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Yee Shan Dan, Qiu Ying Wong, Daryle Jason Go Yu, Quan V Hoang, Chee Wai Wong; Complications of pathologic myopia in extremely long eyes ≥30.0mm and their impact on vision. Invest. Ophthalmol. Vis. Sci. 2020;61(7):2684.
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© ARVO (1962-2015); The Authors (2016-present)
To describe the prevalence of complications associated with pathologic myopia in extremely long eyes of axial length (AL) ≥30.0mm, and assess their impact on vision
This is a clinic-based observational study of 78 eyes of 49 patients with AL ≥ 30.0 mm, enrolled from the high myopia clinic of the Singapore National Eye Centre. AL and anterior chamber depth (ACD) were measured with the IOLmaster. Myopic maculopathy (MMD) was graded from fundus photographs according to the META-PM Classification and defined as META-PM category ≥ 2. Swept source optical coherence tomography of the macula and optic nerve was performed and examined for the presence of retinal and optic disc lesions. The diagnosis of glaucoma was made by a fellowship trained glaucoma specialist. The prevalence of each of these lesions were described and the impact of MMD, MTM and glaucoma on visual acuity were assessed.
The mean age was 58.3±9.1 years, mean AL was 31.9±1.4mm and mean logMAR BCVA was 0.34±0.27. The majority of patients were female (n=35, 71.4%). MMD was detected in 72 (92.3%) eyes: 39 (50.0%) were graded as META-PM category 2, 28 (35.9%) as META-PM category 3 and 5 (6.4%) as META-PM category 4. MTM was found in 21 eyes (26.6%) and the most common lesion was extrafoveal macular schisis (n=15, 20.0%). Glaucoma was diagnosed in 8 eyes (10.3%), of these, primary open angle glaucoma (3 eyes) and secondary glaucoma (3 eyes) were the most common, followed by normal tension glaucoma (2 eyes). Mean logMAR BCVA was 0.46±0.50, 0.63±0.63 and 0.32±0.22 in eyes with MMD, MTM and glaucoma respectively. BCVA worsened with increasing number of PM complications (0.32±0.10, 0.36±0.36 and 0.64±0.65 for 0, 1 and 2 complications respectively, p=0.001). Compared to glaucoma and MMD, MTM had the greatest impact on visual acuity on multivariate analysis adjusted for age, gender and AL (p=0.03).
Extremely long eyes with AL≥30.0mm had a high prevalence of MMD, MTM and glaucoma. Compared to glaucoma and MMD, MTM had the greatest impact on visual acuity in these eyes.
This is a 2020 ARVO Annual Meeting abstract.
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