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Victor Koh, Ching-Yu Cheng, Colin S Tan, Gerard Nah, Paul Zhao, Mellisa Tan, Adeline Yang, Kyoko Ohno-Matsui, Seang-Mei Saw; Optic Disc and Retinal Changes in Highly Myopic Young Adolescent Eyes. Invest. Ophthalmol. Vis. Sci. 2014;55(13):3620.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the prevalence of myopia-related optic disc, macular and peripheral retinal changes in highly myopic eyes of young Asian adolescents
The current study was conducted in 2012 which included 718 randomly selected myopic (spherical equivalent [SE] worse than -6.00 D) male subjects aged between 19 and 25 years undergoing pre-employment screening for public service in Singapore. All participants underwent cycoplegic refraction, best corrected visual acuity (BCVA), axial length measurement and ophthalmoscopic examination of the peripheral retina was performed. Seven colour fundus photographs were taken including the optic disc-centred view rotated at 30 degrees to the right and left, macula-centred view, and the peripheral views. These photos were graded systematically using a standard template to determine the presence of disc and macular lesions.
A total of 265 myopic (SE between -6.00 to -7.99 D), 204 high myopic (-8.00 to -9.99 D) and 141 very highly myopic (worse than -10.00 D) eyes were included for analysis. The mean age was 21.1 ± 1.2 years, all were male subjects, mean BCVA was 0.027 ± 0.10 logMAR and mean axial length was 26.6 ± 1.8 mm. The main optic disc findings were peripapillary atrophy (PPA) (97.3%) and disc tilt (27.5%). The most common myopia-related macular findings included posterior staphyloma (43.8%), chorioretinal atrophy (8.4%) and lacquer cracks (1.0%). There were no cases of myopic CNV and Fuchs’ spots. The most common peripheral retinal findings were white-without-pressure (57.2%), lattice degeneration (16.6%) and peripheral retinal tear/detachment (4.3%). Longer axial length was significantly associated with most lesions including optic disc tilt (odds ratio [OR] 1.31; 95% CI: 1.15, 1.51), PPA (OR 2.45; 95% CI: 1.44, 4.15), posterior staphyloma (OR 1.80; 95% CI: 1.56, 2.08), chorioretinal atrophy (OR 1.92; 95% CI: 1.53, 2.41), peripheral lattice degeneration (OR 1.30; 95% CI: 1.10, 1.52), and white-without-pressure (OR 1.21; 95% CI: 1.07, 1.38). Similar associations with SE were present.
Our study showed a high prevalence of myopia-related changes of the optic disc, macula and peripheral retina in highly myopic eyes even at a young age. These findings are significantly associated with increasing axial length and SE. Disc tilt, PPA, posterior staphyloma and white-without-white pressure are the predominant early pathologic myopia signs in young adults.
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