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Peripheral retina strategies may impede myopia progression

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VANCOUVER, British Columbia — By concentrating on peripheral retina strategies and moving beyond “foveocentric” strategies, it may be possible to correct myopia or even slow its progression, according to a speaker here.

“We need to expand our thought processes away from the fovea and also think about the peripheral retina,” David B. Granet, MD, FACS, FAAP, told colleagues at the American Association for Pediatric Ophthalmology and Strabismus meeting in a workshop on myopia that was jointly hosted with the American Academy of Pediatrics.

The mechanisms of myopia are under study, but no definitive cause has been established, he said.

Traditional correction for myopia puts the image on the fovea but leaves the peripheral retina unfocused, so there is hyperopic defocus out in the periphery. Conventional spectacles induce relative hyperopia in the periphery, Granet said.

Optimal correction would bring the peripheral image forward, increasing the effective curvature of field, and not only correct central errors, but also either correct peripheral errors or induce peripheral myopic defocus, according to the presentation.

Bifocal contact lenses and spectacles that use a peripheral retina approach to myopia correction are under study, with some results in select populations showing an effect on myopia progression as well, according to the presentation.

“Peripheral treatment strategies produce an anti-myopia treatment effect, in general — there are some studies that aren’t quite as clear — while maintaining optimal central vision,” Granet said. “Peripheral treatment strategies also seem to produce clarity in the periphery.”

Peripheral treatment strategies can be implemented using traditional optical treatment methods, such as spectacles, contact lenses, orthokeratology and corneal laser surgery, according to Granet. – by Patricia Nale, ELS

Reference: Granet DB. A close up look at treatments for myopia. Workshop C. Myopia – Pathogenesis, control and treatment: A practical update for the clinician. Presented at: American Association for Pediatric Ophthalmology and Strabismus 42nd annual meeting; April 6-10, 2016; Vancouver, British Columbia.

Disclosure: Granet reports no relevant financial disclosures.