Lattice Degeneration Research Articles

Evaluation of Systematic Reviews of Interventions for Retina and Vitreous Conditions

Patient care and clinical practice guidelines should be informed by evidence from reliable systematic reviews. The reliability of systematic reviews related to forthcoming guidelines for retina and vitreous conditions is unknown. To summarize the reliability of systematic reviews on interventions for 7 retina and vitreous conditions, describe characteristics of reliable and unreliable systematic reviews, and examine the primary area in which they appeared to be lacking. A cross-sectional study of systematic reviews was conducted. Systematic reviews of interventions for retina- and vitreous-related conditions in a database maintained by the Cochrane Eyes and Vision United States Satellite were identified. Databases that the reviewers searched, whether any date or language restrictions were applied, and bibliographic information, such as year and journal of publication, were documented. The initial search was conducted in March 2007, and the final update was performed in July 2018. The conditions of interest were age-related macular degeneration; diabetic retinopathy; idiopathic epiretinal membrane and vitreomacular traction; idiopathic macular hole; posterior vitreous detachment, retinal breaks, and lattice degeneration; retinal and ophthalmic artery occlusions; and retinal vein occlusions. The reliability of each review was evaluated using prespecified criteria. Data were extracted by 2 research assistants working independently, with disagreements resolved through discussion or by 1 research assistant with verification by a senior team member. Proportion of reviews that meet all of the following criteria: (1) defined eligibility criteria for study selection, (2) described conducting a comprehensive literature search, (3) reported assessing risk of bias in included studies, (4) described using appropriate methods for any meta-analysis performed, and (5) provided conclusions consistent with review findings. A total of 327 systematic reviews that addressed retina and vitreous conditions were identified; of these, 131 reviews (40.1%) were classified as reliable and 196 reviews (59.9%) were classified as not reliable. At least 1 reliable review was found for each of the 7 retina and vitreous conditions. The most common reason that a review was classified as not reliable was lack of evidence that a comprehensive literature search for relevant studies had been conducted (149 of 196 reviews [76.0%]). The findings of this study suggest that most systematic reviews that addressed interventions for retina and vitreous conditions were not reliable. Systematic review teams and guideline developers should work with information professionals who can help navigate sophisticated and varied syntaxes required to search different resources.

Rhegmatogenous Retinal Detachment: Pathophysiology and Risk Factors

Rhegmatogenous retinal detachment is one of the most important retinal diseases requiring urgent surgical treatment. To be aware of the pathophysiology of the disease and to know the risk factors; it is crucial to prevent the development of the disease or overcome the complications that may arise and understand the surgical treatment principles. Major factors in the development of RRD: retinal tears, vitreous liquefaction, and detachment, traction on the retina surface. Myopia, previous cataract surgery, trauma, posterior vitreous detachment, lattice degeneration are the most important risk factors.

Posterior Vitreous Detachment, Retinal Breaks, and Lattice Degeneration Preferred Practice Pattern®

Posterior Vitreous Detachment, Retinal Breaks, and Lattice Degeneration Preferred Practice Pattern®

Updated chandelier illumination-assisted scleral buckling using 3D visualization system.

PurposeTo assess the updated chandelier illumination-assisted scleral buckle procedures using a 3D visualization system.Subjects and methodsWe report a single-center, retrospective, consecutive surgical case series of 18 eyes of 16 patients that underwent scleral buckle procedures combining the use of chandelier endoillumination, a noncontact wide-angle viewing system, an anti-drying contact lens, and a recently developed 3D visualization system. The mean age of the patients was 30.2 years, and the mean follow-up time was 11.3 months.ResultsRetinal reattachment was achieved after the first surgery in all cases. There were no cases that required conversion of the 3D visualization to a conventional microscopic view. This updated chandelier-assisted scleral buckle procedure was successfully performed without any intraoperative or postoperative complications, except for the occurrence of postoperative diplopia in one case in which a supplementary radial buckle was used for a deep tear.ConclusionThe updated chandelier illumination-assisted scleral buckling surgery using a 3D visualization system appears to be a valuable and promising method for managing rhegmatogenous retinal detachment due to atrophic holes in lattice degeneration or ciliary tears in younger cases.

