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A Novel MRI-Based Approach to Peripheral Refraction and Prediction of Myopia Progression.
S C M Kneepkens1, L van Vught2, J R Polling3
1Department of Ophthalmology (S.K., J.P., C.K., J.T.), Erasmus University Medical Center, Rotterdam, The Netherlands; The Generation R Study Group (S.K., C.K., J.T.), Erasmus University Medical Center, Rotterdam, The Netherlands.
American Journal of Ophthalmology
|June 18, 2025
Summary
Peripheral hyperopic refractive error, measured using MRI and ray tracing, is linked to faster myopia progression in children. This highlights the need for personalized myopia management strategies due to significant eye shape variations.
Area of Science:
- Ophthalmology
- Biomedical Imaging
- Pediatric Optometry
Background:
- Optical interventions for myopia aim to create peripheral myopic defocus.
- Peripheral refraction plays a role in myopia development and progression.
Purpose of the Study:
- To investigate if peripheral refraction, measured via MRI and ray tracing, can predict myopia progression in children.
- To assess the association between relative peripheral refraction (RPR) and myopia progression and incidence.
Main Methods:
- Utilized MRI scans and ocular biometry from 1635 children (Generation R Study).
- Calculated peripheral refraction profiles using ray tracing at 50-degree eccentricity.
- Analyzed relative peripheral refraction (RPR) and its association with axial length progression and incident myopia using regression models and ROC analysis.
Main Results:
- Myopic children exhibited more hyperopic RPR compared to emmetropic children.
- Higher vertical and horizontal RPR were significantly associated with faster axial length progression.
- Increased RPR correlated with a higher risk of incident myopia, with a maximum predictive AUC of 0.77 for fast progressors.
- MRI revealed substantial interindividual variations in retinal curvature, leading to significant peripheral refractive differences.
Conclusions:
- Peripheral hyperopic refractive error, assessed by eye shape, is more pronounced in myopic children and strongly predicts myopia progression.
- Significant anatomical variability in retinal radii necessitates personalized treatment strategies for effective myopia management.
- Individualized optical interventions may improve the efficacy of myopia control.
