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Yee-Ling Wong, Charumathi Sabanayagam, Yang Ding, Chee-Wai Wong, Anna Chwee-Hong Yeo, Yin-Bun Cheung, Gemmy Cheung, Audrey Chia, Kyoko Ohno-Matsui, Tien-Yin Wong, Jie Jin Wang, Ching-Yu Cheng, Quan V. Hoang, Ecosse Lamoureux, Seang-Mei Saw; Prevalence, Risk Factors, and Impact of Myopic Macular Degeneration on Visual Impairment and Functioning Among Adults in Singapore. Invest. Ophthalmol. Vis. Sci. 2018;59(11):4603-4613. doi: 10.1167/iovs.18-24032.
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To determine the prevalence, risk factors, and impact of myopic macular degeneration (MMD) on visual impairment and functioning among adults in Singapore.
A comprehensive eye examination, including subjective refraction, axial length, and visual acuity (VA) measurements, was performed in adults aged ≥40 years in the Singapore Epidemiology of Eye Diseases (SEED) study. From fundus photographs, MMD was graded using the International META-PM classification. Vision-specific functioning (VSF) was assessed with a validated visual-functioning questionnaire (VF-11) using Rasch analysis.
A total of 8716 phakic subjects were included in this analysis. The mean age (± SD) was 57.2 ± 9.5 years (33.5% Malays, 33.2% Indians, and 33.3% Chinese). The prevalence of myopia (spherical equivalent [SE] ≤ −0.5 diopters [D]) and high myopia (SE ≤ −5.0 D) was 35.7% and 6.0%, respectively. The age-standardized prevalence of MMD was 3.8% (95% confidence interval [CI], 3.4–4.3%). The prevalence of MMD was 7.7% among low to moderate myopes, and 28.7% among high myopes. The prevalence of MMD increased nonlinearly with SE and age. MMD was associated with older age, more myopic SE, and lower education. Subjects with Meta-PM categories 3 or 4 in the better-seeing eye had worse best-corrected VA (β, 0.19; 95%CI, 0.16–0.23) and poorer VSF (β, −9.7; 95%CI, −17.6 to −1.8) than those without MMD after multivariate adjustments.
Approximately 1 in 26 phakic adults in Singapore has MMD. Older age and myopic SE are major risk factors of MMD. Severe MMD has a substantial impact on visual impairment and functioning.
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