AL or corneal radius) that could cause refractive errors.…”

Section: Discussionmentioning

confidence: 99%

“…There is a paucity of models for the developing eye that need to consider the changes in the biometry of the eye and the AL/CRC ratio as the eye grows. 41,46,47 Furthermore, the growing eye is exposed to different mismatches (of AL or corneal radius) that could cause refractive errors. Developmental models could provide insight into the process of emmetropisation and the development of myopia.…”

Section: F I G U R Ementioning

confidence: 99%

A comparative analysis of the influence of refractive error on image acuity using three eye models

Debowy,

Pierscionek

2023

Ophthalmic Physiologic Optic

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PurposeTo analyse and compare image acuity for different refractive errors generated by either altering axial length or corneal curvature and using three human eye models with two pupil sizes.MethodsThree different eye models, Liou‐Brennan, Goncharov and Navarro, were used. Simulations were made (using Ansys Zemax OpticStudio 22.3) for real pupil sizes of 3 and 6 mm with refractive errors ranging from −2 to +2 D in 0.25 D increments. Refractive errors were simulated by varying axial length or corneal curvature. Root mean square (RMS) values were used to determine image acuity.ResultsFor the 3‐mm pupil, all models gave similar results, with the Navarro model having slightly higher RMS values for the emmetropic eye. For the 6‐mm pupil, the Liou‐Brennan and Goncharov eye models gave similar results, with RMS values lower than for the Navarro eye model. The highest RMS value was visible in the axial length‐induced refractive errors. Refractive errors generated by altering corneal curvature give smaller RMS values than those generated by altering axial length. The axial length and corneal radius simulations indicate a wide spread of results for myopic, hyperopic and emmetropic eyes. There are multiple outcomes that give the same refractive error, even within a single‐eye model. The axial length/corneal curvature ratio showed a higher ratio for myopes than hyperopes for every model.ConclusionsThe influence of refractive error on image acuity varied depending on the simulation method of refractive error and the model used. The origins of refractive error and the influence it has on image acuity need further investigation. As models become more sophisticated, personalised and biologically relevant, they will better represent the image acuity of the eye for varying refractive errors, ethnicities, ages and pupil sizes.

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“…The axial length (AL) and AL to corneal radius of curvature ratio (AL/CR) have been reported to be strongly correlated with ocular refraction, and play an important role in the screening and monitoring of myopia 13. Cycloplegic refraction is considered the gold standard for measuring refractive errors, but limited by the fact that mydriatic drops can induce mydriasis and cycloplegia 14.…”

Section: Introductionmentioning

confidence: 99%

Myopia prevalence and ocular biometry in children and adolescents at different altitudes: a cross-sectional study in Chongqing and Tibet, China

Xiang,

Cheng,

Sun

et al. 2024

BMJ Open

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ObjectiveTo investigate the differences in myopia prevalence and ocular biometry in children and adolescents in Chongqing and Tibet, China.DesignCross-sectional study.SettingThe study included children and adolescents aged 6–18 years in Chongqing, a low-altitude region, and in Qamdo, a high-altitude region of Tibet.ParticipantsA total of 448 participants in Qamdo, Tibet, and 748 participants in Chongqing were enrolled in this study.MethodsAll participants underwent uncorrected visual acuity assessment, non-cycloplegic refraction, axial length (AL) measurement, intraocular pressure (IOP) measurement and corneal tomography. And the participants were grouped according to age (6–8, 9–11, 12–14 and 15–18 years group), and altitude of location (primary school students: group A (average altitude: 325 m), group B (average altitude: 2300 m), group C (average altitude: 3250 and 3170 m) and group D (average altitude: 3870 m)).ResultsThere was no statistical difference in mean age (12.09±3.15 vs 12.2±3.10, p=0.549) and sex distribution (males, 50.4% vs 47.6%, p=0.339) between the two groups. The Tibet group presented greater spherical equivalent (SE, −0.63 (−2.00, 0.13) vs −0.88 (−2.88, –0.13), p<0.001), shorter AL (23.45±1.02 vs 23.92±1.19, p<0.001), lower prevalence of myopia (39.7% vs 47.6%, p=0.008) and flatter mean curvature power of the cornea (Km, 43.06±1.4 vs 43.26±1.36, p=0.014) than the Chongqing group. Further analysis based on age subgroups revealed that the Tibet group had a lower prevalence of myopia and higher SE in the 12–14, and 15–18 years old groups, shorter AL in the 9–11, 12–14 and 15–18 years old groups, and lower AL to corneal radius of curvature ratio (AL/CR) in all age subgroups compared with the Chongqing group, while Km was similar between the two groups in each age subgroup. Simple linear regression analysis showed that SE decreased with age in both the Tibet and Chongqing groups, with the Tibet group exhibiting a slower rate of decrease (p<0.001). AL and AL/CR increased with age in both the Tibet and Chongqing groups, but the rate of increase was slower in the Tibet group (p<0.001 of both). Multiple linear regression analysis revealed that AL had the greatest effect on SE in both groups, followed by Km. In addition, the children and adolescents in Tibet presented thinner corneal thickness (CCT, p<0.001), smaller white to white distance (WTW, p<0.001), lower IOP (p<0.001) and deeper anterior chamber depth (ACD, p=0.015) than in Chongqing. Comparison of altitude subgroups showed that the prevalence of myopia (p=0.002), SE (p=0.031), AL (p=0.001) and AL/CR (p<0.001) of children at different altitudes was statistically different but the Km (p=0.189) were similar. The highest altitude, Tengchen County, exhibited the lowest prevalence of myopia and greatest SE among children, and the mean AL also decreased with increasing altitude.ConclusionsMyopia prevalence in Tibet was comparable with that in Chongqing for students aged 6–8 and 9–11 years but was lower and myopia progressed more slowly for students aged 12–14 and 15–18 years than in Chongqing, and AL was the main contributor for this difference, which may be related to higher ultraviolet radiation exposure and lower IOP in children and adolescents at high altitude in Tibet. Differences in AL and AL/CR between Tibet and Chongqing children and adolescents manifested earlier than in SE, underscoring the importance of AL measurement in myopia screening.

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The accuracy of the axial length and axial length/corneal radius ratio for myopia assessment among Chinese children

Cited by 12 publications

References 34 publications

Prediction of Spherical Equivalent Refraction and Annual Myopia Progression Rate in Chinese Schoolchildren Based on Random Forest Model

Prediction of Spherical Equivalent Refraction and Annual Myopia Progression Rate in Chinese Schoolchildren Based on Random Forest Model

A comparative analysis of the influence of refractive error on image acuity using three eye models

Myopia prevalence and ocular biometry in children and adolescents at different altitudes: a cross-sectional study in Chongqing and Tibet, China

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