Distribution and association of visual impairment with myopic maculopathy across age groups among highly myopic eyes – based on the new classification system (ATN)

Abstract

Purpose To investigate the percentages and risk factors for visual impairment (VI) across age groups in a highly myopic cohort with a wide range of age (18–93 years). Methods A total of 2099 eyes (1220 participants) were enrolled. All participants underwent detailed ocular examinations. Myopic maculopathy (MM) was assessed as myopic atrophy maculopathy (MAM), myopic traction maculopathy (MTM) or myopic neovascular maculopathy (MNM) based on the ATN system. Results Most participants younger than 50 years had normal vision, while the cumulative risk of VI and blindness gradually increased after 50–59 years. The percentage of each type of MM increased nonlinearly with ageing (all p < 0.001), with an accelerated period of increase after 45 years for MAM, and after 50 years for MTM and MNM. Axial length (AL) ≥30 mm was the only associated factor for mild VI or worse in participants aged 18–39 years (p < 0.001). Older age, AL ≥30 mm and the presence of MAM were predictors for mild VI or worse in the group aged 40–49 years (all p < 0.05). In participants aged ≥50 years, older age, female sex, longer AL and increased severity of MM were risk factors for VI and blindness (all p < 0.05). Conclusion The percentages of MM and related VI increased nonlinearly with older age, with a turning point at 45 years for MAM, preceding that of MTM, MNM and VI by 5 years, warranting future longitudinal studies to confirm. Different age groups presented different risk factors for VI. Timely screening should be in place for middle‐aged high myopes.

Prevalence and associated health and lifestyle factors of myopic maculopathy in northern China: the Kailuan eye study

“…The risk of MM is higher in persons of older age, regardless of myopia severity and AL, which places MM as an age-related degenerative disease [ 26 – 28 ]. This is consistent with our findings, reporting an increase of prevalence with higher age (OR = 1.084 per year).…”

“…It has been demonstrated that MM was the leading cause of bilateral visual impairment and blindness [ 2 – 4 , 28 ]. Our study mirrored this link between MM and visual impairment and blindness, with 81.7% (76/93) of participants with MM having a present visual acuity classified as visual impairment or blindness.…”

Relationship Between Paravascular Abnormalities and Choroidal Thickness in Young Highly Myopic Adults

“…Details about this study are available in our previous publication. 18 The protocol was approved by the Ethics Committee of Shanghai General People's Hospital, Shanghai Jiao Tong University School of Medicine, in compliance with the tenets of the Declaration of Helsinki. Written informed consent forms were signed by all participants.…”

Association of Macular Outward Scleral Height with Axial Length, Macular Choroidal Thickness and Morphologic Characteristics of the Optic Disc in Chinese Adults

“…It was conducted on Chinese adults (≥ 18 years old) who volunteered to participate after reading our study description and an open invitation to become participants. Details about SHMSA and SGHMS have been described in our previous study [24,25]. The exclusion criteria were presence of secondary myopia, intraocular pressure (IOP) > 21 mmHg, corneal opacity, severe cataract, glaucoma, fundus lesions that were unrelated to myopia (e.g., age-related macular degeneration, diabetic retinopathy, and optic neuropathy), systemic diseases with ocular involvement, history of eye surgery (except cataract surgery), and poor-quality images (image quality < 60).…”