Screening for Myopia-Related Retinal Changes Among Teenagers

Prevalence of fundus changes in healthy school-aged children and adolescents aged 5-19 years in Beijing

OBJECTIVES

To investigate and analyse the epidemiological characteristics of fundus changes among school-aged children, and to explore its correlation with myopia.

METHODS

School-aged children from 20 schools in Beijing were screened under cooperation between Beijing Tongren Hospital and Beijing Daxing District Education Commission from September 2022 to March 2023. Uncorrected non-dilated visual acuity and refraction were examined. Fundus photographs of both eyes were evaluated by skilled clinicians. The differences in fundus changes among demographic characteristics were compared.

RESULTS

A total of 15,031 participants (30,062 eyes) from 20 schools were included, including 14 elementary schools and 6 secondary schools. The prevalence of fundus changes was 3.3%, 5.9%, and 6.2% for elementary schools, junior and senior high schools, respectively. The top five fundus changes comprised of myopia-related fundus changes (2.0%), physiologic enlarged cup (1.2%), suspected glaucoma (0.3%), myelinated nerve fibres (0.1%), and papillomacular bundle defect (PMBD) (0.1%). Males exhibited a 7.627 and 1.388 times higher risk of developing PMBD and physiological enlarged cup (p < 0.01, respectively). Eyes with myopia-related fundus changes and suspected glaucoma exhibited larger interpupillary distance, longer eye axis, worse visual acuity and lower spherical equivalent.

CONCLUSIONS

The prevalence of fundus changes varies with school ages, gender, and myopia status. The prevalence of myopia-related fundus changes, suspected glaucoma, and other retinopathy or optic neuropathy escalates with increasing age and the severity of myopia. The pathological myopia is scarce in children. Male gender is a risk factor for PMBD and is also modestly associated with physiological enlarged cup.

Observations on relative peripheral refraction in Chinese adults with myopia based on a novel application of multispectral refraction topography

In this population-based observational cross-sectional study, we investigated retinal peripheral refraction in Chinese adults with myopia. We categorized 1511 Chinese adults with myopia (18 - 55 years) into low (LM), moderate (MM), and high myopia (HM) groups. Axial length, central corneal thickness, steep keratometry, flat keratometry, and intraocular pressure were measured. Refractive difference values (RDVs) for different eccentricities (RDV0-53) and the superior (RDV-S), inferior (RDV-I), temporal (RDV-T), and nasal (RDV-N) retinal regions were measured using multispectral refractive topography. The hyperopic defocus was higher for the MM group than for the LM group in RDV20-53, RDV-S, and RDV-T and HM group in RDV20-53, RDV-S, RDV-T and RDV-N. The hyperopic defocus was higher for the HM group than for the LM group in RDV20-53, RDV-S and RDV-T but lower for the LM group in RDV-N. RDV-N decreased with age (R2 = 0.0191, slope = - 0.01, p < 0.0001), whereas RDV-S (R2 = 0.0112, slope = 0.01,p < 0.0001) and RDV-T increased (R2 = 0.0038, slope = 0.01, p = 0.0160). RDV correlated with central spherical equivalent and axial length. Flat keratometry explained the most RDV variation (RDV20-30: β = 0.0714, p < 0.0001; RDV-N: β = 0.1801, p < 0.0001; RDV-S: β = 0.1426, p < 0.0001; RDV-T: β = 0.1239, p < 0.0001). Reference values for peripheral retinal defocus are provided for Chinese adults with different myopia ranges.

Comparative Study of Relative Peripheral Refraction in Children With Different Degrees of Myopia

Purpose

To investigate the difference in the retinal refraction difference value (RDV) using multispectral refractive topography (MRT).

