A Quantitative Comparison of Multispectral Refraction Topography and Autorefractometer in Young Adults

Correlation Between Relative Peripheral Refraction and Efficacy of Myopia Control After Wearing Multifocal Soft Contact Lenses in Children

INTRODUCTION

This study investigated the relationship between relative peripheral refraction (RPR), retinal choroidal vessel, and the growth rate of axial length (AL) in children with myopia wearing multifocal soft contact lenses (MiSight CLs).

METHODS

Forty-four eyes of 44 children with myopia wearing MiSight CLs were included in the study. RPRs and retinal choroidal vessel were measured at baseline, 3 months, 6 months, and 1 year using multispectral refraction topography (MRT) and optical coherence tomography angiograghy (OCTA). MRT presented RPR at different fields of view and OCTA presented retinal choroidal vessel characteristics centered on the macula. The correlation between the changes of RPR (ΔRPRs) and the growth rate of AL was analyzed.

RESULTS

The baseline AL, spherical equivalent, age, and average growth rate of AL of children are 24.76 ± 0.95 mm,  - 3.22 ± 1.77 D, 11.25 ± 2.42 years, and 0.22 ± 0.17 mm/year. At 3 months, TRPR (RPR of the circular visual field of 53° centered on macular fovea) (p = 0.0007), RPR-15 (p = 0.0042), RPR-30 (p = 0.0012), RPR-45 (p = 0.0031), and RPR-I (p = 0.0082) of children with myopia wearing MiSight CLs were significantly lower than baseline. The ΔRPR was negatively correlated with the growth rate of AL (ΔTRPR, r = - 0.43, p = 0.003; ΔRPR-45, r = - 0.43, p = 0.004; ΔRPR-I, r = - 0.35, p = 0.02; ΔRPR-N, r = - 0.32, p = 0.04). At 1 year, there was a significant difference in the retina vessel volume index compared to baseline (p = 0.0002).

CONCLUSION

RPR showed significant changes at 3 months after wearing multifocal soft contact lenses, but noticeable changes in retinal vessel volume index occurred only at 1 year. MRT demonstrates a higher efficacy in the early detection of the effectiveness of myopia control measures.

Experimental and modeling analysis of lenses with concentric cylindrical annular refractive elements: impact on peripheral imaging

The mechanism by which myopia-managing spectacle lenses slow myopia progression remains controversial. Understanding the changes these lenses introduce to peripheral imaging properties helps shed light on this controversial issue. Given the difficulty of directly measuring these changes in clinical settings, this study combined experimental and modeling approaches to evaluate changes in images at the retina induced by myopia-managing lenses. Optical characteristics that may related to the efficacy of the lenses with concentric cylindrical annular refractive elements (CARE) in myopia control were investigated. Three lenses were evaluated: MyoCare (MC), MyoCare S (MCS), and a single vision (SV) lens with a custom-built physical eye model and optical simulations for the analysis. The simulated PSFs are consistent with the measured ones. PSF analysis showed that MC and MCS lenses produce discrete curves, resulting in remarkable distortion in the simulated retina images, especially for large eccentricities. Whether they increase or decrease contrast depends on the spatial frequencies and eccentricities. These lenses also increase retinal light intensity at different eccentricities. The positive power of the CARE structure introduces myopic defocus of less than 0.25 D at only a limited range of eccentricities. The proposed approaches present relatively straightforward techniques for evaluating the optical performance of myopia-managing spectacle lenses.

The Association of Peripheral Refraction and Relative Peripheral Refraction with Astigmatism in Shanghai Schoolchildren's Myopia: A Cross-Sectional Study

PURPOSE

Currently, no relevant studies have reported a relationship between astigmatism and peripheral refraction (PR). We aimed to describe the association between PR and relative peripheral refraction (RPR) with astigmatism in Chinese children with mild to moderate myopia, and to provide new insights into the influence of astigmatism.

