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Variability of retinal steepness at the posterior pole in children 7-15 years of age
1Pennsylvania College of Optometry, Elkins Park, PA 19027, USA. gschmid@pco.edu
Insights
Peripheral refraction correlates with retinal steepness, explaining variations in eye growth control. Measuring retinal steepness may improve myopia progression estimates and identify at-risk children for targeted treatments.
Area of Science:
- Ophthalmology
- Optometry
- Vision Science
Background:
- Axial and peripheral refraction significantly influence eye growth.
- Variability in peripheral refraction suggests diverse refractive errors in the peripheral retina.
- Accurate measurement techniques for peripheral refraction and retinal steepness are needed.
Purpose of the Study:
- To develop and utilize an Optical Low Coherence Reflectometer (OLCR) for assessing retinal steepness.
- To investigate the correlation between peripheral refraction and retinal steepness.
- To understand the role of peripheral refraction in eye growth control.
Main Methods:
- Retinal steepness was measured in 63 children (ages 7-15) using OLCR and Binocular Auto-Refractometry.
- Eye length (EL) and spherical equivalent refraction (SER) were assessed axially and peripherally (15 degrees temporal, nasal, inferior, superior).
- Relative peripheral EL and SER were compared across refractive groups (myopic, emmetropic, hyperopic) and analyzed for correlation.
Main Results:
- Significant differences in relative peripheral EL and SER were found between refractive groups at several locations.
- A significant correlation between relative peripheral EL and SER was observed.
- These findings suggest peripheral refraction variability is linked to retinal steepness.
Conclusions:
- Peripheral refraction is strongly correlated with retinal steepness.
- Variability in peripheral refraction primarily reflects differences in retinal steepness.
- Measuring retinal steepness can enhance myopia progression prediction and identify at-risk children for specialized treatments.
Purpose:
Considerable evidence suggests that both axial and peripheral refraction play important roles in eye growth control. The large variability in peripheral refraction seen in adults and children indicates that the peripheral retina is exposed to a wide range of refractive errors. The current lack of appropriate measurement techniques has hampered the determination of whether variability in peripheral refraction between individuals can be correlated with variability in retinal steepness. An Optical Low Coherence Reflectometer (OLCR) was developed to determine retinal steepness.
Methods:
Retinal steepness was assessed in right eyes of 63 children 7-15 years of age by measuring eye length (EL) and spherical equivalent refraction (SER) axially and at 15 degrees temporally, nasally, inferiorly and superiorly with OLCR and Binocular Auto-Refractometry, respectively, during cycloplegia. At each peripheral location, relative peripheral EL and SER (i.e., the difference between peripheral and axial readings) were compared between myopic, emmetropic and hyperopic eyes, and the correlation between relative peripheral EL and SER was analyzed.
Results:
Although the standard deviations were large, significant differences in relative peripheral EL and SER between refractive groups as well as a significant correlation between relative peripheral EL and SER were observed at several of the assessed locations. CONCLUSIONS. The results strongly suggest that peripheral refraction is correlated with retinal steepness and that previously observed variability in peripheral refraction chiefly reflects variability in retinal steepness. If peripheral refraction represents a determining parameter in the control of eye growth, the precise measurement of retinal steepness could be used not only to improve estimates of myopic progression, but also to identify children who are at high risk of developing myopia. It may lead to specialized clinical/optical treatments, e.g. the correction of not only axial but also peripheral refractive errors, which are more effective than current treatments in individuals who are at risk of myopia development or progression.