Methods

Ninety myopic participants, who met the enrolment requirements, were examined with an automatic optometer after mydriasis. According to the value of the spherical equivalent (SE), the participants were divided into Emmetropia group (E, +0.5D < SE < −0.5D), Low Myopia (LM, −0.5D < SE ≤ −3D), and Moderate and high Myopia (MM, −3D < SE ≤ −10D). The ocular biological parameters were detected by optical biometrics (Lenstar 900, Switzerland), including axial length (AL), lens thickness (LT), and keratometry (K1, K2). Furthermore, the MRT was used to measure the retinal RDV at three concentric areas, with 15-degree intervals from fovea into 45 degrees (RDV-15, RDV 15–30, and RDV 30–45), and four sectors, including RDV-S (RDV-Superior), RDV-I (RDV-Inferior), RDV-T (RDV-Temporal), and RDV-N (RDV-Nasal).

Results

In the range of RDV-15, there was a significant difference in the value of RDV-15 between Group E (−0.007 ± 0.148) vs. Group LM (−0.212 ± 0.399), and Group E vs. Group MM (0.019 ± 0.106) (P < 0.05); In the range of RDV 15–30, there was a significant difference in the value of RDV 15–30 between Group E (0.114 ± 0.219) vs. Group LM (−0.106 ± 0.332), and Group LM vs. Group MM (0.177 ± 0.209; P < 0.05); In the range of RDV 30–45, there was a significant difference in the value of RDV 30–45 between Group E (0.366 ± 0.339) vs. Group LM (0.461 ± 0.304), and Group E vs. Group MM (0.845 ± 0.415; P < 0.05); In the RDV-S position, there was a significant difference in the value of RDV-S between Group LM (−0.038 ± 0.636) and Group MM (0.526 ± 0.540) (P < 0.05); In the RDV-I position, there was a significant difference in the value of RDV-I between Group E (0.276 ± 0.530) vs. Group LM (0.594 ± 0.513), and Group E vs. Group MM (0.679 ± 0.589; P < 0.05). In the RDV-T position, there was no significant difference in the value of RDV-T among the three groups. In the RDV-N position, there was a significant difference in the value of RDV-N between Group E (0.352 ± 0.623) vs. Group LM (0.464 ± 0.724), and Group E vs. Group MM (1.078 ± 0.627; P < 0.05). The RDV analysis in all directions among the three groups showed a significant difference between RDV-S and RDV-I in Group LM (P < 0.05). Moreover, the correlation analysis showed that SE negatively correlated with AL, RDV 30–45, RDV-S, RDV-I, and RDV-N.

Conclusions

In this study, there was a significant difference in the value of RDV among Group E, Group LM, and Group MM, and the value of RDV in Group MM was the highest on the whole. In the range of RDV 30–45, there was a growing trend with the increase in the degree of myopia among the three groups. Furthermore, the SE negatively correlated with AL, RDV 30–45, RDV-S, RDV-I, and RDV-N.

A large population study reveals a novel association between congenital color vision deficiency and environmental factors

PURPOSE

To assess the associations between the prevalence of congenital color vision deficiency (CVD) and genetics and environment, represented by place of origin (ethnic background) and place of birth, respectively.

METHODS

This is a retrospective study of the computerized database of the northern recruitment center of Israel of 53,895 consecutive male Jewish conscripts 16-19 years old, who completed the medical profiling process between 1988 and 2011. CVD was diagnosed using the 24-pseudo-isochromatic plate Ishihara test. Associations of CVD prevalence with sociodemographic variables, anthropometric indices, refractive errors, and mainly place of origin and place of birth were tested by both univariate analysis and multivariate regression models.

RESULTS

Elevated BMI (obesity) and blood pressure (hypertension), as well as myopia, were all positively associated with congenital CVD. The composition of the study population provides a unique opportunity to investigate the relationship between ethnicity and environment. The prevalence of CVD significantly differs among subpopulations of different ethnic background as well as among those who were born in different geographical locations. Additionally, differences in the prevalence of CVD (1.2-1.6%) were observed among conscripts from the same origin, who were born in Israel, compared to those who were born elsewhere. Both place of origin (p < 0.01) and place of birth (p < 0.05) were associated with the prevalence of CVD in a multivariable regression model.

CONCLUSION

This study affirms previously established associations of CVD with certain variables and reveals a possible novel association of CVD with environmental factors.