Xiangui He1, Haidong Zou2, Lina Lu1, Rong Zhao1, Huijuan Zhao3, Qiangqiang Li3, Jianfeng Zhu1. 1. Department of Eye Disease Prevention, Shanghai Eye Disease Prevention & Treatment Center, Shanghai, China. 2. Department of Eye Disease Prevention, Shanghai Eye Disease Prevention & Treatment Center, Shanghai, China; Department of Ophthalmology, Shanghai First Peoples' Hospital, affiliated Shanghai Jiaotong University, Shanghai, China. 3. Department of School Health, Baoshan Center for Disease Prevention and Control, Shanghai, China.
Abstract
PURPOSE: To evaluate the association between the AL/CR ratio and refractive state and explore the effectiveness of this ratio in the assessment of myopia, especially when combined with uncorrected visual acuity in schoolchildren among whom myopia is common. METHODS: Cross sectional study. 4686 children from 6 primary schools, aged from 6 to 12 years were selected using the clustered-stratified random sampling method. Uncorrected visual acuity (UCVA), axial length (AL), corneal radius of curvature (CR), and cycloplegic refraction were tested. Refraction was measured as the spherical equivalent (SE). RESULTS: 3922 children were included in the analysis. The mean AL/CR ratio was 2.973±0.002, increased with age, and different in gender. The coefficients of correlations of the SE with the AL/CR ratio, AL, and CR were -0.811, -0.657, and 0.095, respectively. Linear regression showed a 10.72 D shift towards myopia with every 1 unit increase in the AL/CR ratio (P<0.001, r2 = 66.4%). The estimated SE values obtained by substituting the AL/CR ratio and gender back to the regression model that were within a difference of ±0.50 D in ATE/LER (allowable total error and limits for erroneous results) zones compared to the actual measured values was 51%. The area under the ROC curve of the AL/CR ratio, AL, and UCVA for myopia detection were 0.910, 0.822, and 0.889, respectively, and the differences between each pair were statistically significant (P<0.01). At a specificity of 90%, the sensitivities were 72.98%, 50.50%, 71.99%, and 82.96%, respectively, for the AL/CR ratio, AL, UCVA, and the combination of the AL/CR ratio and UCVA. CONCLUSIONS: The AL/CR ratio was found to explain the total variance in SE better than AL alone. The effectiveness of the AL/CR ratio was statistically significantly better than UCVA for detecting myopia in children, and combining the two produced increased sensitivity without significantly decreasing specificity.
PURPOSE: To evaluate the association between the AL/CR ratio and refractive state and explore the effectiveness of this ratio in the assessment of myopia, especially when combined with uncorrected visual acuity in schoolchildren among whom myopia is common. METHODS: Cross sectional study. 4686 children from 6 primary schools, aged from 6 to 12 years were selected using the clustered-stratified random sampling method. Uncorrected visual acuity (UCVA), axial length (AL), corneal radius of curvature (CR), and cycloplegic refraction were tested. Refraction was measured as the spherical equivalent (SE). RESULTS: 3922 children were included in the analysis. The mean AL/CR ratio was 2.973±0.002, increased with age, and different in gender. The coefficients of correlations of the SE with the AL/CR ratio, AL, and CR were -0.811, -0.657, and 0.095, respectively. Linear regression showed a 10.72 D shift towards myopia with every 1 unit increase in the AL/CR ratio (P<0.001, r2 = 66.4%). The estimated SE values obtained by substituting the AL/CR ratio and gender back to the regression model that were within a difference of ±0.50 D in ATE/LER (allowable total error and limits for erroneous results) zones compared to the actual measured values was 51%. The area under the ROC curve of the AL/CR ratio, AL, and UCVA for myopia detection were 0.910, 0.822, and 0.889, respectively, and the differences between each pair were statistically significant (P<0.01). At a specificity of 90%, the sensitivities were 72.98%, 50.50%, 71.99%, and 82.96%, respectively, for the AL/CR ratio, AL, UCVA, and the combination of the AL/CR ratio and UCVA. CONCLUSIONS: The AL/CR ratio was found to explain the total variance in SE better than AL alone. The effectiveness of the AL/CR ratio was statistically significantly better than UCVA for detecting myopia in children, and combining the two produced increased sensitivity without significantly decreasing specificity.
Authors: K Zadnik; D O Mutti; N E Friedman; P A Qualley; L A Jones; P Qui; H S Kim; J C Hsu; M L Moeschberger Journal: Invest Ophthalmol Vis Sci Date: 1999-08 Impact factor: 4.799
Authors: Jian Feng Wu; Hong Sheng Bi; Shu Mei Wang; Yuan Yuan Hu; Hui Wu; Wei Sun; Tai Liang Lu; Xing Rong Wang; Jost B Jonas Journal: PLoS One Date: 2013-12-23 Impact factor: 3.240