Coexistence of Peripheral Retinal Diseases with Macular Hole

Objectives:To investigate the frequency of retinal tear, retinal hole, and lattice degeneration in peripheral retinal examination of patients with macular hole.Materials and Methods:The files of patients who underwent pars plana vitrectomy surgery with a diagnosis of macular hole at Eskişehir Osmangazi University Department of Ophthalmology between 2008 and 2018 were retrospectively analyzed. A total of 106 patients with primary macular hole who underwent peripheral retinal examination were included in the study. The frequency of retinal tears, holes, and lattice degeneration associated with macular hole was investigated.Results:Peripheral retinal examination of 106 patients who underwent macular hole surgery revealed retinal tear in 3 patients (2.8%), retinal hole in 4 patients (3.8%), and lattice degeneration in 10 patients (9.4%). Retinal hole and lattice degeneration were observed concomitantly in 1 patient.Conclusion:This study showed that patients with macular hole have concomitant retinal tears and holes, which are also thought to arise due to vitreoretinal traction, at a frequency similar to that in the general population. This result suggests that both the anterior and posterior vitreous may have different pathologies at the same time related to these diseases.

PREDICTIVE FACTORS FOR PROLIFERATIVE VITREORETINOPATHY FORMATION AFTER UNCOMPLICATED PRIMARY RETINAL DETACHMENT REPAIR.

To determine predictive factors of proliferative vitreoretinopathy (PVR) formation after uncomplicated primary retinal detachment repair. Retrospective, single-center, case-control study of 74 consecutive patients with (37 eyes) and without (37 eyes) PVR formation after undergoing uncomplicated primary surgery for retinal detachment repair. Logistic regression was used to assess factors associated with PVR formation. Retinal detachment involving the macula was 4.2 times (adjusted odds ratio; 95% confidence interval, 1.4-12.9; P = 0.0119) more likely to have PVR formation compared with those without. Patients who were current or former smokers were 3.6 times (adjusted odds ratio; 95% confidence interval, 1.1-11.7; P = 0.0352) more likely to have PVR formation compared with nonsmokers. Compared with 25-gauge (g) vitrectomy, larger gauge vitrectomy (20 g or 23 g) was 3.6 times (adjusted odds ratio; 95% confidence interval, 1.2-11.3; P = 0.0276) more likely to have PVR formation. Duration of retinal detachment symptoms, high myopia, lens status, lattice degeneration, location of retinal break, number of retinal breaks, and surgical technique (e.g., scleral buckle with or without vitrectomy versus vitrectomy alone) were not found to be predictive of PVR formation. Cigarette smoking and macular involvement are significant risk factors predictive of PVR formation after uncomplicated primary retinal detachment repair.

Rhegmatogenous Retinal Detachment, Pathophysiology and Risk Factors

Rhegmatogenous retinal detachment is one of the most important retinal diseases requiring urgent surgical treatment. To be aware of the pathophysiology of the disease and to know the risk factors; it is crucial to prevent the development of the disease or overcome the complications that may arise and understand the surgical treatment principles. Major factors in the development of RRD: retinal tears, vitreous liquefaction, and detachment, traction on the retina surface. Myopia, previous cataract surgery, trauma, posterior vitreous detachment, lattice degeneration are the most important risk factors.

Peripheral Retinal Degenerations with Risk of Rhegmatogenous Retinal Detachment and Management

Retinal degenerations are common lesions involving the peripheral retina, and most of them are clinically insignificant. Lattice degeneration, cystic retinal tuft, zonular traction tuft, snail track degeneration, degenerative retinoschisis, white without pressure lesions can result in a rhegmatogenous retinal detachment. In this paper, we aimed to discuss peripheric retinal degenerations that predispose retinal detachment and the treatments for them.

