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Myopia-related fundus changes in Singapore adults with high myopia.
Am J Ophthalmol 2013; 155(6):991-999.e1AJ

Abstract

PURPOSE

To examine the pattern of myopia-related macular and optic disc changes in Singapore adults with high myopia (spherical equivalent ≤-6.00 diopters).

DESIGN

Asian adults with high myopia from 3 population-based surveys.

METHODS

Adults 40 years and older (n = 359) with high myopia were pooled from 3 population-based surveys in Singapore Asians: (1) the Singapore Prospective Study Program (SP2, n = 184); (2) the Singapore Malay Eye Study (SiMES, n = 98); and (3) the Singapore Indian Eye Study (SINDI, n = 77). All study participants underwent standardized refraction and fundus photography, and SiMES and SINDI subjects also completed ocular biometry measurements. Myopia-related macular (posterior staphyloma, lacquer cracks, Fuchs spot, myopic chorioretinal atrophy, and myopic choroidal neovascularization) and optic disc (optic nerve head tilt, optic disc dimensions, and peripapillary atrophy) changes were evaluated.

RESULTS

The most common myopia-related macular finding in adults with high myopia was staphyloma (23%), followed by chorioretinal atrophy (19.3%). There were few cases of lacquer crack (n = 6, 1.8%), T-sign (n = 6, 1.8%), retinal hemorrhage (n = 3, 0.9%), active myopic choroidal neovascularization (n = 3, 0.9%), and no case of Fuchs spot. The most common disc finding associated with high myopia was peripapillary atrophy (81.2%), followed by disc tilt (57.4%). Staphyloma and chorioretinal atrophy increased in prevalence with increasing age, increasing myopic refractive error, and increasing axial length (all P < .001). Ethnicity comparisons demonstrated the highest proportion of staphyloma (P = .04) among Malays, the highest proportion of peripapillary atrophy (P = .01) and disc tilt (P < .001) among Chinese, and the largest cup-to-disc ratio (P < .001) among Indians.

CONCLUSIONS

Staphyloma and chorioretinal atrophy lesions were the most common fundus findings among Asian adults with high myopia. In this population, tilted discs and peripapillary atrophy were also common, while choroidal neovascularization and Fuchs spot were rare. In contrast with Singapore teenagers, in whom tilted disc and peripapillary atrophy were common while staphyloma and chorioretinal atrophy were rare, pathologic myopia appears to be dependent on the duration of disease and, thus, age of the individual.

Authors+Show Affiliations

Duke Eye Center, Duke University Medical Center, Durham, North Carolina, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23499368

Citation

Chang, Lan, et al. "Myopia-related Fundus Changes in Singapore Adults With High Myopia." American Journal of Ophthalmology, vol. 155, no. 6, 2013, pp. 991-999.e1.
Chang L, Pan CW, Ohno-Matsui K, et al. Myopia-related fundus changes in Singapore adults with high myopia. Am J Ophthalmol. 2013;155(6):991-999.e1.
Chang, L., Pan, C. W., Ohno-Matsui, K., Lin, X., Cheung, G. C., Gazzard, G., ... Saw, S. M. (2013). Myopia-related fundus changes in Singapore adults with high myopia. American Journal of Ophthalmology, 155(6), pp. 991-999.e1. doi:10.1016/j.ajo.2013.01.016.
Chang L, et al. Myopia-related Fundus Changes in Singapore Adults With High Myopia. Am J Ophthalmol. 2013;155(6):991-999.e1. PubMed PMID: 23499368.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Myopia-related fundus changes in Singapore adults with high myopia. AU - Chang,Lan, AU - Pan,Chen-Wei, AU - Ohno-Matsui,Kyoko, AU - Lin,Xiaoyu, AU - Cheung,Gemmy C M, AU - Gazzard,Gus, AU - Koh,Victor, AU - Hamzah,Haslina, AU - Tai,E Shyong, AU - Lim,Su Chi, AU - Mitchell,Paul, AU - Young,Terri L, AU - Aung,Tin, AU - Wong,Tien-Yin, AU - Saw,Seang-Mei, Y1 - 2013/03/15/ PY - 2012/10/25/received PY - 2013/01/10/revised PY - 2013/01/10/accepted PY - 2013/3/19/entrez PY - 2013/3/19/pubmed PY - 2013/7/19/medline SP - 991 EP - 999.e1 JF - American journal of ophthalmology JO - Am. J. Ophthalmol. VL - 155 IS - 6 N2 - PURPOSE: To examine the pattern of myopia-related macular and optic disc changes in Singapore adults with high myopia (spherical equivalent ≤-6.00 diopters). DESIGN: Asian adults with high myopia from 3 population-based surveys. METHODS: Adults 40 years and older (n = 359) with high myopia were pooled from 3 population-based surveys in Singapore Asians: (1) the Singapore Prospective Study Program (SP2, n = 184); (2) the Singapore Malay Eye Study (SiMES, n = 98); and (3) the Singapore Indian Eye Study (SINDI, n = 77). All study participants underwent standardized refraction and fundus photography, and SiMES and SINDI subjects also completed ocular biometry measurements. Myopia-related macular (posterior staphyloma, lacquer cracks, Fuchs spot, myopic chorioretinal atrophy, and myopic choroidal neovascularization) and optic disc (optic nerve head tilt, optic disc dimensions, and peripapillary atrophy) changes were evaluated. RESULTS: The most common myopia-related macular finding in adults with high myopia was staphyloma (23%), followed by chorioretinal atrophy (19.3%). There were few cases of lacquer crack (n = 6, 1.8%), T-sign (n = 6, 1.8%), retinal hemorrhage (n = 3, 0.9%), active myopic choroidal neovascularization (n = 3, 0.9%), and no case of Fuchs spot. The most common disc finding associated with high myopia was peripapillary atrophy (81.2%), followed by disc tilt (57.4%). Staphyloma and chorioretinal atrophy increased in prevalence with increasing age, increasing myopic refractive error, and increasing axial length (all P < .001). Ethnicity comparisons demonstrated the highest proportion of staphyloma (P = .04) among Malays, the highest proportion of peripapillary atrophy (P = .01) and disc tilt (P < .001) among Chinese, and the largest cup-to-disc ratio (P < .001) among Indians. CONCLUSIONS: Staphyloma and chorioretinal atrophy lesions were the most common fundus findings among Asian adults with high myopia. In this population, tilted discs and peripapillary atrophy were also common, while choroidal neovascularization and Fuchs spot were rare. In contrast with Singapore teenagers, in whom tilted disc and peripapillary atrophy were common while staphyloma and chorioretinal atrophy were rare, pathologic myopia appears to be dependent on the duration of disease and, thus, age of the individual. SN - 1879-1891 UR - https://www.unboundmedicine.com/medline/citation/23499368/Myopia_related_fundus_changes_in_Singapore_adults_with_high_myopia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9394(13)00072-X DB - PRIME DP - Unbound Medicine ER -