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.