Progression of myopic maculopathy in a Caucasian cohort of highly myopic patients with long follow-up: a multistate analysis

Coco‐Martín, Rosa M.; Belani-Raju, Minal; Fuente-Gomez, Daniel de la; Sanabria, María R.; Fernández, Itziar

doi:10.1007/s00417-020-04795-5

Cited by 11 publications

(10 citation statements)

References 31 publications

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Section: Discussionsupporting

confidence: 91%

“…Previous studies have shown that compared with individuals with stable fundus, those with myopic maculopathy progression were more likely to have worse BCVA, longer AL, faster AL elongation, and higher myopic SE. 14,16,[20][21][22][23][24] Our results were largely consistent with these publications, except for older age. Interestingly, similar to another investigation focused on the young Chinese population, 11 age did not show an association with the progression of myopic maculopathy in our study.…”

Section: Discussionsupporting

confidence: 90%

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Four-Year Progression of Myopic Maculopathy in Children and Adolescents With High Myopia

Jiang,

Wang,

Xiao

et al. 2024

JAMA Ophthalmol

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ImportanceIndividuals with high myopia younger than 18 years are at relatively high risk of progressively worsening myopic maculopathy. Additional studies are needed to investigate the progression of myopic maculopathy in this age group, as well as the risk factors associated with progression.ObjectiveTo investigate the 4-year progression of myopic maculopathy in children and adolescents with high myopia, and to explore potential risk factors.Design, Setting, and ParticipantsThis hospital-based observational study with 4-year follow-up included a total of 548 high myopic eyes (spherical power −6.00 or less diopters) of 274 participants aged 7 to 17 years. Participants underwent comprehensive ophthalmic examination at baseline and 4-year follow-up. Myopic maculopathy was accessed by the International Photographic Classification and Grading System. The data analysis was performed from August 1 to 15, 2023.Main Outcomes and MeasuresThe progression of myopic maculopathy progression over 4 years and associated risk factors.ResultsThe 4-year progression of myopic maculopathy was found in 67 of 548 eyes (12.2%) of 274 participants (138 girls [50.4%] at baseline and 4-year follow-up) with 88 lesion changes, including new signs of the tessellated fundus in 16 eyes (18.2%), diffuse atrophy in 12 eyes (13.6%), patchy atrophy in 2 eyes (2.3%), lacquer cracks in 9 eyes (10.2%), and enlargement of diffuse atrophy in 49 eyes (55.7%). By multivariable analysis, worse best-corrected visual acuity (odds ratio [OR], 6.68; 95% CI, 1.15-38.99; P = .04), longer axial length (AL) (OR, 1.73; 95% CI, 1.34-2.24; P &lt; .001), faster AL elongation (OR, 302.83; 95% CI, 28.61-3205.64; P &lt; .001), and more severe myopic maculopathy (diffuse atrophy; OR, 4.52; 95% CI, 1.98-10.30; P &lt; .001 and patchy atrophy; OR, 3.82; 95% CI, 1.66-8.80; P = .002) were associated with myopic maculopathy progression.Conclusions and RelevanceIn this observational study, the progression of myopic maculopathy was observed in approximately 12% of pediatric high myopes for 4 years. The major type of progression was the enlargement of diffuse atrophy. Risk factors for myopic maculopathy progression were worse best-corrected visual acuity, longer AL, faster AL elongation, and more severe myopic maculopathy. These findings support consideration of follow-up in these individuals and trying to identify those at higher risk for progression.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 90%

Four-Year Progression of Myopic Maculopathy in Children and Adolescents With High Myopia

Jiang,

Wang,

Xiao

et al. 2024

JAMA Ophthalmol

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“…A study published in 2010 found that MP was the second most common cause of visual impairment in a nursing home [21]. In addition, our previous study showed differences between our population and Asian populations [22].…”

Section: Introductionmentioning

confidence: 43%

“…We used structural SS-OCT and SS-OCTA supported by retinography to detect macular lesions related to PM. To our knowledge, this is the largest study that uses a Caucasian sample and focuses on a high number of lesions, which is important, as Spanish PM cohorts may not behave in the same way as Asian cohorts [22]. Our study highlights the importance and potential of the use of widefield SS-OCT to detect less frequently reported complications in PM, such as macular pits, choroidal cavitations, scleral dehiscence, PSV, or vessel folds.…”

Section: Discussionmentioning

confidence: 82%

Does PLEX® Elite 9000 OCT Identify and Characterize Most Posterior Pole Lesions in Highly Myopic Patients?

