Abstract:IMPORTANCE Although myopic maculopathy has become a major cause of vision impairment worldwide, few data from Russia and Central Asia on the prevalence of myopic maculopathy have been available. OBJECTIVE To assess the prevalence of myopic maculopathy and its associations with ocular and systemic parameters in a population in Russia. DESIGN, SETTING, AND PARTICIPANTS The Ural Eye and Medical Study, a population-based casecontrol study, was conducted in rural and urban areas in Bashkortostan, Russia, from Octob… Show more
“…3). For the latter analysis, we included only the moderately to highly myopic individuals (with a cut-off value of 25.5 mm), since the prevalence of myopic complications, mainly myopic maculopathy and myopia-associated optic neuropathy, markedly increases with longer axial length beyond an axial length of approximately 25.5 mm or 26 mm 18 . In the multivariable analysis, we dropped, due to collinearity the parameters of serum concentration of glucose (prevalence of diabetes), creatinine (chronic kidney disease) and hemoglobin (anemia), body weight (body mass index), and refractive error (axial length).…”
Section: Resultsmentioning
confidence: 99%
“…3 ). For the latter analysis, we included only the moderately to highly myopic individuals (with a cut-off value of 25.5 mm), since the prevalence of myopic complications, mainly myopic maculopathy and myopia-associated optic neuropathy, markedly increases with longer axial length beyond an axial length of approximately 25.5 mm or 26 mm 18 . Figure 1 Graph showing the association between the prevalence of moderate to severe vision impairment (visual acuity < 6/18 but ≥ 3/60 in the better eye) in the Ural Eye and Medical Study, stratified by age and gender.…”
To assess prevalence of mild vision impairment (MVI; best corrected visual acuity (BCVA) < 6/12 to 6/18 in the better eye), moderate-to-severe vision impairment (MSVI; BCVA < 6/18 but ≥ 3/60) and blindness (BCVA < 3/60) in a local population in Russia, we conducted the population-based Ural Eye and Medical Study. Out of 7,328 eligible individuals aged 40 + years, 5,899 (80.5%) individuals participated. MVI was present in 184 (3.1%; 95% confidence interval (CI) 2.7, 3.6) individuals, MSVI in 182 (3.1%; 95% CI 2.7, 3.5) individuals, and 11 individuals (0.19%; 95% CI 0.008, 0.30) were blind. Causes for MSVI were cataract (n = 109; 59.9%), late stage of age-related macular degeneration (n = 14; 7.7%; geographic atrophy and neovascular AMD in 7 (3.8%) individuals) each), myopic maculopathy (n = 11; 6.0%), glaucoma (n = 9; 4.9%), non-glaucomatous optic nerve damage (n = 5; 2.7%), and diabetic retinopathy (n = 4; 2.2%). Causes for blindness were cataract (n = 3; 27.3%), myopic maculopathy (n = 2; 18.2%), retinal dystrophies (n = 2; 18.2%), glaucoma (n = 1; 9.1%), and corneal scars (n = 1; 9.1%). Higher prevalence of MSVI/blindness was associated with age (P < 0.001; odds ratio (OR)1.10; 95% CI 1.08, 1.12), male gender (P < 0.001; OR 2.32; 95% CI 1.47, 3.66), educational level (P < 0.001; OR 0.83; 95% CI 0.76,0.92), manual grip force (P < 0.001; OR 0.94; 95% CI 0.92, 0.96), diabetes prevalence (P = 0.006; OR 1.67; 95% CI 1.08, 2.56) and axial length (P < 0.001; OR 1.43; 95% CI 1.26,1.62). In this population from Bashkortostan/Russia, prevalence of MVI, MSVI and blindness was 3.1%, 3.1% and 0.19%, respectively. Cataract was the most frequent cause of reversible vision impairment, while AMD, myopic maculopathy and glaucoma were the most common reasons for irreversible vision impairment. Vision impairment and blindness are of utmost importance for the quality of life for the individual and for public health in general 1,2. Recent global and regional meta-analyses summarizing available data on visual impairment and blindness have revealed that out of 7.33 billion people living in 2015, approximately 36.0 million (80% Uncertainty interval (UI): 12.9-65.4 million; 55% female) individuals globally were blind, 216.6 million (80% UI: 98.5-359.1 million) individuals were moderately to severely vision impaired, and 188.5 million individuals (80% UI: 64.5-350.2 million; 54% female) were mildly vison impaired 3,4. These meta-analyses also showed that for Russia comprehensive data on vision impairment and blindness have only scarcely been available so far, although Russia is by area the largest, and by population one of the largest, countries worldwide 5,6. In addition, most of the previous population-based studies on VI and blindness have only rudimentarily assessed associations between the prevalence of VI and blindness and other ocular and systemic parameters 3,4,6. We therefore conducted the Ural Eye and Medical Study (UEMS) to examine the prevalence of VI and blindness in a local population in Bashkortostan/Russia and to explore ...
