Optical Quality of Emmetropic and Myopic Eyes in the Periphery Measured with High-Angular Resolution

PURPOSE. On average, myopic eyes present a relative hyperopia in the peripheral retina. This has been associated with the possibility that by modifying the peripheral refraction, the progression of central myopia could be controlled. The authors explored how refractive errors and optical aberrations interact in the formation of the retinal image in the periphery, in eyes with different central refractions. METHODS. The authors used a fast and high-angular resolution scanning wavefront sensor to measure the optical image quality of the eye in the horizontal meridian (+/- 40 degrees) in 202 eyes of 101 subjects, 54 males and 47 females with an average age (std) of 27.5 (+/- 7.2) years and an average foveal refraction (std) of -0.8 (+/- 1.3 D) of which 64 were non-myopes (refraction +/- std: 0.01 +/- 0.46 D) and 37 myopes (-2.12 +/- 1.08 D). They evaluated the relationship between peripheral optical properties and central refraction using different metrics. RESULTS. The authors observed a significant tendency to a relative hyperopia in the periphery of the myopic eyes. The relative peripheral refraction (RPR) was significantly different between the emmetropic and myopic eyes from 15 degrees-40 degrees temporal retina and from 20 degrees-40 degrees nasal retina. The mean RPR metric correlated with the central refraction of the subject (r = -0.552/-0.560 [OD / OS]). The image quality presented only minor differences between the various refractive groups at angles of 30 degrees-40 degrees when the central refraction was corrected. CONCLUSIONS. Peripheral overall blur is mostly influenced by the interaction of defocus and oblique astigmatism, and at larger eccentricities is similar for the different refractive groups. This could argue against the hypothesis that a relative peripheral hyperopia could drive eyes toward myopia. (Invest Ophthalmol Vis Sci. 2012;53:3405-3413) DOI:10.1167/iovs.11-8993