Abstract
Purpose :
To examine the association between baseline myopia status with 6-year incident visual impairment. Myopia is the most common type of refractive error with significant morbidity on visual function. The disease has been associated with higher risk of developing myopic macular degeneration, choroidal neovascularisation, cataract and glaucoma.
Methods :
We conducted a population-based prospective cohort study on participants from the Singapore Epidemiology of Eye Diseases (SEED) Study. Adults aged ≥40 years with no VI at baseline were recruited and followed up at the 6-year mark for incident VI. VI was defined as best-corrected visual acuity <20/40 determined by subjective refraction, consisting of low vision between <20/40 and ≥20/200 and blindness of <20/200. Myopia was defined as SE <-0.5 D. We performed multivariable Poisson regression with robust variance to evaluate the association between baseline myopia status and incident VI, adjusting for age, gender, ethnicity, alcohol intake, smoking, BMI, diabetes mellitus, hypertension, hyperlipidaemia, cardiovascular disease, chronic kidney disease, housing, education, and income. Generalized estimating equation (GEE) with exchangeable correlation structure was applied to account for correlation between pairs of eyes.
Results :
A total of 6,077 participants (11,559 eyes) with no baseline VI were included in the analysis (2,385 Chinese, 1,722 Malay, and 1,970 Indian individuals). Subjects included in the final analysis had a mean age of 56.0 ± 8.6 years and 2,955 (48.6%) were male. Compared to eyes with no myopia (n=7860), eyes with low myopia (n=2359) (-3D<SE≤-0.5; RR=1.33; 95%CI, 1.09-1.63; P=0.006) and high myopia (n=367) (SE≤-6D; RR=3.34; 95%CI, 2.09-5.33; P<0.001) had increased risk of incident VI. Eyes with axial length >26mm were 2.8 times more likely to develop VI (95%CI, 1.83-4.27; P<0.001) compared to those with AL≤23mm. Primary causes of incident VI were cataracts (71.0%), age-related macular degeneration (6.93%), posterior capsular opacification, and maculopathy (Table 1).
Conclusions :
In this multiethnic population-based cohort study, myopia, in particular high myopia, was associated with higher incident risk of best-corrected VI. Our findings provide further impetus for close monitoring and screening of individuals with high myopia for incident vision loss.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.