OBSERVATIONAL STUDY OF DARK WITHOUT PRESSURE IN MYOPIC PEOPLE BASED ON ULTRA-WIDEFIELD SWEPT SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY AND ULTRA-WIDEFIELD COLOR FUNDUS PHOTOGRAPHY

PURPOSE: This study aimed to investigate the incidence and distribution characteristics of dark without pressure (DWOP), a relatively underexplored retinal feature, in myopic people based on ultra-widefield swept source optical coherence tomography angiography and ultra-wide field color fundus photography. METHODS: Subjects were recruited from December 2021 to May 2024 at Sichuan Provincial People's Hospital. Each eye underwent a comprehensive ophthalmic examination, including ultra-wide field color fundus photography and 24 × 20-mm ultra-widefield swept source optical coherence tomography angiography. Eyes were categorized based on spherical equivalent into four groups: emmetropia, mild myopia, moderate myopia, and high myopia. RESULTS: A total of 304 subjects (592 eyes) were recruited. The overall incidence of DWOP was 25.5%. It was significantly higher in the high myopia group (44.3%) compared with the emmetropia group (10.9%) ( P < 0.001). Axial length greater than 26 mm and spherical equivalent less than -6.0 D were associated with increased DWOP risk. DWOP was predominantly found in the inferotemporal mid-periphery (68.9%). Retinal thickness in the DWOP region was 205.0 ± 13.6 µ m, 1.70% lower than that in the normal region ( P = 0.001). Among the 34 eyes followed for 3 to 49 months, 52.4% of eyes showed an increase of DWOP area size, and 28.6% showed a decrease in area size. CONCLUSION: DWOP is commonly observed in high myopic eyes, primarily in the midperipheral inferior temporal region, with boundaries that change over time. These findings suggest a need for further investigation into the clinical significance of DWOP progression in myopic patients.