| Title | Ocular biometrics and uncorrected visual acuity for detecting myopia in Chinese school students |
| Authors | Zhao, Ethan Wang, Xinyi Zhang, Huiyan Zhao, Eric Wang, Jianyong Yang, Ying Gu, Fang Gu, Lei Huang, Jianyao Zhang, Ronghua Ying, Gui-shuang Cui, Hongguang |
| Affiliation | Weill Cornell Med, New York, NY USA Peking Univ, Natl Sch Dev, Beijing, Peoples R China Hangzhou Vocat & Tech Coll, Hangzhou, Peoples R China Univ Penn, Sch Engn & Appl Sci, Philadelphia, PA 19104 USA Zhejiang Univ, Affiliated Hosp 1, Coll Med, Dept Ophthalmol, Hangzhou, Peoples R China Ctr Dis Control & Prevent Jinyun Cty, Jinyun, Zhejiang, Peoples R China Zhejiang Prov Ctr Dis Control & Prevent Hangzhou, Hangzhou, Peoples R China Cent Hosp Jinyun Cty, Dept Ophthalmol, Jinyun, Zhejiang, Peoples R China Univ Penn, Perelman Sch Med, Ctr Prevent Ophthalmol & Biostat, Dept Ophthalmol, 3711 Market St,Suite 801, Philadelphia, PA 19104 USA Zhejiang Univ, Affiliated Hosp 1, Coll Med, 79 Qingchun Rd, Hangzhou 310003, Peoples R China |
| Keywords | CORNEAL RADIUS RATIO AXIAL LENGTH REFRACTIVE ERROR CHILDREN AGE AUTOREFRACTION CYCLOPLEGIA PARAMETERS NECESSITY IMI |
| Issue Date | 4-Nov-2022 |
| Publisher | SCIENTIFIC REPORTS |
| Abstract | The study is to evaluate the performance of ocular biometric measures and uncorrected visual acuity (UCVA) for detecting myopia among Chinese students. Among 5- to 18-year-old Chinese students from two cities of China, trained eye-care professionals performed assessment of ocular biometrics (axial length (AL), corneal curvature radius (CR), anterior chamber depth) under noncycloplegic conditions using NIDEK Optical Biometer AL-Scan, distance visual acuity using retro-illuminated logMAR chart with tumbling-E optotypes, and cycloplegic refractive error using NIDEK autorefractor with administration of 0.5% tropicamide. Spherical equivalent (SER) in diopters (D) was calculated as sphere plus half cylinder, and myopia was defined as SER <= - 0.5 D. Performances of ocular biometrics and UCVA (individually and in combination) for detecting myopia were evaluated using sensitivity and specificity, predictive values, and area under ROC curve (AUC) in both development dataset and validation dataset. Among 3436 students (mean age 9.7 years, 51% female), the mean (SD) cycloplegic SER was - 0.20 (2.18) D, and 1269 (36.9%) had myopia. Cycloplegic SER was significantly correlated with AL (Pearson Correlation coefficient r = - 0.82), AL/CR ratio (r = - 0.90), and UCVA (r = 0.79), but was not correlated with CR (r = 0.02, p = 0.15). The AL/CR ratio detected myopia with AUC 0.963 (95% CI 0.957-0.969) and combination with UCVA improved the AUC to 0.976 (95% CI 0.971-0.981). Using age-specific AL/CR cutoff (> 3.00 for age < 10 years, > 3.06 for 10-14 years, > 3.08 for >= 15 years) as myopia positive, the sensitivity and specificity were 87.0% (95% CI 84.4-89.6%) and 87.8% (86.0-89.6%), respectively, in the development dataset and 86.4% (95% CI 83.7-89.1%) and 89.4% (95% CI 87.3-91.4%), respectively, in the validation dataset. Combining AL/CR and UCVA (worse than 20/32 for age < 10 years, and 20/25 for >= 10 years) provided 91.9% (95% CI 90.4-93.4%) sensitivity and 87.0% (95% CI 85.6-88.4%) specificity, positive value of 80.6% (95% CI 78.5-82.6%) and negative value of 94.8% (95% CI 93.8-95.8%). These results suggest that AL/CR ratio is highly correlated with cycloplegic refractive error and detects myopia with high sensitivity and specificity, AL/CR ratio alone or in combination with UCVA can be used as a tool for myopia screening or for estimating myopia prevalence in large epidemiological studies with limited resources for cycloplegic refraction. |
| URI | http://hdl.handle.net/20.500.11897/658166 |
| ISSN | 2045-2322 |
| DOI | 10.1038/s41598-022-23409-0 |
| Indexed | SCI(E) |
| Appears in Collections: | 国家发展研究院 |
