Progression of Myopic Maculopathy in Chinese Children With High Myopia

Yin, Guisheng; Liu, Lijuan; Tang, Ping; Lv, Yanyun; Wu, Min; Xu, Liang; Zhang, Lin; Jonas, Jost B.; Wang, Yan

doi:10.1097/iae.0000000000003018

Cited by 21 publications

(15 citation statements)

References 30 publications

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“…Guo Yin et al used OCTA to analyze 274 eyes with differing degrees of myopia and found that the RNFL thickness in the superior and inferior quadrants was negatively correlated with AL. 16 Al-Sheikh Mayss found that the RNFL thickness became thinner with increasing myopia. 17 …”

Section: Discussionmentioning

confidence: 99%

Study on the Optic Nerve Fiber Layer Thickness and Changes in Blood Flow in Myopic Children

Lin¹,

Su²,

Lin³

et al. 2021

IJGM

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Objective: The present study aims to observe the optic nerve fiber layer thickness and blood flow density in the papillary area and investigate the effects of axial length (AL) and the refractive state of the optic papilla blood flow density in children with different refractive conditions. Methods: The present study was a clinical control study. The right eyes of 204 minors aged 6-17 years were studied. The eyes were divided into four groups according to myopic refractive states. OCTA analyzed the data to compare the radial peripapillary capillary (RPC) density and the difference in the retinal nerve fiber layer (RNFL) thickness adjacent to the optic papilla between the four refraction groups. Results: The intra-optic disc blood flow density was significantly and negatively correlated with the AL and was negatively correlated with the AL in the inferior temporal quadrants. The RNFL in the superior, nasal, and inferior quadrants was negatively correlated with the AL. The RNFL in the temporal quadrant was positively correlated with the AL. Conclusion: Our present study revealed that aAs myopia increased and the AL grew in children, the blood density of the entire image of the optic papilla, in the optic disc, and the retinal capillaries in the inferior parapapillary and temporal quadrant would change significantly. With increasing AL, a significant decrease in the intra-disc and para-disc RNFL was observed in the superior, nasal, and inferior quadrants, while a substantial increase in RNFL was observed in the temporal quadrant.

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Section: Discussionmentioning

confidence: 99%

Study on the Optic Nerve Fiber Layer Thickness and Changes in Blood Flow in Myopic Children

Lin¹,

Su²,

Lin³

et al. 2021

IJGM

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“…The earlier the onset of myopia, the greater the likelihood of high myopia later in life, 40 , 41 increasing the risk of developing myopia related pathology, 42 , 43 , 44 with a reduction in quality of life 45 and an associated economic burden. 46 , 47 Each dioptre progression of myopia is shown to increase the likelihood of developing myopic maculopathy by 40% irrespective of the degree of myopic refractive error.…”

Section: Discussionmentioning

confidence: 99%

Time spent outdoors as an intervention for myopia prevention and control in children: an overview of systematic reviews

Dhakal

Shah

Huntjens

et al. 2022

Ophthalmic Physiologic Optic

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Purpose: Outdoor light exposure is considered a safe and effective strategy to reduce myopia development and aligns with existing public health initiatives to promote healthier lifestyles in children. However, it is unclear whether this strategy reduces myopia progression in eyes that are already myopic. This study aims to conduct an overview of systematic reviews (SRs) reporting time spent outdoors as a strategy to prevent myopia or slow its progression in children. Methods:We searched the Cochrane Library, EMBASE, MEDLINE and CINAHL from inception to 1 November 2020 to identify SRs that evaluated the association between outdoor light exposure and myopia development or progression in children. Outcomes included incident myopia, prevalent myopia and change in spherical equivalent refraction (SER) and axial length (AL) to evaluate annual rates of myopia progression. The methodological quality and risk of bias of included SRs were assessed using the AMSTAR-2 and ROBIS tools, respectively.Results: Seven SRs were identified, which included data from 47 primary studies with 63,920 participants. Pooled estimates (risk or odds ratios) consistently demonstrated that time outdoors was associated with a reduction in prevalence and incidence of myopia. In terms of slowing progression in eyes that were already myopic, the reported annual reductions in SER and AL from baseline were small (0.13-0.17 D) and regarded as clinically insignificant. Methodological quality assessment using AMSTAR-2 found that all reviews had one or more critical flaws and the ROBIS tool identified a low risk of bias in only two of the included SRs. Conclusion:This overview found that increased exposure to outdoor light reduces myopia development. However, based on annual change in SER and AL, there is insufficient evidence for a clinically significant effect on myopia progression. The poor methodological quality and inconsistent reporting of the included systematic reviews reduce confidence in the estimates of effect.

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“…Despite the significance of myopic maculopathy, there is limited documentation regarding its progression in children and adolescents . In a longitudinal study conducted by Yokoi et al involving 29 pediatric patients with high myopia followed up for 20 years or more, it was discovered that the presence of peripapillary diffuse chorioretinal atrophy in childhood may serve as an indicative factor for the future development of pathologic myopia in adulthood.…”

Section: Introductionmentioning

confidence: 99%

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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Progression of Myopic Maculopathy in Chinese Children With High Myopia

Abstract: Supplemental Digital Content is Available in the Text. A retrospective study followed up for a mean of 4.9 years showed that progression of myopic maculopathy was detected in 18.9% among highly myopic schoolchildren aged 4 to 17 years.

Cited by 21 publications

References 30 publications

Study on the Optic Nerve Fiber Layer Thickness and Changes in Blood Flow in Myopic Children

Study on the Optic Nerve Fiber Layer Thickness and Changes in Blood Flow in Myopic Children

Time spent outdoors as an intervention for myopia prevention and control in children: an overview of systematic reviews

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

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