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Higher-Order Aberrations in Children and Adolescents of Southwest China

Zhang, Ning, PhD1,2; Liu, Longqian, MD, PhD1*; Yang, Bi, PhD1; Ma, Wei, MM1; Wang, Xue, BSc1; Ye, Wu, MM1; Yang, Xubo, PhD1; Lam, Carly S., Y., PhD, MCOptom, FAAO2

doi: 10.1097/OPX.0000000000001160
Original Investigations

SIGNIFICANCE This study provides a descriptive characterization of higher-order optical aberrations for the eyes of a larger number of Chinese children and adolescents.

PURPOSE To determine the distribution of higher-order aberrations (HOAs) of Han Chinese young subjects with normal vision and their relationship to age.

METHODS Children and adolescents, aged from 3 to 17 years, with normal visual acuity were enrolled, and their wavefront aberrations for a 6-mm pupil were evaluated by the Zywave II aberrometer. Their correlations with age were analyzed, and the 95% statistical reference ranges were computed for each Zernike term.

RESULTS A total of 1634 eyes (287 for preschool-age children, 897 for school-age children, and 450 for adolescents) were analyzed. There was a significant correlation with age and the root mean square (RMS) of total HOAs (r = 0.256, P < .0001), third-order aberrations (r = 0.062, P = .029), fourth-order aberrations (r = 0.197, P < .0001), fifth-order aberrations (r = 0.067, P = .017), and trefoil-like aberrations (r = 0.100, P < .0001) in the myopic group. There were significant differences in RMS values (except coma-like aberrations, χ2 = 4.179, P = .124) as well as the Zernike coefficients among three different age groups. Therefore, the 95% statistical normal reference values were calculated separately for three age groups.

CONCLUSIONS The RMS value of total HOAs, coma-like, trefoil-like, third-order, fourth-order, and fifth-order aberrations are correlated with age, and the RMS values and Zernike coefficients of aberrations were different in different age stages of the subjects. This study described the distribution of HOAs in children and adolescents and established 95% statistical normal values of HOAs for different ages of children and adolescents by analyzing the HOAs in a large number of the Han Chinese clinical population.

1Department of Optometry and Vision Science, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China

2Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong China *

Supplemental Digital Content: The appendix, available at, lists the 95% reference range for Zernike coefficients (μm) for preschool-age children, school-age children, and adolescents. As not all the data belong to normal distribution, the detailed results are listed in the Appendix for reference. For the data that belonged to normal distribution, (−1.96 s, +1.96 s) were used to calculate the 95% normal reference range, which are shown in bold. For data that did not belong to normal distribution, the ranks were calculated and correspond to the 2.5th and 97.5th percentiles for 95%.

Submitted: November 29, 2016

Accepted: October 18, 2017

Funding/Support: This study was supported by the Sichuan Province Scientific Plan Project, China (no. 2015SZ0069).

Conflict of Interest Disclosure: None of the authors have reported a conflict of interest.

Author Contributions and Acknowledgments: Writing — Original Draft: NZ; Writing — Review and Editing: NZ, CL; Conceptualization: LL; Project Administration: LL; Investigation: BY, WM, XW, WY; Methodology: BY, XY; Visualization: CL.

The author would like to thank the optometrist and ophthalmologist in the Department of Ophthalmology of West China Hospital, who gave data collection support for this study, and Dr Kee Chea-su and other colleagues for their suggestions when writing this article.

Supplemental Digital Content: Direct URL links are provided within the text.

© 2018 American Academy of Optometry