Arlanzon-Lope

Campos

Fernandez-Bueno

et al. 2023

JCM

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High myopia (HM) is defined as an axial length (AL) ≥ 26 mm that may result in various pathologies that constitute pathologic myopia (PM). The PLEX® Elite 9000 (Carl Zeiss AC, Jena, Germany) is a new swept-source optical coherence tomography (SS-OCT) underdevelopment that allows wider, deeper and more detailed posterior-segment visualization; it can acquire ultra-wide OCT angiography (OCTA) or new ultra-wide high-density scans in one image. We assessed the technology’s ability to identify/characterize/quantify staphylomas and posterior pole lesions or image biomarkers in highly myopic Spanish patients and estimate the technology’s potential to detect macular pathology. The instrument acquired 6 × 6 OCTA, 12 × 12 or 6 × 6 OCT cubes, and at least two high-definition spotlight single scans. A hundred consecutive patients (179 eyes; age, 51.4 ± 16.8 years; AL, 28.8 ± 2.33 mm) were recruited in one center for this prospective observational study. Six eyes were excluded because images were not acquired. The most common alterations were perforating scleral vessels (88.8%), classifiable staphyloma (68.7%), vascular folds (43%), extrafoveal retinoschisis (24%), dome-shaped macula (15.6%), and more uncommonly, scleral dehiscence (4.46%), intrachoroidal cavitation (3.35%), and macular pit (2.2%). The retinal thickness of these patients decreased, and the foveal avascular zone increased in the superficial plexus compared with normal eyes. SS-OCT is a novel potent tool that can detect most main posterior pole complications in PM and may provide us with a better understanding of the associated pathologies; some pathologies were identifiable only with this new kind of equipment, such as perforating scleral vessels, which seem to be the most common finding and not so frequently related to choroidal neovascularization, as previously reported.

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“…The progression rate of myopic maculopathy in highly myopic eyes with DCA, the META-PM category 2, was reported to be various from 14.2 to 70.8% 8,[16][17][18][19][20][21] , probably due to differences in the study population and length of follow-up. Although most studies have detailed progression patterns, e.g.…”

Section: Discussionmentioning

confidence: 99%

Progression pattern of myopic maculopathy according to the severity of diffuse chorioretinal atrophy and choroidal thickness

Park

Lee

Yoon

et al. 2022

Sci Rep

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This observational cohort study aimed to evaluate the progression pattern of diffuse chorioretinal atrophy (DCA) according to its severity. Highly myopic eyes with DCA were graded according to its extent in the 532-nm (green) and 633-nm (red) wavelengths images of the Optos ultra-widefield scanning laser ophthalmoscope at baseline: grade 1 and 2 were defined when increased reflectance at peripapillary region, not beyond the fovea, were observed in red laser image only and in both laser images, respectively; grade 3 and 4 were defined when increased reflectance beyond the fovea were observed in red laser image only and in both laser images, respectively. A total of 307 eyes (221 patients) were included, and progression of myopic maculopathy during follow-up of ≥ 3 years was evaluated. The mean visual acuity and subfoveal choroidal thickness (CT) differed among DCA grades (P = 0.015 and P < 0.001); a higher DCA grade had worse visual acuity and thinner choroid. During follow-up, development of patchy atrophy (PA) was observed in 3.2%, 5.5%, 12.8%, and 23.2% (P < 0.001), while changes in lacquer crack (LC) and/or development of myopic macular neovascularization were observed in 20.6%, 29.1%, 33.3%, and 15.8% (P = 0.061) of 63, 110, 39, and 95 eyes with DCA grade of 1, 2, 3, and 4 at baseline, respectively. New LC formation tended to occur in eyes with thicker CT at baseline compared to PA development and progression of pre-existing LC. In highly myopic eyes with DCA, progression pattern of myopic maculopathy is different according to its severity and CT at baseline. Grading based on separated wavelength images of ultra-widefield scanning laser ophthalmoscope is useful to evaluate the severity and prognosis of DCA in Asian patients with high myopia.

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Progression of myopic maculopathy in a Caucasian cohort of highly myopic patients with long follow-up: a multistate analysis

Cited by 11 publications

References 31 publications

Four-Year Progression of Myopic Maculopathy in Children and Adolescents With High Myopia

Four-Year Progression of Myopic Maculopathy in Children and Adolescents With High Myopia

Does PLEX® Elite 9000 OCT Identify and Characterize Most Posterior Pole Lesions in Highly Myopic Patients?

Progression pattern of myopic maculopathy according to the severity of diffuse chorioretinal atrophy and choroidal thickness

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