Frequency of retinal findings after 8 years in the Bifocal Lenses in Nearsighted Kids (BLINK) Study

Abstract

Purpose: The purpose of the study is to report the frequency of retinal findings in myopic children and determine the association with the amount of myopia or axial length.

Design: The BLINK study was a myopia control, multi-centre randomised clinical trial following myopic children with multifocal soft contact lenses.

Participants: Children aged 7-11 years with myopia (sphere) from -0.75 to -5.00 D and 1.00 D cylinder or less at baseline who completed the final BLINK2 study visit (n = 235).

Methods: Children had an annual dilated fundus examination. Retinal findings were classified into three main categories: vitreous, peripheral retina and other retinal findings, and further subdivided into 17 subcategories.

Main outcome measures: Frequencies were calculated. Groups used median splits of spherical equivalent refractive error and axial length, and differences were assessed using chi-squared tests. Incidence was calculated.

Results: Overall, 186/235 (79.1%) participants had at least one retinal finding and 81/235 (34.5%) participants had at least one vitreous or peripheral retinal finding that could increase the risk of sight-threatening complications. One participant had a retinal detachment. The incidence of any retinal finding in those with no previous findings was 12.5/100 person-years (95% confidence interval = 10.2-15.0). Peripheral retinal finding incidence was 2.4/100 person-years (1.8-3.2), while the vitreous finding incidence was 1.7/100 person-years (1.2-2.4). At each dilated examination, at least 7.2% of participants had a newly documented finding. Sex, age, spherical equivalent refractive error and axial length were not associated with differences in findings (all p ≥ 0.08).

Conclusion: Almost 80% of children with juvenile-onset myopia had a documented retinal finding, which was not associated with the amount of myopia or axial length. Almost 35% had a vitreous or peripheral retina finding that could increase the risk for potential sight-threatening complications, which warrants routine dilation and close follow-up to monitor for retinal changes.

Keywords: contact lenses; myopia; paediatric; retina.

FIGURE 1

Distributions of axial length (a) and spherical equivalent refractive error (b) among participants with vitreous findings (A), peripheral retina findings (B) and any findings (C). The vertical axes provide the percentage of findings within the bin.