Wide-Field Imaging with NAVILAS Laser System

Purpose: to study the potential of wide-field imaging with NAVILAS laser system.Material and methods. In this study we included patients diagnosed with indirect ophthalmoscopy as having one of the follows: diabetic retinopathy (6 eyes), central retinal vein occlusion (5 eyes), choroidal melanoma (3 eyes), rhegmatogenous retinal detachment (4 eyes), and peripheral chorioretinal degeneration (10 eyes). Using NAVILAS 532 laser system and a wide-field contact lens (HR Wide Field (VOLK)) a wide-field central image and a panoramic (consisted of 4 to 6 images) images were obtained in all patients. Fundus images were evaluated according to their diagnostic value versus indirect ophthalmoscopy and wideness of the viewing angle versus standard color fundus photography (55°). In each patient within a single session were obtained: 1) a central fundus image and 2) panoramic image (4-field and in dynamic mode). In a subgroup of patients with central retinal vein occlusion and lattice retinal degeneration, we studied the ability of simultaneous laser photocoagulation wide-field imaging.Results. A single field images obtained with NAVILAS allows to visualize up to 130.3 ± 9.6° of the eye fundus while four-field and dynamic acquisition up to 150.1 ± 8.9° and 171.3 ± 17.0°, respectively. Representative findings of diabetic retinopathy, central retinal vein occlusion, choroidal melanoma, rhegmatogenous retinal detachment, and peripheral lattice degeneration were identified in all cases. Insufficient visualization was found for “snail track” degeneration because the subtle retina and choroid changes were hardly seen on the low magnified image. In 4 patients with lattice retinal degeneration and 3 patients with central retinal vein occlusion within a single session, both wide-field imaging and laser photocoagulation were performed. Surgical goals were achieved in all cases.Conclusion. Wide-field imaging with NAVILAS laser system demonstrated high potential in the documentation of the most widely spread eye fundus disease the and represents an adequate alternative for wide-field fundus cameras. Aside from wide-field imaging this approach also allows for simultaneous laser photocoagulation in entire eye fundus including far peripheral retina.

Prevalence and Associations of Posterior Segment Manifestations in a Cohort of Egyptian Patients with Pathological Myopia

ABSTRACT Purpose To determine the prevalence of posterior segment manifestations among consecutive patients with pathological myopia attending our University Hospital general ophthalmology clinic and their association with age, refractive error, axial length and each other. Methods Patients diagnosed with pathological myopia underwent full ophthalmological examination, optical coherence tomography, fluorescein angiography, and ocular ultrasonography. Manifestations detected were recorded for each eye and their prevalence and association with age, refractive error, axial length and each other was determined. Results A total of 127 eyes of 77 patients with pathological myopia were examined. The most prevalent manifestation was peripheral retinal lesions, found in 63.8% of examined eyes, followed by tigroid fundus, found in 59.1%. Peripheral lesions were significantly associated with more myopia (P = .02) and longer axial length (P = .046). The commonest peripheral lesion was white without pressure, found in 37.8% of eyes. Lattice degeneration was found in 11.8% and snail track degeneration in 4.7% and was not associated with degree of myopia or axial length. Diffuse chorioretinal atrophy was present in 40.9% of eyes, while patchy atrophy was present in 18.9%. Macular holes were present in 4.7% of eyes and were significantly associated with foveoschisis (P = .035) and retinal detachment (P = .003), while foveoschisis was present in 5.5% and was significantly associated with older age (P = .012), longer axial length (P = .010) and patchy chorioretinal atrophy (P = .024). Retinal detachment was found in 6.3% of eyes and retinal breaks in 4.7%. Posterior staphyloma was detected in 33.1% and lacquer cracks and choroidal neovascular membranes in 6.3% of eyes. Conclusions The prevalence of pathological myopia manifestations may differ between different populations. This may be due to the multiple genetic and environmental factors involved which may result in a variable natural history of the condition among different populations.

Long-term outcomes of patients with myopic traction maculopathy after phacoemulsification for incident cataract.

To evaluate the long-term effect of cataract surgery on highly myopic patients with myopic traction maculopathy (MTM) and the risk factors associated with MTM progression. Highly myopic patients with cataract and MTM were included. Phacoemulsification surgery was performed on patients who had vision loss below 20/63 and were willing to operation. Exclusion criteria included full thickness macular hole, foveal/retinal detachment, history of vitreoretinal surgery, myopic choroidal neovascularization, macular chorioretinal atrophy, peripheral lattice degeneration, incomplete follow up, or intraoperative complications. All patients underwent a complete ophthalmological examination. Optical coherence tomography examinations and microperimetry examinations were performed. A total of 229 patients (mean age: 57 ± 6 years) were recruited, including 179 operated patients and 50 unoperated patients. Both the best corrected visual acuity (BCVA) and macular sensitivity (MS) were significantly improved after cataract surgeries throughout the follow-up period (p = 0.000). No difference was found in the proportion of MTM staging and in the rate of resolving/stable or progressive MTM (p = 0.757) between the operated and the unoperated groups. Of all patients, those with S2 to S4 MTM at baseline had significantly higher risk of progressive MTM (p < 0.001). Patients with absence of posterior vitreous detachment or with longer axial length at baseline had higher risks of progressive MTM. Cataract surgery generally improves the BCVA and MS of highly myopic patients with MTM. Preoperative vitreoretinal adhesion, longer axial length, and S2 to S4 MTM are risk factors for progressive MTM. A long-term follow-up on the development of MTM is recommended.

