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Updated: Jun 3, 2026
Binocular Dynamic Visual Acuity in Eyeglass-Corrected Myopic Patients
Published on: March 29, 2022
Association between retinal steepness and central myopic shift in children
1Pennsylvania College of Optometry, Salus University, Elkins Park, Pennsylvania, and Vision CRC, Sydney, New South Wales, Australia. gschmid@salus.edu
Insights
Children with steeper temporal retinas experienced greater myopic shift, suggesting eye shape influences refractive development. This finding may aid in predicting myopia progression.
Area of Science:
- Ophthalmology
- Pediatric eye care
- Refractive error development
Background:
- Peripheral refraction influences central refractive development.
- Retinal steepness at the posterior pole is linked to peripheral refraction.
Purpose of the Study:
- To investigate the association between retinal steepness and central myopic shift in children.
- To determine if eye shape influences myopia progression in pediatric populations.
Main Methods:
- Measured central sphere equivalent refraction (CSER) in 140 children (7-11 years) over ~30 months.
- Estimated retinal steepness using relative peripheral eye length (RPEL) via optical low coherence interferometry.
- Analyzed the association between baseline RPEL and central refractive shift using Structural Equation Modeling.
Main Results:
- A weak but significant correlation (r=0.207, p=0.049) was found between temporal retinal steepness (RPEL) and myopic shift in CSER.
- Steeper retinas were associated with greater myopic shifts.
- Myopic shift correlated with axial elongation but not baseline refraction.
Conclusions:
- Temporal retinal steepness is associated with central myopic shift in children, independent of baseline refraction.
- Eye shape at the posterior pole may influence visually guided axial eye growth, potentially via peripheral defocus.
- Further research is needed to explore the predictive value and temporal specificity of this finding.
Purpose:
Retinal steepness at the posterior pole was shown to be associated with peripheral refraction, and there exists strong evidence that peripheral refraction influences central refractive development. The purpose of this study was to investigate whether retinal steepness is associated with central myopic shift in children.
Methods:
Central refraction was measured in OD of 140 children aged 7 to 11 years as central sphere equivalent refraction (CSER) and central sphere refraction at baseline and after ~30 months. For the estimation of retinal steepness, relative peripheral eye length (RPEL) was determined in OD by measuring length axially with a custom-made optical low coherence interferometer and subtracting it from eye length measured peripherally at 20° in the nasal, inferior, temporal, and superior fields. Association between baseline RPEL at the various locations and shift in central refraction was evaluated with a Structural Equation Modeling analysis.
Results:
CSER at baseline measured +0.05 ± 0.54 diopters (D) (mean ± SD). Shift in CSER, as standardized over a 30-month interval to account for individual differences in the follow-up period, was -0.21 ± 0.56 D. A weak, but significant, correlation was observed between baseline RPEL in the temporal retina and myopic shift in CSER (r = 0.207, p = 0.049), steeper retinas displaying greater myopic shifts. Myopic shift was correlated with axial elongation but not correlated with baseline refraction. Analyses were performed for both CSER and central sphere refraction with near-identical results. RPEL did not change significantly.
Conclusions:
The significant correlation between temporal RPEL and central myopic shift, with the latter being independent of baseline refraction, supports the hypothesis that eye shape at the posterior pole is one of the factors influencing visually guided axial eye growth, possibly through associated peripheral defocus. Its predictive value for refractive development and limitation to the temporal retina require further investigation.