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Karla Zadnik, Donald O. Mutti, Nina E. Friedman, Pamela A. Qualley, Lisa A. Jones, Pei–hua Qiu, H. S. Kim, Jason C. Hsu, Melvin L. Moeschberger; Ocular Predictors of the Onset of Juvenile Myopia. Invest. Ophthalmol. Vis. Sci. 1999;40(9):1936-1943.
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purpose. The purpose of this study was to identify reliable predictors of the
onset of juvenile myopia.
methods. The data from 554 children enrolled in the Orinda Longitudinal Study of
Myopia (OLSM) as nonmyopes with baseline data from the third grade were
evaluated to develop a predictive profile for later onset of juvenile
myopia. Myopia was defined as at least −0.75 D of myopia in the
vertical and horizontal meridians of the right eye as measured by
cycloplegic autorefraction (n = 45 children). Chosen
predictors were refractive error and the ocular components: corneal
power, Gullstrand crystalline lens power, and axial length. Sensitivity
and specificity were calculated. Receiver operating characteristic
(ROC) curves were generated to evaluate and compare these predictors
singly and combined.
results. Refractive error, axial length, Gullstrand lens and pod corneal power
were all significant predictive factors for the onset of juvenile
myopia. The best single predictor of future myopia onset in the right
eye was the right eye’s cycloplegic autorefraction spherical
refractive error value (mean sphere across 10 readings) at baseline.
For a cut point of less than +0.75 D hyperopia in the third grade,
sensitivity was 86.7% and specificity was 73.3%. The area under the
ROC curve for this mean sphere was 0.880. Producing a logistic model
combining mean sphere, corneal power, Gullstrand lens power, and axial
length results in a slight improvement in predictive ability (area
under the ROC curve = 0.893).
conclusions. Onset of juvenile myopia can be predicted with moderate accuracy using
the mean cycloplegic, spherical refractive error in the third grade.
Measurement of other ocular components at this age improves predictive
ability, albeit incrementally. Further improvements in the prediction
of myopia onset will require the use of longitudinal data in addition
to one-time measurement of refractive error and the ocular components.
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