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  • Title: [A study on the distribution characteristics of peripheral retinal defocus in children and adolescents].
    Author: Zheng XH, Shi HL, You JX, Li YS, Li CR.
    Journal: Zhonghua Yan Ke Za Zhi; 2024 Apr 11; 60(4):337-342. PubMed ID: 38583057.
    Abstract:
    Objective: To explore the distribution characteristics of peripheral retinal defocus in children and adolescents. Methods: This cross-sectional study included 500 individuals aged 3 to 18 years, who visited the People's Hospital of Lincang, the First Affiliated Hospital of Dali University and Dali Ophthalmology Hospital between January and December 2021. Data of the right eye of each participant was analyzed. There were 226 males (45.20%) and 274 females (54.80%), with an average age of (10.79±3.79) years. All participants underwent post-cycloplegic refraction, optical biometry, and intraocular pressure measurement to obtain spherical equivalent, average corneal curvature, axial length, and intraocular pressure. Multispectral refraction topography was performed to obtain topographic maps and values at various field angles and orientations of peripheral retinal defocus. Based on multispectral refraction topography, peripheral retinal defocus values were categorized as crater type, hemilateral upturn type, saddle type, and relatively flat type. The distribution of different refractive states was analyzed. Results: The spherical equivalent of the 500 participants was(-1.51±2.61) D, axial length was (24.10±1.28) mm, and average corneal curvature was (43.20±1.22) D. Among the 500 eyes, 382 exhibited hyperopic peripheral retinal defocus values, with 316 eyes (82.72%) being myopic. Myopic peripheral retinal defocus values were observed in 118 eyes, with 15 eyes (12.72%) being myopic. Among different types of peripheral retinal defocus values, 112 eyes (22.4%) exhibited a crater type, 153 eyes (30.6%) exhibited a hemilateral upturn type, 107 eyes (21.4%) exhibited a saddle type, and 128 eyes (25.6%) exhibited a flat type. The proportion of myopia was 82.14% (92 eyes), 69.28% (106 eyes), 60.75% (65 eyes), and 3.90% (5 eyes), respectively. The peripheral retinal defocus values at 15°, 30°, and 45° were (0.01±0.08) D, (0.06±0.21) D, and (0.20±0.37) D, respectively. The peripheral retinal defocus values at temporal, inferior, nasal, and superior locations were (0.58±0.69) D, (0.52±0.63) D, (0.21±0.64) D, and (-0.26±0.67) D, respectively. Notably, the superior primarily manifested as myopic, while the others were predominantly hyperopic. Conclusions: Approximately three-fourths of children and adolescents exhibit hyperopic peripheral retinal defocus values, with a higher prevalence of myopia in this subgroup. The hyperopia peripheral retinal defocus value increases with the distance from the retina to the macula. The peripheral retinal defocus values between superior and inferior, nasal and temporal locations are asymmetrical, with the temporal hyperopic peripheral retinal defocus value being most prominent and the superior myopic peripheral retinal defocus value being most evident. 目的： 探讨儿童青少年视网膜周边离焦的分布特点。 方法： 横断面研究。收集2021年1至12月在临沧市人民医院眼科、大理大学第一附属医院眼科及大理眼视光眼科医院就诊的3~18岁人群500例，纳入其右眼进行研究。其中男性226例（45.20%），女性274例（54.80%）；年龄为（10.79±3.79）岁。所有受试者进行睫状肌麻痹后验光、光学生物测量仪检查及眼压测量获取屈光度数、角膜平均曲率、眼轴长度及眼压，并进行多光谱屈光地形图检查获取视网膜周边离焦的地形图及不同视野角度和不同方位的离焦量。根据地形图表现将离焦类型分为火山口型、半侧翘起型、马鞍型和相对平坦型，分别统计各种离焦类型中不同屈光状态眼的分布。 结果： 500例受试者等效球镜度数为（-1.51±2.61）D；眼轴长度为（24.10±1.28）mm；角膜平均曲率为（43.20±1.22）D。500只眼中，382只眼的视网膜周边离焦为远视离焦，其中近视眼316只（82.72%）；近视离焦为118只眼，其中近视眼15只（12.72%）。不同视网膜周边离焦类型中，火山口型112只眼（22.4%），半侧翘起型153只眼（30.6%）、马鞍型107只眼（21.4%）、相对平坦型128只眼（25.6%）。其中火山口型、半侧翘起型、马鞍型和平坦型的眼中，近视眼的占比分别为82.14%（92只眼）、69.28%（106只眼）、60.75%（65只眼）和3.90%（5只眼）。受试者的RDV-15°、RDV-30°、RDV-45°分别为（0.01±0.08）、（0.06±0.21）、（0.20±0.37）D。视网膜周边颞侧、下方、鼻侧、上方的离焦分别（0.58±0.69）、（0.52±0.63）、（0.21±0.64）、（-0.26±0.67）D；其中上方离焦为主要表现为近视性，其余主要为远视性。 结论： 青少年儿童中视网膜周边远视离焦者约占3/4，这部分人群中近视眼患者更多。视网膜距离黄斑越远的位置远视离焦量越大。上方和下方、鼻侧和颞侧的视网膜离焦并不对称，颞侧远视离焦最明显，上方近视离焦最明显。.
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