Association between myopia and relative peripheral refraction in children with monocular Tilted disc syndrome.

Background: This study aimed to investigate the refractive error and relative peripheral refraction in pediatric patients with monocular tilted disc syndrome.

Methods: This single-center, prospective, cross-sectional, observational study included 49 patients from the Pediatric Ophthalmology Department of the Second Hospital of Hebei Medical University aged 5-17 years with monocular tilted disc syndrome. Eyes with tilted optic discs formed the study group, and contralateral eyes with normal discs served as controls, with mean spherical equivalents of - 3.24 D and - 0.47 D, respectively. Best-corrected visual acuity, spherical equivalent, axial length, tilt ratio, defined as the ratio of maximum to minimum disc diameters, and relative peripheral refraction, assessing myopia-related defocus were compared between groups. Pearson's correlation analysis assessed associations between optic disc tilt and spherical equivalent, axial length, and the total refraction difference value.

Results: Tilted optic discs were associated with significantly greater myopia (- 3.24 ± 1.83 D in tilted eyes and - 0.47 ± 0.72 D in non-tilted eyes, P <.001), longer axial length (24.59 ± 1.04 mm in tilted eyes and 23.45 ± 0.78 mm in non-tilted eyes, P <.001), and a higher tilt ratio (1.43 ± 0.05 in tilted eyes and 1.14 ± 0.04 in non-tilted eyes, P <.001). Discrepancies between tilted and non-tilted eyes were observed in the superior, inferior, and nasal quadrants, and the total refraction difference value (P <.001). In eyes with tilted disc syndrome, a negative correlation was found between the total refraction difference value and the spherical equivalent (P <.001). The tilt ratio of optic disc eyes was significantly greater than that of contralateral eyes and was negatively correlated with the spherical equivalent. There was a positive correlation between the tilt ratio and axial length (P <.001).

Conclusions: Pediatric patients with monocular tilted disc syndrome exhibited longer axial lengths, more myopic spherical equivalent, and more positive relative peripheral refraction. A greater tilt ratio is associated with larger relative peripheral refraction and axial length, corresponding to more severe myopia.