Characteristics of peripheral refractive errors of myopic and non-myopic Chinese eyes

Interest in peripheral refractive errors has increased as it was hypothesized that peripheral hypermetropia might provide a stimulus for axial elongation (Smith et al., 2005), this study was to determine relative peripheral refractive errors (RPRE) of the eyes of a group of Chinese children and adults. Central and peripheral (20 degrees , 30 degrees , 40 degrees at nasal, temporal, superior and inferior meridians of retina) refractive errors were obtained from cyclopleged eyes of 40 children and 42 adults with a Shin-Nippon auto-refractor. Only right eyes were considered. Central spherical equivalent (M) was used to classify the eyes as Moderate Myopia (MM, -3.00 < M < or = -6.00D), Low Myopia (LM, -0.50 < or = M < or = -3.00D), Emmetropia (E, -0.50<M<+0.50D) and Low Hypermetropia (LH, +0.50<M+2.00D). RPRE was calculated as the difference in M between the central and peripheral positions. The results showed that in both children and adults, horizontally, the RPRE profile for the MM group had a relative hypermetropic shift and in contrast, the profile for LH demonstrated a relative myopic shift. The difference in the profile between the MM and LH group was significant (p<0.05). Also, the RPRE profile for MM group was different between adults and children with adult eyes showing greater amount of hypermetropic shift. Vertically, the RPRE profile of all the refractive error groups showed a myopic shift. Off-axis astigmatism increased and horizontally a shift from 'with the rule' to 'against the rule' astigmatism was observed for all groups. Our observations demonstrated that in Chinese eyes, the myopic group present a hyperopic shift in the periphery, the hypermetropic eye present a myopic shift and the emmetropic eyes present no differences to the fovea, which are similar to those reports in Caucasian eyes. The variations in the RPRE between various refractive error groups can be explained on the basis of eye shape.