Five-Year cumulative Incidence and Progression of Myopic Maculopathy in the German population – results from the Gutenberg Health Study

Abstract

Purpose : To investigate the five-year cumulative incidence and progression of myopic maculopathy in the general population in Germany and to analyze potential risk factors.

Methods : The Gutenberg Health Study (GHS) is a population-based cohort study, including 15,010 participants aged 35 to 74 years at baseline. Myopic maculopathy incidence and progression was assessed by grading of fundus photographs according to a recent international photographic classification system (META-PM), in phakic eyes with spherical equivalent ≤ -6D (baseline). 509 eyes of 334 participants (mean age 50.4 ± 9.2 years; median: -7.25D myopic refractive error) without myopic maculopathy at baseline and 34 eyes of 27 subjects (mean age 56.7 ± 9.1 years; median -9D myopic refractive error) with myopic maculopathy met the conditions and had gradable fundus photographs at baseline and five-year follow-up. Multivariable logistic regression analysis was used to assess risk factors for progression of myopic maculopathy.

Results : 5-year cumulative incidence of myopic maculopathy was 0.3% (95%CI: 0.02-1.92%; n=1). Progression occurred in 17 of 34 eyes (50%) with prior myopic maculopathy over 5 years with 4 changes in category. The most common types of progression were enlargement of chorioretinal and patchy atrophy; a new pathology was present in 8 eyes. Higher IOP (OR=1.62, 95%CI: 1.03-2.53, p=0.035) was associated with progression of myopia, while female gender (OR=5.54, 95%CI: 0.93-32.92, p=0.060) and higher myopic refractive error (OR=1.62 per diopter, 95%CI: 0.99-1.49, p=0.063) showed a tendency towards progression.

Conclusions : Incidence of myopic maculopathy is rare in highly myopic eyes in the general population in Germany at age 35 to 74 years. Progression of eyes with myopic maculopathy in the German population occurred in 50% of prior diseased highly myopic eyes. These population-based five-year follow-up data on incidence and progression of myopic maculopathy are the first in Europe.

This is a 2021 ARVO Annual Meeting abstract.