Purpose

To better understand juvenile myopia in the context of overall refractive development during childhood and to suggest more informative ways of analysing relevant data, particularly in relation to early identification of those children who are likely to become markedly myopic and would therefore benefit from myopia control.

Methods

Examples of the frequency distributions of childhood mean spherical refractive errors (MSEs) at different ages, taken from previously-published longitudinal and cross-sectional studies, are analysed in terms of Flitcroft’s model of a linear combination of two Gaussian distributions with different means and standard deviations. Flitcroft hypothesises that one, relatively-narrow, Gaussian (Mode 1) represents a “regulated” population which maintains normal emmetropisation and the other, broader, Gaussian (Mode 2) a “dysregulated” population.

Results

Analysis confirms that Flitcroft’s model successfully describes the major features of the frequency distribution of MSEs in randomly-selected populations of children of the same age. The narrow “regulated” Gaussian typically changes only slightly between the ages of about 6 and 15, whereas the mean of the broader “dysregulated” Gaussian changes with age more rapidly in the myopic direction and its standard deviation increases. These effects vary with the ethnicity, environment and other characteristics of the population involved. At all ages there is considerable overlap between the two Gaussians. This limits the utility of simple refractive cut-off values to identify those children likely to show marked myopic progression.

Conclusions

Analysing the frequency distributions for individual MSEs in terms of bi-Gaussian models can provide useful insights into childhood refractive change. A wider exploration of the methodology and its extension to include individual progression rates is warranted, using a range of populations of children exposed to different ethnic, environmental and other factors.

中文翻译：

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Flitcroft 的儿童屈光发育模型以及可能识别出有严重近视风险的儿童

目的

为了更好地了解儿童期整体屈光发育背景下的青少年近视，并提出分析相关数据的更多信息方法，特别是在早期识别那些可能变得明显近视并因此将从近视控制中受益的儿童方面。

方法

不同年龄的儿童平均球面屈光不正 (MSE) 的频率分布示例，取自先前发表的纵向和横断面研究，根据 Flitcroft 的模型进行分析，该模型是两个具有不同均值和标准的高斯分布的线性组合偏差。Flitcroft 假设一个相对窄的高斯（模式 1）代表一个“调节”的群体，它保持正常的正视化，而另一个更广泛的高斯（模式 2）代表一个“失调”的群体。

结果

分析证实，Flitcroft 的模型成功地描述了随机选择的同龄儿童群体中 MSE 频率分布的主要特征。狭窄的“调节”高斯通常在大约 6 到 15 岁之间仅发生轻微变化，而更广泛的“失调”高斯的平均值随着年龄的增长在近视方向上变化得更快，并且其标准差增加。这些影响因所涉人口的种族、环境和其他特征而异。在所有年龄段，这两个高斯人之间都有相当大的重叠。这限制了使用简单的屈光截止值来识别那些可能表现出明显近视进展的儿童的效用。

结论

根据双高斯模型分析单个 MSE 的频率分布可以为儿童屈光变化提供有用的见解。有必要使用一系列暴露于不同种族、环境和其他因素的儿童群体，对该方法及其扩展到包括个人进展率进行更广泛的探索。