目的：研究青少年近视程度与眼轴长度、角膜曲率半径及轴率比的相关性。方法：横断面研究。采用随机抽样法选取2021年1月至2023年6月于郑州大学第五附属医院眼科门诊就诊验配角膜塑形镜的8-18岁青少年246例492眼为研究对象(其中45眼不符合纳入标准，故剔除，最终符合纳入447眼)。在小瞳孔下行生物测量收集眼轴(AL)、角膜曲率半径(CR)和轴率比(AL/CR)等生物参数，在睫状肌麻痹状态下验光，根据等效球镜度(SE)分为轻度近视(216眼)、中度近视(231眼)，通过多元线性回归分析青少年近视程度与AL和CR及AL/CR的关系。结果：8-12岁青少年与13-18岁青少年近视程度分布有差异(均P<0.001)。青少年轻度近视与中度近视SE、AL、AL/CR比值有差异(均P<0.001)。线性回归分析显示，青少年SE与AL、AL/CR呈负相关(r=-0.531、-0.598，均P<0.001)。AL/CR联合性别年龄、AL/CR、AL和CR的ROC曲线下面积分别为0.812(95%CI：0.773-0.852)、0.800(95%CI：0.759-0.841)、0.726(95%CI：0.680-0.773)、0.548(95%CI：0.494-0.601)。AL/CR预测中度近视的最佳截断值为3.189，敏感性为0.632，特异性为0.852，可作为中度近视的监测点。结论：青少年轻中度近视患者的AL/CR、AL与SE呈负相关。AL/CR联合性别年龄对近视SE诊断的准确性最大，AL/CR可以在一定程度上独立于验光预测青少年儿童的近视程度。

AIM: To investigate the correlation of degree of myopia in adolescents with axial length, corneal curvature and axial ratio.METHODS: Cross-sectional study. A total of 246 adolescents(492 eyes)aged 8-18 years consecutively enrolled for orthokeratology lens fitting at the Fifth Affiliated Hospital of Zhengzhou University between 2021 and 2023 were included based on random sampling method, with 447 eyes finally included due to the elimination of 45 eyes that did not meet the inclusion criteria. Biometric measurements under scotopic conditions assessed axial length(AL), corneal radius of curvature(CR), and AL/CR ratio. Cycloplegic refraction determined spherical equivalent(SE), classifying eyes into mild(216 eyes)or moderate(231 eyes)myopia groups. Furthermore, the correlation of degree of myopia with AL, CR and AL/CR was analyzed by multiple linear regression analysis.RESULTS: A statistically significant difference in myopia severity was observed between the 8-12-year-old and 13-18-year-old age groups(all P<0.001). There were statistically significant differences between mild and moderate groups in SE, AL and AL/CR(all P<0.001). Linear regression analysis revealed significant negative correlations of SE with AL and AL/CR(r=-0.531, -0.598, all P<0.001). The areas under the ROC curve(AUC)for predicting moderate myopia were 0.812(95% CI: 0.773-0.852)for AL/CR combined with gender and age, 0.800(95% CI: 0.759-0.841)for AL/CR alone, 0.726(95% CI: 0.680-0.773)for AL alone, and 0.548(95% CI: 0.494-0.601)for CR alone. The optimal AL/CR cut-off value for predicting moderate myopia was 3.189(sensitivity: 0.632, specificity: 0.852), suggesting its potential as a clinical threshold.CONCLUSION: In adolescents with mild-to-moderate myopia, AL/CR, AL, and SE showed significant negative correlations. The combination of AL/CR with gender and age demonstrated the highest diagnostic accuracy for SE. AL/CR shows independent predictive value for myopia degree in adolescents, irrespective of refractive status.

郑州市科技惠民计划项目(No.2023KJHM0020)