Peripheral Retinal changes in moderate to severe myopia and their relation with axial lenth

Abstract

Background: The prevalence of myopia in developed countries across East and Southeast Asia has surged, affecting over 80% of children completing schooling, with high myopia rates reaching 10-20%. This refractive error leads to peripheral fundus changes such as white without pressure (WWOP), lattice degeneration, holes, pigmentary degeneration, and paving stone degeneration. Complications associated with axial elongation due to myopia rank as the sixth leading cause of blindness. Consequently, myopia has emerged as a significant health concern in East Asia over recent decades. Materials and Methods: This cross-sectional observational study was conducted over 18 months at a tertiary care centre and involved 105 patients aged 12 to 20 years with moderate to severe myopia (-3D to -10D). The aim was to determine the prevalence of retinal changes and their correlation with axial length. Ethical approval was obtained from the Institutional Ethical Committee. Results: Among the 105 participants, 54 were male and 51 were female. Moderate myopia (-3 to -6D) was present in 181 eyes, while severe myopia (more than -6D) was observed in 19 eyes. The most prevalent peripheral retinal change was WWOP, found in 11 patients (16 eyes), followed by lattice degeneration in 8 patients (13 eyes) and retinal holes in 3 patients (3 eyes). Statistical analysis revealed a significant association between axial length and the presence of WWOP (P=RE:0.02, LE:0.003), lattice degeneration (P=<0.0001), and retinal holes (P=RE:0.048, LE:0.040). The highest number of peripheral retinal changes occurred in individuals with an axial length of 26.01 to 27.00mm and myopia exceeding -6D. Conclusion: The study shows a significant association between peripheral retinal degenerations, longer axial length, and the severity of myopia, emphasizing the importance of early detection to prevent vision-threatening complications.

Keywords: Myopia, Axial length, Lattice degeneration, White without pressure