The prevalence of myopia was lower or comparable to that reported in other populations from age 3 to 5 years, but increased dramatically after 6 years, consistent with a strong environmental role of schooling on myopia development.

Purpose To explore macular perfusion changes in patients with rhegmatogenous retinal detachment (RRD) involved the macula following successful surgery and to evaluate the correlation between macular blood flow density and visual outcomes using optical coherence tomography angiography (OCTA). Methods This retrospective study included 14 eyes (14 patients) with macular-off RRD that underwent a standard three-port 23gauge pars plana vitrectomy (PPV) and intraocular gas tamponade combined with phacoemulsification, aspiration, and intraocular lens implantation. OCTA was used to evaluate the macular perfusion changes throughout postoperative 12 weeks in the superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillary plexus (CCP). The fellow unaffected eyes were used as controls for comparison. Results A significant increase in the superficial capillary plexus flow density (SCPFD) (P = 0.000) was observed over time in RRD eyes with successful PPV, as well as the deep capillary plexus flow density (DCPFD) (P = 0.000) and the choriocapillary plexus flow density (CCPFD) (P = 0.000). Final best-corrected visual acuity (BCVA) was positively associated with CCPFD (r = − 0.577, P = 0.031) and non-correlated with SCPFD and DCPFD (P > 0.05). Conclusions Macular perfusion gradually recovered following successful RRD repair by PPV. OCTA provided a non-invasive method to explore the underlying reason for different postoperative visual outcomes in macular-off RRD patients.

ImportanceCohort studies could not only reveal associations between change of refractive components and onset/progression of myopia, but also risk factors, which is important for understanding mechanism and providing strategies.BackgroundPrevalence of myopia is high in Shanghai, being reported to be 52.2% in children aged 10 years old.DesignCohort study.ParticipantsA total of 1856 students from six randomly selected primary schools in Baoshan District, Shanghai.MethodsChildren underwent comprehensive ocular measurement, including axial length (AL), corneal curvature radius and cycloplegic auto‐refraction. Questionnaires about eye usage time were collected. Grade 1 students were followed for 4 years, and grade 2 and 3 students for 2 years.Main Outcome Measures(i) Change of spherical equivalent (SE) and AL and (ii) risk factors for progression and incidence of myopia.ResultsThe average 2‐year progress of SE was 0.91D, 0.91D and 1.11D for grade 1, 2 and 3, respectively, and the average elongation of AL was 0.70 mm, 0.64 mm and 0.71 mm, respectively. Only parental myopia, but not near work time, near work diopter time, outdoor activity time or attending tutoring classes, was associated with myopia incidence and progression in the present population. Using baseline SE could be a simple and effective indicator for myopia prediction.Conclusions and RelevanceIncidence and progression of myopia is relatively high in schoolchildren in Shanghai compared with children of Western countries, East Asia and other parts of China. Effective strategies to control myopia prevalence are in urgent need.

Alpha zone and beta zone of peripapillary atrophy, respectively, occur in about 70 and 20%, respectively, of elderly Chinese. As peripapillary atrophy changes in glaucomatous optic neuropathy, these normative data may be helpful for glaucoma detection.

ObjectivesTo report on: (a) overall myopia and high myopia prevalence, and (b) the impact of education on the spherical equivalent refractive error in children across Shanghai.DesignCross-sectional study.SettingAcross all 17 districts of Shanghai.Participants910 245 children aged 4–14 years from a school-based survey conducted between 2012 and 2013.Main outcome measuresData of children with non-cycloplegic autorefraction, visual acuity assessment and questionnaire were analysed (67%, n=6 06 476). Prevalence of myopia (≤−1.0 D) and high myopia (≤−5.0 D) was determined. We used a regression discontinuity design to determine the impact of school entry cut-off date (1 September) by comparing refractive errors at each age, for children born pre-September to post-1 September, and performed a multivariate analysis to explore risk factors associated with myopia. Data analysis was performed in 2017–2018.ResultsPrevalence rates of myopia and high myopia were 32.9% (95% CI: 32.8% to 33.1%) and 4.2% (95% CI: 4.1% to 4.2%), respectively. From 6 years of age onwards, children born pre-September were more myopic compared with those born post-1 September (ahead in school by 1 year, discontinuity at 6 years: −0.19 D (95% CI: −0.09 to −0.30 D); 14 years: −0.67 D (95% CI: −0.21 to −1.14 D)).ConclusionsOur findings suggest that myopia is associated with education, that is primarily focused on near-based activities. Efforts to reduce the burden should be directed to public awareness, reform of education and health systems.

For clinical assessment of RNFL thickness, the influence of refractive error and axial length should be taken into account.

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ImportanceNearly half of children suffering vision impairment reside in China with myopia accounting for the vast majority.BackgroundTo describe the design and methodology of the Shanghai Child and Adolescent Large‐scale Eye Study (SCALE).DesignThe SCALE was a city wide, school‐based, prospective survey.ParticipantsChildren and adolescents aged 4–14 years from kindergarten (middle and senior), primary schools and junior high schools of all 17 districts and counties of the city of Shanghai, China were examined in 2012–2013.MethodsEach enrolled child underwent vision assessment (distance visual acuity; uncorrected and with corrective device if worn) and their parent/carer completed a questionnaire designed to elicit risk factors associated with myopia. Additionally, non‐cycloplegic autorefraction and ocular axial length was measured in a subset of the larger sample.Main Outcome MeasuresPrevalence and the associated factors of vision impairment, myopia and high myopia in Shanghai.ResultsIn 2012–2013, a total of 910 245 of the eligible 1 196 763 children and adolescents identified from census (76%, mean age 9.0 ± 2.7 years [4–14 years]) were enrolled with visual acuity screened in the city of Shanghai. Of these, 610 952 children (67% of the entire sample) underwent non‐cycloplegic autorefraction and 219 188 (24% of the entire sample) had both non‐cycloplegic autorefraction and axial length measurements.Conclusions and RelevanceThe study results will provide insights on the burden of vision impairment, myopia and high myopia in children and adolescents in a metropolitan area of China, and contribute to the policies and strategies to address and limit the burden.