METHODS

Three-hundred-and-seven children (6-14 years old) from Shanghai were included in this study. The PR and RPR were measured using multispectral refraction topography (MRT). Cycloplegic refraction was measured using an autorefractor (KR-8900, Topcon), whereas axial length and ocular biological parameters were measured using Zeiss IOLMaster 700. Only data from the right eye were analyzed. Multivariate linear regression was used to explore the relationship between cylinder power and MRT parameters.

RESULTS

Overall, the median spherical equivalent was -1.50 D (interquartile range, IQR: -2.25, -0.88), showing an apparent trend of hyperopic defocus from the macula to the peripheral retina. Astigmatism was correlated with PR rather than RPR especially at eccentrically inferior and within a 45° radius of the retina (coefficients 0.12-0.18, p < 0.05). Multivariate linear regression analysis demonstrated that the effect of astigmatism on PR tended to increase with greater lens thickness.

CONCLUSIONS

Astigmatism may be a risk factor for myopia due to its impact on peripheral refraction as opposed to relative peripheral refraction. In this cross-sectional study, we also found evidence supporting the association between peripheral hyperopia and myopia.

Repeatability and agreement of multispectral refraction topography in school children before and after cycloplegia

BACKGROUND

The purpose of this study was to evaluate the repeatability and agreement of multispectral refraction topography (MRT) in measuring retinal refraction before and after cycloplegia in children. The results of this study will provide valuable insights into the accuracy and reliability of MRT as a tool for assessing retinal refraction in pediatric patients.

METHODS

Children aged 7 to 18 years old were recruited for this prospective research. The central and peripheral retinal refraction was measured three times using multispectral refraction topography (MRT) before and after cycloplegia. The retinal deviation value (RDV) was used to describe the average peripheral refractive error of the retina. In addition, objective refraction (OR) and subjective refraction (SR) measurements were also performed.

RESULTS

A total of 60 children with a mean age of 10.50 ± 1.81 years were enrolled. Before cycloplegia, all the central and peripheral retinal refraction parameters showed good repeatability with the lowest intraclass correlation coefficient (ICC) being 0.78 in the retinal deviation value from 45° eccentricity to 53° of the retina (RDV 45-53). After cycloplegia, the repeatability of MRT was significantly enhanced (lowest ICC = 0.91 in RDV-I). The 95% limits of agreement (LoA) of the central refraction and OR ranged from - 2.1 to 1.8 D before cycloplegia, and from - 1.69 to 0.27 D after cycloplegia. The 95% LoA of the central refraction and SR ranged from - 1.57 to 0.36 D after cycloplegia. All the 95% LoA demonstrated high agreement.

CONCLUSIONS

The MRT shows high agreement with autorefractometry and experienced optometrist in measuring central refraction. Additionally, the MRT provides good repeatable measurements of retinal peripheral refraction before and after cycloplegia in schoolchildren.

Observations on relative peripheral refraction in Chinese adults with myopia based on a novel application of multispectral refraction topography

In this population-based observational cross-sectional study, we investigated retinal peripheral refraction in Chinese adults with myopia. We categorized 1511 Chinese adults with myopia (18 - 55 years) into low (LM), moderate (MM), and high myopia (HM) groups. Axial length, central corneal thickness, steep keratometry, flat keratometry, and intraocular pressure were measured. Refractive difference values (RDVs) for different eccentricities (RDV0-53) and the superior (RDV-S), inferior (RDV-I), temporal (RDV-T), and nasal (RDV-N) retinal regions were measured using multispectral refractive topography. The hyperopic defocus was higher for the MM group than for the LM group in RDV20-53, RDV-S, and RDV-T and HM group in RDV20-53, RDV-S, RDV-T and RDV-N. The hyperopic defocus was higher for the HM group than for the LM group in RDV20-53, RDV-S and RDV-T but lower for the LM group in RDV-N. RDV-N decreased with age (R2 = 0.0191, slope = - 0.01, p < 0.0001), whereas RDV-S (R2 = 0.0112, slope = 0.01,p < 0.0001) and RDV-T increased (R2 = 0.0038, slope = 0.01, p = 0.0160). RDV correlated with central spherical equivalent and axial length. Flat keratometry explained the most RDV variation (RDV20-30: β = 0.0714, p < 0.0001; RDV-N: β = 0.1801, p < 0.0001; RDV-S: β = 0.1426, p < 0.0001; RDV-T: β = 0.1239, p < 0.0001). Reference values for peripheral retinal defocus are provided for Chinese adults with different myopia ranges.

