Observational studyOphthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists)2026
Longitudinal Changes in Relative Peripheral Refraction During Childhood Myopia Onset: A 3-year Prospective Observation.
Observational study in Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo investigate 3-year dynamic changes in relative peripheral refraction (RPR) and their association with axial elongation and myopia progression stages in children.
methodsA total of 564 children (mean age 9.22 ± 0.59 years; 51.1% female) completed three annual visits in a longitudinal observational cohort study (2020-2023) in Guangzhou, China. Annual assessments included cycloplegic spherical equivalent refraction (SER), axial length (AL) and multispectral refractive topography. RPR was calculated across annular diameters up to 53° and quadrants; the total RPR (TRPR) was the mean across all regions. Analysis was stratified by baseline refractive status (myopia: SER ≤ -0.50 D, non-myopic: SER > -0.50 D) and 3-year outcomes (remained non-myopic, myopia onset or established myopia). Right eye data were included in the analysis.
resultsIn non-myopic children, differences in baseline RPR were observed 1 year before myopia onset. Baseline temporal RPR showed a modest association with myopia onset (odds ratio = 2.24, 95% CI: 1.08-4.66, p = 0.03). Longitudinal hyperopic RPR shifts were more pronounced in the peripheral retina >30°. The 3-year ΔTRPR was higher in the myopia-onset group (0.21 D) and the remaining non-myopic group (0.16 D) than in established myopia (0.06 D). Additionally, significant differences in ΔAL were observed: myopia-onset (+0.91 mm), established myopia (+0.81 mm) and remained non-myopic (+0.45 mm) (p < 0.001). ΔTRPR was correlated with ΔAL in the myopia-onset group (r = 0.32, p < 0.001), but not in established myopia. Baseline SER alone showed strong predictive accuracy for 1-year onset with an area under the curve (AUC) of 0.87, while RPR alone yielded moderate accuracy (AUC = 0.71), outperforming AL alone (AUC = 0.64). Adding RPR to SER did not improve discrimination (AUC = 0.88).
conclusionsBaseline central refractive error remains the dominant predictor of myopia onset. Changes in RPR may be associated with myopia development. Dynamic RPR changes may provide complementary information regarding ocular shape remodelling, with limited added predictive value beyond baseline SER. CLINICAL TRIAL NUMBER: Not applicable.
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