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Relative peripheral refraction in children: twelve-month changes in eyes with different ametropias
1School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong. ttlee1@netvigator.com
Insights
Peripheral refraction (RPR) patterns differ in children with ametropias. However, RPR does not predict central refractive changes over time, suggesting it
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Refractive Error Development
Background:
- Understanding refractive error progression in children is crucial for developing effective interventions.
- Peripheral refraction (RPR) is hypothesized to influence central refractive changes, particularly myopia progression.
Purpose of the Study:
- To characterize peripheral refraction in children with various ametropias.
- To investigate the relationship between baseline RPR, changes in RPR, and central refractive changes over 12 months.
Main Methods:
- Biannual cycloplegic refraction (central and peripheral) in children aged 6-9 years for 12 months.
- Peripheral refraction measured at 10°, 20°, and 30° in nasal and temporal fields.
- Refractive data analyzed using M, J0, and J45 vectors; RPR calculated by subtracting central from peripheral measurements.
Main Results:
- Distinct RPR patterns observed: relative peripheral myopia in hyperopic eyes, relative peripheral hyperopia in myopic eyes.
- No significant correlation found between baseline RPR or RPR changes and central refractive changes over 12 months.
- Faster myopic progression subgroups did not show significantly different RPR; RPR asymmetry increased over time.
Conclusions:
- Peripheral refraction patterns vary significantly across different refractive error groups in children.
- Baseline RPR and its longitudinal changes are not predictive of central refractive changes.
- Current findings do not support RPR as a causative factor in pediatric myopia progression.
Purpose:
To determine the peripheral refraction of children with different types of ametropias and to evaluate the relationship between central refractive changes, baseline relative peripheral refraction (RPR) and changes in RPR over a 12-month monitoring period.
Methods:
Cycloplegic central and peripheral refraction were performed biannually on the right eyes of children aged 6-9 for 12 months, using an open-view autorefractor. Peripheral refraction were measured along 10°, 20° and 30° from central fixation in both nasal and temporal fields. Refractive data were transposed into M, J0 and J45 vectors for analyses. RPR was determined by subtracting the central measurement from each peripheral measurement.
Results:
Hyperopic eyes showed relative peripheral myopia while myopic eyes had relative hyperopia across the central 60° horizontal field at baseline. Emmetropic eyes had relative myopia within but showed relative hyperopia beyond the central 30° field. However, there was no significant correlation between central refractive changes and baseline RPR or between changes in central refraction and RPR over twelve months in any refractive groups. Correlations between changes in PR and central myopic shift were found mainly in the nasal field in different groups. In the subgroup analysis on the initially emmetropic and the initially myopic groups, the subgroups with faster myopic progression did not have significantly different RPR from the subgroups with slower progression. The RPR pattern of the initially emmetropic and the initially myopic groups became more asymmetric at the end of the study period with a larger increase in relative hyperopia in the temporal field.
Conclusions:
RPR patterns were different among hyperopic, emmetropic and myopic eyes. However, baseline RPR and changes in RPR cannot predict changes in central refraction over time. Our results did not provide evidence to support the hypothesis of RPR as a causative factor for myopic central refractive changes in children.
