{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T18:13:27Z","timestamp":1788200007398,"version":"build-2803163510"},"reference-count":25,"publisher":"BMJ","funder":[{"name":"Shanghai Health Commission Clinical Research Special General Program","award":["202340065"],"award-info":[{"award-number":["202340065"]}]},{"name":"National Administration of Traditional Chinese Medicine Three-Year Action Plan","award":["1-4-1"],"award-info":[{"award-number":["1-4-1"]}]},{"name":"Disease Control Bureau Public Health Special General Program","award":["2024GKM28"],"award-info":[{"award-number":["2024GKM28"]}]},{"DOI":"10.13039\/501100013105","name":"Shanghai Rising-Star Program","doi-asserted-by":"publisher","award":["24QA2708300"],"award-info":[{"award-number":["24QA2708300"]}],"id":[{"id":"10.13039\/501100013105","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Shanghai Health Commission Medical New Technology Research and Translation Seed Program","award":["2025ZZ2004"],"award-info":[{"award-number":["2025ZZ2004"]}]},{"name":"Shanghai Science and Technology Commission Academic Leader Program","award":["22XD1422900"],"award-info":[{"award-number":["22XD1422900"]}]},{"name":"Shanghai Health Commission Medical New Technology Research and Translation Seed Program","award":["2025ZZ1002"],"award-info":[{"award-number":["2025ZZ1002"]}]},{"name":"National Natural Science Foundation of China (NSFC) General Program","award":["82273648"],"award-info":[{"award-number":["82273648"]}]},{"name":"National Natural Science Foundation of China (NSFC) General Program","award":["82574119"],"award-info":[{"award-number":["82574119"]}]},{"name":"Shanghai Health Commission Academic Leader Program","award":["2022XD032"],"award-info":[{"award-number":["2022XD032"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2026,8,18]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To investigate how corneal radius (CR) affects the optimal axial length-to-corneal radius (AL\/CR) ratio cut-off for myopia detection and to construct a multivariable model for estimating myopia probability in children and adolescents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 6782 children and adolescents aged 3\u201318 years from Shanghai, China, were included. Myopia was defined as a cycloplegic spherical equivalent (SE) less than or equal to \u22120.50 dioptres. Participants were stratified into six CR groups (0.25 mm intervals). Receiver operating characteristic curve analysis was used to determine optimal AL\/CR cut-off values for each CR group. Linear regression was performed to model the relationship between CR and optimal cut-offs. A multivariable logistic regression model incorporating CR, AL\/CR ratio, age and sex was fitted, and model-based estimates were summarised using contour plots and lookup tables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean age was 9.36\u00b13.59 years, and myopia prevalence was 33.8%. Optimal AL\/CR cut-offs decreased with increasing CR, from 3.10 (7.08\u2264CR\u22647.33 mm) to 2.93 (8.33&lt;CR\u22648.60 mm), with areas under the curve (AUCs) of 0.94\u20130.97 across groups. The optimal AL\/CR cut-off was linearly associated with CR (optimal cut-off=4.073\u22120.135\u00d7CR; R\n                      <jats:sup>2<\/jats:sup>\n                      =0.948; p=0.001). The multivariable model showed high discrimination (AUC=0.97) in this dataset. Age- and sex-specific lookup tables and probability contour plots were generated to summarise model-based estimates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The optimal AL\/CR ratio cut-off for myopia detection varies systematically with CR. These findings indicate that CR contributes to variation in AL\/CR-based myopia classification. The fitted equation, probability contour plots and lookup tables provide CR-informed reference estimates for interpreting AL\/CR in children and adolescents.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjo-2026-329775","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T17:20:18Z","timestamp":1788196818000},"page":"bjo-2026-329775","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Corneal radius-specific axial length\/corneal radius ratio cut-offs for improved myopia detection in children: a population-based study"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2677-2047","authenticated-orcid":false,"given":"Daixi","family":"Chen","sequence":"first","affiliation":[{"name":"Clinical Research Center, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai Engineering Research 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Health Research Center, School of Medicine, Tongji University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Chen","sequence":"additional","affiliation":[{"name":"Clinical Research Center, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai Vision Health Center, Shanghai Children Myopia Institute, Eye Public Health Research Center, School of Medicine, Tongji University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2279-9514","authenticated-orcid":false,"given":"Jingjing","family":"Wang","sequence":"additional","affiliation":[{"name":"Clinical Research Center, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai Vision Health Center, Shanghai Children Myopia Institute, Eye Public Health Research Center, School of Medicine, Tongji University, Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haidong","family":"Zou","sequence":"additional","affiliation":[{"name":"Clinical Research Center, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai Vision Health Center, Shanghai Children Myopia Institute, Eye Public Health Research Center, School of Medicine, Tongji University, Shanghai, China"},{"name":"Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of ocular fundus diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4246-4343","authenticated-orcid":false,"given":"Xun","family":"Xu","sequence":"additional","affiliation":[{"name":"Clinical Research Center, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai Vision Health Center, Shanghai Children Myopia Institute, Eye Public Health Research Center, School of Medicine, Tongji University, Shanghai, China"},{"name":"Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of ocular fundus diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8938-1879","authenticated-orcid":false,"given":"Xiangui","family":"He","sequence":"additional","affiliation":[{"name":"Clinical Research Center, Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, School of Medicine, Tongji University, Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai Vision Health Center, Shanghai Children Myopia Institute, Eye Public Health Research Center, School of Medicine, Tongji University, Shanghai, China"},{"name":"Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of ocular fundus diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, People's Republic of 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