Chen Yanxian, Ding Xiaohu, Xiong Ruilin, Zhang Jian, Song Fan, Zhao Ziwei, Lai Mengying, Zeng Yangfa, He Mingguang
School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR.
Research Centre for SHARP Vision (RCSV), The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR.
PLoS One. 2025 Jan 24;20(1):e0317756. doi: 10.1371/journal.pone.0317756. eCollection 2025.
To investigate the pattern and threshold of physiological growth, defining as axial length (AL) elongation that results in little refraction progression, among Chinese children and teenagers, a total of 916 children aged between 7 and 18 years from a 6-year longitudinal cohort study were included for analysis. Ocular biometry, cycloplegic refraction and demographic data were obtained annually. Physiological growth was calculated based on myopic progression and Gullstrand eye model, respectively. The annual change in AL was found to be significantly smaller in the persistent emmetropia (PE) group compared to the incident myopia (IM) and persistent myopia (PM) group at all ages (all P < 0.05). In children with non-progressive myopia, there was observed axial elongation ranging from 0.17 to 0.23 mm/year between the ages of 9 and 12. This growth rate persisted at approximately 0.10 mm/year beyond the age of 12. While the compensated AL growth calculated using Gullstrand model was only 0.02 to 0.15 mm/year at age of 9-12, and decreased to around 0 mm/year after age of 12. For children aged 7-9 years, the cutoff point for AL growth to distinguish between progressive myopia and non-progressive myopia was 0.19 mm/year. These findings indicate a notable disparity between the thresholds of physiological growth calculated using myopic progression and Gullstrand eye model. This observation suggests that when formulating effective myopia control strategies, consideration should be given to different calculation methods when applying physiological AL growth as a starting point or target.
为了研究中国儿童和青少年生理性生长的模式和阈值（定义为导致屈光度进展较小的眼轴长度（AL）伸长），我们纳入了一项为期6年的纵向队列研究中的916名7至18岁儿童进行分析。每年获取眼部生物测量、睫状肌麻痹验光和人口统计学数据。分别基于近视进展和Gullstrand眼模型计算生理性生长。结果发现，在所有年龄段，持续性正视（PE）组的AL年变化均显著小于新发近视（IM）和持续性近视（PM）组（所有P < 0.05）。在近视无进展的儿童中，9至12岁期间观察到眼轴伸长范围为0.17至0.23 mm/年。12岁以后，这种生长速率维持在约0.10 mm/年。而使用Gullstrand模型计算的代偿性AL生长在9至12岁时仅为0.02至0.15 mm/年，12岁以后降至约0 mm/年。对于7至9岁的儿童，区分进展性近视和非进展性近视的AL生长截断点为0.19 mm/年。这些发现表明，使用近视进展和Gullstrand眼模型计算的生理性生长阈值之间存在显著差异。这一观察结果表明，在制定有效的近视控制策略时，以生理性AL生长作为起点或目标时，应考虑不同的计算方法。
