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Published on: March 29, 2022
Myopia Control Effect Is Influenced by Baseline Relative Peripheral Refraction in Children Wearing Defocus
Hanyu Zhang1,2, Carly S Y Lam1,2, Wing-Chun Tang1
1Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China.
Insights
Peripheral refraction influences myopia control in Chinese children wearing DIMS lenses. Baseline myopic RPR correlated with increased myopia progression and axial elongation in DIMS wearers, suggesting personalized approaches may optimize myopia control.
Area of Science:
- Ophthalmology
- Optometry
- Pediatric Eye Care
Background:
- Myopia is a growing public health concern, particularly in East Asian populations.
- Peripheral refraction (RPR) plays a role in myopia progression, but its influence on myopia control interventions is not fully understood.
- Defocus Incorporated Multiple Segments (DIMS) lenses are a common method for myopia control.
Purpose of the Study:
- To investigate whether baseline relative peripheral refraction (RPR) affects the efficacy of DIMS lenses in controlling myopia progression in Chinese children.
- To analyze the relationship between baseline RPR and changes in refractive error and axial length over a two-year period.
Main Methods:
- A two-year randomized controlled trial involving Chinese myopic children.
- Measurement of peripheral refraction at 10°, 20°, and 30° nasal and temporal retina at six-month intervals.
- Statistical analysis to correlate baseline RPR with myopia progression and axial length changes in DIMS and single vision (SV) lens groups.
Main Results:
- In the DIMS group, a more myopic baseline RPR was associated with greater myopia progression and axial elongation, particularly at nasal retinal locations (10°N, 20°N).
- In the SV group, baseline RPR correlated with myopia progression but not axial elongation after Bonferroni correction.
- Children with baseline hyperopic RPR showed significantly less myopia progression and axial elongation with DIMS lenses compared to those with myopic RPR.
Conclusions:
- Baseline RPR may not significantly influence myopia progression or axial elongation in single vision lens wearers.
- DIMS lenses demonstrated better myopia control in children with baseline hyperopic RPR compared to those with myopic RPR.
- Individualizing myopia control strategies based on peripheral retinal profiles, including RPR, could enhance treatment efficacy.
Abstract:
The aim of this study is to investigate if baseline relative peripheral refraction (RPR) influences the myopia control effects in Chinese myopic children wearing Defocus Incorporated Multiple Segments (DIMS) lenses. Peripheral refraction at 10°, 20°, and 30° nasal (10 N, 20 N, 30 N) and temporal (10 T, 20 T, 30 T) retina were measured at six-month intervals for children who participated in a 2-year randomized controlled trial. The relationship between the baseline peripheral refractions and myopia progression and axial length changes were analysed. A total of 79 children and 81 children in the DIMS and single vision (SV) group were investigated, respectively. In the DIMS group, more baseline myopic RPR spherical equivalent (SE) was associated with more myopic progression (10 N: r = 0.36, p = 0.001; 20 N: r = 0.35, p = 0.001) and greater axial elongation (10 N: r = −0.34, p = 0.001; 20 N: r = −0.29, p = 0.006) after adjusting for co-factors. In the SV group, baseline RPR had association with only myopia progression (10 N: r = 0.37, p = 0.001; 20 N: r = 0.36, p = 0.001; 30 N: r = 0.35, p = 0.002) but not with axial elongation after Bonferroni correction (p > 0.008). No statistically significant relationship was found between temporal retina and myopia progression or axial elongation in both groups. Children with baseline myopic RPR had statistically significant more myopia progression (mean difference around −0.40 D) and more axial elongation (mean difference 0.15 mm) when compared with the children having baseline hyperopic RPR in the DIMS group but not in the SV group. In conclusion, the baseline RPR profile may not influence future myopia progression or axial elongation for the SV lens wearers. However, DIMS lenses slowed down myopia progression and was better in myopia control for the children with baseline hyperopic RPR than the children with myopic RPR. This may partially explain why myopia control effects vary among myopic children. Customised myopic defocus for individuals may optimise myopia control effects, and further research to determine the optimal dosage, with consideration of peripheral retinal profile, is warranted.
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