The Longitudinal Danish High Myopia Study, Cohort 1948: at age 66 years visual ability is only occasionally affected by visual field defects

Abstract

Purpose: A descriptive study on visual fields, as part of a 50-year follow-up of high myopia in an unselected cohort-based Danish sample, now aged 66 years. Methods: In a Copenhagen 1948 birth cohort (n = 9243), 39 individuals aged 14 years were identified with myopia of at least À6 D, and with regular clinical follow-ups since then. In 2002 (n = 34, age 54 years) and 2008 (n = 32, age 60), the individual ambulatory visual field was outlined by kinetic Goldmann large object perimetry (IV or V,4e). At age 66 years, 28 attended for the 2014-2015 follow-up, at which smaller Goldmann objects (II and I,4e) were added, further to identify relative defects. Results: Repeated large object perimetry disclosed statistically significant general peripheral narrowing over the 12-13-year test period, though slight and without practical implications. Two new cases showing absolute defects were however added to the three already known. The addition of small Goldmann objects disclosed relative defects in another eight participants, in some to suggest a refraction-related pattern (fundus ectasia; uncorrected high myopia). However, comparing eyes with and without defects, statistical importance could not be attached to the degree of myopia, fundus ectasia or optic disc morphology (v 2 , n.s.). Conclusion: (i) Serial large object Goldmann isopters over the 'senior' decade up to age 66 demonstrated a slight general peripheral narrowing by age of visual fields in high myopia. (ii) Overall 42% of the participants had absolute or relative defects (in 5 and 8, respectively), however, without socio-visual consequences when binocular. (iii) Visual field loss by age still appears a minor issue in clinically unselected high myopia.

Choroidal thickness at age 66 years in the Danish high myopia study cohort 1948 compared with follow‐up data on visual acuity over 40 years: a clinical update adding spectral domain optical coherence tomography

“…Fledelius et al. ). Funduscopy after dilation (topical Mydriacyl 0.5%; Alcon, Copenhagen S, Denmark) was conducted by direct OPTOS (widescreen fundus photographs, Optos, Dunfermline, UK).…”

“…An extended evaluation of kinetic Goldmann visual field findings and the recent set of OPTOS recordings will be reported separately (Fledelius et al. ).…”

Design and Pilot data of the high myopia registration study: Shanghai Child and Adolescent Large‐scale Eye Study (SCALE‐HM)

“…The structural changes seen in patients with high myopia are also associated with changes in microperimetry and electrophysiology (Luu et al 2006 ; Wolsley et al 2008 ; Qin et al 2010 ; Gella et al 2011 ; Ho et al 2012 ; Park et al 2013 ; Zaben et al 2015 ; Alzaben et al 2017 ). Additionally, one longitudinal study reported that visual field defects may develop in high myopes, while the visual ability is only occasionally affected (Fledelius et al 2019 ). However, many unknowns still exist with respect to the early morphological and visual functional changes, as well as their developmental processes in children with high myopia.…”

Treatment effect of posterior scleral reinforcement on controlling myopia progression: A systematic review and meta-analysis

“…In terms of observation group, a 53-year long-term follow-up study showed that in non-selected high myopia cohort, the presence of aging or myopia complicated visual field defect was not correlated to the degree of myopia or extreme AXL. [23] From this we infer that the PSR surgery slows myopia progression anatomically, but functionally, it does not necessarily preserve the visual field, decrease the incidence of myopia complications, or increase the quality of life.…”