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Daryle Jason Go Yu, Chee Wai Wong, Judith Ow, Yee Shan Dan, Qiu Ying Wong, Quan V Hoang; Influence of Greater Axial Length on Prevalence of Myopic Maculopathy in a Cohort of Highly Myopic Eyes. Invest. Ophthalmol. Vis. Sci. 2020;61(7):2677.
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© ARVO (1962-2015); The Authors (2016-present)
To quantify the increased prevalence of myopic macular degeneration (MMD) and vision-threatening macular changes in highly myopic (HM) eyes with axial length (AL) ≥ 29.5mm versus those with AL < 29.5 mm in a Singaporean cohort of HM.
A consecutive series of HM patients (<-6.00D and/or >25 mm AL) clinically-diagnosed with staphyloma or MMD, were seen between 8/2019-11/2019. All patients underwent dilated retinal exam, AL measurement, fundus photography/autofluorescence and swept-source optical coherence tomography. The cohort was stratified into eyes with AL 25 to 29.5 mm and those > 29.5 mm.
226 eyes of 120 HM patients (51.67% female, 59.5 ±13.89 years-old, range 21-82) were evaluated. AL was 29.5 ±2.4mm (25.0 - 35.81 mm). Using the Meta-analysis of Pathologic Myopia classification to assess the MMD, the severity of MMD was higher in the longer AL group than the shorter AL group with 21.24%, 19.91%, 3.10%, and 4.87% of eyes in MMD Category 1, 2, 3 and 4 respectively in the short AL group versus 1.77%, 17.70%, 19.47% and 11.06% in the longer AL group. The longer AL group was found to have significantly higher prevalence of: foveoschisis 49.5% vs. 15.9% in the shorter AL group (Chi-square statistic 28.8107, p< 0.0001), vitreomacular traction 23.4% vs. 10.6% (6.5169, p= 0.0107), dome-shaped macula 16.2% vs. 4.4% (8.45, p= 0.0037), epiretinal membrane 31.5% vs. 14.3% (9.3997, p= 0.0022) and myopic choroidal neovascularization 23.4% vs. 9.7% (7.6093, p= 0.0058). The two groups did not differ in terms of past or present lamellar or full-thickness macular hole 12.6% vs. 8.8% (0.8289, p= 0.3626).
HM eyes with AL ≥29.5 mm have a higher prevalence of various vision-threatening myopic macular pathologies as compared to HM eyes 25-29.5 mm. This information adds to the database of knowledge of risk of vision loss associated with HM.
This is a 2020 ARVO Annual Meeting abstract.
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