Refraction centile curves for Caucasian and Chinese children and adolescents from simulated data cohorts

This study aimed to derive centile charts for refraction in young children and adolescents from two ethnic groups – Caucasian and Chinese using simulated (synthetic) individual-level data generated from published studies. Mean cycloplegic refraction estimates, along with standard deviation, were extracted from 10 eligible studies. Data were simulated using a non-normal distribution in R based on the extracted summary statistics for each of the ten studies. The simulated data were then collated to develop centile curves using Generalized Additive Models for Location Scale and Shape (GAMLSS) for both Caucasian and Chinese ethnicities. Marked differences were noted in the centile curves of the two ethnicities, particularly in the myopic centiles. Centile curves from simulated cycloplegic refraction of Chinese children were more myopic across all age groups and centiles compared to the centile curves of Caucasian children. These centile charts provide a means to compare ethnic differences and serve as communication tools for clinicians to explain the risks of myopia progression and guide its management.