title: Relative peripheral refractive error and the risk of onset and progression of myopia in children.
abstract: OBJECTIVE
  To investigate whether relative peripheral hyperopia is a risk factor for either the onset of myopia in children or the rate of myopic progression.
  
  
  METHODS
  The risk of myopia onset was assessed in 2043 nonmyopic third-grade children (mean age ± SD = 8.8 ± 0.52 years) participating in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) Study between 1995 and 2007, 324 of whom became myopic by the eighth grade. Progression analyses used data from 774 myopic children in grades 1 to 8. Foveal and relative peripheral refractive error 30° in the nasal visual field was measured annually by using cycloplegic autorefraction. Axial length was measured by A-scan ultrasonography.
  
  
  RESULTS
  The association between more hyperopic relative peripheral refractive error in the third grade and the risk of the onset of myopia by the eighth grade varied by ethnic group (Asian children odds ratio [OR] = 1.56, 95% confidence interval [CI] = 1.06-2.30; African-American children OR = 0.75, 95% CI = 0.58-0.96; Hispanics, Native Americans, and whites showed no significant association). Myopia progression was greater per diopter of more hyperopic relative peripheral refractive error, but only by a small amount (-0.024 D per year; P = 0.02). Axial elongation was unrelated to the average relative peripheral refractive error (P = 0.77), regardless of ethnicity.
  
  
  CONCLUSIONS
  Relative peripheral hyperopia appears to exert little consistent influence on the risk of the onset of myopic refractive error, on the rate of myopia progression, or on axial elongation.
authors.affiliation: The Ohio State University College of Optometry, Columbus, OH, USA. mutti.2@osu.edu
authors.forename: Donald O
authors.initials: DO
authors.lastname: Mutti
authors.forename: Loraine T
authors.initials: LT
authors.lastname: Sinnott
authors.forename: G Lynn
authors.initials: GL
authors.lastname: Mitchell
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Jones-Jordan
authors.forename: Melvin L
authors.initials: ML
authors.lastname: Moeschberger
authors.forename: Susan A
authors.initials: SA
authors.lastname: Cotter
authors.forename: Robert N
authors.initials: RN
authors.lastname: Kleinstein
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Manny
authors.forename: J Daniel
authors.initials: JD
authors.lastname: Twelker
authors.forename: Karla
authors.initials: K
authors.lastname: Zadnik
mesh_terms: D058452:Axial Length, Eye; D002648:Child; D018450:Disease Progression; D005006:Ethnicity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006956:Hyperopia / Q000150:complications* / Q000208:ethnology; D008297:Male; D009216:Myopia / Q000209:etiology* / Q000503:physiopathology*; D012307:Risk Factors