{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:21:17Z","timestamp":1784938877306,"version":"3.55.0"},"reference-count":15,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T00:00:00Z","timestamp":1751587200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T00:00:00Z","timestamp":1751587200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82101171"],"award-info":[{"award-number":["82101171"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To document age\u2010related ocular and visual acuity (VA) development during childhood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The Zengcheng schOOl Myopia Study is a prospective cohort study which recruited four cohorts of children from Guangzhou, China in 2018: first\u2010year kindergarten (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u20091366, 48.32% girls, mean age: 3.68 [0.35] years, range: 2.51\u20134.50\u2009years), first\u2010year primary school (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u20091461, 44.15% girls, mean age: 6.80 [0.35] years, range: 6.00\u20137.75\u2009years), fourth\u2010year primary school (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u20092333, 45.86% girls, mean age: 9.55 [0.41] years, range: 8.50\u201310.84\u2009years) and first\u2010year junior high school (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u20091193, 45.43% girls, mean age: 12.60 [0.40] years, range: 11.15\u201313.57\u2009years). Cycloplegic autorefraction (KR8800), ocular biometry (IOLMaster 700) and VA (ETDRS chart) measurements were conducted at baseline and annually afterwards.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      From 2018 to 2023, 4016 children (mean age: 7.51 [2.73] years, 41.81% girls) remained non\u2010myopic and were included in the analysis. Both uncorrected and best\u2010corrected VA improved rapidly and typically achieved adult level (nearly 20\/20) around age 7, with minimal difference in\u2010between. Best\u2010corrected VA of 20\/20 was attainable as early as age 4 across a spherical equivalent (SE) range of \u22120.375 to 4.825\u2009D, indicating VA development largely independent of SE changes. Mean SE showed a gradual myopic shift, from 1.375\u2009D in 3\u2010year\u2010olds to 0.375\u2009D in the 15\u2010year\u2010olds, with notable inflection points at ages 7 (around 1.25\u2009D) and 11 (around 0.75\u2009D). Lens power consistently decreased. Axial length (AL) increased steadily with marked deceleration around age 11. AL increases were significantly associated with height increases (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) before age 11 but not afterwards.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We observed asynchronous development of VA, SE and ocular biometrics. Best\u2010corrected VA develops mainly due to maturation of retinal circuits, even under conditions that lead to marked changes in the development of refractive errors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aos.17540","type":"journal-article","created":{"date-parts":[[2025,7,5]],"date-time":"2025-07-05T02:33:34Z","timestamp":1751682814000},"page":"75-81","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Ocular and vision development during childhood: Insights from a large prospective cohort study in Chinese children"],"prefix":"10.1111","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6836-3447","authenticated-orcid":false,"given":"Xiaotong","family":"Han","sequence":"first","affiliation":[{"name":"State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Guangdong Provincial Clinical Research Center for Ocular Diseases Sun Yat\u2010Sen University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Jin","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Guangdong Provincial Clinical Research Center for Ocular Diseases Sun Yat\u2010Sen University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian G.","family":"Morgan","sequence":"additional","affiliation":[{"name":"Research School of Biology Australian National University  Canberra Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuai","family":"Chang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Guangdong Provincial Clinical Research Center for Ocular Diseases Sun Yat\u2010Sen University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianyun","family":"Chen","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Guangdong Provincial Clinical Research Center for Ocular Diseases Sun Yat\u2010Sen University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Decai","family":"Wang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Guangdong Provincial Clinical Research Center for Ocular Diseases Sun Yat\u2010Sen University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiran","family":"Zhang","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Guangdong Provincial Clinical Research Center for Ocular Diseases Sun Yat\u2010Sen University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Chen","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Guangdong Provincial Clinical Research Center for Ocular Diseases Sun Yat\u2010Sen University  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yabin","family":"Qu","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Center for Disease Control and Prevention  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weijia","family":"Liu","sequence":"additional","affiliation":[{"name":"School Health Unit Guangzhou Center for Disease Control and Prevention  Guangzhou Guangdong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingguang","family":"He","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Ophthalmology, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Zhongshan Ophthalmic Center, Guangdong Provincial Clinical Research Center for Ocular Diseases Sun Yat\u2010Sen University  Guangzhou Guangdong China"},{"name":"Experimental Ophthalmology The Hong Kong Polytechnic University  Hong Kong China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9519-3076","authenticated-orcid":false,"given":"Yangfa","family":"Zeng","sequence":"additional","affiliation":[{"name":"State Key Laboratory of 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