Longitudinal quantitative fundus changes after posterior scleral reinforcement in children with progressive high myopia

Purpose To evaluate longitudinal quantitative changes in myopic fundus characteristics over a 3-year period following posterior scleral reinforcement (PSR) in children with progressive high myopia. Methods Thirty-seven children with progressive high myopia underwent PSR using a crosslinked bovine pericardial patch. Thirty-two age-, spherical equivalent (SE)-, and axial length (AL)-matched children with myopia progression of < −1.00 D/year served as controls. Changes in SE (ΔSE), AL (ΔAL), and myopic fundus characteristics were evaluated over 3 years. Results No significant differences were observed in either ΔSE or ΔAL (ΔSE: −1.23 ± 0.89 D vs. −1.60 ± 1.15 D, P = 0.195; ΔAL: 0.70 ± 0.43 mm vs. 0.80 ± 0.53 mm, P = 0.713) between the PSR and non-PSR groups over the 3-year follow-up period. However, the PSR group demonstrated significantly slower progression of macular fundus tessellated density than the control group (−0.65 ± 5.74% vs. 3.69 ± 3.80%, P = 0.002). In addition, the reduction in subfoveal choroidal thickness was significantly smaller in the PSR group than in the non-PSR group (−9.93 ± 20.14 μm vs. −23.07 ± 15.23 μm, P = 0.044). Conclusions PSR using a crosslinked bovine pericardial patch appears to be safe and may delay the progression of early myopic maculopathy in children, as evidenced by reduced progression of macular FTD and better preservation of SFCT. However, no significant effect on axial elongation or refractive progression was observed over the 3-year follow-up period.