Change in Peripheral Refraction over Time in Singapore Chinese Children

PURPOSE. Relative peripheral hyperopia has been associated with central myopia. This study was conducted to determine whether baseline relative peripheral hyperopia is associated with an increased risk of developing myopia or myopia progression in young Singapore Chinese children. METHODS. One hundred eighty-seven children who participated in the Peripheral Refraction in Preschool Children (PREP) Study at baseline underwent a follow-up examination. Autorefraction was performed at five eccentricities with an infrared autorefractor after cycloplegia: central axis and 15° and 30° eccentricities in the nasal and temporal visual fields. The primary outcomes were development of myopia among children who were nonmyopic at baseline, and myopia progression in those who were myopic at baseline. RESULTS. The mean age of the children at baseline was 7.2 ± 3.0 years, and the mean duration of follow-up was 1.26 years. At baseline, 96 children were myopic (mean central spherical equivalent [SE] -2.75 ± 1.72 D) and 91 were nonmyopic (mean central SE 0.76 ± 0.81 D). Baseline relative peripheral hyperopia was not associated with a greater likelihood of becoming myopic or myopia progression. At follow-up, children who remained nonmyopic (n = 24) retained relative peripheral myopia at all eccentricities, whereas those who became myopic (n = 67) developed relative peripheral hyperopia at the nasal (+0.44 ± 0.72 D) and temporal 30° (+0.13 ± 0.74 D). The mean change in central SE was -1.51 ± 0.63 D/y for children who developed myopia, -0.82 ± 0.76 D/y for children who were myopic at baseline, and -1.05 ± 0.80 D/y for all children. CONCLUSIONS. Baseline peripheral refraction did not predict the subsequent onset of myopia or influence the progression of myopia.