Prevalence and Clinical Characteristics of Dark Without Pressure Retinal Changes in a Chinese Hospital-Based Population.

INTRODUCTION

This study investigates the clinical characteristics and prevalence of dark without pressure (DWP) retinal changes in a hospital-based Chinese population and evaluates its association with common fundus diseases.

METHODS

This cross-sectional study analyzed data from 6787 eligible patients recruited from the Ophthalmology Department of Peking University First Hospital between April and July 2023. All participants underwent ultra-wide-field color fundus photography (UWF CFP) for the detection of DWP. Patients were screened by excluding those without UWF CFP images, with blurred images, or who had undergone intraocular surgery, while consolidating duplicate visits. Participants were categorized into diseased (n = 3741) and control (n = 3046) groups. Prevalence rates were compared between the control group and various disease subgroups (including age-related macular degeneration [AMD], diabetic retinopathy, high myopia, uveitis, retinal hole [RH], retinal detachment [RD], and retinal vein occlusion), as well as across demographic strata, using chi-square tests.

RESULTS

The overall prevalence of DWP was 21.84% (1481/6787), with a prevalence of 18.55% (565/3046) in the control group. Patients with RH showed the highest prevalence (35.33%, 59/167), whereas those with AMD exhibited the lowest (19.50%, 86/441). There were significant differences in prevalence between the control group and most disease subgroups (all P < 0.05), except for AMD (P = 0.632). Additionally, DWP prevalence was inversely associated with age (P < 0.05) but did not differ by gender (P > 0.05). Longitudinal observation revealed diverse DWP patterns, including complete progression, gradual reduction, and bidirectional progression-regression.

CONCLUSIONS

DWP is highly prevalent in Chinese populations, particularly among younger individuals and patients with retinal disorders. These findings underscore the need for individualized retinal monitoring to prevent unnecessary interventions. Moreover, the dynamic progression of DWP may represent a potential biomarker for retinal disease activity, meriting further mechanistic studies.