Abstract
Purpose :
To determine the prevalence and risk factors for myopic macular degeneration (MMD) in adults with high myopia in central China.
Methods :
The Aier-SERI High Myopia study is a prospective longitudinal cohort of Chinese adults (> 40 years) with high myopia worse than -5 Diopters (D) in the Aier Hospital in Changsha, central China. 192 adults with high myopia have been enrolled in the baseline visit since 2021. Autorefraction and biometry using the IOLMaster were performed. Fundus photographs were graded using the Meta-PM Criteria whereby category 2 indicates macular diffuse chorioretinal atrophy, category 3 patchy chorioretinal atrophy and category 4 macular atrophy. Analyses of associations with MMD were performed using GEE multivariable logistic regression models. Risk factors of MMD, including age, gender, education, spherical equivalent (SE) and axial length (AL), were evaluated.
Results :
The mean age was 47.4 years, 60.9% were female, and the mean SE was -9.8 D [standard deviation (SD) =4.5]. The prevalence of MMD was 9.9% (95% confidence interval [CI], 6.4-14.9%) in adults with high myopia worse than -6 D with 3.0% (95% CI: 0.4-5.6%) in MMD Meta-PM category 2, 6.0% (95% CI: 2.4-9.5%) in Category 3 and 2.4 % (95% CI: 0.08-4.7%) in Category 4. Of adults with extreme myopia > -10.0 D, 34.9% (95% CI: 28.2-41.6%) had MMD, 7.5%(95% CI: 1.2-13.8%), 13.4% (95% CI: 5.3-21.6%) and 6% (95% CI: 0.3-11.6%) had MMD category 2, 3, and 4, respectively. Worse SE (p<0.001) and longer AL (p< 0.001) at baseline were independently associated with MMD in multivariate logistic regression models.
Conclusions :
Approximately 1 in five adults aged 40 years and above with high myopia have MMD in Changsha, central China. A more severe myopia or longer axial length increases the risk of MMD. Further investigations into the pattern of MMD will provide valuable data on the screening, treatment and projected number of the MMD cases in the next few decades in China.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.