Purpose: Peripheral refraction and retinal shape may influence refractive development. Peripheral refraction has been shown to have a high degree of variability and can take considerable time to perform. Spectral domain optical coherence tomography (SD-OCT) and peripheral axial length measures may be more reliable, assuming that the retinal position is more important than the peripheral optics of the lens/cornea.
Methods: Seventy-nine subjects' right eyes were imaged for this study (age range, 22 to 34 years; refractive error, -10 to +5.00). Thirty-degree SD-OCT (Spectralis, Heidelberg Engineering, Heidelberg, Germany) images were collected in a radial pattern along with peripheral refraction with an autorefractor (Shin-Nippon Autorefractor) and peripheral axial length measurements with partial coherence interferometry (IOLMaster, Zeiss). Statistics were performed using repeated-measures analysis of variance in SPSS (IBM, Armonk, NY), Bland-Altman analyses, and regression. All measures were converted to diopters to allow direct comparison.
Results: Spectral domain OCT showed a retinal shape with an increased curvature for myopes compared with emmetropes/hyperopes. This retinal shape change became significant around 5 degrees. The SD-OCT analysis for retinal shape provides a resolution of 0.026 diopters, which is about 10 times more accurate than using autorefraction (AR) or clinical refractive techniques. Bland-Altman analyses suggest that retinal shape measured by SD-OCT and the partial coherence interferometry method were more consistent with one another than either was with AR.
Conclusions: With more accurate measures of retinal shape using SD-OCT, consistent differences between emmetropes/hyperopes and myopes were found nearer to the fovea than previously reported. Retinal shape may be influenced by central refractive error, and not merely peripheral optics. Partial coherence interferometry and SD-OCT appear to be more accurate than AR, which may be influenced by other factors such as fixation and accommodation. Autorefraction does measure the optics directly, which may be a strength of that method.