Analysis of the peripheral refraction in myopic adults using a novel multispectral refraction topography

Purpose

To determine the distribution and characteristics of peripheral refraction in adults with myopia using the novel multispectral refraction topography.

Method

A total of 187 adults with myopia were recruited for this study. This study was conducted in two stages. Part I: participants were divided into 6 groups based on the central refraction of the right eyes, Part II: according to the interocular differences in refractive error (IOD) of the central refraction, we divided the participants into isomyopia group (IOD<1.00 D) and anisomyopia group (IOD≥1.0 D). We surveyed the characteristics of peripheral refraction and relative peripheral refraction (RPR), as well as the correlation between RPR and central refraction, age, sex, and axial length.

Result

Part I: With an increase in the degree of myopia, relative peripheral hyperopia developed from the center to the periphery. A statistically significant hyperopia shift compared to the center (P < 0.05) was first observed on the temporal side within a 40° field of view at the posterior pole of the retina. The RPR of the temporal, superior, and inferior retinas positively correlated only with age. Part II: In the isomyopic participants, there was no difference in peripheral refraction between the eyes (P < 0.05). In the anisomyopic participants, the RPR of the more myopic eyes was more hyperopic than that of the less myopic eyes in NRDV40-50, SRDV10-20, SRDV30-50, TRDV20-30, TRDV40-50, and IRDV10-40.

Conclusion

With an increase in the degree of myopia, relative peripheral hyperopia developed from the center to the periphery, and peripheral refraction progressed at different rates in various retinal zones.

Relative peripheral refraction in school children with different refractive errors using a novel multispectral refraction topographer

AIM

To compare relative peripheral refraction (RPR) in Chinese school children with different refractive errors using multispectral refraction topography (MRT).

METHODS

A total of 713 eyes of primary school children [172 emmetropia (E), 429 low myopia (LM), 80 moderate myopia (MM), and 32 low hypermetropia (LH)] aged 10 to 13y were analyzed. RPRs were measured using MRT without mydriasis. MRT results showed RPR at 0-15° (RPR 0-15), 15°-30° (RPR 15-30), and 30°-45° (RPR 30-45) annular in the inferior (RPR-I), superior (RPR-S), nasal (RPR-N), and temporal (RPR-T) quadrants. Spherical equivalent (SE) was detected and calculated using an autorefractor.

RESULTS

There were significant differences of RPR 15-30 between groups MM [0.02 (-0.12; 0.18)] and LH [-0.13 (-0.36; 0.12)] (P<0.05), MM and E [-0.06 (-0.20; 0.10)] (P<0.05), and LM [-0.02 (-0.15; 0.15)] and E (P<0.05). There were also significant differences of RPR 30-45 between groups MM [0.45 (0.18; 0.74)] and E [0.29 (-0.09; 0.67)] (P<0.05), and LM [0.44 (0.14; 0.76)] and E (P<0.001). RPR values increased from the hyperopic to medium myopic group in each annular. There were significant differences of RPR-S between groups MM [-0.02 (-0.60; 0.30)] and E [-0.44 (-0.89; -0.04)] (P<0.001), and LM [-0.28 (-0.71; 0.12)] and E (P<0.05). There were also significant differences of RPR-T between groups MM [0.37 (0.21; 0.78)] and LH [0.14 (-0.52; 0.50)] (P<0.05), LM [0.41 (0.06; 0.84)] and LH (P<0.05), and LM and E [0.29 (-0.10; 0.68), P<0.05]. A Spearman's correlation analysis showed a negative correlation between RPR and SE in the 15°-30° (P=0.005), 30°-45° (P<0.05) annular (P=0.002), superior (P<0.001), and temporal (P=0.001) quadrants.

