Role of corneal radius of curvature in early identification of fundus tessellation in children with low myopia

Aim To assess the role of the corneal radius of curvature (CR) in the identification of fundus tessellation in children with low myopia. Methods In the cross-sectional study, students aged 9-12 years from 24 primary schools in Shanghai were enrolled by cluster sampling. Participants underwent measurements including cycloplegic refraction and axial length. Fundus images and choroidal thickness were obtained by swept-source optical coherence tomography. Fundus tessellation was classified into four grades according to fundus photographs. Results A total of 1127 children with low myopia (spherical equivalence (SE) >-3.00 dioptre (D) but <=-0.50 D) were included, with a mean age of 10.29 +/- 0.60 years and a mean SE of -1.44 +/- 0.69 D. Fundus tessellation was found in 591 (52.4%) cases (grade 1: 428, 38.0%; grade 2: 128, 11.4%; grade 3: 35, 3.1%). Choroidal thickness decreased as fundus tessellation grade increased (p trend <0.001). According to regression analysis, higher fundus tessellation grade was independently associated with larger CR (OR, 7.499; 95% CI 2.279 to 24.675, p=0.001). For those with CR >7.9 mm, along with CR, degree and proportion of fundus tessellation increased sharply. Conclusion Fundus tessellation existed in more than half of children with low myopia. Preliminary fundus photography conducted in children with low myopia with large CR would be necessary and beneficial to the early management of myopic fundus changes.