Prevalence and progression of myopic retinopathy in an older population.
OBJECTIVE
To determine the prevalence and progression of myopic retinopathy in an older community-based population sample.


METHODS
Population-based epidemiologic study.


METHODS
Eligible residents aged 49 years or older (n = 3654) who attended the Blue Mountains Eye Study, west of Sydney, Australia.


METHODS
Participants had a detailed eye examination including measurement of logarithm of the minimum angle of resolution (logMAR) visual acuity, standardized refraction, and retinal stereophotography. All patients were invited to attend follow-up examinations after 5 years.


METHODS
Myopic retinopathy was defined to include staphyloma, lacquer cracks, Fuchs' spot and myopic chorioretinal atrophy. beta-peripapillary atrophy was assessed separately.


RESULTS
Signs of myopic retinopathy were found in 67 eyes from 44 participants (1.2%), a prevalence of 1.4% in women and 1.0% in men; this increased from 1% in right eyes with myopia <3 diopters to over 50% in right eyes with myopia > or =9 diopters. There was a nonsignificant age-related trend in prevalence. The average spherical equivalent refraction was -6.1 diopters and the average visual acuity was 20/40 in eyes with myopic retinopathy. Visual impairment (<20/40) was present in 38.8% of affected eyes. Myopic retinopathy was bilateral in 52% of cases. Staphyloma was present in 26 participants (0.7%), bilateral in 35%, with a strong concordance of staphyloma location. Lacquer cracks were seen in 8 participants (0.2%), Fuchs' spot in 3 (0.1%), and chorioretinal atrophy in 7 (0.2%). Forty-six eyes (68.7%) with myopic retinopathy were reexamined after 5 years; 8.7% had new or increased numbers of lacquer cracks and 15.2% had new or expanded areas of chorioretinal atrophy. In those eyes developing lacquer cracks or chorioretinal atrophy, best-corrected visual acuity decreased by a mean of two LogMAR lines.


CONCLUSIONS
This study documented the age and sex-specific prevalence of myopic retinopathy and 5-year progression in an older white population.
Vongphanit
Jerry
J
Department of Ophthalmology and Save Sight Institute, the University of Sydney and Millenium Institute, Westmead Hospital, Hawkesbury Road, Westmead, NSW, Australia 2145.
Mitchell
Paul
P
Wang
Jie Jin
JJ
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000453:epidemiology* / Q000503:physiopathology; D009517:New South Wales / Q000453:epidemiology; D010781:Photography; D015995:Prevalence; D012029:Refraction, Ocular; D012164:Retinal Diseases / Q000453:epidemiology* / Q000503:physiopathology; D017678:Sex Distribution; D014505:Urban Population / Q000706:statistics & numerical data; D014792:Visual Acuity