Prevalence of myopia-related retinal changes among 12-18 year old Hong Kong Chinese high myopes.

PURPOSE: To determine the prevalence and risk factors of myopia-related retinal changes in Hong Kong Chinese adolescents with high myopia. METHODS: A cross-sectional study on Hong Kong Chinese teenage subjects with high myopia was conducted between January 2005 and June 2009. Subjects were recruited via newspaper advertisements, invitation letters to schools, leaflets and posters. Data collected included history related to myopia progression and retinal characteristics. RESULTS: In total, 120 subjects (61 boys and 59 girls) were recruited. The mean age was 14.8 ± 1.6 years (range: 12-18 years). The mean SER of the eyes was -8.41 ± 1.60 D. Ninety four of the 120 adolescents were found to have a retinal change of which 0.8% were sight-threatening, 2.5% were posterior pole changes, and 61.7% were peripheral retinal changes. The five most frequent retinal changes found were optic nerve crescents (52.5%), white-without-pressure (51.7%), lattice degeneration (5.8%), microcystoid degeneration (5%) and pigmentary degeneration (4.2%). After adjusting for myopia over -8 D, age, gender, duration of myopia, family retinal history and intraocular pressure (IOP), binary logistic regressions showed that an axial length longer than 26.5 mm was a significant risk factor for peripheral retinal changes, optic nerve crescents and white-without-pressure. CONCLUSIONS: Peripheral retinal degenerative changes and optic nerve crescent were found in a significant proportion of high myopic teenage subjects. There is increased risk of retinal changes in eyes with an axial length >26.5 mm in 12-18 year-olds.

Retinal thickness in myopic and non-myopic eyes.

PURPOSE: To investigate the retinal thickness profile in myopic and non-myopic eyes. METHODS: The retinal thickness profile of 30 myopic eyes [spherical equivalent error (SER) between -6.00 and -13.63 D] and 31 non-myopic eyes (SER between +2.75 and -0.50 D) were measured using the Stratus OCT (Carl Zeiss Meditec, Dublin, CA, USA). Two scan types were used: the Macular Thickness Map and the Customized Line Scan for a central 80° horizontal retinal thickness profile. RESULTS: At foveal center and fovea, myopic eyes had a thicker retina than the non-myopic group (p = 0.002 and 0.044, respectively). At other zones of the macula, the retina was significantly thinner in myopic eyes compared to non-myopic eyes (p < 0.01, unpaired t-test). From 40° nasal to 40° temporal retina, a general reduction of retinal thickness was observed across the myopic retina compared to the non-myopic retina except at 20° nasal to fixation. CONCLUSIONS: There was general reduction in retinal thickness within the horizontal central 80° in myopic eyes compared with non-myopic eyes.

Use of the Optomap with lid retraction and its sensitivity and specificity.

BACKGROUND: Optomap uses the ultra-wide field scanning laser ophthalmoscopy to provide retinal examination. It permits fundus examination without the use of a mydriatic, which is more comfortable for the patients. This paper determines the sensitivity and specificity of the Optomap for detecting retinal signs under non-mydriatic conditions. METHODS: Fifty-four eyes identified with retinal/choroidal signs and eight normal eyes were recruited from 31 Hong Kong Chinese subjects. Photo-documentation of fundal changes was obtained with the Optomap under non-mydriatic conditions before a dilated fundus examination by a clinician using standard procedures. The eyelid was retracted using a cotton bud when necessary. Dilated fundus examinations were performed by another clinician using binocular indirect ophthalmoscopy and slitlamp biomicroscopy with a fundus lens. The Optomap images were evaluated by four other investigators under masked condition. The International Classification of Disease, Ninth Revision (ICD-9-CM) was adopted for recording retinal features. Screening results were compared with those obtained using the dilated fundus examination as the gold standard. RESULTS: The cotton bud method for eyelid retraction showed an improvement in the area of retina that could be visualised. The sensitivity and specificity of the Optomap averaged 76.4 and 71.9 per cent, respectively. Some fundal signs were missed by all observers in the Optomap but not with the biomicroscope. These included white-without-pressure, lattice degeneration, paramacular drusen and pigmentary changes at central fundus. CONCLUSION: Optomap serves as a reliable screening tool for fundus examination especially because it covers a much wider area of the peripheral retina than other digital instruments for fundus photography.