Abstract:Abstract Objective: To observe the defocus state and myopia control in myopic children wearing single-vision, defocus, and orthokeratology lenses using a multispectral refraction topography (MRT). Methods: This clinical retrospective study involved 290 myopic patients aged 8–14 years old with an equivalent spherical lens (SE) of ?7.00D to ?0.50D, treated at the Aier Eye Hospital of Chengdu from June 2022 to December 2023. Patients who volunteered for the study, were assigned to three groups A total of 97 patients were provided with single-vision spectacle lenses (SVL group), 95 received individualized ocular refraction customization (IORC group), and 98 orthokeratology lenses (OK group). Simultaneously, the three groups were further categorized into low (?3.00D to ?0.50D), moderate (?6.00D to ?3.25D), and high myopia (?7.00D to ?6.25D) groups according to their degree of SE (the right eye was selected as test eye). We used a multispectral refraction topography (MRT) to compare the defocus changes of the retina in four quadrants (upper, lower, nasal, temporal quadrants (RDV-S, RDV-I, RDV-N, RDV-T) and three eccentric regions (0~15o, 15o~30o, 30o~45o, RDV-15, RDV-30, RDV-45) in the three groups. A one-way analysis of variance was used for intergroup comparisons and a paired t-test was used for intragroup comparisons. Univariate and multivariate linear regression analyses were used to analyze the factors related to changes in the AL at one year after intervention. Results: There was a significant difference in 1-year equivalent spherical lens and axial length growth among patients in the SVL, IORC, and OK groups before and after intervention (P < 0.05). The pairwise comparison of 1-year equivalent spherical lens and the difference of ocular axis growth in patients with low myopia was significantly different among SVL, IORC, and OK groups (P <0.05); however, there was no significant difference between the IORC and OK mirror groups (P >0.05). Further, there were significant differences between moderate myopia treatment 1 a (P < 0.05), and high myopia (HM) interval treatment 1 a, OK lens group compared with the IORC and SVL groups, (P < 0.05), whereas the IORC and SVL groups showed no significant differences (P > 0.05). In addition, there were significant differences in the four quadrants and three eccentric regions RPRE among myopia groups (P < 0.05). Pin-wise comparison of the growth difference of 1 a eccentric D-RDV-15 in low myopia group showed significant differences between the SVL, IORC, and OK groups (P < 0.05), but no significant differences between the IORC and OK groups (P > 0.05). Moderate myopia interval treatment 1a eccentric D-RDV-30 in the SVL group was compared with that of IORC and OK groups. The difference was statistically significant (P < 0.05).Further the IORC and OK groups showed no significant differences (P > 0.05); the high myopia treatment 1 a eccentric D-RDV-15, there was a significant difference among OK, IORC, and SVL groups (P < 0.05) but there was no significant difference between the IORC and SVL groups (P > 0.05). Univariate and multivariate linear regression model analysis showed that the changes in D-TRVD, D-RDV-45, RDV-N, and D-RDV-I correlated with the increase in the difference in 1a AL. Conclusion: MRT can be used to guide the clinical control of myopia. Myopia development is related to the peripheral retinal defocus state, and the difference of defocus quantity in the inferior nasal side at 30o~45o eccentricity may be a factor regulating the rapid progression of myopia.
