Peripheral Refractive Changes Associated with Myopia Progression

PURPOSE. To evaluate the changes in peripheral refraction profiles associated with myopia progression and treatment modalities used in the Cambridge Anti-Myopia Study. METHODS. One hundred and seventy-seven myopes in the age range of 14 to 22 years were enrolled in the study. The mean spherical equivalent refractive error was -3.12 +/- 1.87 diopters (D) and the refractive error of each participant was corrected with contact lenses. The participants were randomly assigned to one of four treatment groups, which included: altered spherical aberration and vision training, altered spherical aberration only, vision training only, and control. Peripheral refractive error was measured using an open field autorefractor in the central 60 degrees of the retina in 10 degrees steps. The refractive error was measured using cycloplegic autorefraction. Two-year refractive progression data and initial peripheral refraction measurements were available in 113 participants. Measurements of peripheral refraction and cycloplegic refraction were obtained at three visits over 2 years in 12-month intervals for 92 participants. RESULTS. All subjects showed a relative peripheral hyperopia, especially in the nasal retina. A limited magnitude of myopia progression of -0.34 +/- 0.36 D over 2 years was found in each of the four groups on average. There were no significant differences in the rate of progression between any of the treatment groups (P > 0.05). Initial peripheral J45 astigmatic refractive error at 20 degrees and 30 degrees in the nasal retina was weakly correlated with progression of myopia over 2 years (r = -0.27, P = 0.004 and r = -0.20, P = 0.040, respectively; n = 113). The change in spherical equivalent peripheral refractive error at 30 degrees nasal retina over time was also significantly correlated with progression of myopia especially at 24 months (r = 0.24, P = 0.017, n = 92). CONCLUSIONS. Relative peripheral hyperopia is associated with myopia. Myopia progression may be weakly linked to changes in the peripheral refraction profiles in the nasal retina. However, a causative link between peripheral refractive error and myopia progression could not be established. (Invest Ophthalmol Vis Sci. 2013;54:1573-1581) DOI: 10.1167/iovs.12-10278