Expert consensus on the application of axial length in myopia prevention and control management (2023)

The current measurement method of axial length (AL) is non-invasive and convenient, with objective and stable results.Unlike refractive diopter, which is influenced by the eye accommodation, the measurement of AL is not affected.Therefore, AL has gradually received attention and application in myopia prevention and control in recent years, and has become an important evaluation index for myopia management in children and adolescents.However, there is currently a lack of AL reference values that comprehensively reflect the refractive status or progression of children and adolescents aged 3-18 years in China, as well as operational standards for AL measurement and measurement equipment evaluation, posing great challenges to the determination of myopia screening results, the accurate establishment of refractive profiles, the observation of longitudinal trend of refractive status, and the comparability of measurement data of children and adolescents.In order to promote and standardize the rational application of existing AL data of children and adolescents in China, as well as the measurement and recording of AL data, the Expert consensus on the application of axial length in myopia prevention and control management (2023) expert workgroup extensively solicited and collected the main issues related to AL evaluation in myopia screening and clinical practice in children and adolescents in China, and conducted analysis and summary.The expert workgroup conducted research and discussion on seven scientific contents, including the definition and measurement requirements of AL and related parameters in children and adolescents in China, the growth and development characteristics of the population, the application in cross-sectional screening of populations, the application in dynamic management of refraction, the conversion relationship between AL changes and refractive diopter changes, the predictive effect of AL combined with other parameters on myopia, and the accuracy evaluation of AL measurement instruments.Based on the summary and analysis of important literature at home and abroad and combined with the specific practices in China, the Expert consensus on the application of axial length in myopia prevention and control management (2023) was formulated to provide relatively standardized expert recommendations for public health, clinical physicians, and related practitioners in the specific working practices and operational processes.Meanwhile, the consensus aims to provide guidance for relevant policy managers to formulate programs about myopia prevention and control in China and implement public health prevention, early myopia warning and risk assessment, as well as clinical control of myopia, to promote the precision of stratified and classified management of myopia and improve the effectiveness of prevention and control of myopia onset and progression.