Zhao Qi, Wang Yanhua, Liang Tiangang, Nie Weixiang, Xue Pei, Cheng Jie
Shanxi Aier Eye Hospital Aier Eye Hospital Group, Changsha, China.
Aier Eye Hospital Jinan University, Guangzhou, China.
J Ophthalmol. 2024 Aug 8;2024:7712516. doi: 10.1155/2024/7712516. eCollection 2024.
Peripheral retinal refraction plays a crucial role in myopia, but the specific mechanism is not clear. We refined the retinal partitions to explore the characteristics of peripheral retinal refraction and its role in emmetropic, low, and moderate myopic children aged 6 to 12 years.
A total of 814 subjects (814 eyes) were enrolled in the study. The participants were divided into three groups according to the central spherical equivalent refraction (SER), which were emmetropia group (E), low myopia group (LM) and moderate myopia group (MM). Multispectral refractive topography (MRT) was used to measure the retinal absolute and relative refractive difference value (RDV) in different regions. The range was divided into superior, inferior, temporal, and nasal RDV (SRDV, IRDV, TRDV, and NRDV) on the basis of several concentric circles extending outward from the macular fovea (RDV15, RDV30, RDV45, RDV30-15, RDV45-30, and RDV-45). Kruskal-Wallis test was used to analyze the differences of peripheral refraction for all the regions among the three groups. Spearman rank correlation was performed to explore correlations between SER and RDV, axial length (AL) and RDV.
The absolute value of RDV decreased with increasing degree of myopia in all regions ( < 0.01). Subjects with different refractive degrees had different relative value of RDV. In nasal position within 45° and temporal position within 30°, the peripheral retina exhibited significantly different relative hyperopic refractive status among Group , Group LM, and Group MM ( < 0.05). SER was negatively correlated with NRDV within 30° (especially in the range of NRDV30-15) ( = -0.141, < 0.01), positively correlated with TRDV within 15° ( = 0.080, = 0.023), and not significantly correlated with SRDV and IRDV when the retina was divided into four parts. AL was positively correlated with NRDV within 30° (especially in the range of NRDV30-15) ( = 0.109, = 0.002), negatively correlated with TRDV within 15° ( = -0.095, = 0.007).
The peripheral defocus has significant implications for the genesis of myopia. The peripheral defocus of the horizontal direction, especially within the range of NRDV30, has greater effect on the development of myopia in children. Higher NRDV30 is associated with lower SER and longer AL.
周边视网膜屈光在近视中起着关键作用，但其具体机制尚不清楚。我们细化了视网膜分区，以探讨6至12岁正视、低度和中度近视儿童周边视网膜屈光的特征及其作用。
本研究共纳入814名受试者（814只眼）。根据中央等效球镜度（SER）将参与者分为三组，即正视组（E）、低度近视组（LM）和中度近视组（MM）。采用多光谱屈光地形图（MRT）测量不同区域的视网膜绝对和相对屈光差值（RDV）。基于从黄斑中心凹向外延伸的几个同心圆，将范围分为上、下、颞侧和鼻侧RDV（SRDV、IRDV、TRDV和NRDV）（RDV15、RDV30、RDV45、RDV30-15、RDV45-30和RDV-45）。采用Kruskal-Wallis检验分析三组所有区域周边屈光的差异。进行Spearman等级相关分析，以探讨SER与RDV、眼轴长度（AL）与RDV之间的相关性。
所有区域的RDV绝对值均随近视程度增加而降低（<0.01）。不同屈光度数受试者的RDV相对值不同。在45°以内的鼻侧位置和30°以内的颞侧位置，正视组、低度近视组和中度近视组的周边视网膜相对远视屈光状态存在显著差异（<0.05）。30°以内SER与NRDV呈负相关（尤其是在NRDV30-15范围内）（=-0.141，<0.01），15°以内与TRDV呈正相关（=0.080，=0.023），当将视网膜分为四个部分时，与SRDV和IRDV无显著相关性。AL与30°以内的NRDV呈正相关（尤其是在NRDV30-15范围内）（=0.109，=0.002），与15°以内的TRDV呈负相关（=-0.095，=0.007）。
周边离焦对近视的发生具有重要意义。水平方向的周边离焦，尤其是在NRDV30范围内，对儿童近视的发展影响更大。较高的NRDV30与较低的SER和较长的AL相关。