CONCLUSION

Without pupil dilation, values for RPR 15-30, 30-45, RPR-S, and T shows significant differences between myopic eyes and emmetropia, and the differences are negatively correlated with SE.

Characteristics of Peripheral Retinal Refraction and Its Role in Children with Different Refractive States

Introduction

Peripheral retinal refraction plays a crucial role in myopia, but the specific mechanism is not clear. We refined the retinal partitions to explore the characteristics of peripheral retinal refraction and its role in emmetropic, low, and moderate myopic children aged 6 to 12 years.

Methods

A total of 814 subjects (814 eyes) were enrolled in the study. The participants were divided into three groups according to the central spherical equivalent refraction (SER), which were emmetropia group (E), low myopia group (LM) and moderate myopia group (MM). Multispectral refractive topography (MRT) was used to measure the retinal absolute and relative refractive difference value (RDV) in different regions. The range was divided into superior, inferior, temporal, and nasal RDV (SRDV, IRDV, TRDV, and NRDV) on the basis of several concentric circles extending outward from the macular fovea (RDV15, RDV30, RDV45, RDV30-15, RDV45-30, and RDV-45). Kruskal-Wallis test was used to analyze the differences of peripheral refraction for all the regions among the three groups. Spearman rank correlation was performed to explore correlations between SER and RDV, axial length (AL) and RDV.

Results

The absolute value of RDV decreased with increasing degree of myopia in all regions (P < 0.01). Subjects with different refractive degrees had different relative value of RDV. In nasal position within 45° and temporal position within 30°, the peripheral retina exhibited significantly different relative hyperopic refractive status among Group E, Group LM, and Group MM (P < 0.05). SER was negatively correlated with NRDV within 30° (especially in the range of NRDV30-15) (r = -0.141, P < 0.01), positively correlated with TRDV within 15° (r = 0.080, P = 0.023), and not significantly correlated with SRDV and IRDV when the retina was divided into four parts. AL was positively correlated with NRDV within 30° (especially in the range of NRDV30-15) (r = 0.109, P = 0.002), negatively correlated with TRDV within 15° (r = -0.095, P = 0.007).

Conclusions

The peripheral defocus has significant implications for the genesis of myopia. The peripheral defocus of the horizontal direction, especially within the range of NRDV30, has greater effect on the development of myopia in children. Higher NRDV30 is associated with lower SER and longer AL.

Effect of Individualized Ocular Refraction Customization Spectacle Lens Wear on Visual Performance in Myopic Chinese Children

Purpose

Individualized ocular refraction customization (IORC) lenses can be individually adjusted depending on the initial relative peripheral refraction to determine the myopic defocus (MD). We aimed to compare visual performance of children wearing IORC lenses with different amounts of MD to determine whether higher MD resulted in greater visual compromise.

Methods

This study included 184 myopic children aged eight to 12 years, and 172 completed the trial. The participants were randomly assigned to wear IORC lenses with low (IORC-L, 2.50 D), medium (IORC-M, 3.50 D), or high (IORC-H, 4.50 D) MD or single-vision spectacle lenses (SVL). Distance and near best-corrected visual acuity (BCVA), contrast sensitivity function (CSF) and questionnaires were evaluated at baseline and after six and 12 months.

Results

CSF over all frequencies and distance and near BCVA were not affected by lens design (all P > 0.05). The SVL group outperformed the three IORC lens groups in terms of ghosting images at baseline, and IORC-H and IORC-M groups outperformed IORC-L group (all P < 0.001); however, no differences were observed at the six- or 12-month visit. There were no significant differences among the four groups for any other subjective variables at any of the follow-up visits regarding vision clarity, vision stability, eyestrain, dizziness, headache, or overall vision satisfaction (all P > 0.05).