“…3). For the latter analysis, we included only the moderately to highly myopic individuals (with a cut-off value of 25.5 mm), since the prevalence of myopic complications, mainly myopic maculopathy and myopia-associated optic neuropathy, markedly increases with longer axial length beyond an axial length of approximately 25.5 mm or 26 mm 18 . In the multivariable analysis, we dropped, due to collinearity the parameters of serum concentration of glucose (prevalence of diabetes), creatinine (chronic kidney disease) and hemoglobin (anemia), body weight (body mass index), and refractive error (axial length).…”
Section: Resultsmentioning
confidence: 99%
“…3 ). For the latter analysis, we included only the moderately to highly myopic individuals (with a cut-off value of 25.5 mm), since the prevalence of myopic complications, mainly myopic maculopathy and myopia-associated optic neuropathy, markedly increases with longer axial length beyond an axial length of approximately 25.5 mm or 26 mm 18 . Figure 1 Graph showing the association between the prevalence of moderate to severe vision impairment (visual acuity < 6/18 but ≥ 3/60 in the better eye) in the Ural Eye and Medical Study, stratified by age and gender.…”
To assess prevalence of mild vision impairment (MVI; best corrected visual acuity (BCVA) < 6/12 to 6/18 in the better eye), moderate-to-severe vision impairment (MSVI; BCVA < 6/18 but ≥ 3/60) and blindness (BCVA < 3/60) in a local population in Russia, we conducted the population-based Ural Eye and Medical Study. Out of 7,328 eligible individuals aged 40 + years, 5,899 (80.5%) individuals participated. MVI was present in 184 (3.1%; 95% confidence interval (CI) 2.7, 3.6) individuals, MSVI in 182 (3.1%; 95% CI 2.7, 3.5) individuals, and 11 individuals (0.19%; 95% CI 0.008, 0.30) were blind. Causes for MSVI were cataract (n = 109; 59.9%), late stage of age-related macular degeneration (n = 14; 7.7%; geographic atrophy and neovascular AMD in 7 (3.8%) individuals) each), myopic maculopathy (n = 11; 6.0%), glaucoma (n = 9; 4.9%), non-glaucomatous optic nerve damage (n = 5; 2.7%), and diabetic retinopathy (n = 4; 2.2%). Causes for blindness were cataract (n = 3; 27.3%), myopic maculopathy (n = 2; 18.2%), retinal dystrophies (n = 2; 18.2%), glaucoma (n = 1; 9.1%), and corneal scars (n = 1; 9.1%). Higher prevalence of MSVI/blindness was associated with age (P < 0.001; odds ratio (OR)1.10; 95% CI 1.08, 1.12), male gender (P < 0.001; OR 2.32; 95% CI 1.47, 3.66), educational level (P < 0.001; OR 0.83; 95% CI 0.76,0.92), manual grip force (P < 0.001; OR 0.94; 95% CI 0.92, 0.96), diabetes prevalence (P = 0.006; OR 1.67; 95% CI 1.08, 2.56) and axial length (P < 0.001; OR 1.43; 95% CI 1.26,1.62). In this population from Bashkortostan/Russia, prevalence of MVI, MSVI and blindness was 3.1%, 3.1% and 0.19%, respectively. Cataract was the most frequent cause of reversible vision impairment, while AMD, myopic maculopathy and glaucoma were the most common reasons for irreversible vision impairment. Vision impairment and blindness are of utmost importance for the quality of life for the individual and for public health in general 1,2. Recent global and regional meta-analyses summarizing available data on visual impairment and blindness have revealed that out of 7.33 billion people living in 2015, approximately 36.0 million (80% Uncertainty interval (UI): 12.9-65.4 million; 55% female) individuals globally were blind, 216.6 million (80% UI: 98.5-359.1 million) individuals were moderately to severely vision impaired, and 188.5 million individuals (80% UI: 64.5-350.2 million; 54% female) were mildly vison impaired 3,4. These meta-analyses also showed that for Russia comprehensive data on vision impairment and blindness have only scarcely been available so far, although Russia is by area the largest, and by population one of the largest, countries worldwide 5,6. In addition, most of the previous population-based studies on VI and blindness have only rudimentarily assessed associations between the prevalence of VI and blindness and other ocular and systemic parameters 3,4,6. We therefore conducted the Ural Eye and Medical Study (UEMS) to examine the prevalence of VI and blindness in a local population in Bashkortostan/Russia and to explore ...
