{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T05:03:41Z","timestamp":1779685421191,"version":"3.53.1"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To describe the clinical and ocular biometric characteristics of high myopia in children and adolescents, analyze the relationship between age and axial length (AL) and axial ratio (AL\/CR), identify high-risk structural populations, and evaluate binocular asymmetry and follow-up progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively extracted data from the outpatient medical record system of our hospital, including patients whose age at the last follow-up was less than 18 years and whose spherical equivalent (SE) of at least one eye was \u2264 \u22126.00D. The last follow-up data were used as the main analysis, and best corrected visual acuity (BCVA), SE, axial length (AL), and AL\/corneal radius (AL\/CR) were extracted. Pearson correlation analysis was used to evaluate the correlation between age and AL, AL\/CR. In addition, the differences between the left and right eyes of the same patient (| \u0394SE|, | \u0394AL|) were calculated, and a longitudinal description was made for the subset with repeated biometric records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 84 patients (47 males and 37 females) were included, with a total of 146 highly myopic eyes. The average spherical equivalent (SE) of highly myopic eyes was \u22128.87 \u00b1 2.58D; the axial length (AL) was 26.41 \u00b1 1.33 mm (\n                      <jats:italic>n<\/jats:italic>\n                      = 118); and the AL\/corneal radius (CR) ratio was 3.38 \u00b1 0.19 (\n                      <jats:italic>n<\/jats:italic>\n                      = 73). Age was significantly positively correlated with AL (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.485,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001), and age was also significantly positively correlated with the AL\/CR ratio (\n                      <jats:italic>r<\/jats:italic>\n                      = 0.505,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001). Generalized estimating equations (GEE) confirmed that age independently predicted AL (\u03b2 = 0.200 mm\/year,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001) and AL\/CR (\u03b2 = 0.028 per year,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001), and the effect of SE on AL remained significant after adjusting for age (\u03b2 = \u22120.239 mm\/D,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001). Anisometropia was relatively common in both eyes of the patients, with | \u0394SE| \u2265 2.0D accounting for 27.7%. In the follow-up subset (34 eyes), the annual growth rate of AL was approximately 0.224 \u00b1 0.264 mm\/year.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Children with high myopia show obvious ocular structural abnormalities and heterogeneous progression. GEE analysis further validated the independent contributions of age and refractive error to axial elongation in this population. AL and AL\/CR can be used as key structural indicators for follow-up; unilateral high myopia or significant binocular asymmetry suggests the need for enhanced individualized myopia monitoring and intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1841384","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T04:36:31Z","timestamp":1779683791000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Interocular asymmetry and ocular biometric patterns in pediatric high myopia: implications for early risk stratification"],"prefix":"10.3389","volume":"13","author":[{"given":"Siqi","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, The Second Affiliated Hospital of Dalian Medical University, Dalian","place":["Liaoning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, The Second Affiliated Hospital of Dalian Medical University, Dalian","place":["Liaoning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaoxing","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, The Second Affiliated Hospital of Dalian Medical University, Dalian","place":["Liaoning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, The Second Affiliated Hospital of Dalian Medical University, Dalian","place":["Liaoning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"39","DOI":"10.55047\/transtool.v1i1.106","article-title":"Increased myopia prevalence in youngsters as a result of online learning.","volume":"1","author":"Tirayoh","year":"2021","journal-title":"Trans Lang Literature Technol Overview Learn."},{"key":"B2","doi-asserted-by":"publisher","first-page":"81","DOI":"10.12688\/f1000research.50880.1","article-title":"Digital screen time during the COVID-19 pandemic: a public health concern.","volume":"10","author":"Sultana","year":"2021","journal-title":"F1000Research."},{"key":"B3","doi-asserted-by":"publisher","first-page":"2635","DOI":"10.1038\/s41433-025-03949-1","article-title":"Current and emerging strategies for myopia control: a narrative review of optical, pharmacological, behavioural, and adjunctive therapies.","volume":"39","author":"Maulvi","year":"2025","journal-title":"Eye."},{"key":"B4","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1111\/opo.13464","article-title":"Myopia is predominantly genetic or predominantly environmental?","volume":"45","author":"Verhoeven","year":"2025","journal-title":"Ophthal Physiol Opt."},{"key":"B5","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1097\/APO.0000000000000489","article-title":"China turns to school reform to control the myopia epidemic: a narrative review.","volume":"11","author":"Morgan","year":"2022","journal-title":"Asia-Pacific J Ophthalmol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1136\/jmg.37.3.227","article-title":"The heritability of high myopia: a reanalysis of Goldschmidt\u2019s data.","volume":"37","author":"Guggenheim","year":"2000","journal-title":"J Med Genet."