Conclusions

The IORC lenses with an actual MD of 4.50 D provided acceptable objective and subjective visual performance and were well tolerated by children.

Translational Relevance

IORC lenses with an actual MD of 4.50 D provided acceptable visual performance.

Impact of pupil and defocus ring intersection area on retinal defocus

PURPOSE

With the rising prevalence of myopia, especially among the young, orthokeratology (Ortho-K) stands out as a promising approach, not only to reduce myopia but also to control the progression of axial length (AL). This study examined how the intersection area between the pupil and defocus ring influenced retinal defocus and axial growth after Ortho-K.

METHODS

A case-control study was conducted with 100 participants (100 eyes). Both AL and the refraction difference value (RDV), that is, the peripheral refractive error measured with respect to the central value after wearing Ortho-K lenses, were determined. Subjects were categorised into two groups based on the size of the intersection area after 3 months of lens wear: Group A (<4.58 mm2 ) and Group B (≥4.58 mm2 ).

RESULTS

Group B demonstrated significantly lower changes in AL and RDV at 30-40° and 40-53° compared with Group A after 3 months of lens wear (all p < 0.05). After 6 months of lens wear, Group B showed significantly lower changes in AL and RDV in the 40-53° region compared with Group A (all p < 0.05). Correlation analysis revealed that as the intersection area increased, the changes in AL and RDV at 0-53°, 30-40° and 40-53° eccentricity decreased after both 3 and 6 months of lens wear (all p < 0.01).

CONCLUSIONS

A larger intersection area between the pupil and defocus ring within a certain time period can cause a greater amount of myopic defocus at 30-53° from the fovea. The results suggest that a larger intersection area might lead to more effective control of axial growth.

Association Between Peripheral Retinal Defocus and Myopia by Multispectral Refraction Topography in Chinese Children

Objective

To investigate the association between the peripheral refractive errors of the fundus in different regions and moderate and high myopia.

Methods

In this case-control study, 320 children and adolescents aged 6 to 18 years were recruited. Peripheral refractive errors were measured using multispectral retinal refractive topography (MRT). Spherical equivalent (SE) and cylinder errors were classified into low, moderate, and high categories based on the magnitude range. Logistic regression was performed to test the factors associated with myopia.

Results

There were 152 participants with low myopia and 168 participants with moderate and high myopia included in the current study. Participants with moderate and high myopia were most likely to be older, with larger axial length (AL), lower SE, less time to watch electronic devices on the weekend, a higher difference between central refractive error and paracentral refractive error from the superior side of the retina (RDV-S), but a smaller difference between the central refractive error and paracentral refractive error from the inferior side of the retina (RDV-I) than those with low myopia (all P <0.05). After logistic analysis, female sex (odds ratio [OR] = 4.14; 95% confidence interval [CI] = 2.16-7.97, P <0.001), AL (OR = 6.88, 95% CI = 4.33-10.93, P <0.001), and RDV-I (OR = 0.52, 95% CI = 0.32-0.86, P = 0.010) were independent factors for moderate and high myopia.

Conclusion

Our study demonstrated that the retina peripheral refraction of the eyes (RDV-I) was associated with moderate and high myopia, and RDV-S was only associated with high myopia.

Observation of peripheral refraction in myopic anisometropia in young adults

AIM

To investigate the differences in retinal refraction difference values (RDVs) of adult patients with myopic anisometropia compared with those without myopic anisometropia, and to investigate the relationship between ocular biometric measurements and relative peripheral refraction.

