Abstract
Purpose :
To determine the impact of eye shape using three-dimensional magnetic resonance imaging (3D MRI) on myopic maculopathy (MM) progression.
Methods :
At baseline, 67 participants with bilateral high myopia (≤ -6.00 diopter spherical error) were selected. Eye shape was classified into spheroidal, ellipsoidal, conical, nasally distorted, temporally distorted and barrel-shape based on 3D MRI. Among them, spheroidal and ellipsoidal were defined as non-deformity, otherwise others were defined as eye deformity. The MM progression was determined through color fundus photography.
Results :
Within 4-year follow-up, 17.1% (7/41) of patients with non-deformed eye shape had MM progression, whereas 69.2% (18/26) of patients with deformed eye shape had MM progression. In multivariate analysis, eye shape deformity (Odds ratio [OR], 4.35; 95% confidence interval [CI], 1.10-17.29; P = 0.036) and axial length (AL) of 28 mm or greater (OR, 12.75; 95% CI, 2.27-71.48; P = 0.004) were significantly associated with MM progression. The area under the curve (AUC) for discriminating MM progression when eye shape considered as a single risk factor was 0.765, showing no significant difference in predictive efficacy compared with AL alone (AUC: 0.750) (P = 0.486). The prediction model that included age, sex, AL and eye shape, achieved an AUC of 0.862 for discriminating MM progression. When adjusting for age, sex and AL, the presence of posterior staphyloma significantly correlated with MM progression (OR, 11.56; 95% CI,1.73-77.07; P = 0.011).
Conclusions :
Eye shape deformity assessed by 3D MRI, equally as important as AL, is a novel predictor of MM progression in highly myopic individuals.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.