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Prevalence of myopic maculopathy in the German population: results from the Gutenberg health study
  1. Susanne Hopf1,
  2. Christina Korb1,
  3. Stefan Nickels1,
  4. Andreas Schulz2,
  5. Thomas Münzel2,
  6. Philipp S Wild2,3,
  7. Matthias Michal4,
  8. Irene Schmidtmann5,
  9. Karl J Lackner6,
  10. Norbert Pfeiffer1,
  11. Alexander K Schuster1
  1. 1Department of Ophthalmology, University Medical Center Mainz, Mainz University, Mainz, Germany
  2. 2Preventive Cardiology and Preventive Medicine/Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
  3. 3Center for Thrombosis and Hemostasis (CTH), University Medical Center Mainz, Mainz, Germany
  4. 4Psychosomatic Medicine and Psychiatry, University Medical Center Mainz, Mainz, Germany
  5. 5Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
  6. 6Institute for Clinical Chemistry and Laboratory Medicine, Univeritätsmedizin, Mainz, Germany
  1. Correspondence to Dr Susanne Hopf, Department of Ophthalmology, University Medical Center Mainz, Mainz University, Mainz 55131, Germany; hopf101{at}


Aims To determine the prevalence of myopic maculopathy in the general population in Germany and to analyse potential associations with ocular and systemic factors.

Design The Gutenberg Health Study is a population-based study, including 15 010 participants aged 35–74 years.

Methods Myopic maculopathy was graded in phakic eyes with spherical equivalent ≤−6 D by assessing fundus photographs according to a recent international photographic classification system (META-PM). 801 eyes of 519 participants (mean age 51.0±0.77 years) met the conditions and had gradable fundus photographs. Age-specific prevalence estimates were computed. Multivariable logistic regression analysis was used to assess associated factors with myopic maculopathy.

Results Myopic maculopathy was present in 10.3% (95% CI 7.9 to 13.3) study participants. The prevalence was 8.6% (95% CI 6.1% to 11.9%) in the 397 right eyes and 8.7% (95% CI 6.2% to 12.0%) in the 404 left eyes. The most common type of pathology was diffuse atrophy (8.1%), followed by patchy atrophy (1.3%) and macular atrophy (0.5%); plus lesions were present in 3% (right eyes). Age (OR 1.07 per year, 95% CI 1.03 to 1.11, p<0.001), higher myopic refractive error (p<0.001), and male gender (p=0.02) were associated with myopic maculopathy, while cardiovascular risk factors and socioeconomic factors were not.

Conclusions The prevalence of myopic maculopathy in the German population was 0.5%, and 10% in high myopic participants, aged 35–74 years. These population-based data are the first in Europe. Myopic maculopathy was related to severity of myopic refractive error and age.

  • myopia
  • tessellations
  • diffuse atrophy
  • patchy atrophy
  • myopic maculopathy
  • epidemiology
  • pathologic myopia
  • refractive error
  • myopic macular degeneration
  • Caucasian
  • Europe

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  • Contributors SH, SN, NP and AKS conceived and designed the study. SH, SN, CK, AS, IS and AKS analysed and interpreted the data. SH, SN and AKS wrote the paper. TM, PSW, MM and KJL made substantial contributions to the study design. All authors revised the manuscript critically and approved the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The Gutenberg Health Study was approved by the Medical Ethical Committee of the State Chamber of Medicine of Rhineland Palatinate in Mainz, Germany.

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

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.