Normative data and percentile curves for axial length and axial length/corneal curvature in Chinese children and adolescents aged 4–18 years

PurposeTo develop age-specific and gender-specific reference percentile charts for axial length (AL) and AL/corneal radius of curvature (AL/CR) and, to use percentiles to determine probability of myopia and estimate refractive error (RE).MethodsAnalysis of AL, cycloplegic RE and CR of 14 127 Chinese...

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Published in:British journal of ophthalmology Vol. 107; no. 2; pp. 167 - 175
Main Authors: He, Xiangui, Sankaridurg, Padmaja, Naduvilath, Thomas, Wang, Jingjing, Xiong, Shuyu, Weng, Rebecca, Du, Linlin, Chen, Jun, Zou, Haidong, Xu, Xun
Format: Journal Article
Language:English
Published: BMA House, Tavistock Square, London, WC1H 9JR BMJ Publishing Group Ltd 01.02.2023
BMJ Publishing Group LTD
BMJ Publishing Group
Subjects:
Adolescent
Age
Child
Clinical Science
Cornea
Datasets
diagnostic tests/investigation
East Asian People
embryology and development
epidemiology
Gender
Humans
Medical diagnosis
Myopia
Myopia - diagnosis
Myopia - epidemiology
optics and refraction
public health
Refraction, Ocular
Regression analysis
Teenagers
Vision Tests
Visual impairment
Young adults
Japan
Germany
epidemiology
diagnostic tests/investigation
optics and refraction
embryology and development
public health
ISSN:0007-1161, 1468-2079, 1468-2079
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Summary:PurposeTo develop age-specific and gender-specific reference percentile charts for axial length (AL) and AL/corneal radius of curvature (AL/CR) and, to use percentiles to determine probability of myopia and estimate refractive error (RE).MethodsAnalysis of AL, cycloplegic RE and CR of 14 127 Chinese participants aged 4–18 years from 3 studies. AL and AL/CR percentiles estimated using Lambda-Mu-Sigma method and compared for agreement using intraclass correlation (ICC). Logistic regression was used to model risk of myopia based on age, gender, AL and AL/CR percentiles. Accuracy of AL progression and RE estimated using percentiles was validated using an independent sample of 5742 eyes of children aged 7–10 years.ResultsAge-specific and gender-specific AL and AL/CR (3rd, 5th, 10th, 25th, 50th, 75th, 90th and 95th) percentiles are presented. Concordance between AL and AL/CR percentiles improved with age (0.13 at 4 years to >0.75 from 13 years) and a year-to-year change was observed for all except <10th percentile from 15 years. Increasing age, AL and AL/CR was associated with a more myopic RE (r2=0.45,0.70 and 0.83, respectively). The sensitivity and specificity of the model to estimate probability of myopia was 86.0% and 84.5%, respectively. Estimation of 1-year change in AL using percentiles correlated highly with actual AL (ICC=0.98). Concordance of estimated to actual RE was high (ICC=0.80) and within ±0.50D and ±1.0D of actual RE for 47.4% and 78.9% of eyes, respectively.ConclusionAge-specific and gender-specific AL and AL/CR percentiles provide reference data, aid in identifying and monitoring individuals at risk of myopia and have utility in screening for myopia. AL/CR percentiles were more accurate in estimating probability of myopia in younger children.
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ISSN:0007-1161
1468-2079
1468-2079
DOI:10.1136/bjophthalmol-2021-319431