METHODS

This clinical observation study included 130 patients with myopia (-0.25 to -10.00 D) between October 2022 and January 2023 aged between 18 and 40y. The patients were divided into anisometropia (n=63; difference in binocular anisometropia ≥1.00 D) and non-anisometropia (n=67; difference in binocular anisometropia <1.00 D) groups accordingly. Ocular biometric measurements were performed by optical biometrics and corneal topography to assess the steep keratometry (Ks), flap keratometry (Kf), axial length (AL), corneal astigmatism (CYL; Ks-Kf), surface regularity index (SRI), surface asymmetry index (SAI), and central corneal thickness (CCT). The RDV was measured at five retinal areas from the fovea to 53 degrees (RDV-0-10, RDV-10-20, RDV-20-30, RDV-30-40, and RDV-40-53), the total RDV (TRDV) of 53 degrees, and four regions, including RDV-superior, RDV-inferior, RDV-temporal, and RDV-nasal. An analysis of Spearman correlation was carried out to examine the correlation between RDV and the spherical equivalent (SE) and ocular biological parameters.

RESULTS

Within RDV-20-53, both groups showed relative hyperopic defocus, and the increase in RDV corresponds to the increase in eccentricity. In the myopic anisometropia group, the TRDV, RDV-20-53, RDV-superior, and more myopic eyes had significantly higher RDV-temporal values than less myopic eyes. (P<0.05). In the non-anisometropia group, there was no significant difference in the RDV between the more and less myopic eyes at different eccentricities (P>0.05). There was a negative correlation between SE and TRDV (r=-0.205, P=0.001), RDV-20-53 (r=-0.281, -0.183, -0.176, P<0.05), RDV-superior (r=-0.251, P<0.001), and RDV-temporal (r=-0.230, P<0.001), a negative correlation between CYL and RDV-10-30 (r=-0.147, -0.180, P<0.05), and a negative correlation between SRI and RDV-0-20 (r=-0.190, -0.170, P<0.05). AL had a positive correlation with RDV-20-30 (r=0.164, P=0.008) and RDV-temporal (r=0.160, P=0.010).

CONCLUSION

More myopic eyes in patients with myopic anisometropia show more peripheral hyperopic defocus. Diopter and corneal morphology may affect peripheral retinal defocus.

Changes in relative peripheral refraction and optical quality in Chinese myopic patients after small incision lenticule extraction surgery

PURPOSE

To observe changes in retinal refraction difference values (RDV) and aberrations after small incision lenticule extraction (SMILE) surgery and evaluate their correlations.

METHODS

This study recruited 112 patients (112 eyes) who underwent SMILE for myopia. Participants were classified into the Low and Moderate Myopia group (LM, -0.50 to -6.0 D) and High Myopia group (HM, >-6.0 D) according to the central spherical equivalent (SE). RDVs in the five retinal eccentricities from 0° to 10°, 10° to 20°, 20° to 30°, 30° to 40°, and 40° to 53° are recorded as RDV-(0-10), RDV-(10-20), RDV-(20-30), RDV-(30-40), and RDV-(40-53), respectively; additionally, RDVs have four sectors, i.e., RDV-Superior (RDV-S), RDV-Inferior (RDV-I), RDV-Temporal (RDV-T), and RDV-Nasal (RDV-N). With a 3-month follow-up, changes in RDV (ΔRDV) and changes in aberrations [Δtrefoil, Δcoma, Δspherical aberration (SA), and Δtotal higher-order aberrations (HOA)] after surgery were recorded.

RESULTS

No significant differences were observed in total RDV (TRDV), RDV-(0-53), RDV-S, RDV-I, RDV-N, trefoil, coma, and SA between the two groups before SMILE surgery. However, after SMILE, hyperopic defocus values [TRDV, RDV-(20-53), RDV-S, RDV-T, and RDV-N] in the LM group and hyperopic defocus values [TRDV, RDV-(20-53), RDV-S, and RDV-N] in the HM group were significantly lower at 3 months postoperatively than preoperatively, and the RDV-(40-53), RDV-S, and RDV-N were lower in the HM group than in the LM group. Aberrations [trefoil (vertical), coma, and HOA] in the LM group and aberrations (trefoil, coma, SA, and HOA) in the HM group were significantly higher at 3 months postoperatively than preoperatively, and the coma, trefoil(horizontal), SA, and HOA were higher in the HM group than in the LM group. In the multivariate analysis, ΔRDV-(40-53) was significantly correlated with ΔSA, and ΔRDV-T and ΔRDV-N were significantly correlated with Δcoma (horizontal).

