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Axial Length Growth Reference Curves and LMS Parameters for Japanese Children and Adolescents Aged 4-20 Years: The

Masayuki Kobayashi1,2, Mami Ishikuro3,4, Taku Obara1,5,6

  • 1Graduate School of Medicine, Tohoku University, Sendai, Japan.

Ophthalmic & Physiological Optics : the Journal of the British College of Ophthalmic Opticians (Optometrists)
|June 27, 2026
PubMed

Insights

This study developed axial length (AL) growth reference curves and lambda-mu-sigma (LMS) parameters for Japanese children and adolescents. These tools enable standardized evaluation of ocular development and myopia progression in this population.

Area of Science:

  • Ophthalmology
  • Pediatrics
  • Biometry

Background:

  • Axial length (AL) growth reference curves are crucial for monitoring ocular development.
  • Existing AL growth references are insufficient for Japanese children and adolescents.
  • Standardized methods for AL-for-age z-score calculation are needed.

Purpose of the Study:

  • To develop AL growth reference curves for Japanese children and adolescents aged 4-20 years.
  • To establish lambda-mu-sigma (LMS) parameters for AL z-score calculation in this population.
  • To provide a standardized tool for evaluating ocular development and myopia progression.

Main Methods:

  • Cross-sectional analysis of AL data from 14,482 Japanese children (Tohoku Medical Megabank Project).
  • Optical biometry with mean values from 10 measurements per eye to reduce variability.
  • LMS method with Box-Cox-Cole-Green distribution using the gamlss package in R.

Main Results:

  • Generated age- and sex-specific LMS values for AL z-score calculation at 0.1-year intervals.
  • Developed percentile and standard deviation curves for AL across ages 4-20 years for both sexes.
  • Observed AL growth patterns comparable to other East Asian populations.

Conclusions:

  • Established AL growth reference curves and LMS parameters provide a clinically relevant framework for Japanese children.
  • These references aid in monitoring myopia-related axial elongation and ocular growth.
  • The study supports early identification and intervention in childhood myopia management.
Abstract

Keywords:
Axial lengthChildrenGrowth curveJapanLMS method

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