Ao M X, Zhang Y, Wang Y Q, Zhao J X, Hu F R, Mandan D T Y, Chen Y G
Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing 100191, China.
Peking University Health Science Center, Beijing 100191, China.
Zhonghua Yan Ke Za Zhi. 2025 May 11;61(5):367-375. doi: 10.3760/cma.j.cn112142-20241010-00442.
To compare the differences in peripheral retinal defocus values (RDVs) and wavefront aberrations between myopic and emmetropic eyes in children with unilateral myopic anisometropia, and to analyze the association between RDVs and wavefront aberrations. The cross-sectional study consecutively enrolled patients aged 8 to 15 years, who were initially diagnosed as unilateral myopic anisometropia in the Department of Ophthalmology in Peking University Third Hospital from August 2023 to November 2024. Multispectral refraction topography was used to measure RDVs in the regions with eccentricity of 0° to <15° (RDV-15), 15° to <30° (RDV-30), and 30° to 45° (RDV-45), as well as in the superior (RDV-S), inferior (RDV-I), nasal (RDV-N), and temporal (RDV-T) directions under the mesopic condition at physiologic pupil sizes. A visual function analyzer was used to measure and calculate the higher order aberrations (HOAs), astigmatism (Z⁻², Z²), trefoil (Z⁻³, Z³), coma (Z⁻¹, Z¹), and spherical aberration (Z⁰) of the eyes and those arising from internal and corneal components within a pupil diameter of 4 mm. There were 69 eligible patients (138 eyes), including 35 males (70 eyes) and 34 females (68 eyes). The age was (10.6±1.6) years. The myopic eyes showed higher RDV-30 [-0.06 (-0.19, 0.05) D], RDV-45 [0.01 (-0.34, 0.39) D], RDV-S [-0.75 (-1.16, -0.09) D], RDV-I [0.35 (-0.14, 0.95) D], RDV-T [-0.02 (-0.34, 0.40) D], and RDV-N [0.21 (-0.35, 0.88) D] values compared to the emmetropic eyes [-0.14 (-0.28, 0.00), -0.29 (-0.50, -0.02), -0.93 (-1.47, -0.39), -0.02 (-0.62, 0.54), -0.28 (-0.82, 0.04), -0.14 (-0.64, 0.20) D], with statistically significant differences (all <0.05). The myopic eyes had lower ocular astigmatism Z [0.062 (0.032, 0.112) μm] and Z [0.149 (0.085, 0.249) μm], corneal astigmatism Z [0.276 (0.193, 0.389) μm], and internal ocular HOA [0.121 (0.088, 0.160) μm] values compared to the emmetropic eyes [0.078 (0.035, 0.151), 0.199 (0.098, 0.339), 0.327 (0.215, 0.501), 0.134 (0.088, 0.203) μm], with statistically significant differences (all <0.05). The ocular spherical aberration Z [0.036 (0.017, 0.058) μm] was higher in myopic eyes than the emmetropic eyes [0.026 (0.009, 0.051) μm] (<0.05). In myopic eyes, the spherical equivalent (SE) showed negative correlations with RDV-30 (=-0.294), RDV-45 (=-0.475), RDV-S (=-0.253), and RDV-N (=-0.471) (<0.05). The ocular astigmatism Z positively correlated with RDV-S (=0.240) and RDV-N (=0.273) (<0.05). In the emmetropic eyes, the axial length positively correlated with RDV-15 (=0.268, <0.05), the ocular astigmatism Z negatively correlated with RDV-15 (=-0.335, <0.05), and corneal astigmatism Z positively correlated with RDV-S (=0.254, <0.05). The interocular SE differences negatively correlated with the RDV-30 (=-0.388), RDV-45 (=-0.469), RDV-I (=-0.361), RDV-T (=-0.328), and RDV-N (=-0.337) differences (all <0.05). The interocular axial length differences positively correlated with the RDV-30 (=0.294), RDV-45 (=0.463), RDV-I (=0.312), RDV-T (=0.293), and RDV-N (=0.306) differences (<0.05). The interocular RDV-15 differences positively correlated with the ocular spherical aberration Z differences (=0.306, <0.05) and negatively correlated with the ocular astigmatism Z differences (=-0.249, <0.05). In children with unilateral myopic anisometropia, the myopic defocus changed into hyperopic defocus in the region of 15° to 45°, which was associated with the degree of myopia. The increase of the RDV of 0° to 15° was correlated to the decrease of ocular astigmatism (Z) and the increase of ocular spherical aberration (Z).
