目的：探讨单眼近视患者的视网膜周边离焦特点及其相关因素。

方法：横断面研究。连续性纳入2023年8月至2025年3月在我院就诊的单眼近视患者。根据等效球镜与裸眼视力分为两组：近视眼组(等效球镜≤-0.50 D且裸眼视力<0.2 LogMAR)与对侧正常眼组(等效球镜≥-0.25 D且裸眼视力≥0 LogMAR)。比较两组患者全视野内的总离焦值(TRDV)，15°、30°、45°视野内的总离焦值(RDV-15、RDV-30、RDV-45)，以及上方、下方、颞侧、鼻侧眼底区域的总离焦值(RDV-S、RDV-I、RDV-T、RDV-N)。

结果：本研究共纳入81例单眼近视患者，近视眼组81眼，对侧正常眼组81眼。其中男42例、女39例，8-12岁47例、13-17岁34例，平均年龄11.8±2.4岁。两组患者TRDV、RDV-30、RDV-45、RDV-I、RDV-S、RDV-N、RDV-T均有差异(均P<0.001)。8-12岁和13-17岁患者近视眼组和对侧正常眼组RDV-15比较均无差异(均P>0.05)，13-17岁患者中近视眼组和对侧正常眼组RDV-S比较均无差异(均P>0.05)，其余参数在8-12岁和13-17岁患者近视眼组和对侧正常眼组间比较均有差异(均P<0.05)。Pearson相关分析结果显示近视眼组患者年龄与TRDV(r=0.31，P=0.005)、RDV-30(r=0.33，P=0.002)、RDV-45(r=0.32，P=0.004)、RDV-N(r=0.37，P<0.001)呈正相关； 对侧正常眼组患者暗瞳直径与TRDV(r=-0.25，P=0.03)、RDV-45(r=-0.25，P=0.02)、RDV-S(r=-0.29，P=0.008)、RDV-N(r=-0.27，P=0.014)呈负相关； 年龄与RDV-N(r=0.30，P=0.006)、眼轴与RDV-T(r=0.30，P=0.006)呈正相关。

结论：单眼近视患者的近视眼与对侧视力正常眼的视网膜周边离焦状态存在差异，前者呈远视性离焦且离焦量随年龄而增长，后者呈近视性离焦且暗瞳直径越大、近视性离焦量越大。

METHODS: This cross-sectional study included consecutive anisometropic myopic patients who visited Center for Optometry and Visual Science from August 2023 to March 2025 in Guangxi Zhuang Autonomous Region. Eyes were classified based on spherical equivalent(SE)and uncorrected visual acuity(UCVA): myopic eyes(SE ≤-0.50 D, UCVA <0.2 LogMAR)and contralateral normal eyes(SE ≥-0.25, UCVA ≥0 LogMAR). Total relative defocus value(TRDV)across the visual field, RDV at 15°, 30°, and 45°(RDV-15, RDV-30, RDV-45), and quadrant-specific RDV(superior/RDV-S, inferior/RDV-I, temporal/RDV-T, nasal/RDV-N)were compared between groups.

RESULTS: This study enrolled 81 anisometropic patients(81 myopic eyes, 81 contralateral normal eyes). The cohort comprised 42 males and 39 females, 47 patients aged 8-12 y and 34 patients aged 13-17 y(mean age: 11.8±2.4 y). Myopic eyes demonstrated significantly higher values in TRDV, RDV-30, RDV-45, RDV-I, RDV-S, RDV-N, and RDV-T versus contralateral normal eyes(all P<0.001). RDV-15 showed no significant difference between groups in either 8-12-year-olds or 13-17-year-olds(both P>0.05). Among 13-17-year-olds, RDV-S also exhibited no intergroup difference(P>0.05). All other parameters differed significantly across both age strata(all P<0.05). In myopic eyes, age positively correlated with TRDV(r=0.31, P=0.005), RDV-30(r=0.33, P=0.002), RDV-45(r=0.32, P=0.004), and RDV-N(r=0.37, P<0.001). In contralateral eyes, scotopic pupil diameter negatively correlated with TRDV(r=-0.25, P=0.03), RDV-45(r=-0.25, P=0.02), RDV-S(r=-0.29, P=0.008), and RDV-N(r=-0.27, P=0.014). And age positively correlated with RDV-N(r=0.30, P= 0.006), axial length positively correlated with RDV-T(r=0.30, P=0.006).

CONCLUSION: The peripheral defocus of unilateral myopic eyes varies from that of their contralateral normal counterparts. The former presents hyperopic defocus, which augments with age, while the latter displays myopic defocus, which accentuates with the increase of the scotopic pupil size.