Centile curves of refraction in children and adolescents aged 5–18 in Hubei Province:a study based on GAMLSS to predict refraction developmentOA

●AIM:To establish percentile curves of refractive development for children and adolescents aged 5–18y in Hubei Province.●METHODS:A cross-sectional study was conducted in 103 county-level administrative districts of Hubei Province via a multistage stratified cluster sampling strategy.Participants underwent non-cycloplegic autorefraction,and spherical equivalent refraction(SER)of the right eye was calculated.Generalized additive models for location,scale,and shape(GAMLSS)were applied to construct age-specific standard SER percentile curves stratified by gender and region.Moreover,age-related curves of annual refractive progression rate at each percentile were plotted.●RESULTS:A total of 1255454 participants(673341 boys and 582113 girls)aged 5–18y(mean age:11.13±3.59y)were enrolled.An overall myopic shift trend was observed with advancing age.The median SER was+0.25 diopters(D)at 5 years of age and decreased to-0.50 D at 9 years of age.From 5 to 18 years of age,the refractive progression was-6.63 D at the 3rd percentile,while the values were-3.25 D and-1.00 D at the 50th and 97th percentiles,respectively.Girls and rural children presented higher myopic degrees.The annual age-dependent refractive progression rate curve showed a U-shaped pattern,with greater annual refractive changes in lower percentiles and peak refractive progression occurring at younger ages.●CONCLUSION:Children in lower SER percentiles suffer from more severe myopia and faster refractive progression.Therefore,earlier and targeted intensive myopia interventions are warranted for children with SER below the 50th percentile.