Influence of higher order aberrations and retinal image quality in myopisation of emmetropic eyes

•Higher order aberrations at baseline was not associated with myopisation.•Retinal image quality for 5mm pupil diameter was not associated with myopisation.•The eyes with myopic change decreased in positive spherical aberration.•The eyes with no change increased in positive spherical aberration.•The change in spherical aberration is associated with changes in crystalline lens. Refractive error, higher order aberrations (HOA), axial length (AL), anterior chamber depth (ACD) and average corneal radius of curvature were measured after cycloplegia from 166 emmetropic participants at the Sydney Myopia Study (SMS, 2004–2005, age 12.63±0.48years). Measurements were repeated approximately 5years later at the Sydney Adolescent Vascular and Eye Study (SAVES, 2009–2010, age 17.08±0.67years). The baseline spherical equivalent (M) did not differ significantly between the participants lost to follow-up (65%) and the participants enrolled in SAVES study (p=0.932). Refractive error and HOA were measured using a Shack-Hartmann aberrometer for a pupil diameter of 5mm and AL, ACD and average corneal curvature measured using IOL Master at both visits. Retinal image quality in terms of Visual Strehl ratio (VSOTF) for a 5mm pupil diameter was determined using on-axis lower and HOA. General linear model was used to determine the association of HOA and retinal image quality with change in refraction. Of the 166 emmetropes, 41 (25%) had myopic change (change in M>−0.50D) and 125 (75%) had no change in refraction (change in M between +0.49D and −0.49 D). Change in C[4,0] (p