},{"key":"B7","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1167\/iovs.62.5.3","article-title":"IMI risk factors for myopia.","volume":"62","author":"Morgan","year":"2021","journal-title":"Invest Ophthalmol Vis. Sci."},{"key":"B8","doi-asserted-by":"publisher","first-page":"887","DOI":"10.1001\/jamaophthalmol.2019.1415","article-title":"Association between type of educational system and prevalence and severity of myopia among male adolescents in Israel.","volume":"137","author":"Bez","year":"2019","journal-title":"JAMA Ophthalmol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.1016\/j.ophtha.2016.01.006","article-title":"Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050.","volume":"123","author":"Holden","year":"2016","journal-title":"Ophthalmology."},{"key":"B10","doi-asserted-by":"crossref","DOI":"10.14232\/phd.10963","volume-title":"Multidisciplinary Diagnostic Approach and Surgical Ophthalmologic Therapy for Progressive High Myopia.","author":"Sz\u00e9ll","year":"2021"},{"key":"B11","doi-asserted-by":"publisher","first-page":"CD014758","DOI":"10.1002\/14651858.CD014758.pub2","article-title":"Interventions for myopia control in children: a living systematic review and network meta-analysis.","volume":"2023","author":"Lawrenson","year":"2023","journal-title":"Cochrane Database Syst Rev."},{"key":"B12","doi-asserted-by":"publisher","first-page":"9006","DOI":"10.1038\/s41598-021-88579-9","article-title":"Elongation of the disc-fovea distance and retinal vessel straightening in high myopia in a 10-year follow-up of the Beijing eye study.","volume":"11","author":"Jonas","year":"2021","journal-title":"Sci Rep."},{"key":"B13","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1167\/iovs.64.6.4","article-title":"IMI\u2014The dynamic choroid: new insights, challenges, and potential significance for human myopia.","volume":"64","author":"Ostrin","year":"2023","journal-title":"Invest Ophthalmol Vis. Sci."},{"key":"B14","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1186\/s12967-024-04886-5","article-title":"Clinical and genetic risk factors underlying severe consequence identified in 75 families with unilateral high myopia.","volume":"22","author":"Jiang","year":"2024","journal-title":"J Trans Med."},{"key":"B15","doi-asserted-by":"publisher","first-page":"936","DOI":"10.1038\/eye.2015.53","article-title":"Congenital high myopia and central macular atrophy: a report of 3 families.","volume":"29","author":"Hull","year":"2015","journal-title":"Eye."},{"key":"B16","doi-asserted-by":"publisher","first-page":"2117","DOI":"10.1007\/s40123-023-00716-x","article-title":"Distribution and characteristics of ocular biometric parameters among a chinese population: a hospital-based study.","volume":"12","author":"Chen","year":"2023","journal-title":"Ophthalmol Therapy."},{"key":"B17","doi-asserted-by":"publisher","first-page":"777","DOI":"10.1007\/s10654-019-00512-7","article-title":"Interaction between lifestyle and genetic susceptibility in myopia: the Generation R study.","volume":"34","author":"Enthoven","year":"2019","journal-title":"Eur J Epidemiol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3760\/cma.j.cn115989-20231010-00121","article-title":"Expert consensus on the application of axial length in myopia prevention and control management (2023).","volume":"42","year":"2024","journal-title":"Chin J Exp Ophthalmol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"318","DOI":"10.1186\/s12886-021-02071-6","article-title":"Prevalence of myopia in 3-14-year-old Chinese children: a school-based cross-sectional study in Chengdu[J\/OL].","volume":"21","author":"Wang","year":"2021","journal-title":"BMC Ophthalmol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1025","DOI":"10.1136\/bjo.87.8.1025","article-title":"Unilateral high myopia: optical components, associated factors, and visual outcomes.","volume":"87","author":"Weiss","year":"2003","journal-title":"Br J Ophthalmol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1167\/iovs.64.6.5","article-title":"IMI\u2014Nonpathological human ocular tissue changes with axial myopia.","volume":"64","author":"Jonas","year":"2023","journal-title":"Invest Ophthalmol Vis Sci."},{"key":"B22","doi-asserted-by":"publisher","first-page":"CD004916","DOI":"10.1002\/14651858.CD004916.pub4","article-title":"Interventions to slow progression of myopia in children.","volume":"1","author":"Walline","year":"2020","journal-title":"Cochrane Database Syst Rev."},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.2174\/18743641-v16-e2112241","article-title":"Prevalence of visual disorders among urban palestinian preschool children.","volume":"16","author":"Labadi","year":"2022","journal-title":"Open Ophthalmol J."},{"key":"B24","doi-asserted-by":"publisher","first-page":"127","DOI":"10.4103\/tmj.tmj_2_24","article-title":"Correlation between axial length and choroidal changes in high myopia.","volume":"52","author":"Rady","year":"2024","journal-title":"Tanta Med J."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1841384\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T04:36:39Z","timestamp":1779683799000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1841384\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,25]]},"references-count":24,"alternative-id":["10.3389\/fmed.2026.1841384"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1841384","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,25]]},"article-number":"1841384"}}