{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:23:26Z","timestamp":1787027006199,"version":"build-2736575974"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T00:00:00Z","timestamp":1736121600000},"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. Ophthalmol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      The pathophysiologic mechanisms underlying early-onset myopia remain unclear; in this study, we investigate the pathogenesis by examining the interrelationships between axial length to corneal curvature radius ratio (\n                      <jats:inline-formula>\n                        <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" display=\"inline\" id=\"im1\">\n                          <mml:mrow>\n                            <mml:mtext>AL<\/mml:mtext>\n                            <mml:mo stretchy=\"false\">\/<\/mml:mo>\n                            <mml:mtext>CR<\/mml:mtext>\n                          <\/mml:mrow>\n                        <\/mml:math>\n                      <\/jats:inline-formula>\n                      ) and choroidal blood flow.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This cross-sectional study included 202 eyes from myopic children, categorized into 141 eyes with mild myopia, 47 eyes with moderate myopia, and 14 eyes with high myopia. Optical coherence tomography angiography (OCTA) was used to measure choroidal blood flow perfusion within a 6\u00a0mm \u00d7 6\u00a0mm area of the macular region, divided into nine subareas based on ETDRS partitioning: macular fovea, nasal side 1, superior 1, temporal side 1, inferior 1, nasal side 2, superior 2, temporal side 2, and inferior 2. Data on corneal curvature and ocular axial length were collected to calculate the\n                      <jats:inline-formula>\n                        <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" display=\"inline\" id=\"im2\">\n                          <mml:mrow>\n                            <mml:mtext>AL<\/mml:mtext>\n                            <mml:mo stretchy=\"false\">\/<\/mml:mo>\n                            <mml:mtext>CR<\/mml:mtext>\n                          <\/mml:mrow>\n                        <\/mml:math>\n                      <\/jats:inline-formula>\n                      , with equivalent spherical lens power, gender, and age gathered for group comparisons, and the correlation between AL\/CR and choroidal blood flow perfusion volume was analyzed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      <jats:inline-formula>\n                        <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" display=\"inline\" id=\"im3\">\n                          <mml:mrow>\n                            <mml:mtext>AL<\/mml:mtext>\n                            <mml:mo stretchy=\"false\">\/<\/mml:mo>\n                            <mml:mtext>CR<\/mml:mtext>\n                          <\/mml:mrow>\n                        <\/mml:math>\n                      <\/jats:inline-formula>\n                      was significantly negatively correlated with choroidal blood flow perfusion (\n                      <jats:inline-formula>\n                        <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" display=\"inline\" id=\"im4\">\n                          <mml:mrow>\n                            <mml:mtext>P<\/mml:mtext>\n                            <mml:mi>&lt;<\/mml:mi>\n                            <mml:mn>0.001<\/mml:mn>\n                          <\/mml:mrow>\n                        <\/mml:math>\n                      <\/jats:inline-formula>\n                      ). Linear regression and mediation analyses indicated that for each unit increase in choroidal blood perfusion volume in nasal region 1,\n                      <jats:inline-formula>\n                        <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" display=\"inline\" id=\"im5\">\n                          <mml:mrow>\n                            <mml:mtext>AL<\/mml:mtext>\n                            <mml:mo stretchy=\"false\">\/<\/mml:mo>\n                            <mml:mtext>CR<\/mml:mtext>\n                          <\/mml:mrow>\n                        <\/mml:math>\n                      <\/jats:inline-formula>\n                      decreased by an average of 0.421 units. This relationship is mediated by several factors, with axial length serving as a key mediator.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      <jats:inline-formula>\n                        <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" display=\"inline\" id=\"im6\">\n                          <mml:mrow>\n                            <mml:mtext>AL<\/mml:mtext>\n                            <mml:mo stretchy=\"false\">\/<\/mml:mo>\n                            <mml:mtext>CR<\/mml:mtext>\n                          <\/mml:mrow>\n                        <\/mml:math>\n                      <\/jats:inline-formula>\n                      correlates with choroidal blood flow perfusion, indicating a link between refractive biological parameters and ocular blood circulation. Myopia is an ischemic eye condition that warrants attention to fundus microcirculation changes in myopic children.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fopht.2024.1540410","type":"journal-article","created":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T02:05:01Z","timestamp":1736129101000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Axial length to corneal curvature radius ratio is negatively correlated with choroidal blood flow in myopic children"],"prefix":"10.3389","volume":"4","author":[{"given":"Yurong","family":"Ye","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zizhong","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Su","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yeyu","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songtao","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.1047787","article-title":"Global trends and frontiers of research on pathologic myopia since the millennium: A bibliometric analysis","volume":"10","author":"Yang","year":"2022","journal-title":"Front Public