title: Myopic Maculopathy and Optic Disc Changes in Highly Myopic Young Asian Eyes and Impact on Visual Acuity.
abstract: OBJECTIVE
  To determine the prevalence and risk factors of myopic maculopathy and specific optic disc and macular changes in highly myopic eyes of young Asian adults and their impact on visual acuity.
  
  
  METHODS
  Prospective cross-sectional study.
  
  
  METHODS
  In total, 593 highly myopic (spherical equivalent refraction [SER] less than -6.00 diopters [D]) and 156 emmetropic (SER between -1.00 and +1.00 D) male participants from a population-based survey were included. All participants underwent standardized medical interviews, ophthalmic examination, and color fundus photographs. These photographs were graded systematically to determine the presence of optic disc and macular lesions. Myopic maculopathy was classified based on the International Classification of Myopic Maculopathy.
  
  
  RESULTS
  The mean age was 21.1 ± 1.2 years. The mean SER for the highly myopic and emmetropic group was -8.87 ± 2.11 D and 0.40 ± 0.39 D, respectively (P < .001). Compared to emmetropic eyes, highly myopic eyes were significantly more likely to have optic disc tilt, peripapillary atrophy (PPA), posterior staphyloma, chorioretinal atrophy, and myopic maculopathy (all P < .001). The main findings included PPA (98.3%), disc tilt (22.0%), posterior staphyloma (32.0%), and chorioretinal atrophy (8.3%). Myopic maculopathy was present in 8.3% of highly myopic eyes and was associated with older age (odds ratio [OR] 1.66; 95% CI: 1.22, 2.26), reduced choroidal thickness (OR 0.99; 95% CI: 0.98, 0.99), and increased axial length (AL) (OR 1.52; 95% CI: 1.06, 2.19). The presence of disc tilt, posterior staphyloma, and chorioretinal atrophy were associated with reduced visual acuity.
  
  
  CONCLUSIONS
  Our study showed that myopia-related changes of the optic disc and macula were common in highly myopic eyes even at a young age. The risk factors for myopic maculopathy include increased age, longer AL, and reduced choroidal thickness. Some of these changes were associated with reduced central visual function.
authors: Vision Performance Centre, Military Medicine Institute, Singapore; Department of Ophthalmology, National University Health System, Singapore.
authors: Victor
authors: V
authors: Koh
authors: Department of Ophthalmology, Tan Tock Seng Hospital, Singapore.
authors: Colin
authors: C
authors: Tan
authors: Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors: Pei Ting
authors: PT
authors: Tan
authors: Vision Performance Centre, Military Medicine Institute, Singapore; Department of Ophthalmology, National University Health System, Singapore.
authors: Marcus
authors: M
authors: Tan
authors: Department of Ophthalmology, National University Health System, Singapore.
authors: Vinay
authors: V
authors: Balla
authors: Vision Performance Centre, Military Medicine Institute, Singapore.
authors: Gerard
authors: G
authors: Nah
authors: Department of Ophthalmology, National University Health System, Singapore; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.
authors: Ching-Yu
authors: CY
authors: Cheng
authors: Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan.
authors: Kyoko
authors: K
authors: Ohno-Matsui
authors: Defence Medical & Environmental Research Institute, DSO National Laboratories, Singapore.
authors: Mellisa M H
authors: MM
authors: Tan
authors: Defence Medical & Environmental Research Institute, DSO National Laboratories, Singapore.
authors: Adeline
authors: A
authors: Yang
authors: Vision Performance Centre, Military Medicine Institute, Singapore.
authors: Paul
authors: P
authors: Zhao
authors: Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.
authors: Tien Yin
authors: TY
authors: Wong
authors: Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Singapore Eye Research Institute, Singapore National Eye Centre, Singapore. Electronic address: seang_mei_saw@nuhs.edu.sg.
authors: Seang-Mei
authors: SM
authors: Saw
mesh_terms: D000328:Adult; D044466:Asian People / Q000208:ethnology; D058452:Axial Length, Eye / Q000473:pathology; D002829:Choroid / Q000473:pathology; D003430:Cross-Sectional Studies; D006801:Humans; D008297:Male; D047728:Myopia, Degenerative / Q000150:complications* / Q000208:ethnology / Q000503:physiopathology; D009898:Optic Disk / Q000473:pathology*; D009901:Optic Nerve Diseases / Q000208:ethnology / Q000209:etiology* / Q000503:physiopathology; D015995:Prevalence; D011446:Prospective Studies; D012029:Refraction, Ocular / Q000502:physiology; D056910:Republic of Korea / Q000453:epidemiology; D012164:Retinal Diseases / Q000208:ethnology / Q000209:etiology* / Q000503:physiopathology; D012307:Risk Factors; D014792:Visual Acuity / Q000502:physiology*; D055815:Young Adult