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Myopic Maculopathy and Optic Disc Changes in Highly Myopic Young Asian Eyes and Impact on Visual Acuity.
Am J Ophthalmol. 2016 Apr; 164:69-79.AJ

Abstract

PURPOSE

To determine the prevalence and risk factors of myopic maculopathy and specific optic disc and macular changes in highly myopic eyes of young Asian adults and their impact on visual acuity.

DESIGN

Prospective cross-sectional study.

METHODS

In total, 593 highly myopic (spherical equivalent refraction [SER] less than -6.00 diopters [D]) and 156 emmetropic (SER between -1.00 and +1.00 D) male participants from a population-based survey were included. All participants underwent standardized medical interviews, ophthalmic examination, and color fundus photographs. These photographs were graded systematically to determine the presence of optic disc and macular lesions. Myopic maculopathy was classified based on the International Classification of Myopic Maculopathy.

RESULTS

The mean age was 21.1 ± 1.2 years. The mean SER for the highly myopic and emmetropic group was -8.87 ± 2.11 D and 0.40 ± 0.39 D, respectively (P < .001). Compared to emmetropic eyes, highly myopic eyes were significantly more likely to have optic disc tilt, peripapillary atrophy (PPA), posterior staphyloma, chorioretinal atrophy, and myopic maculopathy (all P < .001). The main findings included PPA (98.3%), disc tilt (22.0%), posterior staphyloma (32.0%), and chorioretinal atrophy (8.3%). Myopic maculopathy was present in 8.3% of highly myopic eyes and was associated with older age (odds ratio [OR] 1.66; 95% CI: 1.22, 2.26), reduced choroidal thickness (OR 0.99; 95% CI: 0.98, 0.99), and increased axial length (AL) (OR 1.52; 95% CI: 1.06, 2.19). The presence of disc tilt, posterior staphyloma, and chorioretinal atrophy were associated with reduced visual acuity.

CONCLUSIONS

Our study showed that myopia-related changes of the optic disc and macula were common in highly myopic eyes even at a young age. The risk factors for myopic maculopathy include increased age, longer AL, and reduced choroidal thickness. Some of these changes were associated with reduced central visual function.

Authors+Show Affiliations

Vision Performance Centre, Military Medicine Institute, Singapore; Department of Ophthalmology, National University Health System, Singapore.Department of Ophthalmology, Tan Tock Seng Hospital, Singapore.Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.Vision Performance Centre, Military Medicine Institute, Singapore; Department of Ophthalmology, National University Health System, Singapore.Department of Ophthalmology, National University Health System, Singapore.Vision Performance Centre, Military Medicine Institute, Singapore.Department of Ophthalmology, National University Health System, Singapore; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan.Defence Medical & Environmental Research Institute, DSO National Laboratories, Singapore.Defence Medical & Environmental Research Institute, DSO National Laboratories, Singapore.Vision Performance Centre, Military Medicine Institute, Singapore.Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore. Electronic address: seang_mei_saw@nuhs.edu.sg.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

26850176

Citation

Koh, Victor, et al. "Myopic Maculopathy and Optic Disc Changes in Highly Myopic Young Asian Eyes and Impact On Visual Acuity." American Journal of Ophthalmology, vol. 164, 2016, pp. 69-79.
Koh V, Tan C, Tan PT, et al. Myopic Maculopathy and Optic Disc Changes in Highly Myopic Young Asian Eyes and Impact on Visual Acuity. Am J Ophthalmol. 2016;164:69-79.
Koh, V., Tan, C., Tan, P. T., Tan, M., Balla, V., Nah, G., Cheng, C. Y., Ohno-Matsui, K., Tan, M. M., Yang, A., Zhao, P., Wong, T. Y., & Saw, S. M. (2016). Myopic Maculopathy and Optic Disc Changes in Highly Myopic Young Asian Eyes and Impact on Visual Acuity. American Journal of Ophthalmology, 164, 69-79. https://doi.org/10.1016/j.ajo.2016.01.005
Koh V, et al. Myopic Maculopathy and Optic Disc Changes in Highly Myopic Young Asian Eyes and Impact On Visual Acuity. Am J Ophthalmol. 2016;164:69-79. PubMed PMID: 26850176.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Myopic Maculopathy and Optic Disc Changes in Highly Myopic Young Asian Eyes and Impact on Visual Acuity. AU - Koh,Victor, AU - Tan,Colin, AU - Tan,Pei Ting, AU - Tan,Marcus, AU - Balla,Vinay, AU - Nah,Gerard, AU - Cheng,Ching-Yu, AU - Ohno-Matsui,Kyoko, AU - Tan,Mellisa M H, AU - Yang,Adeline, AU - Zhao,Paul, AU - Wong,Tien Yin, AU - Saw,Seang-Mei, Y1 - 2016/02/03/ PY - 2015/09/10/received PY - 2016/01/04/revised PY - 2016/01/23/accepted PY - 2016/2/7/entrez PY - 2016/2/7/pubmed PY - 2016/9/1/medline SP - 69 EP - 79 JF - American journal of ophthalmology JO - Am. J. Ophthalmol. VL - 164 N2 - PURPOSE: To determine the prevalence and risk factors of myopic maculopathy and specific optic disc and macular changes in highly myopic eyes of young Asian adults and their impact on visual acuity. DESIGN: Prospective cross-sectional study. METHODS: In total, 593 highly myopic (spherical equivalent refraction [SER] less than -6.00 diopters [D]) and 156 emmetropic (SER between -1.00 and +1.00 D) male participants from a population-based survey were included. All participants underwent standardized medical interviews, ophthalmic examination, and color fundus photographs. These photographs were graded systematically to determine the presence of optic disc and macular lesions. Myopic maculopathy was classified based on the International Classification of Myopic Maculopathy. RESULTS: The mean age was 21.1 ± 1.2 years. The mean SER for the highly myopic and emmetropic group was -8.87 ± 2.11 D and 0.40 ± 0.39 D, respectively (P < .001). Compared to emmetropic eyes, highly myopic eyes were significantly more likely to have optic disc tilt, peripapillary atrophy (PPA), posterior staphyloma, chorioretinal atrophy, and myopic maculopathy (all P < .001). The main findings included PPA (98.3%), disc tilt (22.0%), posterior staphyloma (32.0%), and chorioretinal atrophy (8.3%). Myopic maculopathy was present in 8.3% of highly myopic eyes and was associated with older age (odds ratio [OR] 1.66; 95% CI: 1.22, 2.26), reduced choroidal thickness (OR 0.99; 95% CI: 0.98, 0.99), and increased axial length (AL) (OR 1.52; 95% CI: 1.06, 2.19). The presence of disc tilt, posterior staphyloma, and chorioretinal atrophy were associated with reduced visual acuity. CONCLUSIONS: Our study showed that myopia-related changes of the optic disc and macula were common in highly myopic eyes even at a young age. The risk factors for myopic maculopathy include increased age, longer AL, and reduced choroidal thickness. Some of these changes were associated with reduced central visual function. SN - 1879-1891 UR - https://www.unboundmedicine.com/medline/citation/26850176/Myopic_Maculopathy_and_Optic_Disc_Changes_in_Highly_Myopic_Young_Asian_Eyes_and_Impact_on_Visual_Acuity_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9394(16)30026-5 DB - PRIME DP - Unbound Medicine ER -