CONCLUSIONS

Our findings suggest that SMILE reduces retinal peripheral hyperopic defocus but introduces some higher-order aberrations, especially in people with high myopia refractive errors.

Chinese Version of the Vision-Related Quality of Life (NEI-VFQ-25) among Patients with Various Ocular Disorders: A Pilot Study

Background and Objectives: Subjective visual function is currently becoming an increasing appreciation in assessing the health-related quality of life. This study aimed to assess the vision-related quality of life (VRQOL) among patients with refractive errors, keratoconus, senile cataract, and age-related macular degeneration (AMD) using the Chinese version of the National Eye Institute Visual Function Questionnaire 25 (NEI-VFQ-25). Materials and Methods: The questionnaire of NEI-VFQ-25 was filled out in a clinical setting or by telephone/mail. Univariate and multivariate analyses were used to determine which factors are associated with the NEI-VFQ-25. Results: From June 2018 to January 2019, 28 patients with refractive error, 20 patients with keratoconus, 61 with senile cataracts, and 17 with AMD completed the questionnaire NEI-VFQ-25. There were significant differences in the NEI-VFQ-25 subscale of general vision (p = 0.0017), ocular pain (p = 0.0156), near activities (p = 0.0002), vision-specific social functioning (p = 0.007), vision-specific mental health (p = 0.0083), vision-specific dependency (p = 0.0049), color vision (p < 0.0001), peripheral vision (p = 0.0065), and total score (p < 0.0001) among four disease groups, respectively. The multiple linear regression revealed that the best-corrected visual acuity (BCVA) and disease group were important factors of the total NEI-VFQ-25. After adjusting for BCVA, patients with AMD had a worse total NEI-VFQ-25 score than patients with refractive error, keratoconus, or senile cataracts. Conclusions: Among the patients with four ocular disorders and a broad vision spectrum from normal, partial sight, low vision to legal blindness, the BCVA of their better eye was the most important factor in the VRQOL.

Agreement and Repeatability of Central and Peripheral Refraction by One Novel Multispectral-Based Refractor

Purpose: To evaluate the repeatability of a multispectral-based refractor in central and peripheral refraction measurement, and to assess the agreement of such measurements with objective refraction (OR) and subjective refraction (SR) in patients with myopia.

Methods: A total of 60 subjects were recruited in this prospective research. Patients were divided into three groups according to the refractive error. Next, the central and peripheral refraction parameters were measured using multispectral refractive tomography (MRT) before and after cycloplegia. In addition, OR and SR measurements were also performed. The intraobserver repeatability was analyzed using within-subject standard deviation (Sw), test–retest repeatability (TRT), and intraclass correlation coefficient (ICC). Agreement was evaluated using Bland-Altman plot and 95% limits of agreement (LoA).

Results: The ICC value of central and peripheral refraction were all higher than 0.97 with or without cycloplegia. The peripheral refraction in the nasal, temporal, superior, and inferior quadrants was slightly worse than other parameters, with the largest error interval being 1.43 D. The 95% LoA of the central refraction and OR or SR ranged from −0.89 to 0.88 D and −1.24 to 1.16 D without cycloplegia, respectively, and from −0.80 to 0.42 D and −1.39 to −0.84 D under cycloplegia, respectively.

Conclusions: The novel multispectral refraction topography demonstrated good repeatability in central and peripheral refraction. However, the refraction in the nasal, temporal, superior, and inferior quadrants were not as good as that of central and circle peripheral refraction.