Centre for Optometry and Vision Science Research, School of Biomedical Sciences, Ulster University, Coleraine, UK.
Ophthalmic Physiol Opt. 2023 Sep;43(5):985-996. doi: 10.1111/opo.13185. Epub 2023 Jun 20.
Controversy exists regarding the influence of peripheral visual experience on the onset and progression of childhood myopia. This longitudinal, observational study evaluated the relationship between relative peripheral refraction (RPR) and changes in refractive error and axial length (AL) over 12 months in White children aged 6-7 and 12-13 years with a range of baseline refractive errors.
Cycloplegic baseline autorefraction at horizontal retinal eccentricities of 0° and ±30° were recorded with the Shin-Nippon NVision-K 5001 while AL was measured using the Zeiss IOLMaster 700. Measurements were repeated after 12 months on a subgroup. Refractive data were transposed into power vectors as mean spherical equivalent (M), J and J . RPR was calculated by subtracting central from peripheral measurements. Participants were defined as myopic (M ≤ -0.50 D), premyopic (-0.50 D < M ≤ +0.75 D), emmetropic (+0.75 D < M < +2.00 D) or hyperopic (M ≥ +2.00 D).
Data were collected from 222 and 245 participants aged 6-7 and 12-13 years, respectively. Myopic eyes demonstrated, on average, more hyperopic RPR. Emmetropes and premyopes displayed emmetropic RPR, and hyperopes showed a myopic RPR. Fifty-six 6- to 7-year-olds and seventy 12- to 13-year-olds contributed 12-month repeated measures. Longitudinal data demonstrated a significant relationship between a more hyperopic RPR in the nasal retina and greater short-term axial elongation in teens with myopia at baseline (β = 0.69; p = 0.04). Each dioptre of relative peripheral hyperopia in the nasal retina was associated with an additional 0.10 mm (95% CI: 0.02-0.18 mm) annual increase in AL.
Hyperopic RPR in the nasal retina of myopic children is indicative of increased risk for rapid axial elongation and may be a useful metric to support decision-making in myopia management.
关于周边视觉经验对儿童近视发生和进展的影响存在争议。本纵向观察性研究评估了在 6-7 岁和 12-13 岁白种儿童中，基线屈光不正范围较大的情况下，相对周边离焦（RPR）与 12 个月内屈光不正和眼轴（AL）变化之间的关系。
使用 Shin-Nippon NVision-K 5001 在水平视网膜偏心率为 0°和±30°时记录睫状肌麻痹的基线自动折射，使用 Zeiss IOLMaster 700 测量 AL。在亚组中，12 个月后重复测量。将屈光数据转换为平均球镜等效值（M）、J 和 J 的屈光矢量。通过从周边测量值中减去中央测量值来计算 RPR。参与者定义为近视（M≤-0.50 D）、近视前期（-0.50 D<M≤+0.75 D）、正视（+0.75 D<M<+2.00 D）或远视（M≥+2.00 D）。
分别从 6-7 岁和 12-13 岁的 222 名和 245 名参与者中收集数据。近视眼的平均周边离焦更偏远视。正视眼和近视前期显示正视周边离焦，远视眼显示近视周边离焦。56 名 6-7 岁儿童和 70 名 12-13 岁儿童提供了 12 个月的重复测量值。纵向数据显示，在基线时患有近视的青少年中，鼻侧视网膜的 RPR 越远视，短期内轴向伸长的幅度越大（β=0.69；p=0.04）。鼻侧视网膜每 1 屈光度的相对周边远视与 AL 每年增加 0.10 毫米（95%CI：0.02-0.18 毫米）相关。
近视儿童鼻侧视网膜的远视周边离焦预示着轴向伸长速度加快的风险增加，可能是近视管理中决策支持的有用指标。
