Xiangjiang Aier Eye Hospital, Changsha 410000, China

Abstract

Objective: The relative peripheral refractive errors (RPRE) of retina in different regions of children aged 4-12 years were measured by using multispectral retinal refractive topography (MRT), and the relationship between RPRE and the development of myopia was discussed. Methods: In this cases control study, 170 children (170 eyes) aged 4 to 12 years were recruited in Changsha Xiangjiang Aier Eye Hospital from September 2021 to March 2022. According to the refractive status, the patients were divided into low myopia group (n=78), low hyperopia group (n=49) and emmetropia group (n=43). Eye biometrics were  measured before pupil dilation using the LS900. Axial length (AL), central corneal thickness (CCT), anterior chamber depth (AD), lens thickness (LT), keratometry (K1, K2) and astigmatism (AST=K2-K1) were recorded. MRT was used to measure the RPRE in different areas of children after pupil dilation, and the average values were summarized as follows: TRVD (Peripheral refractive error from center to peripheral 53°of retina), RDV-15 (The difference of central refractive error and paracentral refractive error from center to 15° of retina), RDV-30 (The difference of central refractive error and paracentral refractive error from 15° to 30° of retina), TRV-45 (The difference of central refractive error and paracentral refractive error from 30° to 45° of retina). All test results were taken from the right eye. The differences of RPRE with different eccentricities were analyzed by nonparametric test. Spearman correlation analysis was used to analyze the relationship between different diopters and RPRE. Multiple linear regression was used to test the correlation between different eccentricity degrees of RPRE and eyeball biological parameters. 

Results: In the eccentricity range of 15° to 45°, the RPRE of low myopia children was hyperopic defocus, and the RPRE increased with the increase of eccentricity. On the contrary, the RPRE of children with low hyperopia was myopic defocus, and RPRE decreases with the increase of eccentricity. In emmetropic children, the refractive state within 30° of eccentricity was basically the same as that at the fovea. However, when eccentricity is between 30° and 45°, RPRE increases with the increase of distance from the fovea, and it is a hyperopic defocus. There was no correlation between RPRE and AL when eccentricity was 0°- 15° (P>0.05). When eccentricity was 15°-30° and 30°-45°, RPRE was positively correlated with AL (r=0.33, 0.40, both P<0.001). When eccentricity was 0°-15°, there was no significant correlation between RPRE and ocular biological parameters (P>0.05). When eccentricity was 15°-30° and 30°-45°, AL was an independent risk factor for RPRE (both P<0.001). Conclusions: RPRE in children aged 4-12 years with low myopia and emmetropia is hyperopic defocus, RPRE in children with low hyperopia is myopic defocus, and RPRE in the eccentricity range of 15° to 45° may be closely related to the development of axial myopia in children.

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