Choroidal change assessment with enhanced depth imaging optical coherence tomography in myopic choroidal neovascularization

Objectives The aim was to evaluate the importance of choroidal changes as measured by enhanced depth imaging optical coherence tomography (OCT) in patient with myopic choroidal neovascularization (mCNV) and to assess the correlation between choroidal thickness (CT) and other parameters such as age, sex, refraction, and staphyloma. Background High myopia is associated with profound changes in the choroid, which are important in the pathogenesis of many important visually significant abnormalities such as choroidal atrophy, CNV, and lattice degeneration. Therefore, it is called pathologic myopia. Patients and methods This prospective study was conducted from June 2016 to January 2017. Two groups of eyes were included: mCNV eyes (31 eyes) and eyes without CNV (19 eyes). CT was measured using the spectralis spectral domain OCT (specralis software version 4.0) in the Ophthalmology Department of the Menoufia University Hospital. Results It was found that CT was significantly decreased in the mCNV eyes compared with normal eyes, as the mean subfoveal CT in eyes with CNV was 103.10 ± 41.09. The mean subfoveal CT in eyes without CNV was 193.28 ± 17.38 (P Conclusion The ability of enhanced depth imaging OCT to visualize the ocular structure provides a more in-depth understanding of the various ocular pathologies. We found that in patients, CT decreased with the presence of mCNV, as compared with controls.

LINCOFF RULES ARE NOT FOLLOWED IN RETINAL DETACHMENT WITH POSTERIOR BREAKS AND ATTACHED CORTICAL VITREOUS.

1) To evaluate factors governing flow of subretinal fluid and validate Lincoff rules (LRs) in cases of rhegmatogenous retinal detachment. 2) To identify cases of rhegmatogenous retinal detachment where LRs are not followed. This was a retrospective study where 253 patients of rhegmatogenous retinal detachment were identified through surgery records. Two hundred and twenty-nine case sheets with complete record of ocular examination and surgical findings were analyzed. Seventy-five of the 229 patients, having subtotal rhegmatogenous retinal detachment where LR could be applied were included for analysis. Validity of LR was analyzed about location of break, lattice degeneration, posterior vitreous detachment (PVD), proliferative vitreoretinopathy, lens status, myopia, and trauma. The mean age of the patients was 40.12 years. Sixty-one were men. Lincoff rule was validated in 59 of the 75 patients. Anterior breaks (P < 0.008) and PVD (P < 0.001) were found to have a significant association with validity of LR. Other attributes did not have a statistically significant association with validity of LR. Presence of posterior retinal breaks and absent PVD is associated with unusual flow of subretinal fluid. Lincoff rules are valid in most of the clinical scenarios.

The Pneumatic Retinopexy versus Vitrectomy for the Management of Primary Rhegmatogenous Retinal Detachment Outcomes Randomized Trial (PIVOT)

The optimal surgery to repair rhegmatogenous retinal detachment (RRD) is unknown. The purpose of this trial was to compare outcomes of pneumatic retinopexy (PnR) versus pars plana vitrectomy (PPV) for the management of primary RRD. Prospective, randomized controlled trial. Patients with RRD demonstrating a single retinal break or a group of breaks in detached retina within 1 clock hour above the 8- and 4-o'clock meridians, with any number, location and size of retinal breaks or lattice degeneration in attached retina. Patients were randomized to undergo either PnR or PPV. Macula-on and macula-off patients were assigned to intervention group by stratified randomization and were treated within 24 and 72 hours, respectively. The primary outcome was 1-year Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity (VA). Important secondary outcomes were subjective visual function (25-item National Eye Institute Visual Function Questionnaire), metamorphopsia score (M-CHARTS), and primary anatomic success. One hundred seventy-six patients were recruited between August 2012 and May 2016. ETDRS VA after PnR exceeded that after PPV by 4.9 letters at 12 months (79.9±10.4 letters vs. 75.0±15.2 letters; P= 0.024). Mean ETDRS VA also was superior for the PnR group compared with the PPV group at 3 months (78.4±12.3 letters vs. 68.5±17.8 letters) and 6 months (79.2±11.1 letters vs. 68.6±17.2 letters). Composite 25-item National Eye Institute Visual Function Questionnaire scores were superior for PnR at 3 and 6 months. Vertical metamorphopsia scores were superior for the PnR group compared with the PPV group at 12 months (0.14±0.29 vs. 0.28±0.42; P= 0.026). Primary anatomic success at 12 months was achieved by 80.8% of patients undergoing PnR versus 93.2% undergoing PPV (P= 0.045), with 98.7% and 98.6%, respectively, achieving secondary anatomic success. Sixty-five percent of phakic patients in the PPV arm underwent cataract surgery in the study eye before 12 months versus 16% in the PnR group (P < 0.001). Pneumatic retinopexy should be considered the first line treatment for RRD in patients fulfilling Pneumatic Retinopexy versus Vitrectomy for the Management of Primary Rhegmatogenous Retinal Detachment Outcomes Randomized Trial (PIVOT) recruitment criteria. Pneumatic retinopexy offers superior VA, less vertical metamorphopsia, and reduced morbidity when compared with PPV.

