Clinical profile and distribution of peripheral retinal changes in myopic population in a hospital-based study in North India

Abstract

Purpose: To evaluate the prevalence of different types of peripheral retinal changes in a myopic population in North India and correlate them with axial length.

Methods: This cross-sectional, hospital-based survey included 600 eyes of 300 myopic individuals, aged between 10 and 40 years, attending the outdoor ophthalmology clinic of a tertiary eye care hospital in North India were examined from July 2019 to July 2020. They were divided into mild, moderate, high, and severe myopia according to the spherical equivalent of refraction. Axial length was recorded. Peripheral retinal changes were examined by scleral indentation binocular indirect ophthalmoscopy. Standardized findings considered with their fundus location were lattice degeneration, white without pressure and white with pressure, snail-track degenerations, peripheral chorioretinal atrophy, retinal holes, tears, and detachment. The study was approved by the institutional ethics committee, and all participants provided informed consent.

Results: Peripheral retinal degenerations were found in almost half (53%) of all myopes included in the study. The most common peripheral retinal degeneration found was lattice degeneration, followed by white without pressure, white with pressure, and chorioretinal atrophy. Most of the peripheral retinal degenerations were seen in the temporal quadrant of the fundus, either superotemporal or inferotemporal. There was a significant positive association between the prevalence of peripheral retinal degeneration with age, increased axial length, and severity of myopia.

Conclusion: The results of our study indicate the necessity for careful peripheral fundus examinations of all myopes, irrespective of age and degree of myopia, for early diagnosis and better management of visual-threatening complications like retinal detachment.

Keywords: Axial Length; India; myopia; peripheral fundus examination; peripheral retinal changes.

Figure 1

Flowchart of patient data pool at various levels of inclusion and exclusion stages

Figure 2

Fundus pictures of a few peripheral retinal degenerations seen in patients enrolled in our study: (a) lattice with snail-track degeneration and an atrophic hole at the edge; (b) white without pressure; (c) pigmented lattice with atrophic holes (sclerosed vessels forming a characteristic white network can be seen); and (d) lasered retinal hole

Figure 3

(a) Prevalence of different types of peripheral retinal degenerations. (b) Distribution of peripheral retinal degenerations according to the spherical equivalent of refraction. (c) Association of prevalence of peripheral retinal degenerations with axial length