Abstract
Although the underlying mechanism of macular curvature remains unclear, it has been linked to various ocular diseases. However, changes in macular curvature during growth have not been thoroughly investigated. This study aimed to investigate macular curvature in children of different ages and its association with axial length. A total of 122 right eyes of healthy elementary school students (Group E; 8-9 years old; 61 males and 61 females) and 173 right eyes of healthy junior high school students (Group J; 12-13 years old; 83 males and 90 females) were included. Axial length, color fundus photographs, and optical coherence tomographic vertical cross-sectional images of the macula were obtained and used for analysis. The macular curvature was plotted as the retinal pigment epithelium and fitted to a second-degree polynomial equation using ImageJ software, to calculate the macular curvature. The Mann-Whitney U test compared macular curvature and axial length between the E and J Groups. The association between the macular curvature and axial length was determined using Spearman's correlation analysis. Group J's axial length and macular curvature were significantly greater than Group E's (p < 0.001). Macular curvature was significantly positively correlated with axial length in Group J (r = 0.40, P < 0.001) but not in Group E (r = 0.08, P = 0.40). These findings suggest a possible increase in macular steepness during this period. Further longitudinal cohort studies are needed to confirm these results.