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Prevalence and risk factors of myopic maculopathy in rural southern China: the Yangxi Eye Study
  1. Zhixi Li1,
  2. Ran Liu1,
  3. Guangming Jin1,
  4. Jason Ha2,
  5. Xiaohu Ding1,
  6. Wei Xiao1,
  7. Xiao Xu3,
  8. Lei An3,
  9. Jialiang Zhao4,
  10. Mingguang He1,5
  1. 1 State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, China
  2. 2 Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Melbourne, Victoria, Australia
  3. 3 Rehabilitation Administration Department, National Institute of Hospital Administration, Chinese National Health and Family Planning Commission, Beijing, China
  4. 4 Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Beijing, China
  5. 5 Centre for Eye Research Australia; Ophthalmology, Department of Surgery, Universityof Melbourne, East Melbourne, Victoria, Australia
  1. Correspondence to Dr Mingguang He, State Key Laboratory of Ophthalmology, Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou 510060, China; mingguanghe{at}


Aims To evaluate the prevalence of myopic maculopathy among participants aged 50 years and older in rural southern China.

Methods Population-based, cross-sectional study. Subjects were recruited using cluster sampling from Yangxi County, Guangdong Province, China from August to November in 2014. Non-cycloplegic autorefraction and fundus photography were performed on all of the participants. Myopic maculopathy was graded based on fundus photographs using the International Classification of Myopic Maculopathy.

Results Among 5825 individuals who participated (90.7% response rate), a total of 4469 participants with gradable fundus photographs for myopic maculopathy and automated refractive data were included in this study. The mean age of these participants was 65.50±9.70 years. The crude prevalence of myopic maculopathy was 1.4% (62/4469; 95% confidence interval [CI] 1.0% to 1.8 %) and age-standardised prevalence was 1.2% (95% CI 1.1% to 1.2%). Diffuse chorioretinal atrophy, patchy chorioretinal atrophy, macular atrophy, lacquer cracks and staphyloma were observed in 43 (1.0%), 3 (0.1%), 1 (0.1%), 15 (0.3%) and 8 eyes (0.2%), respectively. Myopic maculopathy was more common in eyes of older participants (OR 1.07; 95% CI 1.03 to 1.11) and more myopic spherical equivalence (OR 1.69; 95% CI 1.57 to 1.84).

Conclusion The prevalence of myopic maculopathy was low among the rural southern Chinese population. Diffuse chorioretinal atrophy was the most common retinal finding among Chinese myopes.

  • prevalence
  • risk factors
  • myopic maculopathy
  • rural China

Statistics from


  • ZL and RL contributed equally.

  • Contributors MH, JZ, XX and LA were involved in the concept, design and conduct of the study. ZL, RL, GJ, JH, XD and WX contributed to the acquisition and analysis. ZL wrote the paper. All authors revised and edited the manuscript.

  • Funding This work was supported by the National Institute of Hospital Administration, the Chinese National Health and Family Planning Commission and ORBIS International. MH receives support from the Fundamental Research Funds of the State Key Laboratory in Ophthalmology, Science and Technology Planning Project of Guangdong Province 2013B20400003, and the University of Melbourne Research Accelerator Program and the CERA Foundation. The Centre for Eye Research Australia receives Operational Infrastructure Support from the Victorian State Government.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Ethics approval This study was approved by the Zhongshan Ophthalmic Center Institutional Review Board and adhered to the tenets of the Declaration of Helsinki.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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