Ocular and vision development during childhood: Insights from a large prospective cohort study in Chinese children.

IF 2.8 3区医学 Q1 OPHTHALMOLOGY

Acta Ophthalmologica Pub Date : 2025-07-04 DOI:10.1111/aos.17540

Xiaotong Han, Ling Jin, Ian G Morgan, Shuai Chang, Qianyun Chen, Decai Wang, Shiran Zhang, Xiang Chen, Yabin Qu, Weijia Liu, Mingguang He, Yangfa Zeng

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引用次数: 0

Abstract

Purpose: To document age-related ocular and visual acuity (VA) development during childhood.

Methods: The Zengcheng schOOl Myopia Study is a prospective cohort study which recruited four cohorts of children from Guangzhou, China in 2018: first-year kindergarten (N = 1366, 48.32% girls, mean age: 3.68 [0.35] years, range: 2.51-4.50 years), first-year primary school (N = 1461, 44.15% girls, mean age: 6.80 [0.35] years, range: 6.00-7.75 years), fourth-year primary school (N = 2333, 45.86% girls, mean age: 9.55 [0.41] years, range: 8.50-10.84 years) and first-year junior high school (N = 1193, 45.43% girls, mean age: 12.60 [0.40] years, range: 11.15-13.57 years). Cycloplegic autorefraction (KR8800), ocular biometry (IOLMaster 700) and VA (ETDRS chart) measurements were conducted at baseline and annually afterwards.

Results: From 2018 to 2023, 4016 children (mean age: 7.51 [2.73] years, 41.81% girls) remained non-myopic and were included in the analysis. Both uncorrected and best-corrected VA improved rapidly and typically achieved adult level (nearly 20/20) around age 7, with minimal difference in-between. Best-corrected VA of 20/20 was attainable as early as age 4 across a spherical equivalent (SE) range of -0.375 to 4.825 D, indicating VA development largely independent of SE changes. Mean SE showed a gradual myopic shift, from 1.375 D in 3-year-olds to 0.375 D in the 15-year-olds, with notable inflection points at ages 7 (around 1.25 D) and 11 (around 0.75 D). Lens power consistently decreased. Axial length (AL) increased steadily with marked deceleration around age 11. AL increases were significantly associated with height increases (p < 0.001) before age 11 but not afterwards.

Conclusion: We observed asynchronous development of VA, SE and ocular biometrics. Best-corrected VA develops mainly due to maturation of retinal circuits, even under conditions that lead to marked changes in the development of refractive errors.

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儿童时期的眼部和视力发育：来自中国儿童的大型前瞻性队列研究的见解。

目的：记录儿童时期与年龄相关的眼和视力（VA）发育。方法：增城学校近视研究是一项前瞻性队列研究，于2018年在中国广州招募了四组儿童：幼儿园一年级（N = 1366，女孩48.32%，平均年龄：3.68[0.35]岁，范围：2.51-4.50岁）、小学一年级（N = 1461，女孩44.15%，平均年龄：6.80[0.35]岁，范围：6.00-7.75岁）、小学四年级(N = 2333，女孩45.86%，平均年龄：9.55[0.41]岁，范围：初中一年级（N = 1193，女生占45.43%，平均年龄12.60[0.40]岁，范围11.15 ~ 13.57岁）。在基线和之后每年进行睫状体麻痹性自屈光（KR8800）、眼生物测量（IOLMaster 700）和VA （ETDRS图）测量。结果：2018 - 2023年，4016名儿童（平均年龄7.51[2.73]岁，其中41.81%为女孩）未近视纳入分析。未矫正和最佳矫正的VA都迅速改善，通常在7岁左右达到成人水平（接近20/20），两者之间的差异很小。在球面等效（SE）范围为-0.375至4.825 D时，早在4岁时就可以达到20/20的最佳校正VA，这表明VA的发展在很大程度上与SE的变化无关。平均SE表现出逐渐的近视转变，从3岁的1.375 D到15岁的0.375 D，在7岁（约1.25 D）和11岁（约0.75 D）有显著的拐点。镜头功率持续下降。轴向长度（AL）在11岁左右稳定增长，并有明显的减速。AL的增加与身高的增加有显著的相关性(p)。结论：我们观察到VA、SE和眼生物特征的非同步发展。即使在导致屈光不正发展发生显著变化的条件下，最佳矫正的视差的发展主要是由于视网膜回路的成熟。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Ophthalmologica 医学-眼科学

CiteScore

7.60

自引率

5.90%

发文量

433

审稿时长

6 months

期刊介绍： Acta Ophthalmologica is published on behalf of the Acta Ophthalmologica Scandinavica Foundation and is the official scientific publication of the following societies: The Danish Ophthalmological Society, The Finnish Ophthalmological Society, The Icelandic Ophthalmological Society, The Norwegian Ophthalmological Society and The Swedish Ophthalmological Society, and also the European Association for Vision and Eye Research (EVER). Acta Ophthalmologica publishes clinical and experimental original articles, reviews, editorials, educational photo essays (Diagnosis and Therapy in Ophthalmology), case reports and case series, letters to the editor and doctoral theses.