Abstract:Abstract Objective: To investigate the differences in ocular parameters among patients with varying degrees of myopia, analyze the correlation between tessellated fundus (FT) severity and ocular biometric parameters as well as fundus lesions, and evaluate the clinical value of ultra-widefield imaging (UWFI) in the risk assessment of myopic fundus lesions. Methods: A cross-sectional study was conducted. A total of 197 eyes were enrolled and divided into four groups: emmetropia and mild myopia group (n=25), moderate myopia group (n=38), high myopia group (n=94), and ultra-high myopia group (n=40). Axial length (AL), anterior chamber depth (ACD), central corneal thickness (CCT), and spherical equivalent (SE) were measured. FT severity (0=none, 1=mild, 2=moderate, 3=severe) and fundus lesions were evaluated. Statistical analyses were performed using the chi-square test, Kruskal-Wallis H test, Mann-Whitney U test, Spearman correlation analysis, and ordinal logistic regression. Results: A total of 197 patients (197 eyes) were enrolled, including 88 males (44.7%) and 109 females (55.3%), with a median age of 36.00 (27.00, 47.00) years (range: 18–60 years). The patients were divided into four groups based on refractive status: emmetropia and mild myopia group (25 eyes), with a median age of 36.00 (23.00, 47.00) years, 13 males (52.0%) and 12 females (48.0%); moderate myopia group (38 eyes), with a median age of 30.00 (23.00, 37.00) years, 18 males (47.4%) and 20 females (52.6%); high myopia group (94 eyes), with a median age of 36.00 (23.00, 47.00) years, 40 males (42.6%) and 54 females (57.4%); and ultra?high myopia group (40 eyes), with a median age of 42.50 (27.25, 52.75) years, 17 males (42.5%) and 23 females (57.5%). Sex distribution was balanced among the four groups (χ² = 0.902, P = 0.825), while age distribution differed significantly (H = 9.911, P = 0.019). Axial length (AL) increased and spherical equivalent (SE) decreased progressively with myopia severity, with significant differences among all groups (both P < 0.001). The severity of foveal thickness (FT) also increased progressively with myopia severity (Kruskal?Wallis H = 68.057, P < 0.001). Spearman correlation analysis showed that FT was positively correlated with AL (rs = 0.669, P < 0.001) and negatively correlated with SE (rs = -0.628, P < 0.001). Multivariate ordinal logistic regression revealed that in the AL?containing model, AL, age, sex, lattice degeneration (LD), and myopic maculopathy (MM) were independent influencing factors for FT (all P < 0.05); in the SE?containing model, SE, age, sex, peripheral retinal pigmentary changes, LD, and MM were independent influencing factors for FT (all P < 0.05). Conclusion: FT severity is positively correlated with the degree of myopia and can serve as a simple indicator reflecting axial elongation and myopia progression. Together with peripheral retinal lesions, it has important clinical value in the risk assessment of myopic fundus lesions. UWFI should be incorporated into routine screening protocols for high-risk myopic patients.
