Abstract
Myopia is a worldwide major public concern, aside from the visual disturbance needing
optical correction, myopia may be associated with open angle glaucoma, retinal detachment
and myopic maculopathy. The higher the myopia the higher the risk for retinal associated
comorbidities, and the axial length is the more important measure to estimate risk
of visual impairment. Recently a formula to predict axial length using spherical equivalent
and keratometry was proposed, with the intention of categorizing the risk of visual
impairment with Tideman et al. classification.
Purpose
To evaluate the accuracy of an axial length prediction formula in a Colombian population
8–17 years old.
Methods
Children from MIOPUR study with optical biometer axial length measure (AL), manifest
refraction and keratometry were included in the analysis. Predicted axial length (PAL)
was calculated with the prediction formula. A Bland-Altman assessment was conducted,
and the concordance correlation coefficient was measured. Proposed classification
of AL to establish risk of visual loss was used with measured AL and with PAL. The
percentage of eyes misclassified was then established.
Results
A total of 2129 eyes were included in the analysis. Mean difference of axial length
(actual AL minus PAL) was −0.516 mm (−1.559 mm – 0.528 mm). Concordance correlation
coefficient (CCC) of 0.656 (IC95 0.636-0.675) was found between the real AL and PAL.
PAL differed from measured AL by 1 mm or more in 16.58 %, and by 2 mm or more, in
0.61 % of the eyes. In myopic eyes, PAL was in average 0.426 mm longer than the AL
actually measured with CCC of 0.714 (IC95 0.666−0.761). PAL differed from measured
AL by 1 mm or more in 21.92 %, and by 2 mm or more, in 0.45 % of the myopic eyes.
The study revealed that 15.03 % of all eyes, and 29.81 % of myopic eyes, were misclassified
when PAL was used.
Conclusions
The proposed axial length prediction formula was not accurate, and it did not adequately
classify risk of visual impairment in myopic eyes in a group of Colombian children.
We consider that it is not possible to predict the axial length based only on optometric
data, such as the corneal radius of curvature and the spherical equivalent. This is
very possibly related to the variability of crystalline lens power within a population.
Keywords
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Article info
Publication history
Published online: May 08, 2021
Accepted:
April 21,
2021
Received in revised form:
March 30,
2021
Received:
January 26,
2021
Identification
Copyright
© 2021 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
