Reference curves for refraction in a German cohort of healthy children and adolescents.

Carolin Truckenbrod,Manuela Brandt,Wieland Kiess,Anne Jurkutat,Christof Meigen,Siegfried Wahl,Mandy Vogel,Hidenaga Kobashi

doi:10.1371/journal.pone.0230291

Carolin Truckenbrod, Manuela Brandt + Show 6 more

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https://doi.org/10.1371/journal.pone.0230291

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Abstract

PurposePercentile curves of refractive development for German children were generated. We hypothesize that refraction in children in central Europe might differ from data in central Asia.MethodsNon-cycloplegic refraction was measured using the ZEISS i.Profiler plus (Carl Zeiss Vision GmbH, Germany) in 1999 children, of which were 1046 male and 953 female, aged 3 to 18 years. Reference curves were calculated with the R-package GAMLSS as continuous function of age.ResultsThere were only little differences for all centiles between the genders at 3 years and a general trend towards more myopia with increasing age. For the 97th centile and the 3rd centile, girls showed higher myopia/ less hyperopia than boys. Between the age of 3 and 18, the median refraction became -0.68 D and -0.74 D more myopic for boys and girls, respectively. At the same time, the 97th centile for boys changed +0.29 D towards hyperopia and in girls -0.52 D towards myopia. A general myopic trend was seen in the 3rd centile, which was -2.46 D for boys and -2.98 D for girls. For both genders, the median became less than zero at the age of 10 years but did not become myopic (less than -0.5 D) up to the age of 18.ConclusionOur analysis presents the first reference curve for refraction in central Europe. In comparison to data from China and Korea, there is only little difference at the age of 5 years in all centiles which then increases continuously. For all ethnicities, a trend towards myopia with increasing age could be observed, but myopia progression is much higher in China and Korea than in Germany. The most marked differences can be seen in the lower centiles. Further investigations should clarify whether commencement of preschool activities with prolonged near-work initiates the divergence in refractive development.

Highlights

Reference centile curves are commonly used in paediatric practice in order to estimate body height and weight development
Our analysis presents the first reference curve for refraction in central Europe
A trend towards myopia with increasing age could be observed, but myopia progression is much higher in China and Korea than in Germany

Summary

Introduction

Reference centile curves are commonly used in paediatric practice in order to estimate body height and weight development. They are used as a screening tool to assess the development and well-being of children [1,2]. Chen et al have introduced the use of reference curves for refractive development in order to identify children at risk for high myopia [3]. Once children at risk to develop high myopia are identified, a treatment to slow down myopia progression can be commenced, like the use of atropine eyedrops, Orthokeratology or contact lenses for myopia treatment [4]. Children with risk for high myopia can be treated with atropine, orthokeratology or special contact lenses. The use of centile curves is interesting for any population

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