Almost 80% of Myopic Children Show Some Retinal Findings, BLINK Study Finds

The increase in retinal findings in myopic children argues for routine dilation and close follow-up to monitor for retinal changes regardless of age and amount of myopia. (Image is from an adult high myope, not a subject of the study discussed here.) Photo: Alia Cappellani, OD. Click image to enlarge. One of the key justifications for initiating a myopia control regimen is to keep retinal complications of high myopia at bay, though they may not develop until years or even decades after childhood. It turns out that retinal signs may arrive much earlier than that.The Bifocal Lenses in Nearsighted Kids (BLINK) study of multifocal soft contact lens use for myopia control found that these lenses slowed myopia progression. In a follow-up to that study, researchers sought to report the frequency of retinal findings in myopic children and determine the association with the amount of myopia or axial length. Included were 235 children between the ages of seven and 11 with myopia from -0.75D to -5.00D and -1.00D cylinder or less at baseline who completed the final BLINK2 study visit. They had an annual dilated fundus exam and retinal findings were classified into three main categories: (1) vitreous, (2) peripheral retina and (3) other, then further subdivided into 17 subcategories.They found that 79.1% of subjects had a documented retinal finding irrespective of 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. At the outset of the original BLINK study, that rate was 6.4%, the researchers wrote in their paper for Ophthalmic and Physiological Optics. There was more than a fivefold increase in vitreous or peripheral retinal findings and more than double the increase in any retinal findings.The incidence of any retinal finding in those with no previous findings was 12.5/100 person-years. Peripheral retinal finding incidence was 2.4/100 person-years, while the vitreous finding incidence was 1.7/100 person-years. At each dilated examination, at least 7.2% of participants had a newly documented finding.The most common findings were optic nerve head crescent/pigment/peripapillary atrophy (41%), white without pressure (35%), congenital hypertrophy of the retinal pigment epithelium (RPE) hyperpigment changes (19%) and RPE hypopigment changes (15%). One participant had a retinal detachment. Despite the mean baseline SER being much lower than other evaluations, disc abnormality (41%), lattice/snail track degeneration (15%), white without pressure (35%), chorioretinal scars (5%), retinal holes (9%) and retinal detachment (0.4%) showed a similar prevalence.“Comparable to the present study, disc anomalies and white without pressure are common in myopes. However, RPE hyper-and hypo-pigmentary changes are not as well documented in other studies unless specifically related to macular pigment changes, which can be indicative of myopic maculopathy,” the authors wrote in their paper.The frequency of retinal findings strongly supports routine dilated fundus examinations in myopic children and close follow-up to monitor retinal changes regardless of age and the amount of myopia, the authors concluded.It has been documented that higher myopia is associated with a greater risk for ocular disease; however, this study showed that even individuals with lower amounts of myopia have retinal findings that could lead to sight-threatening complications. The frequency of retinal findings in this myopic pediatric cohort strongly supports routine dilated fundus examinations in myopic children and close follow-up to monitor retinal changes regardless of age and the amount of myopia.Click here for the journal source. Schulle KL, Sinnott LT, Orr DJ, et al. Frequency of retinal findings after eight years in the Bifocal Lenses in Nearsighted Kids (BLINK) Study. Ophthalmic and Physiolog Opt. June 13, 2025. [Epub ahead of print.]