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Choroidal thickness predicts progression of myopic maculopathy in high myopes: a 2-year longitudinal study
  1. Zhixi Li1,
  2. Wei Wang1,
  3. Ran Liu2,
  4. Decai Wang2,
  5. Jian Zhang2,
  6. Ou Xiao2,
  7. Xinxing Guo2,
  8. Monica Jong3,
  9. Padmaja Sankaridurg4,
  10. Kyoko Ohno-Matsui5,
  11. Mingguang He3
  1. 1 State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guang Zhou, China
  2. 2 Sun Yat-Sen University Zhongshan Ophthalmic Center State Key Laboratory of Ophthalmology, Guangzhou, China
  3. 3 University of Canberra Faculty of Health, Canberra, Australia
  4. 4 Brien Holden Vision Institute, Sydney, Australia
  5. 5 Ophthalmology and Visual Science, Tokyo Medical and Dental University, Bunkyo-ku,Japan
  1. Correspondence to Mingguang He, State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, People’s Republic of China; mingguanghe{at}


Aim To prospectively determine the impact of choroidal thickness (CT) on the myopic maculopathy progression.

Methods This is a prospective, longitudinal, observational study. In total, 434 participants aged 7–70 years with bilateral high myopia (≤-6 D spherical error, range, −6 to −27.0 D) completed follow-up visits for 2 years. The baseline CT centred on the fovea was measured using a swept-source optical coherence tomography (OCT). Myopic maculopathy progression was determined by fundus photography. Logistic model was used to examine the impact of CT at baseline on the myopic maculopathy progression. Likelihood ratio test was adopted for model comparison.

Results The mean baseline age, spherical equivalence and subfoveal CT (SFCT) of the participants were 23.2±12.5 years, −10.50±3.18 D and 153.20±72.76 μm, respectively. Over 2-year’s follow-up, 74 of 434 eyes (17.1%) had myopic maculopathy progression. Baseline SFCT was thinner in eyes with myopic maculopathy progression than those without (67.26±37.67 μm vs 170.95±65.45 μm; mean difference, 99.31 μm; 95% CI 83.61 to 115.01 μm; p<0.001). The same patterns of differences were observed in 7–18 years, 19–39 years and 40–70 years. In multivariate logistic regression model, SFCT was a significant risk factor (adjusted OR=0.97, p<0.005) when age, gender, axial length and baseline myopic maculopathy category were adjusted for. The addition of SFCT significantly improved the predictive discrimination of myopic maculopathy progression in comparison with that included established risk factors alone (area under the receiver operating characteristic curve, 0.899 vs 0.942, p<0.001).

Conclusion CT is an independent predictor for myopic maculopathy progression.

  • Epidemiology
  • Choroid
  • Retina

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  • WW and RL contributed equally

  • Contributors MH had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: XZL, MH. Data acquisition, analysis or interpretation: all authors. Drafting of the manuscript: XZL. Critical revision of the manuscript for important intellectual content: MH. Statistical analysis: XZL, JZ. Obtained funding: MH. Study supervision: JZ, MH.

  • Funding This work was supported by the National Key R&D Program of China (2018YFC0116500), Fundamental Research Funds of the State Key Laboratory of Ophthalmology, National Natural Science Foundation of China (81420108008), Science and Technology Planning Project of Guangdong Province in China (2013B20400003) and a grant from the Brien Holden Vision Institute, Australia. The sponsor or funding organisation had no role in the design or conduct of this research.

  • Competing interests None declared.

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

  • Data availability statement Data are available upon reasonable request.

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