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Sonia Afsari, Kathryn A. Rose, Amy Pai, Jody Leone, Paul Mitchell; Refractive Error in Preschool-Aged Children: Sydney Paediatric Eye Disease Study (SPEDS). Invest. Ophthalmol. Vis. Sci. 2012;53(14):6762.
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To report the age and ethnic specific distributions of refractive error in European Caucasian (EC) and East-Asian (EA) children using cumulative probability distributions (CPD) to describe percentage cut-offs for myopia and hyperopia and prevalence of myopia and hyperopia using AAPOS Vision Screening Committee standards.
SPEDS is a large population-based study of preschool children that examined (2473) children aged 6 months to 6 years. Comprehensive eye examinations were performed on each child, including cycloplegic refraction, following 2 drops of cyclopentolate 1.0%, 5 mins apart (0.5% for children aged 12 months), using auto-refraction (Canon RK-F1 or Retinomax) or by retinoscopy. Refractive status was classified by spherical equivalent (SE) of the right eye. Ethnicity was ascertained by questionnaire and assigned when both parents were of the one ethnicity.
2176 children completed cycloplegic refraction and were included in this report. 1013(41%)were EC and 444(18%) were EA origin. Using CPD ≤5%, EC children had myopic refractions of 0.13,-0.25,-0.13,0.32,0.38,0.13D, in each of the respective age groups of 6-11, 12-23, 24-35, 36-47, 48-59, 60-72months. ≥95% of EC children in each of the respective age groups had a hyperopic refraction of 4.38,2.5,3.38,3.00,2.88,3.19D. In EC children, refractive distributions were statistically different at ages 6-11 and 36-59months from the reference age group 12-23months(p=,0.0018, 0.0421 respectively). Mean refraction by age in EA children were all significantly different. The distribution of refractive error in EC children had a mean of 1.46D(95%CI 0.99-1.96, kurtosis 17.8) and in EA 1.02D(95%CI 0.36-1.52, kurtosis 8.6) Using AAPOS criteria 4.2% of EC were hyperopic, 3.6% were myopic; while EA were 1.4% hyperopic and 5.7% myopic.
Cut-off’s using a large population based study of preschool-aged children have been defined for myopia and hyperopia which could potentially aid in referral criteria and screening settings. Important ethnic and age-variations in prevalence’s and distribution of refractive error compared to other population-based studies have been found.
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