Analysis of the Correlations between Relative Peripheral Refraction Errors and Myopia in Children and Adolescents

This study aimed to characterize relative peripheral refractive error (RPRE) using multispectral refraction topography (MRT) and to determine its association with myopia in school-aged children.

In this cross-sectional and retrospective study, 3036 children aged 7-15 years (1506 boys, 1530 girls) with refractive development records at Jinhua Eye Hospital between 2024 and 2025 were enrolled. Non-cycloplegic autorefraction was used to obtain spherical equivalent (SE) refraction. The SW-9000 optical biometer was used to measure axial length (AL), K1, and K2. MRT was used to measure RPRE in different regions of children's eyes, summed to obtain its average value, and recorded separately based on retinal eccentricity and quadrants: 0°-53° retina (TRDV), eccentricity-specific defocus, and quadrant-based indices. Statistical analyses were performed using one-way analysis of variance (ANOVA) and multiple linear regression analysis.

The TRDV values for different refractive groups were as follows: hyperopia group (H group) (-0.41 ± 0.48) D, emmetropia group (E group) (-0.25 ± 0.42) D, low myopia group (LM group) (-0.04 ± 0.38) D, moderate myopia group (MM group) (-0.10 ± 0.34) D, and high myopia group (HM group) (-0.07 ± 0.37) D. The differences were statistically significant (P < 0.05). Within the 15°-53° eccentricity range, hyperopic and emmetropic eyes exhibited progressively increasing myopic defocus with increasing eccentricity. In contrast, low myopic eyes showed a gradual reduction in myopic defocus, with a shift toward hyperopic defocus at RDV45-53, and exhibited relative hyperopic defocus in inferior retina (RDV-I) and nasal retina (RDV-N). The H group and E group exhibited myopic defocus in all retinal quadrants, and the LM group exhibited relatively higher hyperopic defocus, while the myopia group showed hyperopic defocus in RDV-I and RDV-N. SE showed a negative correlation with TRDV, RDV15-30, RDV30-45, RDV45-53, superior retina (RDV-S), RDV-I, and RDV-N (P < 0.001).

Compared with hyperopic and emmetropic eyes, myopic eyes showed reduced myopic defocus and increased hyperopic defocus in RPRE, with more pronounced changes observed in low myopia. This suggests that RPRE may be an associated factor in the progression of myopia.