Bullimore Mark A, Cheng Xu, Brennan Noel A
University of Houston, College of Optometry, Houston, Texas.
Johnson & Johnson, Jacksonville, Florida.
Optom Vis Sci. 2025 May 1;102(5):299-306. doi: 10.1097/OPX.0000000000002252. Epub 2025 Apr 15.
Pediatric growth charts are widely used to track height and weight. Recently, axial length growth charts have been developed. Unfortunately, they underestimate the rate of normal myopic eye growth, making it challenging to evaluate the benefits of myopia control interventions, due to the conflation of myopes and nonmyopes.
The aim is to assess the value of axial length centile curves in the management of childhood myopia.
Papers reporting centile curves were identified by searching PubMed. For comparison, axial length values for a representative selection of baseline values (21 to 24 mm at 6 years) were calculated as a function of age and ethnicity using published meta-analyses of myopic and emmetropic eye growth data.
Six published centile curves, largely based on cross-sectional data, were identified: three from European populations, two from China, and one from India. The trajectory of the emmetropic eye growth model generally tracks the European and Indian centile curves at lower centiles. This is not the case for the Chinese centile curves, likely due to the significant numbers of myopic children even at lower centiles. In contrast, the trajectory of the myopic eye growth model is steeper than that of the centile curves, even at higher centiles. This suggests that the higher centiles contain substantial numbers of nonmyopic children. Only in the centile curves for Chinese children, who have a higher prevalence of myopia, do they approach myopic eye growth, and then only for older children and at higher centiles.
Centile curves do not accurately represent myopic eye growth, are not the best tool to monitor myopia progression and treatment, do not accurately represent growth in incident myopes, and are not the best way to predict myopia onset. Separate centile curves for myopic eyes do not alleviate the problem because of incident myopia. Annualized growth models may provide a better approach to assessing axial elongation relative to population norms.
儿科生长图表被广泛用于追踪身高和体重。最近，眼轴长度生长图表已被开发出来。不幸的是，由于近视和非近视儿童的混淆，它们低估了正常近视眼的生长速度，这使得评估近视控制干预措施的益处具有挑战性。
目的是评估眼轴长度百分位曲线在儿童近视管理中的价值。
通过检索PubMed确定报告百分位曲线的论文。为了进行比较，使用已发表的近视和正视眼生长数据的荟萃分析，计算了具有代表性的基线值（6岁时为21至24毫米）的眼轴长度值作为年龄和种族的函数。
确定了六条主要基于横断面数据的已发表百分位曲线：三条来自欧洲人群，两条来自中国，一条来自印度。正视眼生长模型的轨迹通常在较低百分位数时追踪欧洲和印度的百分位曲线。中国的百分位曲线并非如此，这可能是因为即使在较低百分位数时也有大量近视儿童。相比之下，近视眼生长模型的轨迹比百分位曲线更陡，即使在较高百分位数时也是如此。这表明较高百分位数包含大量非近视儿童。只有在近视患病率较高的中国儿童的百分位曲线中，它们才接近近视眼的生长，而且仅适用于年龄较大的儿童和较高百分位数。
百分位曲线不能准确代表近视眼的生长，不是监测近视进展和治疗的最佳工具，不能准确代表初发性近视的生长，也不是预测近视发病的最佳方法。由于初发性近视，单独的近视眼百分位曲线并不能缓解问题。相对于人群规范，年化生长模型可能为评估眼轴伸长提供更好的方法。
