Prevalence and predictors of myopic macular degeneration among Asian adults: pooled analysis from the Asian Eye Epidemiology Consortium

Abstract

AimsTo determine the prevalence and predictors of myopic macular degeneration (MMD) in a consortium of Asian studies.MethodsIndividual-level data from 19 885 participants from four population-based studies, and 1379 highly myopic participants (defined as axial length (AL) >26.0 mm) from three clinic-based/school-based studies of the Asian Eye Epidemiology Consortium were pooled. MMD was graded from fundus photographs following the meta-analysis for pathologic myopia classification and defined as the presence of diffuse choroidal atrophy, patchy chorioretinal atrophy, macular atrophy, with or without ‘plus’ lesion (lacquer crack, choroidal neovascularisation or Fuchs’ spot). Area under the curve (AUC) evaluation for predictors was performed for the population-based studies.ResultsThe prevalence of MMD was 0.4%, 0.5%, 1.5% and 5.2% among Asians in rural India, Beijing, Russia and Singapore, respectively. In the population-based studies, older age (per year; OR=1.13), female (OR=2.0), spherical equivalent (SE; per negative diopter; OR=1.7), longer AL (per mm; OR=3.1) and lower education (OR=1.9) were associated with MMD after multivariable adjustment (all p<0.001). Similarly, in the clinic-based/school-based studies, older age (OR=1.07; p<0.001), female (OR=2.1; p<0.001), longer AL (OR=2.1; p<0.001) and lower education (OR=1.7; p=0.005) were associated with MMD after multivariable adjustment. SE had the highest AUC of 0.92, followed by AL (AUC=0.87). The combination of SE, age, education and gender had a marginally higher AUC (0.94).ConclusionIn this pooled analysis of multiple Asian studies, older age, female, lower education, greater myopia severity and longer AL were risk factors of MMD, and myopic SE was the strongest single predictor of MMD.

Prevalence and associated health and lifestyle factors of myopic maculopathy in northern china: the Kailuan Eye Study

“…However, we could not nd association of Diabetes, serum lipids, BMI, smoking, nature of job (mental or physical), and using smart phone (near distance working) with MM after multivariable adjustment in the present study. These ndings are consistent with the results from Wong et al [35] It has been demonstrated that MM was the leading cause of bilateral visual impairment and blindness. [2][3][4] 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 classi ed as visual impairment or blindness.…”

Choroidal remodeling distribution pattern in the macular region in Chinese young patients with myopia

“…Pärssinen et al [28] conducted a 22-year study by following children participants into their adulthood and found that the most important predictors of high myopia were younger age at baseline and faster myopia development during the first follow-up. High myopia carries a greater risk of ocular diseases such as cataracts, glaucoma, and retinal detachment [29], among which myopic macular degeneration (MMD) is one of the most frequent causes of vision loss or irreversible blindness in developed countries, especially in East Asia with higher myopia rates [30,31]. Wong et al [30] found that the degree of choroidal thinning was closely related to the severity of MMD, while scleral thickness was weakly related to MMD; this information suggests that choroidal thinning leads to a reduction in choroid perfusion and choroidal ischemia, with subsequent upregulation of angiogenic factors is important pathogenesis of MMD [32].…”

Choroidal Remodeling Distribution Pattern in the Macular Region in Chinese Young Patients with Myopia

“…Pärssinen et al conducted a 22-year study by following children participants into their adulthood and found that the most important predicators of high myopia were younger age at baseline and faster myopia development during the rst follow-up (29). High myopia carries a greater risk of ocular diseases such as cataracts, glaucoma, and retinal detachment (30), among which myopic macular degeneration (MMD) is one of the most frequent causes of vision loss or irreversible blindness in developed countries, especially in East Asia with higher myopia rates (31, 32). Wong et al (31) found that the degree of choroid thinning was closely related to the severity of MMD, while scleral thickness was weakly related to MMD; this information suggests that choroid thinning leads to reduction in choroid perfusion and choroidal ischemia, with subsequent upregulation of angiogenic factors is an important pathogenesis of MMD (33).…”