Health"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.cn112142-20230802-00020","article-title":"Geographic environment-related research advances on children's myopia: intraocular and environmental exposure factors and analytical methods","volume":"60","author":"Cui","year":"2024","journal-title":"Zhonghua Yan Ke Za Zhi"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1136\/bjo-2024-325427","article-title":"Global prevalence, trend and projection of myopia in children and adolescents from 1990 to 2050: a comprehensive systematic review and meta-analysis","volume":"24","author":"Liang","year":"2024","journal-title":"Br J Ophthalmol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1167\/iovs.61.4.49","article-title":"The complications of myopia: A review and meta-analysis","volume":"61","author":"Haarman","year":"2020","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2021.3303","article-title":"Continued increase of axial length and its risk factors in adults with high myopia","volume":"139","author":"Du","year":"2021","journal-title":"JAMA Ophthalmol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1111\/opo.12812","article-title":"Axial length targets for myopia control","volume":"41","author":"Chamberlain","year":"2021","journal-title":"Ophthalmic Physiol Opt"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1097\/00006324-198809000-00001","article-title":"High axial length\/corneal radius ratio as a risk factor in the development of myopia","volume":"65","author":"Grosvenor","year":"1988","journal-title":"Am J Optom Physiol Opt"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1136\/bjophthalmol-2021-319431","article-title":"Normative data and percentile curves for axial length and axial length\/corneal curvature in Chinese children and adolescents aged 4-18 years","volume":"107","author":"He","year":"2023","journal-title":"Br J Ophthalmol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.901480","article-title":"Prevalence of myopia and its associated factors among Japanese preschool children","volume":"10","author":"Matsumura","year":"2022","journal-title":"Front Public Health"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1111\/aos.14773","article-title":"The influence of the choroid on the onset and development of myopia: from perspectives of choroidal thickness and blood flow","volume":"99","author":"Liu","year":"2021","journal-title":"Acta Ophthalmol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13102777","article-title":"Myopia is an ischemic eye condition: A review from the perspective of choroidal blood flow","volume":"13","author":"Baksh","year":"2024","journal-title":"J Clin Med"},{"key":"B12","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1167\/iovs.62.15.30","article-title":"Decreased choroidal blood perfusion induces myopia in Guinea pigs","volume":"62","author":"Zhou","year":"2021","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"B13","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1167\/iovs.61.13.25","article-title":"Increased choroidal blood perfusion can inhibit form deprivation myopia in Guinea pigs","volume":"61","author":"Zhou","year":"2020","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.preteyeres.2017.11.003","article-title":"Optical coherence tomography angiography","volume":"64","author":"Spaide","year":"2018","journal-title":"Prog Retin Eye Res"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1159\/000531877","article-title":"Myopic vascular changes revealed by optical tomography angiography and their association with myopic fundus manifestations","volume":"66","author":"Xu","year":"2023","journal-title":"Ophthalmic Res"},{"key":"B16","doi-asserted-by":"publisher","first-page":"22190","DOI":"10.1038\/s41598-022-26598-w","article-title":"The age-related pattern of inner retinal thickening is affected by myopia development and progression","volume":"12","author":"Ablordeppey","year":"2022","journal-title":"Sci Rep"},{"key":"B17","doi-asserted-by":"publisher","first-page":"107850","DOI":"10.1016\/j.exer.2019.107850","article-title":"Daily axial length and choroidal thickness variations in young adults: Associations with light exposure and longitudinal axial length and choroid changes","volume":"189","author":"Ulaganathan","year":"2019","journal-title":"Exp Eye Res"},{"key":"B18","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1167\/iovs.65.10.7","article-title":"Choroidal vascularity and axial length elongation in highly myopic children: A 2-year longitudinal investigation","volume":"65","author":"Xuan","year":"2024","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0301844","article-title":"Ciliary muscles contraction leads to axial length extension\u2013The possible initiating factor for myopia","volume":"19","author":"Meng","year":"2024","journal-title":"PloS One"},{"key":"B20","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1167\/iovs.63.6.24","article-title":"Ciliary muscle dimension changes with accommodation vary in myopia and emmetropia","volume":"63","author":"Kaphle","year":"2022","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2022.916323","article-title":"Compartmental analysis of three-dimensional choroidal vascularity and thickness of myopic eyes in young adults using SS-OCTA","volume":"13","author":"Luo","year":"2022","journal-title":"Front Physiol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0047237","article-title":"Parapapillary atrophy: histological gamma zone and delta zone","volume":"7","author":"Jonas","year":"2012","journal-title":"PloS One"}],"container-title":["Frontiers in Ophthalmology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fopht.2024.1540410\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T02:05:03Z","timestamp":1736129103000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fopht.2024.1540410\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,6]]},"references-count":22,"alternative-id":["10.3389\/fopht.2024.1540410"],"URL":"https:\/\/doi.org\/10.3389\/fopht.2024.1540410","relation":{},"ISSN":["2674-0826"],"issn-type":[{"value":"2674-0826","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,6]]},"article-number":"1540410"}}