比较单侧近视性屈光参差儿童近视与正视眼周边视网膜离焦值（RDV）和波前像差的差异，并分析RDV与波前像差之间的关联。本横断面研究连续纳入了年龄在8至15岁之间的患者，这些患者于2023年8月至2024年11月在北京大学第三医院眼科初诊为单侧近视性屈光参差。采用多光谱屈光地形图在生理瞳孔大小的中间视觉条件下，测量偏心率为0°至<15°（RDV-15）、15°至<30°（RDV-30）和30°至45°（RDV-45）区域以及上方（RDV-S）、下方（RDV-I）、鼻侧（RDV-N）和颞侧（RDV-T）方向的RDV。使用视觉功能分析仪测量并计算眼睛以及瞳孔直径为4mm范围内来自眼内和角膜成分的高阶像差（HOA）、散光（Z⁻²，Z²）、三叶草像差（Z⁻³，Z³）、彗差（Z⁻¹，Z¹）和球差（Z⁰）。共有69例符合条件的患者（138只眼），其中男性35例（70只眼），女性34例（68只眼）。年龄为（10.6±1.6）岁。与正视眼[-0.14（-0.28，0.0），-0.29（-0.50，-0.02），-0.93（-1.47，-0.39），-0.02（-0.62，0.54），-0.28（-0.82，0.04），-0.14（-0.64，0.20）D]相比，近视眼的RDV-30[-0.06（-0.19，0.05）D]、RDV-45[0.01（-0.34，0.39）D]、RDV-S[-0.75（-1.16，-0.09）D]、RDV-I[0.35（-0.14，0.95）D]、RDV-T[-0.02（-0.34，0.40）D]和RDV-N[0.21（-0.35，0.88）D]值更高，差异具有统计学意义（均<0.05）。与正视眼[0.078（0.035，0.151），0.199（0.098，0.339），0.327（0.215，0.501），0.134（0.088，0.203）μm]相比，近视眼的眼散光Z[0.062（0.032，0.112）μm]和Z[0.149（0.0８5，0.249）μm]、角膜散光Z[0.276（0.193，0.389）μm]和眼内高阶像差[0.121（0.088，0.160）μm]值更低，差异具有统计学意义（均<0.05）。近视眼的眼球球差Z[0.036（0.017，0.058）μm]高于正视眼[0.026（0.009，0.051）μm]（<0.05）。在近视眼中，等效球镜度（SE）与RDV-30（=-0.294）、RDV-45（=-0.475）、RDV-S（=-0.253）和RDV-N（=-0.471）呈负相关（<0.05）。眼散光Z与RDV-S（=0.240）和RDV-N（=0.273）呈正相关（<0.05）。在正视眼中，眼轴长度与RDV-15呈正相关（=0.268，<0.05），眼散光Z与RDV-15呈负相关（=-0.335，<0.05），角膜散光Z与RDV-S呈正相关（=0.254，<0.05）。双眼SE差异与RDV-30（=-0.388）、RDV-45（=-0.469）、RDV-I（=-0.361）、RDV-T（=-0.328）和RDV-N（=-0.337）差异呈负相关（均<0.05）。双眼眼轴长度差异与RDV-30（=0.294）、RDV-45（=0.463）、RDV-I（=0.312）、RDV-T（=0.293）和RDV-N（=0.306）差异呈正相关（<0.05）。双眼RDV-15差异与眼球球差Z差异呈正相关（=0.306，<0.05），与眼散光Z差异呈负相关（=-0.249，<0.05）。在单侧近视性屈光参差儿童中，15°至45°区域的近视性离焦转变为远视性离焦，这与近视程度有关。0°至15°的RDV增加与眼散光（Z）的降低和眼球球差（Z）的增加相关。
