PURPOSE: To investigate the characteristics, mergers, and risk factors of different types of myopic maculopathy (MM) in a highly myopic population. DESIGN: Population-based, cross-sectional study. METHODS: A total of 1086 eyes (762 patients) were enrolled. Each participant underwent detailed ocular examinations. Combining the fundus photographs and optical coherence tomography images, types of MM were assessed as myopic atrophy maculopathy (MAM), myopic tractional maculopathy (MTM), or myopic neovascular maculopathy (MNM) according to the ATN classification system. Peripapillary atrophy (PPA) area, tilt ratio, and macular choroidal thickness (mChT) were measured individually.RESULTS: Eyes with larger PPA area were more likely to have MAM (odds ratio [OR], 1.220; P [ .037 per 1-mm 2 increase) and MNM (OR, 1.723; P < .001 per 1-mm 2 increase), and eyes with thicker mChT were less likely to have MAM (OR, 0.740; P < .001 per 10-mm increase) and MNM (OR, 0.784; P < .001 per 10-mm increase), whereas eyes with higher tilt ratio were less likely to have MTM (OR, 0.020; P < .001 per 1 increase). The severity of MTM and MNM was not precisely consistent with that of MAM.CONCLUSIONS: Different types of MM have different risk factors; larger PPA area and thinner mChT are risk factors for MAM and MNM, whereas lower tilt ratio is a risk factor for MTM. Our results indicate that the pathogenesis of MTM is different from that of MAM and MNM, and a tractional component should be considered as a possible component to the myopic macular classification. (Am J Ophthalmol 2019;208: 356-366. Ó
Purpose: To explore the characteristics and associated factors of fundus tessellation, especially the alternation of choroidal thickness among different degrees of tessellated fundus in young adults.Design: Cross-sectional, population-based study.Methods: A total of 796 students were included in the study and underwent comprehensive ophthalmic examinations, including anterior segment examinations and swept-source optical coherence tomography (OCT) measurements. The degree of tessellated fundus was assessed by fundus photographs applying an early treatment of diabetic retinopathy study grid to evaluate the location of fundus tessellation and then divided into five groups. The topographic variation and factors, tilted disc ratio, parapapillary atrophy (PPA), retinal thickness (ReT), choroidal thickness (ChT), and subfoveal scleral thickness (SST) related to tessellated fundus were analyzed.Results: Compared to normal fundus, tessellated fundus had a lower spherical equivalent (SE) (p < 0.0001), worse best-corrected visual acuity (BCVA)(p = 0.043), longer axial length (AL) (p < 0.0001), thinner retina (p < 0.0001), thinner (p < 0.0001) choroid, and thinner sclera in center fovea (p = 0.0035). Among all subfields of macular and peripapillary regions, center fovea and macula-papillary region showed the most significant decrease in choroidal thickness. The proportion of fundus tessellation significantly increased with lower body weight index (BMI) (p = 0.0067), longer AL (p < 0.0001), larger PPA(p = 0.0058), thinner choroid (p < 0.0001), and thinner sclera (p < 0.0001).Conclusions: Eyes showed more severe myopic morphological alternation with the increasement of proportion of fundus tessellation to the center fovea, including a significant decrease in both choroid and scleral thickness. Choroidal thinning may progress most rapidly in the macula-papillary region as fundus tessellation approaches to the center fovea.
This study aimed to explore the morphological characteristics of Bruch's membrane opening distance (BMOD), border length (BL), border tissue angle (BTA), vertical tilt angle, and peripapillary atrophy (PPA), as well as their associations with choroidal thickness (ChT) in young healthy highly myopic eyes. METHODS. A total of 167 patients with high myopia and 172 individuals without high myopia were enrolled. All of the subjects were divided by axial length. The PPA area was measured on fundus photographs. BMOD, BL, BTA, vertical tilt angle, macular ChT (mChT), and peripapillary ChT (pChT) were measured on swept-source optical coherence tomography scans. RESULTS. The PPA area (P < 0.0001) and vertical tilt angle (P < 0.0001) were larger, BMOD (P < 0.0001) and BL (P < 0.0001) were longer, and BTA (P < 0.0001) was smaller in the high-myopia group compared with the group without high myopia. Every 1-μm increase in BMOD was associated with a 35.80-μm decrease in mChT; every 1°decrease in BTA was correlated with a 0.32-μm decrease in mChT and a 0.26-μm decrease in pChT; and no association was found between PPA area and ChT in the multivariate linear regression model. CONCLUSIONS. PPA area, BL, BMOD, and vertical tilt angle increased, but BTA decreased with axial elongation of the globe in young, healthy patients with myopia. Longer BMOD was positively correlated with lower mChT, and smaller BTA was positively correlated with lower mChT and pChT in this population.
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