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Quantitative assessment of relative peripheral refraction in children with different refractive statuses and its
Chaoying Ye1,2,3, Xingxue Zhu1,2,3, Yangfan Xu1,2,3
1Department of Ophthalmology and Vision Science, Eye & ENT Hospital, Fudan University, Shanghai, China.
Insights
Relative peripheral refraction (RPR) in children shows a hyperopic shift with increasing eccentricity in emmetropia and myopia, but not in hyperopia. Axial length is strongly linked to peripheral RPR in children.
Area of Science:
- Ophthalmology
- Optometry
- Pediatric Eye Care
Background:
- Understanding peripheral refraction is crucial for myopia progression research.
- Relative peripheral refraction (RPR) distribution varies with refractive status.
- Ocular biometry plays a role in refractive development.
Purpose of the Study:
- To analyze the distribution of RPR in Chinese children across different refractive states (hyperopia, emmetropia, myopia).
- To investigate the relationship between RPR and ocular biometry parameters in these children.
Main Methods:
- Included 309 children (4–14 years) categorized into hyperopic, emmetropic, and myopic groups.
- Ocular biometry data acquired using IOLMaster 700.
- RPR measured via multispectral refraction topography, analyzed using Refraction Difference Values (RDVs) at various eccentricities and quadrants.
Main Results:
- Emmetropic and myopic children exhibited increasing positive RPR with eccentricity (peripheral hyperopic shift).
- Hyperopic children showed decreased RPR beyond 30° eccentricity.
- Spherical equivalent correlated negatively with temporal and total RPR; axial length/corneal radius of curvature (AL/R) strongly associated with peripheral RPR (RDV45-53).
Conclusions:
- RPR patterns differ significantly between refractive groups in children.
- Peripheral hyperopic shift observed in emmetropic and myopic children, unlike hyperopic children.
- Axial length is a key factor influencing peripheral RPR, particularly in the far periphery.
Background:
This study aimed to evaluate the distribution of relative peripheral refraction (RPR) and its relationship with ocular biometry in Chinese children of different refractive statuses.
Methods:
This study included 309 participants aged 4 to 14 years who were divided into three groups based on refraction: hyperopia, emmetropia, and myopia. IOLMaster 700 was used to acquire ocular biometry data, and RPR was measured using multispectral refraction topography. Refraction difference values (RDVs) were used to describe the RPR and included the total defocus (TRDV), defocus at 0° to 15° (RDV15), 15° to 30° (RDV15-30), 30° to 45° (RDV30-45), and 45° to 53° (RDV45-53) eccentricities, and superior (RDV-S), inferior (RDV-I), temporal (RDV-T), and nasal (RDV-N) quadrants.
Results:
In participants with emmetropia and myopia, RPR values became more positive as the distance from the foveal pit increased, whereas hyperopic participants showed a decrease in relative hyperopic defocus in the RDV45-53. Beyond 30° eccentricity, there were significant differences between the refractive groups; those with emmetropia and myopia had significantly higher RPR values than those with hyperopia. The spherical equivalent was negatively correlated with RDV-T (β = -0.31, p < 0.01) and TRDV (β = -0.26, p < 0.01). In myopic children, the correlation extended to multiple peripheral regions with increasing degrees of myopia. The ocular parameter most strongly associated with RDV45-53 was the axial length/corneal radius of curvature (AL/R, β = 0.48, p < 0.01).
Conclusion:
In emmetropic and myopic children, RPR values became progressively positive with greater eccentricity, indicating a relative peripheral hyperopic shift. In contrast, hyperopic children showed a reduction in the RPR beyond 30° eccentricity. The spherical equivalent was negatively correlated with temporal and total RPR, and AL/R showed the strongest association with far peripheral RPR.
