Retinal Sensitive Areas in Myopia Control: Identifying the Potential Retinal 'Sweet Spot'-A Scoping Review

Myopia control may involve targeting the peripheral retina to slow eye growth; however, there is no consensus on the optimal lens design, and treatment effects remain variable. This scoping review explored whether a specific retinal region is sensitive to visual manipulation, which could inform more effective treatments. A literature search was conducted in December 2025, with updates in March and June 2026 using PubMed, MEDLINE, and the Cochrane Library. Full manuscripts in English in animals and humans were included and screened by title, abstract, and full text for relevance. A total of 134 studies were identified, with 22 meeting inclusion criteria (13 human, 9 animal studies). Evidence across studies suggests that both the extent and location of defocus influence axial elongation. Increasing the treatment area may enhance myopia control efficacy, although findings are inconsistent regarding whether this relationship is dose-dependent. Several studies indicate that retinal sensitivity to defocus is not uniform, with the horizontal retina, particularly the temporal region, potentially more responsive to defocus than the vertical retina. Notably, converging evidence from human electrophysiological and intervention studies suggests that the near peripheral retina, approximately 6°-12° eccentricity, may be particularly sensitive to defocus with possible greater sensitivity in the horizontal meridian. While expanding treatment zones may enhance therapeutic effects, the relationship is likely more complex than a simple linear dose-response. Interpretation is limited by variability across studies and heavy reliance on adult and animal studies. Further research in children with progressive myopia is needed to further validate this potential "sweet spot", investigate inter-individual variability in retinal sensitivity, and determine whether targeting the near peripheral, horizontal retina leads to improved clinical outcomes in myopia control.