Research on the predictive performance of using ROC curve to evaluate axial length for myopia in children and adolescents

Abstract Background Assessing myopia risk can help clinicians intervene as early as possible. There is still a lack of reference values for predicting myopia based on the axial length (AL) of children. The study aims to explore the relationship between AL and myopia, and to predict the risk threshol...

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Main Authors: Cui Mingming, Zhu Zhongxin, Gao Yuting, Zong Xinnan, Li Shaoli, Liu Junting, Chen Fangfang, Yang Zhou, Yin Tao, Lyu Yanyu, Zhang Hao
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Ophthalmology
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Online Access:https://doi.org/10.1186/s12886-025-04017-8
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author Cui Mingming
Zhu Zhongxin
Gao Yuting
Zong Xinnan
Li Shaoli
Liu Junting
Chen Fangfang
Yang Zhou
Yin Tao
Lyu Yanyu
Zhang Hao
author_facet Cui Mingming
Zhu Zhongxin
Gao Yuting
Zong Xinnan
Li Shaoli
Liu Junting
Chen Fangfang
Yang Zhou
Yin Tao
Lyu Yanyu
Zhang Hao
author_sort Cui Mingming
collection DOAJ
description Abstract Background Assessing myopia risk can help clinicians intervene as early as possible. There is still a lack of reference values for predicting myopia based on the axial length (AL) of children. The study aims to explore the relationship between AL and myopia, and to predict the risk thresholds of AL in children of different age and sex groups. Method Visual acuity examination, refractive screening and ocular axis examination of 2388 children aged 7–18 (4776 eyes) from 8 schools in a certain area of Beijing were used as the data source, we evaluated the predictive ability of AL for myopia in children using Receiver Operating Characteristic (ROC) curves, and constructed Logistic Regression to analyze the reference value of AL threshold for children of different age and sex groups. Results The myopia rate among children and adolescents was 51.47%. The AL and SE were significantly correlated by Spearman correlation coefficient(P < 0.01). Predicting myopia in children based on their AL has a good reference value(AUC = 0.73). Children with AL ≥ 23.92 mm have a significantly higher myopia rate than those with AL < 23.92 mm (χ²=661.14, P < 0.01). The difference in AL among children of different age groups is statistically significant, and the AL shows an increasing trend with age. Among them, the AL threshold for children aged 7–12 is 23.67 mm, while that for children aged 13–15 is 23.92 mm, and children aged 16–18 is 24.42 mm. Children with an AL ≥ the threshold have a 4.41-fold higher risk of myopia than those with an AL < the threshold (OR = 4.41, 95% CI = 3.88–5.01). There is a statistically significant difference in AL between children of different sex groups. The male group has a higher AL(24.27 mm) than the females (23.71 mm), and children with AL ≥ threshold have a 5.58-fold higher risk of myopia than those with AL < threshold (OR = 5.58, 95% CI = 4.93–6.33). Conclusion The correlation between SE and AL was strong in school children. Age-specific and sex-specific AL threshold for myopia might provide reference data as a useful indicator, aid in identifying and monitoring individuals at risk of myopia and have utility in population-based screening for myopia in children and adolescents.
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spelling doaj-art-7db82eab6ed84011b938ecab5022dba02025-08-20T02:11:46ZengBMCBMC Ophthalmology1471-24152025-04-0125111310.1186/s12886-025-04017-8Research on the predictive performance of using ROC curve to evaluate axial length for myopia in children and adolescentsCui Mingming0Zhu Zhongxin1Gao Yuting2Zong Xinnan3Li Shaoli4Liu Junting5Chen Fangfang6Yang Zhou7Yin Tao8Lyu Yanyu9Zhang Hao10Capital Institute of PediatricsDepartment of Environmental and Occupational Health, School of Public Health, Guangdong Medical UniversityDepartment of Environmental and Occupational Health, School of Public Health, Guangdong Medical UniversityDepartment of Growth and Development, Capital Institute of PediatricsChild Health Big Data Research Center, Capital Institute of PediatricsChild Health Big Data Research Center, Capital Institute of PediatricsDepartment of Epidemiology, Capital Institute of PediatricsDepartment of Ophthalmology, Capital Center for Children’s Health, Capital Medical UniversityDepartment of Science and Technology, Capital Institute of PediatricsExperiment Center, Capital Institute of PediatricsDepartment of Ophthalmology, Capital Center for Children’s Health, Capital Medical UniversityAbstract Background Assessing myopia risk can help clinicians intervene as early as possible. There is still a lack of reference values for predicting myopia based on the axial length (AL) of children. The study aims to explore the relationship between AL and myopia, and to predict the risk thresholds of AL in children of different age and sex groups. Method Visual acuity examination, refractive screening and ocular axis examination of 2388 children aged 7–18 (4776 eyes) from 8 schools in a certain area of Beijing were used as the data source, we evaluated the predictive ability of AL for myopia in children using Receiver Operating Characteristic (ROC) curves, and constructed Logistic Regression to analyze the reference value of AL threshold for children of different age and sex groups. Results The myopia rate among children and adolescents was 51.47%. The AL and SE were significantly correlated by Spearman correlation coefficient(P < 0.01). Predicting myopia in children based on their AL has a good reference value(AUC = 0.73). Children with AL ≥ 23.92 mm have a significantly higher myopia rate than those with AL < 23.92 mm (χ²=661.14, P < 0.01). The difference in AL among children of different age groups is statistically significant, and the AL shows an increasing trend with age. Among them, the AL threshold for children aged 7–12 is 23.67 mm, while that for children aged 13–15 is 23.92 mm, and children aged 16–18 is 24.42 mm. Children with an AL ≥ the threshold have a 4.41-fold higher risk of myopia than those with an AL < the threshold (OR = 4.41, 95% CI = 3.88–5.01). There is a statistically significant difference in AL between children of different sex groups. The male group has a higher AL(24.27 mm) than the females (23.71 mm), and children with AL ≥ threshold have a 5.58-fold higher risk of myopia than those with AL < threshold (OR = 5.58, 95% CI = 4.93–6.33). Conclusion The correlation between SE and AL was strong in school children. Age-specific and sex-specific AL threshold for myopia might provide reference data as a useful indicator, aid in identifying and monitoring individuals at risk of myopia and have utility in population-based screening for myopia in children and adolescents.https://doi.org/10.1186/s12886-025-04017-8ChildrenMyopiaAxial length(AL)ROC curveLogistic regression
spellingShingle Cui Mingming
Zhu Zhongxin
Gao Yuting
Zong Xinnan
Li Shaoli
Liu Junting
Chen Fangfang
Yang Zhou
Yin Tao
Lyu Yanyu
Zhang Hao
Research on the predictive performance of using ROC curve to evaluate axial length for myopia in children and adolescents
BMC Ophthalmology
Children
Myopia
Axial length(AL)
ROC curve
Logistic regression
title Research on the predictive performance of using ROC curve to evaluate axial length for myopia in children and adolescents
title_full Research on the predictive performance of using ROC curve to evaluate axial length for myopia in children and adolescents
title_fullStr Research on the predictive performance of using ROC curve to evaluate axial length for myopia in children and adolescents
title_full_unstemmed Research on the predictive performance of using ROC curve to evaluate axial length for myopia in children and adolescents
title_short Research on the predictive performance of using ROC curve to evaluate axial length for myopia in children and adolescents
title_sort research on the predictive performance of using roc curve to evaluate axial length for myopia in children and adolescents
topic Children
Myopia
Axial length(AL)
ROC curve
Logistic regression
url https://doi.org/10.1186/s12886-025-04017-8
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