Peripheral retina in myopia. With particular reference to retinal breaks.

Abstract

Since Gonin (1921, 1930) established the role of retinal breaks in the aetiology of retinal detachment, the closure or isolation of retinal breaks has become an essential part of all procedures for the treatment of this condition. The "prophylactic" treatment of retinal breaks is practised in many centres, but in recent years it has been shown that asymptomatic retinal breaks without detachment are a frequent finding in "normal" eyes (Halpern, I966; Byer, I967; Rutnin and Schepens, I967).About two-thirds of retinal detachments occur in myopic eyes (Duke-Elder and Dobree, I967). The present report deals with degenerative changes in the peripheral retina of asymptomatic myopic eyes, with special reference to retinal breaks. Material and methodsBiomicroscopical examination of the peripheral fundus of 332 myopic eyes was performed using the Goldmann three-mirror contact lens and the Haag-Streit goo slit lamp. The first two myopic patients appearing in the eye clinic of the Rothschild Government-Municipal Hospital, Haifa, on any receiving day during a 14-month period were included in the study provided that they fulfilled the following criteria: It was felt that the cases examined represented an unselected group of myopes, asymptomatic with regard to retinal disease.Maximum dilatation of the pupil was achieved by one or more instillations of o 5 per cent. tropicamide and io per cent. phenylephrine. The cornea was anaesthetized with 0o4 per cent. novesine.The entire peripheral fundus was examined using both fundus mirrors of the contact lens, turning the slit into the horizontal position for examination of the nasal and temporal periphery. Each eye was examined only once, 5 to I0 minutes being allotted to each examination. Only one eye was examined at each session and all the patients were invited to attend for examination of the second eye at a later date; 2I patients did not attend for examination of the fellow eye and in these cases the results of the examination of only one eye were included in the results.

Peripheral and posterior pole retinal lesions in association with high myopia: a cross-sectional community-based study in Hong Kong

“…The prevalence of lattice degeneration in highly myopic Chinese as observed in our study was 13.6%, which was slightly higher or comparable with those reported in other ethnic groups. 4,6 Moreover, after adjusted analysis for axial length, our results also demonstrated that higher magnitude of spherical equivalent refractive error has an independent association with the presence of peripheral retinal lesion. As myopia and lattice degeneration were demonstrated to be important risk factors for retinal detachment, 9,17,18 close follow-up of highly myopic patients with lattice degeneration in these patients might be warranted.…”

“…Previous studies on the association of retinal lesion and high myopia have shown large variations in findings due to differences in subject recruitment method Retinal lesions in high myopia TYY Lai et al and most subjects were recruited from clinic-based practices. [4][5][6][7][8][9][10][11][12] Moreover, the prevalence of myopia is dependent on the subjects' ethnic background and therefore results from other studies might not be generalisable to various populations. The majority of population in Hong Kong is ethnic Chinese and the prevalence of high myopia among this urban Chinese population is one of the highest in the world.…”

“…[4][5][6][7][8][9][10][11][12] Although some studies have found association between increased axial length or the severity of myopia with peripheral retinal degenerations, some of the results were conflicting and the correlation between axial length and peripheral retinal changes is not clearly established. 5,6 In studies by Pierro et al 5 and Gozum et al, 11 it was found that longer axial length was associated with increased prevalence of peripheral retinal degenerations including lattice degeneration, paving stone degeneration, and white without pressure. However, no correlation was observed between high myopia and peripheral retinal pigment, retinal tears and retinal detachment.…”

“…[4][5][6] As some of the retinal complications are potentially sight-threatening, understanding the risk factors for the development of these complications in high myopia will be beneficial to identify these high-risk subjects.…”

Stabilizing Myopia by Accelerating Reshaping Technique (SMART)-Study Three Year Outcomes and Overview

“…In the United States it affects approximately one-third of individuals over the age of 12 [1] with a much higher percentage of people impacted in parts of Asia [2]. It has been estimated that slowing the progression of myopia could impact 40 million patients in the United States as a result of the incidence of fewer ocular health risks with low (rather than high) myopic refractive error [3][4][5][6][7][8].…”