This issue of Acta

This issue of Acta

Risk factors for retinal breaks during macular hole surgery.

PurposeTo identify risk factors for retinal breaks during macular hole (MH) surgery.Patients and methodsThis retrospective, observational, comparative study included the medical records of 364 consecutive patients (382 eyes) who underwent vitrectomy for MH at Toho University Sakura Medical Center between January 2012 and May 2017. The patients comprised 135 men and 229 women with mean age 67.6±8.0 years. Six eyes with a pre-existing retinal tear treated by laser photocoagulation before MH surgery were excluded. Data on sex, age, presence or absence of lattice degeneration, axial length (measured using an IOL Master®), preoperative refraction, whether or not combined lens extraction/vitrectomy had been performed, whether or not the lens was pseudophakic before vitrectomy, and whether or not a posterior vitreous detachment had been created intraoperatively were collected. The lattice degeneration status was classified as none (0), treated using laser photocoagulation (1), or untreated (2).ResultsThe only item identified in logistic regression analysis with the backward elimination method to be a significant risk factor for retinal breaks during MH surgery was the presence of lattice degeneration (P<0.001).ConclusionOphthalmologists should be aware of the increased risk of retinal breaks during MH surgery in eyes with lattice degeneration. Intraoperative retinal breaks may be less likely to occur in eyes with lattice degeneration treated by photocoagulation preoperatively.

Pneumatic Retinopexy Experience and Outcomes of Vitreoretinal Fellows in the United States: A Multicenter Study

To evaluate the outcomes of patients undergoing pneumatic retinopexy (PR) performed by vitreoretinal fellows at 6 academic centers in the United States. Retrospective, multicenter, consecutive case series. 483 patients with primary retinal detachments who underwent PR by 49 vitreoretinal fellows from 6 U.S. training sites between 2002 and 2016. We reviewed medical records of patients and recorded baseline clinical characteristics (age, sex, baseline visual acuity, lens status, presence of lattice degeneration, presence of vitreous hemorrhage, location of retinal breaks, macular status, and size of detachment), visual and anatomic outcomes at 3-months after PR, as well as training level and PR experience of the fellow at the time of the procedure. Single-procedure anatomic success and visual acuity at 3-months follow-up, and association with clinical and training-related factors. Vitreoretinal fellows performed a variable number of PR, with a median of 7 cases per fellow (range 1-24). Single-procedure anatomic success was 66.8%, and mean LogMAR visual outcome was 0.43 (Snellen equivalent 20/54) at 3 months. Factors that were independently associated with single-procedure success include phakic lens status (P = 0.01), smaller size of retinal detachment (P = 0.02), and the fellow's procedure experience (P = 0.01). The only factor associated with worse visual outcome was baseline visual acuity (P < 0.001). Vitreoretinal fellows perform variably few pneumatic retinopexies but have outcomes comparable to reported rates by experienced specialists. Procedure experience of individual fellows may impact anatomic outcomes.

