Peripheral Refraction Is a Key Predictor of Myopia Progression in Children

Recent research highlights the significant role of relative peripheral refraction (RPR) in predicting the progression of myopia among children. A study published in the American Journal of Ophthalmology on June 16, 2025, demonstrates that both vertical and horizontal RPR are linked to faster axial length growth, which is a primary factor in myopia development. The study involved 1,635 children aged 9 to 13 years, assessed through advanced MRI-based techniques that personalized ray tracing methods to analyze eye structure.

The researchers found that children with more hyperopic RPR—meaning their peripheral vision showed less myopic defocus—had a higher likelihood of rapid myopia progression. Both horizontal and vertical RPR were strongly associated with increased axial length, lower spherical equivalent refraction, and were significant predictors even after adjusting for other factors like birth weight and retinal curvature.

Importantly, the study revealed that each diopter increase in RPR corresponded with a notable rise in the risk of developing myopia. Specifically, the odds ratios were 1.40 for horizontal RPR and 1.29 for vertical RPR, indicating that children with higher RPR values are at greater risk.

The study’s lead author, Dr. Sander C.M. Kneepkens, emphasized the clinical importance of these findings: "We found that higher RPR is strongly associated with faster axial length growth and an increased risk of myopia onset. This suggests that measuring peripheral refraction could improve our ability to predict and eventually prevent the progression of myopia in children."

These insights could pave the way for targeted interventions that modify peripheral defocus, offering new strategies to control myopia progression and reduce the burden of this common visual condition. The use of MRI-based assessments presents a promising avenue for personalized eye care in pediatric populations.

Source: MedicalXpress