Axial Length as a Key Risk Factor for Lattice Degeneration: A Large-Sample Retrospective Analysis

Lattice degeneration (LD) is a well-established precursor lesion of retinal detachment, a condition with often poor prognosis that can lead to permanent vision loss. Early identification of LD is clinically significant for risk assessment. This study aimed to investigate the associations between LD and ocular biometric as well as demographic parameters, and to develop a risk assessment framework. The ultimate goal is to identify individuals at genuinely high risk who may benefit from tailored follow-up or treatment.

In this cross-sectional study, 1776 subjects from 7634 screened individuals at the Eye Health Management Center of Ineye Hospital, Chengdu University of Traditional Chinese Medicine, were enrolled. Comprehensive ophthalmic examinations were conducted. Chi-square tests compared LD prevalence across groups. Independent risk factors were identified through univariate and multivariate logistic regression analyses.

The overall prevalence of LD was 13.3%, with unilateral cases (9.3%) exceeding bilateral cases (4.0%). Prevalence was significantly higher in myopic (15.5%) versus non-myopic individuals (10.5%, p < 0.05), but did not differ by gender or ocular dominance. Spherical equivalent (SE), axial length (AL), axial length/corneal radius ratio (AL/CR), and age were positively correlated with LD risk (all p < 0.05). Age, AL, and best-corrected visual acuity (BCVA) were independently associated with the presence of LD. Among those AL may be a more directly relevant biological parameter for assessing LD risk, each 1.00 mm increase in AL increased risk by 53% (OR = 1.53).

The overall prevalence of LD was 13.3%. Given that AL is a key independent risk factor for LD, it is recommended that individuals with elongated AL undergo peripheral retinal screening. This facilitates early detection and enables prophylactic treatment for those at high risk of retinal detachment.