视网膜不同区域离焦特征与近视儿童眼轴增长及屈光度变化的相关性研究OA

Objective To investigate the distribution characteristics of defocus in different retinal regions and identi-fy key defocus areas associated with myopia progression,so as to provide evidence for precise myopia prevention and con-trol.Methods This longitudinal study enrolled 60 children with low to moderate myopia(diopter:-1.00 to-4.00 D)admitted to the Henan Eye Hospital between July 2022 and August 2023.After one year of follow-up,12 children were lost to follow-up,and a total of 48 children completed the one-year follow-up.Peripheral retinal defocus was measured using multi-spectral refraction topography.Spherical equivalent(SE)and axial length(AL)were measured using an autorefractor and a biometer.SE and AL were remeasured after the children had worn single-vision spectacles for one year.Pearson correlation analysis was used to examine the correlation between peripheral retinal defocus and AL as well as SE.Results The total peripheral retinal defocus value(TRDV),peripheral retinal defocus values at 15°(RDV-15),30°(RDV-30),and 45°(RDV-45),as well as retinal defocus values in the superior(RDV-S),inferior(RDV-I),temporal(RDV-T),and nasal(RDV-N)re-gions were(0.18±0.28)D,(-0.01±0.05)D,(-0.02±0.11)D,(0.11±0.23)D,(-0.57±0.50)D,(0.64±0.42)D,(0.45±0.36)D,and(0.29±0.49)D,respectively.The TRDV,RDV-45,RDV-I,RDV-T,and RDV-N regions exhibited hyperopic defo-cus.In contrast,the RDV-15,RDV-30,and RDV-S regions showed myopic defocus.Pearson correlation analysis revealed no significant correlations between SE or AL and any of the TRDV,RDV-15,RDV-30,RDV-45,RDV-S,RDV-I,RDV-T,and RDV-N(all P>0.05).Annual change in diopter(△SE)demonstrated a negative correlation with RDV-T(r=-0.378,P=0.008)and a positive correlation with RDV-N(r=0.356,P=0.013).No significant correlations were observed between △SE and TRDV,RDV-15,RDV-30,RDV-45,RDV-S,or RDV-I(all P>0.05).Change in AL(△AL)after one-year follow-up showed a positive correlation with RDV-T(r=0.425,P=0.003)and a negative correlation with RDV-N(r=-0.384,P=0.007).No significant correlations were found between △AL and TRDV,RDV-15,RDV-30,RDV-45,RDV-S,or RDV-I(all P>0.05).The difference in temporal-nasal peripheral retinal defocus(T-N)was(0.15±0.68)D.Pearson correlation analyses indicated a significant negative correlation between △SE and T-N(r=-0.458,P=0.001)and a significant positive correlation be-tween △AL and T-N(r=0.503,P<0.001).Conclusion In children with low to moderate myopia,peripheral retinal de-focus exhibits significant nasal-temporal asymmetry.Greater temporal hyperopic defocus is associated with faster myopia progression,whereas greater nasal hyperopic defocus may slow myopic progression.The degree of nasal-temporal defocus asymmetry may serve as a potential indicator for assessing the risk of myopia progression in children.