“…The results of the present study may have clinical implications. Myopic maculopathy and optic nerve atrophy in association with high axial myopia have become some of the most common causes of irreversible vision impairment and blindness 48‐50 . The most important risk factor for the development and progression of myopic maculopathy and highly myopic optic nerve damage is a long axial length and further elongation 51‐53 .…”
To examine the influence of epidermal growth factor (EGF) and its receptor (EGFR) on axial ocular elongation, we intraocularly injected an EGF antibody and an EGFR antibody into young guinea pigs with lens‐induced axial elongation (myopization). Mean axial elongation was reduced in the eyes injected with the EGF/EGFR‐antibody compared with the contralateral control eyes injected with PBS (phosphate‐buffered solution) (0.43 ± 0.13 mm vs 0.53 ± 0.13 mm; P < .001). The intereye difference in axial length increased (P = .005) as the doses of the EGF antibody and EGFR antibody increased. As a corollary, the thickness of the retina at the posterior pole was dose‐dependently increased in the injected eyes compared to the contralateral control eyes. Immunohistochemical staining for EGF and the relative mRNA expression of EGF and EGFR were the highest in eyes not injected with the EGF antibody or EGFR antibody and decreased (P < .05) as the dose of EGF antibody or EGFR antibody increased. In an in vitro study, EGF had a stimulating effect and the EGF antibody had an inhibitory effect on the proliferation and migration of RPE cells. The findings showed that the intravitreal application of an EGF antibody and EGFR antibody is associated with a dose‐dependent reduction in lens‐induced axial elongation in young guinea pigs. The EGFR family may play a role in axial elongation of the eye and in the development of myopia.
“…R ecent population-based studies and their meta-analysis have revealed that pathologic myopia is one of the most common causes for irreversible blindness worldwide. [1][2][3] According to the META-analysis for Pathologic Myopia Study Group, the fundus changes in pathologic myopia can be differentiated into category 1, characterized by an increased fundus tessellation, category 2 showing a diffuse chorioretinal atrophy in the macular region, category 3 with patchy atrophies located in the extrafoveal region and representing the ophthalmoscopical equivalent of a smaller central region with a Bruch membrane (BM) defect and a larger defect in the retinal pigment epithelium (RPE) cell layer, and category 4 with patchy atrophy located in the fovea. 4 Plus lesions are lacquer cracks, choroidal neovascularization, and a macular scar (Fuch spot).…”
Purpose: Previous population-based and hospital-based studies have shown an association between high myopia and higher prevalence of glaucomatous or glaucoma-like optic neuropathy (GON). Here we discuss potential factors associated with such a correlation. Design: Review. Methods: Findings from population-based and clinical investigations were combined with observations from light-microscopical examinations of human eyes. GON was defined by an abnormal shape of the neuroretinal rim as shown by a vessel kinking close to optic disc border in the inferior, superior, or nasal optic disc region. Results: The prevalence of GON increased (P < 0.001) beyond an axial length of 26.5 mm or a myopic refractive error of À8 diopters and reached up to 80% in eyes with an axial length >33 mm. It was associated with a larger optic disc and/or larger parapapillary delta zone. Histological factors potentially associated with the myopia-related increased GON prevalence were an elongation and thinning of the lamina cribrosa resulting in intra-lamina changes and a steepening of the translamina cribrosa pressure gradient; a lengthening and thinning of the peripapillary scleral flange which is the ophthalmoscopical equivalent of parapapillary delta zone and acts as the biomechanical anchor of the lamina cribrosa; and an increased distance of the peripapillary arterial circle of Zinn-Haller to the lamina cribrosa, due to the elongation of the peripapillary scleral flange. In addition to GON, a nonglaucomatous optic nerve damage may occur in the papillo-macular region due to a parapapillary gamma zoneassociated lengthening of the retinal nerve fibers. Conclusions: In highly myopic eyes, one should be vigilant not to overlook GON.
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