Quantitative assessment of relative peripheral refraction in children with different refractive statuses and its associations with ocular biometry

TL;DR

The study examines how peripheral refraction varies in children with different vision types and how it relates to eye structure.

Contribution

The study provides new insights into peripheral refraction patterns and their associations with ocular biometry in children with different refractive statuses.

Findings

Emmetropic and myopic children showed increasing positive peripheral refraction with greater eccentricity.

Hyperopic children exhibited reduced peripheral refraction beyond 30° eccentricity.

Axial length/corneal radius was most strongly associated with far peripheral refraction in myopic children.

Abstract

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.

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.

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).

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.

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