September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Axial length and visual function in high myopia
Author Affiliations & Notes
  • Virginie JM Verhoeven
    Epidemiology, Erasmus Medical Center, Rotterdam, Netherlands
    Ophthalmology, Erasmus Medical Center, Rotterdam, Netherlands
  • Margaretha CC Snabel
    Ophthalmology, University Medical Center Utrecht, Utrecht, Netherlands
  • Gwyneth A van Rijn
    Ophthalmology, Leiden University Medical Center, Leiden, Netherlands
  • Gabrielle HS Buitendijk
    Ophthalmology, Erasmus Medical Center, Rotterdam, Netherlands
    Epidemiology, Erasmus Medical Center, Rotterdam, Netherlands
  • King T Wong
    Ophthalmology, Erasmus Medical Center, Rotterdam, Netherlands
  • Jan EE Keunen
    Ophthalmology, Radboud University Medical Center, Nijmegen, Netherlands
  • Camiel J F Boon
    Ophthalmology, Leiden University Medical Center, Leiden, Netherlands
  • Annette JM Geerards
    The Rotterdam Eye Hospital, Rotterdam, Netherlands
  • Gregorius P. M. Luyten
    Ophthalmology, Leiden University Medical Center, Leiden, Netherlands
  • Caroline C W Klaver
    Epidemiology, Erasmus Medical Center, Rotterdam, Netherlands
    Ophthalmology, Erasmus Medical Center, Rotterdam, Netherlands
  • Footnotes
    Commercial Relationships   Virginie Verhoeven, None; Margaretha Snabel, None; Gwyneth van Rijn, None; Gabrielle Buitendijk, None; King Wong, None; Jan Keunen, None; Camiel Boon, None; Annette Geerards, None; Gregorius P. Luyten, None; Caroline Klaver, None
  • Footnotes
    Support  NWO Vidi 91796357 to C.C.W. Klaver
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 2469. doi:
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      Virginie JM Verhoeven, Margaretha CC Snabel, Gwyneth A van Rijn, Gabrielle HS Buitendijk, King T Wong, Jan EE Keunen, Camiel J F Boon, Annette JM Geerards, Gregorius P. M. Luyten, Caroline C W Klaver; Axial length and visual function in high myopia. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2469.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To study the relationship between axial length and visual impairment in (high) myopia.

Methods : A total of 6,271 participants were included (RS-I: N = 662 (55+ years of age); RS-II: N = 1074 (55+ years); RS-III: N = 1148 (45+ years); ERF: N = 2353 (25+ years); and MYST: N = 671 high myopia (spherical equivalent (SE) ≤ -6 D) cases and 363 controls (SE ≥-1.5 & ≤ 1.5 D), 25+ years)). Participants received an extensive ophthalmic examination, including best-corrected visual acuity (VA), auto-refraction (SE), and measurements of axial length (AL) and corneal curvature (CC). Analyses were based on data from right eyes. Severe visual loss was defined according to the WHO criteria; visual impairment (VI) as VA <0.3 and VA ≥0.05; blindness as VA <0.05. The frequency of visual loss was calculated as a function of AL (in mm), stratified by age. Cumulative risk of severe visual loss per AL category (reference AL: 23-24 mm) was assessed using Kaplan-Meier product-limit analysis.

Results : Mean AL in RS-I, RS-II, RS-III and ERF combined was 23.38 mm (SD: 1.15); in MYST, mean AL was 27.36 mm (SD: 1.62) in cases and 23.49 mm (SD: 0.76) in controls. The correlation of AL between right and left eyes was high (population-based R2 = 0.906; case control R2 = 0.932) . The frequency of severe visual loss in high myopes increased with age (P trend <0.0001). The risk of severe visual loss was 1.8% in high myopes aged 40, irrespective of AL; by age 80, however, the cumulative risk was 7% for AL 23-24 mm, 30.5% for AL 26-28 mm, 44.7% for AL 28-30 mm, and 90.5% for AL ≥30 mm. Mean age at onset was strongly related with AL, and varied from 45 years in AL >28 mm to 58 years in AL 26-28 mm.

Conclusions : The risk of severe visual loss in high myopes highly correlates with AL, and reaches extremely high figures in AL ≥30 mm. In high myopes, each incremental increase in AL worsens the long-term visual prognosis.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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