Spectral-domain optical coherence tomography of peripheral lattice degeneration of myopic eyes before and after laser photocoagulation

To investigate the microstructural characteristics of lattice degenerations before and after laser photocoagulation in myopic eyes by spectral-domain optical coherence tomography (SD-OCT). Twenty-five eyes of 25 consecutive patients at the High Myopia Clinic of the National Taiwan University Hospital were retrospectively reviewed. Myopic eyes with peripheral lattice degeneration were enrolled in the study. Best-corrected visual acuity (BCVA), axial length measurement, color fundus photography was performed. SD-OCT analyses on the lattice degeneration were performed before and after prophylactic laser photocoagulation. All patients were followed for at least 6 months. In total, 25 myopic eyes with peripheral lattice degenerations were studied. The mean refractive error was -9.92±4.77 Diopters (D) with 21 (84%) of the eye being highly myopic (Over -6.0 D). The average axial length was 27.7±1.86mm. In these myopic eyes, retinal thinning was the most common finding (92%), followed by vitreoretinal traction (72%), retinoschisis (44%), vitreous membrane with deposits (36%), and retinal break with subretinal fluid (4%). A blunting effect of the vitreoretinal tractions was found after laser photocoagulation. To our knowledge we firstly investigated the pre- and post-laser photocoagulation microstructural changes using SD-OCT. It demonstrated a beneficial effect of retinoplasty, which released vitreoretinal tractions after laser photocoagulation. Combined with the findings of subtle microstructural retinal breaks and subretinal fluid, early prophylactic laser treatment warrants sincere consideration in these myopic eyes.

Choice of Primary Rhegmatogenous Retinal Detachment Repair Method in US Commercially Insured and Medicare Advantage Patients, 2003-2016

To evaluate trends for rhegmatogenous retinal detachment (RRD) repair and the influence of patient characteristics on repair type in a large US population including children and adults, between 2003 and 2016. Retrospective cohort study. Setting: Administrative claims for beneficiaries in a large nationwide managed-care network, including Medicare Advantage, employer-sponsored, and commercial insurance. Beneficiaries undergoing RRD primary repair procedures. RRD repair procedure type. We identified 31 995 beneficiaries with RRD over the study period, mean age 59.8 years. Ocular comorbidities, including pseudophakia (16.9%), vitreous hemorrhage (14.6%), myopia (2.9%), and lattice degeneration (11.0%), were more common among RRD than non-RRD patients. Pars plana vitrectomy (PPV) was consistently the most common repair procedure, increasing over time. Scleral buckle utilization declined and utilization of other procedures remained relatively constant. After adjustment for age, demographics, and geographic region, PPV was more likely among patients with pseudophakia (OR= 1.81, P < .001) and vitreous hemorrhage (OR= 1.38, P < .001). Lattice degeneration (OR= 1.42, P < .001) and younger age were associated with higher odds of scleral buckle. Pneumatic retinopexy was more likely among patients with better systemic health and less likely among patients with ocular comorbidities including vitreous hemorrhage or lattice degeneration. PPV is increasingly the most common RRD repair procedure across a broadly representative US population. However, other techniques are still preferred for some patients and, in aggregate, choice of repair procedure seems influenced by patient characteristics in a manner consistent with recommendations in the literature.

Prevalence and characteristics of peripheral myopic retinopathy in Guangzhou office workers.

To determine the prevalence and characteristics of peripheral myopic retinopathy among a sample of Guangzhou office workers. A cross-sectional study of Guangzhou Chinese office works in different departments and units of the Guangzhou Power Supply Bureau, China, in 2016. Myopic retinopathy was recorded and analyzed with a scanning laser ophthalmoscope and by slit-lamp microscopy combined with a three-mirror contact lens. In total, 1910 eyes of 955 subjects (508 females and 447 males) aged 21-59y were included; 69.6% of these eyes were myopic. The myopia group had a younger age and worse uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA) when compared with hyperopia and emmetropia groups (P<0.001). The axial length (AL) was significantly longer, the spherical equivalent (SE) was more serious, and the optic nerve crescent was significantly larger in subjects with myopia than with hyperopia and emmetropia. Subjects with myopia, and especially high myopia, had the highest frequency of myopic retinal 18 changes (49.4%, P<0.001) [white-without-pressure (43.8%, P<0.001), lattice degeneration (4.5%, P=0.044)] among the three groups. Logistic regression confirmed that any myopia (OR: 3.41, P<0.001) [mild myopia (OR: 1.93, P=0.001), moderate myopia (OR:3.64, P<0.001), and high myopia (OR:10.58, P<0.001)], a greater AL (OR: 1.55, P<0.001) and a much higher SE (OR: 0.77, P<0.001) increased the risk for peripheral retinal changes. Myopia-related retinal changes are positively associated with greater AL, higher SE, and myopia.