Abstract
Associations between corneal biomechanics, axial elongation and myopia are important but previous results are conflicting. Our population-based study aimed to investigate factors associated with corneal biomechanics, and their relationships with myopia in children and adults. Data from 3643 children and 1994 parents showed that children had smaller deformation amplitudes (DA) than parents (p < 0.001). A larger DA was significantly associated with elongated axial length (AL; children: ß = 0.011; adults: ß = 0.0013), higher corneal curvature (children: ß = 0.0086; adults: ß = 0.0096), older age (children: ß = 0.010; adults: ß = 0.0013), and lower intraocular pressure (IOP; children: ß = −0.029; adults: ß = −0.031) in both cohorts. The coefficient of age for DA in children was larger than in adults (p < 0.001), indicating that the DA change with age in children is faster than in adults. DA was significantly associated with spherical equivalent (p < 0.001) resulting from its correlation with AL and corneal curvature. In conclusion, the cornea is more deformable in adults than in children, whereas corneal deformation amplitude increases faster with age in children than that in adults, along with AL elongation. Longer AL, steeper corneal curvature, older age and smaller IOP correspond to a more deformable cornea. The association between corneal deformation amplitude and refraction was mediated via AL and corneal curvature.
Highlights
Myopia is the most common ocular disorder worldwide, affecting as many as 90% of high school students in East Asia [1,2,3,4] Its prevalence in young adults is up to 80% in Korean military conscripts [5] and 70% in medical students in China [6] It is predicted that nearly half of the world’s population will be myopic by 2050, with as much as 10% being highly myopic [7,8] Understanding the pathogenesis of myopia development should help in finding preventive measures or remedies
[11] In a Singaporean-children-based study, the Corneal hysteresis (CH) and corneal resistance factor (CRF) have no association with refractive error and axial length (AL) [13] While a lower CH was associated with a higher degree of myopia [12] results of corneal biomechanics studies of Ocular response analyzer (ORA) were inconsistent in these associations [14]
We examined the determinants of corneal biomechanics including deformation amplitudes (DA), A1L, A2L, A1V, A2V, peak distance (PD) and radius of curvature (RC), separately, for the child and parent cohorts, using univariate and multiple linear regression models
Summary
Myopia is the most common ocular disorder worldwide, affecting as many as 90% of high school students in East Asia [1,2,3,4] Its prevalence in young adults is up to 80% in Korean military conscripts [5] and 70% in medical students in China [6] It is predicted that nearly half of the world’s population will be myopic by 2050, with as much as 10% being highly myopic [7,8] Understanding the pathogenesis of myopia development should help in finding preventive measures or remedies. Progressive axial elongation results in a higher risk for vision-threatening complications, including glaucoma, retinal detachment, choroidal neovascularization, and myopic foveoschisis [1,2,3,9] This may be attributed to the eyeball’s biomechanical properties, that is, a more deformable eyeball leading to a larger axial elongation. Establishing this association is crucial and may shed the light on eyeball biomechanics as a parameter for myopia control and prevention of high myopia complications. We conducted a population-based study of two Chinese cohorts: a child cohort, aged 6–8 years, and their parents, aged 25–70 years, with the following aims: (1) to describe the difference of corneal biomechanics properties, and their determinants in the two cohorts and (2) to fully evaluate the association between corneal biomechanics and myopia
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