Size of living space as a moderator for central and peripheral refractions in children

Abstract Undesirable living environment may impose risk on myopia development. Furthermore, peripheral refractive error was suggested to contribute to juvenile eye growth modulation. This study aimed to investigate the interaction between peripheral refractive error and living environment in relatio...

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Main Authors: Kai Yip Choi, Tsz Wing Leung, Henry Ho-Lung Chan
Format: Article
Language:English
Published: Nature Portfolio 2023-07-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-023-37454-w
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author Kai Yip Choi
Tsz Wing Leung
Henry Ho-Lung Chan
author_facet Kai Yip Choi
Tsz Wing Leung
Henry Ho-Lung Chan
author_sort Kai Yip Choi
collection DOAJ
description Abstract Undesirable living environment may impose risk on myopia development. Furthermore, peripheral refractive error was suggested to contribute to juvenile eye growth modulation. This study aimed to investigate the interaction between peripheral refractive error and living environment in relation to central refractive status in Hong Kong schoolchildren. Central and peripheral refractive errors, axial length (AL), and corneal radius of curvature (CR) were measured in 573 schoolchildren (age 9.5 ± 0.9 years). The AL/CR ratio was used to represent the central refractive status, accounting for non-cycloplegic refraction. The relative peripheral refractive errors (RPRE) up to ± 20° eccentricities were converted into power vectors: spherical-equivalent error (SER) and J0 astigmatic components and fitted with quadratic equations. The second-order coefficients of SER (aSER) and J0 astigmatism (aJ0) and home size reported by parental questionnaires were analyzed to indicate their relationships with AL/CR. Our results showed that children with higher AL/CR lived in smaller homes (p = 0.01) and had a more hyperopic (p < 0.001) but less astigmatic RPRE (p = 0.01). We further analyzed the relationship between AL/CR with RPRE for children living in small (< 300 ft2), moderate (300–600 ft2), and large home sizes (> 600 ft2). Regardless of the home size, a higher AL/CR remained moderately correlated with a more hyperopic aSER (all p < 0.001). However, a higher AL/CR was associated with a more positive aJ0 only in children living in large homes, and the relationships were not significant for small and moderate home sizes. Linear regression models further indicated that home size was a significant moderator contributing to the relationship between AL/CR and aJ0. In conclusion, our results were consistent with previous studies, showing that children with axial myopia usually lived in smaller homes and had more hyperopic defocus and more positive J0 astigmatism. However, the relationship between peripheral astigmatism and axial refraction was modulated by the home size of Hong Kong schoolchildren. While peripheral astigmatism is hypothesized as a visual cue for axial refractive development in children, extrinsic environmental factors, such as home size, might interfere with the relationship and dominate refractive development.
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spelling doaj.art-04c90f2e8937481bbd89eef7d3a17e792023-07-09T11:11:36ZengNature PortfolioScientific Reports2045-23222023-07-011311810.1038/s41598-023-37454-wSize of living space as a moderator for central and peripheral refractions in childrenKai Yip Choi0Tsz Wing Leung1Henry Ho-Lung Chan2Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic UniversityCentre for Myopia Research, School of Optometry, The Hong Kong Polytechnic UniversityCentre for Myopia Research, School of Optometry, The Hong Kong Polytechnic UniversityAbstract Undesirable living environment may impose risk on myopia development. Furthermore, peripheral refractive error was suggested to contribute to juvenile eye growth modulation. This study aimed to investigate the interaction between peripheral refractive error and living environment in relation to central refractive status in Hong Kong schoolchildren. Central and peripheral refractive errors, axial length (AL), and corneal radius of curvature (CR) were measured in 573 schoolchildren (age 9.5 ± 0.9 years). The AL/CR ratio was used to represent the central refractive status, accounting for non-cycloplegic refraction. The relative peripheral refractive errors (RPRE) up to ± 20° eccentricities were converted into power vectors: spherical-equivalent error (SER) and J0 astigmatic components and fitted with quadratic equations. The second-order coefficients of SER (aSER) and J0 astigmatism (aJ0) and home size reported by parental questionnaires were analyzed to indicate their relationships with AL/CR. Our results showed that children with higher AL/CR lived in smaller homes (p = 0.01) and had a more hyperopic (p < 0.001) but less astigmatic RPRE (p = 0.01). We further analyzed the relationship between AL/CR with RPRE for children living in small (< 300 ft2), moderate (300–600 ft2), and large home sizes (> 600 ft2). Regardless of the home size, a higher AL/CR remained moderately correlated with a more hyperopic aSER (all p < 0.001). However, a higher AL/CR was associated with a more positive aJ0 only in children living in large homes, and the relationships were not significant for small and moderate home sizes. Linear regression models further indicated that home size was a significant moderator contributing to the relationship between AL/CR and aJ0. In conclusion, our results were consistent with previous studies, showing that children with axial myopia usually lived in smaller homes and had more hyperopic defocus and more positive J0 astigmatism. However, the relationship between peripheral astigmatism and axial refraction was modulated by the home size of Hong Kong schoolchildren. While peripheral astigmatism is hypothesized as a visual cue for axial refractive development in children, extrinsic environmental factors, such as home size, might interfere with the relationship and dominate refractive development.https://doi.org/10.1038/s41598-023-37454-w
spellingShingle Kai Yip Choi
Tsz Wing Leung
Henry Ho-Lung Chan
Size of living space as a moderator for central and peripheral refractions in children
Scientific Reports
title Size of living space as a moderator for central and peripheral refractions in children
title_full Size of living space as a moderator for central and peripheral refractions in children
title_fullStr Size of living space as a moderator for central and peripheral refractions in children
title_full_unstemmed Size of living space as a moderator for central and peripheral refractions in children
title_short Size of living space as a moderator for central and peripheral refractions in children
title_sort size of living space as a moderator for central and peripheral refractions in children
url https://doi.org/10.1038/s41598-023-37454-w
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